If you truly get in touch with a piece of carrot, you get in touch with the soil, the rain, the sunshine. You get in touch with Mother Earth and eating in such a way, you feel in touch with true life, your roots, and that is meditation. If we chew every morsel of our food in that way we become grateful and when you are grateful, you are happy.

– Thich Nhat Hanh

 

Read time: 10 minutes

TL;DR Key Points:

  • Nutrition is still a science in its infancy.
  • Not every food science study will hit bulls eye (most don’t)
  • Coffee will kill you
  • No, Coffee will cure you
  • Seriously, coffee is good for you

Based on what is shot gunned all over the Internet, you might notice what I and others have referred to as the “kill or cure” phenomenon with nutrition:

“New plant based diet can cure cancer.”

“Eggs are the new superfood.”

“No, eggs will kill you through heart disease.”

So what’s going on?

Every few months there seems to be a new superfood or supervillain (read more here). Each time we use the same quasi-religious language to describe quinoa, coffee, dairy, coconut oil (is it “pure poison” as a Harvard prof says?). Now, even cannabis being marketed as a wellness and health item (I work in California after all).

Each time, converts of one faction attack members of another (just try saying you’re a vegetarian and enjoy soy at a Crossfit box ). And each time, we all point to a new study to show how this time, finally, we know better than those fools in the past.

So what’s really going on? How has medicine been so royally confused about something that is so central to our lives? After breathing, eating is the most fundamental physiological process mammals do after all.

Perhaps because of these nuances, online nutrition experts in particular have promoted the use of simplistic memes and buzzy phrases to provide false certainty. Food allergies are everywhere, we all have leaky gut, insulin is the devil, and our bodies have not changed since caveman time so of course avoid all grains if you want to live.

Let’s think more critically:

  • Maybe there are no “good” and “bad” foods, but foods that exist on a spectrum of health.
  • Some foods can be healthy to some people some of the times.
  • Response to foods can be varied, rich and diverse
  • The human metabolism is incredibly complex and still harbors deep mysteries

These concepts are not as catchy are they?

While it is confusing to see contradictory headlines, there is a silver lining. To a certain degree, conflict is good. Questioning your own story is good. Not believing your own hype is good. Science is rarely a straightforward linear process to Truth but rather a decidedly messy, human journey to ask better and more sophisticated questions over time. So overturning traditional dogma can be valuable but so can also finding new research to support old notions. It all depends.

The flip side to this is that there is profit in making people confused. Follow my way, take my supplements and listen to my diet protocol. The other ways of eating are false, dangerous, and toxic. Everyone is trying to make a buck after all and there are reasons to blur the core similarities that connect most of the major diets being touted.

But this idea is not valued in an attention starved, impatient culture awash information and content but with a dearth of true wisdom. “6 foods to get a flat belly” is much more likely to get traction than “Nutrition science is really complex and we’re still working on it but here are things to try.”

One reason for these mix up of statements is the nature of the beast itself. If I am interested, for example, if coffee “cures” heart disease how might I answer this question? Note that I am asking an epistemological question – one of methods – and less of an ontological one. (My college philosophy professor must be so proud, I actually remembered something).  If the methods are off, then of course the conclusion derive from that technique are liable to be off also.

Well how would I define the outcome of interest, heart disease? Do I mean atherosclerosis or fatty build up in the heart? Intimal thickness of the blood vessels? Do I mean actual rates of heart attacks? How severe those heart attacks? Overall mortality from cardiovascular disease? The list goes on…

If I choose one of these, how long do I monitor patients for such developments? How many patients do I need to track to be sure I have a large enough sample? You don’t need to be a biostatistician to know the answers will be “a long time” and a “large number.”

How would I know if people are drinking coffee and how much? With sugar, cream or milk or without? Caffeinated or not? Will people tell me in a survey? Surely I can’t track a thousand people every day for months to years to monitor their coffee habits? Will people accurately tell me if their cup of coffee is the same size as my cup of coffee? I mean coffee can mean a lot of things to a lot of people. Have you seen a Starbucks menu recently?!

Personally, I still don’t get what a Frappuccino is.

 

In short, the methods needed to answer the questions we most care about in nutrition are hard with the traditional tools of clinical medical research. Ideally, we would like to perform double blind randomized control trials on various food science questions. But what are going to do, lock up people in a metabolic lab and track every morsel of food and physiological output? Interestingly this type of research is being done, but for obvious reasons, cannot be done for a long period of time.

So what do we do? Well we track a large population over time through surveys and the like or comb through major databases to see if certain exposures –say self reported coffee drinking – is linked with things that concern us – like rates of heart disease. But as you can see, there are numerous sources of bias and limitations that can occur in this process.

We can look to animal studies to hone in on more specific metabolic variables. How might coffee actually affect heart health? Which biochemical mediators underlie this process? That can be useful information to know, but of course, we are not mice and so the information needs to be replicated in future studies in humans.

We can do RCT’s but the logistical realities of these studies is that they are hard to do, often expensive, and can only be done for relatively short periods of time. So far questions on vitamin D exposure and cancer risk, or eggs’ effect on prostate health, coffee and long-term stroke risk, or fruit intake and rates of osteoporosis, this type of study can be too limited in reality to provide rigorous answers.

So is it any surprise that we see so many different headlines on food these days? Because of click bait and the desire to get eyeballs to pages, turgid prose and shock value headlines are written to get you to read, click and scroll. Truth can get lost in the process. Can you imagine how past generations had to deal with this problem and research it before Google?

So the next time you see some shocking new nutrition result (it won’t be long), ask the question behind the headline: How did they come up with this finding?

Michael Pollan, noted food journalist, summed it up well. “Eat food. Not too much. Mostly plants.”

But seriously, coffee is good for you.