So from your respective spaces, what have you seen as the issue with expert-led misinformation? How do you see expert-led misinformation fitting into the net spread of misinformation? Kevin, since your commentary inspired this post, do you wanna go first? [chuckles]

Oh, man.

Uh, yeah, nutrition I think has just always been a hotbed of, uh, misinformation.

I think that's in part 'cause if you say the word expert, nutrition is so all-expansive.

It's everything.

It's got a mix of food science, physiology, medicine, policy, and so like real expertise, I guess this is maybe a spoiler for the whole show, but like real expertise is like super narrow.

Like, you get your PhD in this little micro topic.

And so yeah, like all the incentives are poorly stacked in this whole ecosystem.

Right.

I mean, like, again, everything nutrition is about dose, but it's also about kind of the form in this case.

So fructose is in fruits.

And so you find people saying like, oh, high fructose corn syrup is poisonous and bad because of the fructose.

And therefore, you know, some people tell you to eat coconut sugar.

Some people tell you like, therefore, don't eat fruits.

And I think it takes a lot of the context away where I think the literature is quite clear that like liquid forms are of added sugars are worse than kind of solid forms, particularly because the intestine normally handles little bits of fructose at a time.

I like it.

[laughs]

It just, the amount of misinformation is like, well, I don't want nutrition to win at the expense of, like, immune health.

Um, and these things are in ...

Like, chronic disease and immunology or, you know, um, sort of immunity have been, I think, falsely dichotomized, and they're actually, like, quite highly interactive on a scientific con- like, sense.

And so, um, yeah, the MAHA energy, it's like ...

It's a l- I understand that it's inspiring.

Like, I'm glad there's a bunch of people w- like, realizing that, like, we really need to do something about food.

Mm-hmm.

So I'd love for you to like go a little bit into that and like what is happening, like what they're saying we should be learning and really why that may not be the best choice for our patients.

Yeah.

I think, uh, I'm broadly supportive of doctors learning more about nutrition, and I think they-- a lot of the groundwork is already laid there.

Like you guys take metabolic biochemistry and things.

You're like learning about what the vitamin does and, but tying that directly to clinical practice, like there might be a disconnect between like MS one, MS two, step one kind of stuff, and then what actually happens in year three and four.

But I'm always amazed in talking with like my, uh, I see patients for Danielle Belardo, who's a cardiologist, and we've chatted about this a bunch of times, like, "How many, how many times did you consult a dietician or interact with them in your medical training?" And they're like, "Never." She's a preventative cardiologist.

Yeah, you would think there'd be much more of a continuum o- of care on that.

It's the red 40, and that's gonna make us healthy."

Scientists also continually learned about the existence of more nutrients that were important for our bodies, and they learned more about exactly what those nutrients do in our bodies.

We have the luxury of knowing, like, we know that this nutrient is a cofactor for this enzymatic process, and so we're gonna measure that enzymatic process and figure out how much of the nutrient is needed for that to, like, fully function.

And at the time in 1943, they didn't know.

Most of this biochemistry was not really figured out.

There was maybe, um, studies from animal models, um, and a little bit from humans where we thought, "Okay, we think that this is a nutrient," but its cellular and physiological role really wasn't determined.

And so all of that data was really missing at the time.

And so that all slowly develops on sort of a nutrient-by-nutrient basis over time.

Meanwhile, there are a whole bunch of other studies out there looking at protein intake that the new dietary goals ignored.

(laughs)

...

in nutrition thinks like chickpeas are better than Pop-Tarts.

Like that is almost like, like let's acknowledge that, leave that to the side.

We're getting deep into like the weeds of definitions and whether they can be used for policy.

And when you look at UPFs, I think there is a tendency for a lot of people who are very big fans of the term to say like, "Okay, like how can you defend eating Pop-Tarts when we should be eating spinach and chickpeas?" And it's like that's not the, the comparison they really want to draw out because within that UPF category, you have an unsweetened almond milk that has an emulsifier in it that is now a-...

uh, ultra-processed food.

Um, but how solid is the evidence that the basics of the Mediterranean diet are really useful basics for someone who just likes, who just wants a one-stop shop to, uh, here's a diet that will do me good?