making these videos about science for a general audience, for a non-specialized audience,
week after week forces me to think about two things, the science on one hand, obviously,
but also how to communicate it effectively, because it's like a marriage, right? either
one without the other doesn't exist. so recently i was chatting about this with brad stanfield, he's
a doctor from new zealand he also has a youtube channel so our experiences overlap a lot, and the
topic of saturated fat came up, in this context of scientific communication. take a look. i think
the things that, at least in the clinical space, that isn't controversial but online possibly is,
let's talk about saturated fat, so there's been a lot of research and a lot of, I think,
misinformation online about saturated fat. when a meta-analysis was done by cochrane,
it showed that reducing saturated fat intake can reduce heart disease by about 17%,
and so, on the basis of that, that's strong evidence to reduce the saturated fat intake,
and i think that's one of the reasons why in the clinical guidelines we want to reduce saturated
fat, but when i sometimes mention that on the channel, people say, no, you want to be
increasing saturated fat, and i think it would be quite useful to spend a bit of time on this,
so what's your experience around discussing saturated fat? similar. i'll go over the evidence,
the observational evidence and the bulk of the interventional evidence and i'll even explain
some observations that may seem contradictory but they are explainable with contrast of exposure,
with the comparator, so the replacement, if you don't look at the replacement, some of these
epidemiological studies just look at changes in saturated fat but they don't look at what
the person is eating instead and if you're just looking at a general western population
like in the US for example, the tendency is to replace saturated fat with refined carbohydrate,
so you tend to not see a big difference there, that doesn't mean that there isn't an effect
of the saturated fat, but if you're replacing it with something that's equally problematic,
yeah, you're not going to see much of a benefit, so i've made multiple videos explaining those,
trying to explain those factors. i think it's a very polarizing issue and people are exposed to
a lot of messages online that tend to be extreme and some dietary camps tend to... people hear
essentially that saturated fat is just poison, no matter the amount, no matter the context, and
if you have any saturated fat in your diet you're killing yourself, and in other dietary camps,
people hear the opposite, that it's completely innocuous and good for you, just pile it up,
doesn't matter, and if you go through the evidence systematically, you immediately see that neither
of those make sense. saturated fat is in a lot of, it´s in vegetables, it´s in kale, it´s in lettuce,
it's just very small amounts, so saturated fat itself is not a problem, it's the proportions
and the type of saturated fat and the sources and what you're comparing it to, so yeah,
i think it's normal that there's a lot of emotion and a lot of visceral reactions to this because
people, you know, understandably, diet, nutrition is a very emotional topic for people, but i think
that's the value, when i make a video and i get reactions that are very emotional, i don't mind
that, in a way it tells me that i'm talking about something that's worth talking about, because if
100% of the viewers agree with me i have added no value. if i make a video about how tobacco is bad,
i'm going to get no complaints but they've learned nothing, they've gotten no value out of me, so
i don't mind. most of my videos are on topics that are considered controversial. it's saturated fat,
it's cholesterol, it's statins, it's all these things and we always get complaints,
we always get complaints from both ends of the spectrum and i don't mind, i think it's normal,
if you're talking about something that is an emotional topic and where there's a lot of
messages online that aren't necessarily the most substantial science-wise,
it's expected that people are going to be chafed by some of these messages, but to me that tells me
that it is worth talking about it and showing the science. yeah, i completely agree with that and i
think at the end of the day one of the things that i try to emphasize on my channel is that
my opinion really doesn't matter, it matters what the evidence shows. and i try and explain how to
analyze studies and how to put them on the evidence pyramid, because if you come up
with some observational data that's of 20 people, that's entirely different compared to actually an
interventional study where they're genuinely making a change and comparing that change to
the standards so yeah, i completely agree that if we are making videos about controversial topics,
i think at the end of the day that probably shouldn't be that controversial but because
of all of the misinformation online they have become controversial
but you are gonna come up with people that really don't like that content, and as you say,
that's important, because then you're exposing those people to the evidence
and then they can make up their own decision about what they want to do because at the end of the day
i think both of us, all we're trying to do is just show the evidence so that people can make up their
own mind as to what they want to do, and if people are more informed, that's at the end of the day,
then we've succeeded in our mission. exactly. my favorite topics, when i know that i have a
feeling that a video is going to be productive in terms of pushing buttons but in a good way,
like here's evidence that you haven't seen before. my goal with the videos is exactly to
give access to the evidence to a population that doesn't necessarily have access to it,
precisely in areas where the scientific evidence contrasts with what people are being told on the
internet, and so this type of thing where there is virtually no controversy in the scientific
community, and this is an unpopular thing to say on the internet but you look at the evidence, you
look at guidelines across different countries, i don't know what the new zealand dietary guidelines
are but i'm pretty sure that i can guess that on the fundamentals it would be identical
to the US, to italy, to germany, to Japan. on the fundamentals, right? with cultural differences,
with some details differences, but the fundamentals would overlap overwhelmingly,
and that tells us that there's overwhelming consensus in the scientific community,
but then you see on the internet a completely different picture, and people are exposed almost
entirely to this content, this lay content on the internet, so that's my favorite topics to touch on
is when there's this massive contrast between what scientists see and what the public sees,
and so i already expect there to be some reactions but i'm okay with that, it comes with the
territory. we shouldn't assume that because there is consensus, consensus is kind of a sanity check,
it is relevant to see that there is overwhelming agreement in specialists across the globe,
that is certainly relevant, i wouldn't tell people to assume that the consensus is correct,
nor would i tell them to assume that what somebody's saying online is wrong,
you just have to be very cautious, you have to be very skeptical and really fact check and really
do your homework with information that you're getting from a random source. the danger, I feel,
is when people see something random online and just jump headfirst, if the person seems very
credible, if the person seems charming or if the person is just rapidly going through information
that the viewer isn't familiar with so it's impressive, they go wow, this person knows a lot.
scientists and doctors, we make a lot of mistakes, we have areas of ignorance,
we're not perfect either. challenging a doctor is a good thing, asking questions is a good thing,
going home and then reading up and making sure that what you heard aligns with the evidence,
this is good, i try to encourage my viewers to always do that to my videos, don't just trust me,
go through the evidence, listen to other people and see if what i said is right or not,
challenge me with information that seems contradictory,
i think those are all good mindsets, as long as we're all in a headspace of healthy skepticism
and i think building our confidence gradually as more and more reliable information
points in a consistent direction. that's how i would sum it up. so i think the question is,
how do we cultivate this mindset of skepticism so we don't fall for the first thing we see,
or the first thing we want to believe, right? but at the same time stay open-minded so we don't
start thinking that we already know everything and we stop learning. how do we strike that balance?
i think about this all the time. so i'll leave you three things that i try to do consistently
and you let me know other things that you do or that you think i should do. i'm all ears. number
one, i never stop reading science, i spend several hours every day going over studies. new studies,
older studies, and we never release a video on a topic before we've gone over dozens,
sometimes hundreds of studies on that topic, to make sure that what we're saying, the message that
we're conveying to you, reflects the totality of the evidence. also, i have a personal rule,
i've talked about this in previous videos, anybody who disagrees with anything i say on social media
and presents some peer-reviewed evidence, if i'm not familiar already with what they're showing,
i have to read that study. i leave a tab open on the browser and sooner or later i go through it
and i integrate it into my notes and the general picture of that field. non-negotiable personal
rule. number two, i make sure that i'm not just reading aimlessly but i'm actually forcing myself
to look at the big picture, because you can read endless studies in a pocket of evidence and still
miss 90% of the picture and that's not helpful, right? so that means things like meta-analyses,
systematic reviews, things that are broad overviews of a field that force
me to look at the full landscape. and number three, i try to stay receptive to feedback.
feedback from colleagues for example who watch the videos or who i discuss these topics with.
i know there's a number of RDs who watch our videos and who give me feedback as well. and
feedback from the viewers, comments, people who reach out. the channel is getting a little bigger,
i don't necessarily catch every comment that comes in but i try to keep a finger on the
pulse. i'll give you a concrete example: last week we published a video on lp(a), this lipoprotein,
and the majority of the experts i've talked to, people who study lp(a),
say that the blood levels are stable throughout life, that they don't change that much,
and yet several people contacted me after the video came out and said, you know, i've lowered
my levels a lot using this diet or that diet, so i'm completely open to that being possible. the
science so far hasn't demonstrated it, but that doesn't mean it can't happen in some contexts,
i hope it's true, and i hope future research establishes it, and if it does, i'll be thrilled
to come on and report it. today was a bit of an unusual video, less on the nitty gritty
and the bar graphs and a bit more of a reflection maybe, an attempt to step back and make sure that
we're heading in the right direction, but we do have a video in the pipeline on saturated fat
going over all of the frequently asked questions with a really exciting guest that we just booked,
so stay tuned for that, we are going to keep looking under the hood. in the meantime,
here's a general look at saturated fat and some of the many controversies that surround it
and here's a look at bias and nutrition. take care, see you next time