Kristian
Rett

Miscommunication - facts vs. fake news

Misinformation: is false information that is spread either by mistake or with intent to mislead. 

Disinformation: When there is intent to mislead. Misinformation has the potential to cause substantial harm to individuals and society. It is therefore important to protect people against being misinformed, either by making them resilient against misinformation before it is encountered or by debunking it after people have been exposed ¹

Facing the global twin pandemic of obesity and type 2 diabetes there is consensus in nutrition medicine that we should focus on personalized nutrition and that protective foods and nutrition styles (including protective beverages) trump limitation of single nutrients (calories, fats, carbohydrates, ethanol)².However, public opinion does not necessarily follow the science. Among other possible reasons one culprit is oversupply with alternative facts and truths in social media, but even in high-ranking scientific journals and global agencies^3-5 leading to structural ambiguity, confusion and controversy.
One prominent example of scientific misinformation is the 2018 Global Burden of Disease Study (GBDS)^3,4 a non-experimental, descriptive correlational study. According to scientific grading criteria GBDS is low-level evidence not justifying any recommendation^6,7. GBDS used a complex statistical model to correlate global estimates of alcohol consumption and drinking behaviour with 22 arbitrarily defined alcohol-associated "health problems". The authors emphasized the harm potential of alcohol consumption, confirmed the linear no-threshold-theory and called for global abstinence³.

In a second publication⁴ four years later, consideration of age and country-specific aspects yielded diametrically different results and conclusions:

• J-shaped exposure-weighted relative risk relation for everyone over 40 in all world regions.


• association of low/moderate alcohol consumption with better outcomes in individuals at high cardiovascular risk. Thus, for the first time, GBDS recognizes the net benefit of moderate alcohol consumption as a function of age and cardiovascular risk, and disposes of both the „poison at any dose“ myth and the hegemonic abstinence paradigm. The elegance of this 180 degree turnaround lies in the fact that it is not perceived as such by the public.

The "Guide for Journalists on Reporting on Alcohol" recently published by the World Health Organization (WHO)⁵ fulfils the above disinformation criterion, because the authors intentionally resuscitate the one-dimensional "once poison, always poison" ideology - without citing the relevant literature. A closer look at the list of authors and editors reveals that faith-based temperance organizations and activists prevail in WHO’s Less Alcohol Unit.
Possible solutions to better judge scientific facts and to contain distribution of health-related fake news might be to

• Disseminate published evidence grading criteria^6,7 to a broader audience


• Make affected people resilient by self-management education and support programs (i.e. personalizedmedical care and nutrition for patients with diabetes/obesity and their relatives)


• Debunk misinformation after people have been exposed

In our effort to translate science to the public we should

• Avoid scientific jargon or complex, technical language


• Translate complicated ideas so they are readily accessible to the target audience


• Use semantic aids (well-designed graphs, videos, photos) involving complex or statistical information clearly and concisely

We must not accept a distorted picture of reality based on refutable misinformation.

References

1. Lewandowsky S, Cook J, Ecker UKH et al. (2020) The Debunking Handbook 2020. https://sks.to/db2020. DOI:10.17910/b7.1182


2. Mozaffarian D (2020) Dietary and policy priorities to reduce the global crises of obesity and diabetes. Nature Food 1;38-50.


3. Gakidou E et al (2018) Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 392;1015-35.


4. Gakidou E et al. (2022) Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet 400; 185-235.


5. Reporting about alcohol: a guide for journalists. Geneva: World Health Organization; 2023. Licence: CC BY-NC-SA 3.0 IGO  -  www.who.int/publications/i/item/9789240071490


6. Sackett DL, Rosenberg WM, Gray JA et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312:71-2.


7. Standards of Care in Diabetes (2023) Introduction and Methodology. Diabetes Care 46 (Suppl.1): S1-S4. https://doi.org/10.2337/dc23-SINT