Science-Based Nutrition Part 3: Ethics

Intellectual Integrity

This is part three of my SBN series. Check out parts one and two.

Ethical considerations are important in scientific studies, with individual clients, and within oneself. If we would define ethics we could describe it as a way of knowing how to act in terms of right or wrong/good and bad. Formally, ethics is considered a branch of philosophy trying to ask and answer general questions related to morality. We are more concerned with maximizing the health of individuals in the nutrition space. However, when we mention “health” we are referring more to the physical aspects of health such as chronic disease, nutrient deficiencies, nutrition within the lifespan (nutrition for kids vs. the elderly), sports performance, body composition, etc.

Reasoning with ethics would require practitioners to question not only the efficacy of certain practices but the values held by the client and practitioner. Values refer to the importance of some action to determine which action should be done. Many individuals hold different values which can influence certain experiences and outcomes. Understanding the values of any client is important but it’s also important for practitioners to understand their own values. 

As science-based practitioners, the ethical framework that should be adopted is intellectual integrity. Intellectual integrity or “mental excellence” refers to a set of values one should adopt to think correctly and critically. Dr. Peter Prium, a key contributor to the premises intellectual integrity, describes it as “mental excellence, a mind able to think correctly and critically, not corrupted by shoddy reasoning, with broad curiosity and respect for truth, evidence, and clarity, in order to lead effectively and justly.” Intellectual integrity is more than just having the skills of critical thinking to acquire more knowledge but it is in fact the values we should possess when thinking critically.

Knowledge vs. Information

With the advent of the internet, information on many topics is easily accessible. Practically anyone can gain information about any topic given they have an internet-connected device and wifi network. However, there is a distinction between information and knowledge. Information can be described as a statement that is true but, knowledge is the ability to show that that statement is in fact true. If I tell you to guess how many fingers I’m holding up behind my back, let's say I’m holding 5 fingers up, and you guess correctly I’m holding up 5 fingers. You gave the correct information but you didn’t know the answer. There is a difference.

Similarly, in the nutrition realm, people will repeat what they hear from their favorite videos, blogs, and influencers without knowing why. You can say “the only way to lose weight is through a calorie deficit”, but do you know why? Many people do not have a clear justification for their beliefs, they have access to all this information but can’t make sense of it.

Anyone can cite a study or read an abstract related to nutrition but not many understand many do not understand the full breadth of information that goes into the study’s design to be able to make appropriate conclusions from the study. Thus, intellectual integrity focuses on the acquisition of highly supported knowledge from a particular field of study. The foundations of intellectual integrity enable people to make more informed and ethically appropriate decisions within their society.

Rationality as a Moral Duty

There is a school of thought in philosophy called evidentialism which states that one should base their beliefs on relevant evidence within their possession. The formation of belief is important as it can impact a person's actions. Actions can affect others, and unsupported information can potentially cause harm to people. Renowned philosopher W.K. Clifford structures this more clearly, arguing we have the duty to be rational.

1. We act on our beliefs, and our actions affect other people. 

2. Our false beliefs could lead to actions that harm other people.

3. But, we have a duty to avoid harming others.

Conclusion: We have a moral duty to try to believe what is true and avoid beliefs that are false.

Anecdotally social media horror stories in the fitness or wellness industry are commonplace. I am sure many of us can come up with a clear example of a gym bro coach. Let’s say Coach Bro coaches a woman named Sue. Sue has a difficult relationship with food but she decides to ask her coach for help. Coach Bro knows he doesn’t understand nutrition that well and knows Sue has a difficult relationship with food. Through rationalizing his own expertise in the area gives Sue damaging nutrition advice… “ Just eat clean Sue”, he remarks. He then goes over a list of foods to consume and foods to avoid. Sue follows this list strictly, develops an eating disorder, and has to go to the hospital because of nutrient deficiency.

Coach Bro had no right to give Sue nutrition advice given his lack of knowledge on the subject. He had the moral duty to listen to the evidence and refer Sue to a qualified professional in that area, for example, a registered dietitian or therapist. As practitioners, our beliefs have real-world consequences, and we have the moral duty to use good reasoning and try to justify our beliefs with evidence. 

Experience and Humility

Experience is important, as we outlined in the previous section. Science and experience can go hand in hand to produce the best outcome for clients. However, the experience can be faulty, our perceptual faculties can be off… there are many perceptual illusions showcasing how this might happen. Our own perceptions of the world can trick us. The brain is so good at this social psychologists often call our brains “cognitive misers”.  Cognitive miser refers to the fact the brain often relies on heuristics and biases to make quicker judgments and decisions for the sake of saving energy. For instance, when buying a particular t-shirt most people would probably buy it due to personal preference, convenience, or because it is a popular name brand. Few people deliberately ponder deep logical reasons as to why they bought a particular t-shirt; maybe there was a cheaper shirt at another store made from better material which would logically be the better choice, but that choice wasn’t made for whatever reason.

This is meant to get at the fact experience can be faulty. We are often driven to decision-making due to our brains filtering the information we receive. Sometimes important considerations are left out from this cognitive and perceptual filtration process. Biases, heuristics, fallacies, and perceptual distortions have a functional purpose, they make the world easier to navigate. They’re essential to human functioning but, as with anything, do not come without their limitations. Therefore, it makes sense to say our experiences aren’t infallible. Outside of evidence, science, and reason, the discussion can broaden our perspectives outside of our fallible experience. This is where freedom of expression and the exchange of ideas comes in.

Freedom of Ideas

Intellectual integrity demands freedom of speech. Freedom of speech in this case demands the clear and open expression of viewpoints for dialectic. Each and every idea thought opinion, stance, and argument should be open for discussion and critique. This isn’t to say all views are correct or should be given equal weight for being true, this is to say all ideas should be tested. If a view can be upheld even after the scrutiny of being harshly critiqued then it can be said that the view has value. Importantly, open discussion makes us question our own deeply held views or beliefs. Do you really know why you believe the things you do? It can be argued that many do not know why they believe certain things. they might believe something purely because it’s popular or customary. Belief based on custom can be problematic for a number of reasons.

This allows many to believe possible falsehoods merely because others believe it. One objection could be it is possible to even hold correct beliefs even if they’re held by many. There are times where the majority are right. However, this doesn’t address the fundamental issue, believing something from custom doesn’t mean a person knows why they hold that belief. Being allowed to discuss freely allows the evaluation and criticism of each view but not necessarily the endorsement of said view. As philosopher John Stuart Mill said, “The purpose of allowing a view a hearing is not to endorse it but to put it forward for evaluation and criticism.” Due to this freedom of inquiry truer views should win out over false ones.

That being said, a modern-day consideration not encountered by Mill or most other advocates for freedom of speech is the advent of social media. Social media is not a fair playing field between views. Algorithms often isolate people to what they already support, creating virtual echo chambers, and misinformation spreads faster and further than the truth. The arrival and subsequent issues of social media as far as a source of information and views need to be taken into consideration. The other values of intellectual integrity can help us resist the temptations of misinformation and disinformation. Social media may hamper our conventional understanding of freedom of speech.

Range of Belief

Belief often refers to the acceptance of something. Humans form many beliefs in many areas of life. But have we ever sat down and considered why we believe what we believe? To know if something we believe is justified we should look at the evidence. Intellectual integrity requires that we pay attention to the evidence. Not just any evidence, but the strongest available evidence possible for our topic of inquiry. Let’s go over how to think about this.

Imagine beliefs as a spectrum: on one end, you have the diehard conspiracy theorists and science denialists, and on the other, there are the naive who are plagued by their willingness to believe almost anything. By going over the extremes we can understand the nuance in the middle.

Hardcore conspiracy theorists, like the people who think sugar is killing everyone, have what’s called by Dr. Prium “crippling skepticism”. These individuals are overly skeptical about every claim made and often require absolute certain “proof” on any given topic of disagreement. They’re often the ones telling you to “do your research” or ask you to “prove something”. Various forms of science denial, which includes people who think climate change is a myth, evolution isn’t real, or vaccines aren’t safe, also have these overly skeptical attitudes towards many scientific topics. Both conspiracy theorists and science deniers often conflate “evidence” with “absolute proof” even though the two aren’t comparable. Evidence can be based on probability as it refers to whatever supports a belief to some degree, not whatever absolutely supports a belief. Dr. Prium uses a simple example: suppose I believe I won't live to 190 years old. There is plenty of evidence to support this statement, but none of it can be stated as 'proof. Maybe there is a possibility a person can live to 190 years old, but the chances of that happening for me at this moment in time are slim to none. An example in the realm of nutrition could be the association between higher intakes of fruit and vegetables and better long-term health outcomes. This consistent evidence is strongly supported by the body of evidence but not absolute. We should see evidence in terms of probabilities not absolute. 

The opposite approach in terms of extremes in belief is those who hold beliefs without questioning the validity of that belief. They’re too willing to believe. These are the individuals who tell you to keep an “open mind” and who will probably read a horoscope to tell their future. These are often individuals who believe nearly anything that goes against convention or the mainstream for the sake of going against it. You often hear “alternative facts” or “alternative information,” facts indicating what is the case or the state of affairs, an alternative to the established state of affairs would imply something that goes against the established state of affairs. Therefore, alternative facts would go against the actual facts which means they are, ironically enough, not facts at all. 

Many might wonder how to strike a balance between not being overly skeptical and not being overly naive. An answer is given to us by Philosopher David Hume. Hume states, “A wise man proportions his belief to the evidence” and should “always reject the greater miracle.” In layman's terms, this can mean “believe in proportion to the evidence”. Believing in proportion to the evidence entails holding strong beliefs with relevant strong evidence. There is strong evidence vegetables are good for a person's health, therefore, I hold the strong belief vegetables are good for my health. As a juxtaposition, we should hold weak or no strong beliefs related to topics with weak evidence. For example, there is no strong evidence carbohydrates in of themselves cause fat gain so one should not hold strong beliefs that they do. Yet, there is strong evidence high saturated fat intake increases the risk for cardiovascular disease so a person should hold strong beliefs about that. A person’s confidence in their beliefs should be in proportion to the evidence.