Fibremaxxing* is the latest social media trend. But simply chasing the biggest fibre number might mean missing what really matters: variety and how quickly you increase your intake.

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Most of us aren’t getting enough fibre. In this video, I explain what dietary fibre does, why it matters and how to increase it sensibly.

► Soluble and insoluble fibre
► Fibre, the gut microbiome and short-chain fatty acids
► Why fibre supports fullness, digestion and cholesterol control
► The potential problems of relying heavily on one food
► Added fibres, such as inulin and chicory root
► Why increasing fibre too quickly can upset your gut
► Tips to eat more fibre
► Why fluid intake matters too

Fibremaxxing can be a positive trend, but getting more fibre isn’t the whole story. A varied diet containing veggies, fruit, pulses, wholegrains, nuts and seeds, offers far more than a higher number on a tracker.

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Also check out:

• Eight Reasons to Eat More Fibre

• 10 Easy Ways to Boost Your Fibre Intake

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* “Fibermaxxing” if you’re American!

“GLP-1” is one of the biggest names in weight loss. Unfortunately, some supplement sellers are using that popularity to market oral products with clinical-looking packaging and ambitious claims.

After a friend spent around $100 on two products prominently labelled with GLP-1 language, I examined the packaging, ingredient information and promises being made. One product listed no ingredients at all. The other used extremely small print alongside broad claims involving appetite, metabolism, blood sugar and weight management.

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A supplement mentioning “GLP-1” is not automatically a GLP-1 receptor agonist. So what does “GLP-1 support” actually mean? What might you be buying? And which warning signs should make you stop before taking it?

This video is not an assessment of any company. It’s a consumer warning about unclear ingredients, questionable claims and packaging that looks impressively clinical. If you can’t establish what a supplement contains, where it came from and what evidence supports its claims, don’t put it into your body.

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GLP-1s like Ozempic and Mounjaro may feel like a modern breakthrough, but pharmacological attempts to influence body weight stretch back more than 130 years.

In the video, I trace the remarkable journey from early experimental approaches to today’s GLP-1 era. I explore failed ideas, unexpected discoveries, key safety lessons and the surprising role of a venomous gila monster.

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How did we get from those crude early attempts to Ozempic and Mounjaro? Why were so many previous approaches abandoned? And what can this history teach us about the current excitement surrounding weight loss drugs?

An evidence-led look at the history and science of weight management — without hype, panic or miracle claims.

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More in my previous article.

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Did you know that the amount of calories you eat doesn’t match what your body absorbs?

This difference between calorie intake and calorie uptake is known as caloric availability. It’s influenced by how food is processed and cooked, ripeness and fibre content, the thermic effect of digestion, our gut microbes and even our genetics.

In this video, I explain why the same food can provide different amounts of usable energy to different people in different circumstances.

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Calorie tracking can still be useful for many people. But we should understand that the numbers are estimates rather than exact measurements.

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Read more in the article Caloric Availability (with references).

Those numbers look remarkably precise. In reality, they’re estimates based on a system whose roots stretch back to Wilbur Olin Atwater and the bomb calorimeter in 1896.

In this video, I explore how calories are calculated and why protein, carbohydrates, fibre, polyols, fat and alcohol don’t always fit neatly into the familiar calorie formula.

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We’ll look at:
► How food energy was originally measured … by literally burning food
► Why different amino acids contain different amounts of energy
► How lab methods can over- or underestimate protein
► Why sugars, starches, fibre and polyols have very different calorie values
► How MCTs and different testing methods complicate fat calculations
► Why the alcohol content of wine and beer matters
► How something labelled as 200 calories may not contain 200 calories

This doesn’t mean calorie tracking is useless. It means the numbers should be treated as useful estimates—not exact measurements.

Understanding their limitations allows us to use calorie information more intelligently, without being misled by a false sense of precision.

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More in my article Is Calorie Tracking Accurate?

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There are no solutions. There are only trade-offs.
- Thomas Sowell [1]

“I’ll die on my sword.”

Someone said this to me after I challenged them on one of their claims. The phrase implies a commitment to a belief so strong that any negative consequences and criticisms are preferable to compromise. I wouldn’t have cared, except the person who said it is a Registered Nutritionist: a profession that champions evidence and nuance. Remarks like this are a proclamation of certainty.

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When it comes to communicating publicly, such as on social media, it’s human nature to want to double down on our claims when our beliefs are challenged. To help mitigate this bug of the human psyche, humans have come up with the scientific method and Enlightenment values. Anyone committed to being an honest practitioner should always be open to hearing alternative perspectives. Whether any opposing evidence we encounter is strong or weak, at the very least, we should always be open to changing our mind.

The Strength of Uncertainty

We live in a culture where uncertainty is penalised and certainty is rewarded. Humans don’t like uncertainty. There’s something psychologically uncomfortable about not knowing. Our instinct is to seek out that confident voice, a clear conclusion, something on which we can act. Those veiled in certainty have little need to look for alternative perspectives: they “know” all they need to know. Certainty likes to infer authority and strength; uncertainty risks showing weakness. Yet, in reality, the reverse is true: certainty hates challenge; uncertainty involves hard work.

Certainty is particularly prevalent in fitness and nutrition. One who follows a particular dietology, such as the carnivore diet – a way of eating that consists almost entirely of animal products – might feel that he doesn’t need to consider if his way of eating might be harming his health. Taking advice from someone who shares your beliefs is far less cognitively burdensome than reading a critical review of the pros and cons of meat-heavy diets.

Seeking and understanding opposing perspectives takes time and can be emotionally draining: we don’t like it when we’re confronted with antithetical worldviews. That’s not to say that an honest practitioner needs to be unconfident in the manner in which she expresses herself. Sadly, many genuine experts lack assertiveness, and this enables the ultracrepidarians to land their message by way of their unbounded confidence. We should acknowledge the virtue of a content maker when she concedes her uncertainty. Someone who’s likely worth listening to is someone who’s confidently unconfident with her message.

In life, nothing is certain. Well, there is one thing of which I am 100 per cent certain: I know that I am conscious. Everything – and I mean everything – else I experience involves some degree of uncertainty. By acknowledging this, you realise that everything else mandates the reduction of – rather than the elimination of – uncertainty. To reduce uncertainty, we need evidence. Science is the process of acquiring evidence to evaluate if something is real. It involves the acquisition of data, then interpreting and drawing conclusions from it. When researching an idea, we might formulate a “theory”. When the evidence behind a theory is really strong, we might say that we have “proof”. Proof, however, is not certainty. Strong theories require evidence built on previous evidence. Science is an ever-ongoing process.

How does someone who considers themselves to be an honest adherent to scientific values remain open to changing their mind? This is where Bayesian reasoning comes in: we get closer to the truth by updating our knowledge in proportion to the weight of new evidence. Nothing in life is certain, no matter how strong the evidence. By keeping an open mind, we can adjust and adapt as we encounter new information. Bayesian reasoning takes into account both what we already know and any new evidence. Thinking like a Bayesian means accepting that nothing is certain, that we must rely on informed guesses and that sometimes we have to update our assumptions on the fly. It keeps us open-minded, allowing us to change our opinions when new facts drop.

Let’s embrace uncertainty and shun certainty. Yet, while doing so, we might wonder why our universe is uncertain …

The Beauty of Complexity

People often take “complicated” and “complex” to mean the same thing. Yet understanding the difference is crucial. “Complicated” systems are linear and predictable; “complex” systems are dynamic and unpredictable.

Something complicated has many moving parts but is contained and operates in a fixed, logical pattern. It can be dismantled, analysed and reassembled with predictable results. High-level expertise is required to solve problems in a complicated system, but a solution can be replicated. Cause and effect are directly linked. With the correct understanding, a single person or small group can work with the system.

Complexity involves many interacting components that constantly adapt and change. A complex system cannot be fully controlled or predicted because the parts influence each other dynamically. While expertise helps, previous success does not guarantee future results due to changing variables. Small changes can trigger massive, unpredictable chain reactions. No single individual can grasp a complex system.

A useful example is a car versus traffic. A Ferrari is complicated. It contains thousands of intricate parts: engine, chassis, wheels, axles, exhaust, drive shaft, etc. Lift up the bonnet and I wouldn’t know where to start. However, an experienced mechanic can diagnose any mechanical issue, mend it and know exactly how the car will perform. Fixing the Ferrari might be difficult, but the process can be learned and understood.

Traffic, on the other hand, is complex. Traffic involves millions of human drivers, policy, changing weather, road hazards, fumes and unique behaviours. You can’t fix a traffic jam by reading a manual or replacing a part. A minor brake tap by one driver can cause a massive bottleneck five miles behind. A complex system changes constantly and cannot be fully predicted.

Another example is the metabolic chart. Drawn up by humans, it provides an illustration of the hundreds of known reactions involving numerous substrates, hormones, enzymes, co-enzymes and other factors involved in metabolising food into energy or storing it. Learning the metabolic chart is the bane of every bioscience undergrad’s existence. It’s complicated – horrendously so – but it can be learned.

However, the chart is merely our best approximation of the numerous metabolic processes in the human body. Actual human metabolism is complex. The interaction of all the physiological and biochemical processes working within and between trillions of cells under an unfathomable array of different internal and external conditions in a single organism is impossible to comprehend. A change in one part might have multiple downstream effects. This explains why things like nutrition and medicine are so uncertain.

Embrace Nuance

Complexity gives rise to uncertainty. Complex systems – ant colonies, beehives or modern human society – involve diverse, interacting and interconnecting parts that adapt to one another. The system is in constant flux. Change one aspect of the system and other parts automatically adjust, creating something new altogether. If one person in a crowd stops to chat to someone else, people don’t just carry on, following a fixed trajectory. They adapt and move into a slightly different pathway. Chronic disease, climate change and malnutrition are examples of processes that are both immensely complex and incredibly complicated to understand.

Let’s say you’ve been diagnosed with a serious disease. The doctor suggests two possible courses of action. Uncertain of either outcome or, indeed, if either will be successful, she will outline the options and her rationale. Hopefully, she’ll do this in a confident manner and, ideally, will request a second expert opinion from another doctor. Armed with as much information as possible and by invoking a Bayesian mindset, together you can assess the confidence in each treatment option, enabling you to make an informed decision. There will still be uncertainty, but you can be more confident in making the decision with the best chance of recovery.

Your body is complex; nothing is certain. Any social media influencer who claims that a single food or behaviour is harmful is failing to acknowledge the complexity of humans. Any content maker who speaks in this absolutist way should be ignored.

When it comes to our health, the goal should not be to seek certainty but to reduce uncertainty. This reframing might be subtle, but it’s the very essence of the scientific method. It might seem paradoxical, but thinking this way will enable you to be more confident in your decisions.

Our universe is complex, and everything is uncertain. Acknowledging complexity and embracing nuance will be paramount for any credible understanding of human health, the food system and, well, everything.

Fear certainty. Embrace complexity.

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References:
1. Sowell, T. (2007) A Conflict of Visions: Ideological Origins of Political Struggles. Rev edn. New York: Basic Books.

I’ve been doing the social media thing all wrong. It’s just not possible to condense useful nutrition content into a short reel. Trying to share anything of value in a 60-second clip doesn’t work. Human health is way too complex. While people might think they want bite-sized chunks of information, in reality, there’s little to be gained from attention-grabbing microcontent. In fact, nuance-lacking short-form content is likely a key reason why unscrupulous influencers are able to spread health misinformation.

Yet, I found myself falling into the trap of trying to capture people’s attention by creating quick content.

Now it’s time to change direction.

Welcome to my more in-depth videos! I’ll be posting them here and on my new YouTube channel.

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What to Expect

The videos will range in length from around five to 20 minutes. I’ll be covering a range of topics on nutrition, the food system, health, wellbeing, science and culture. If I stumble across an insight that piques my interest, I’ll dig into the topic and shoot a video with just the right level of detail to be both educational and entertaining.

I’m no “expert” in nutrition. While I have a lot of knowledge on an array of nutrition and health issues, I’m an “expert” in none. The lack of respect for genuine expertise is something I find deeply concerning. The “expert” label has, for some, become a subjective phenomenon in that people feel they have the option of choosing who they deem to be an “expert”. But that’s not how true expertise works. I get to meet genuine experts in many disciplines, such as nutrition, healthcare, environmental science and economics: I know what true expertise looks like. And I know I’m not one. My skill is knowing quite a lot about a lot, while being expert in no single field. This allows me to offer broad knowledge from a range of different subjects and to synthesise different perspectives. Through collating insights into an easy to understand format, I offer a wide boundary lens.

What Not to Expect

I will not be creating classic debunking videos. You know the sort of thing: a clip of a video is shown and the information dissected, the content criticised and the creator attacked, sometimes personally. Shoddy advice must, of course, be exposed, and I fully support those who debunk myths through evidence. However, numerous credible content-makers are doing a fine job revealing quackery in this manner. I feel no need to jump on the bandwagon, particularly as this format is not my style. That’s not to say that I won’t debunk health misinformation where I see the need. I just won’t be doing so by singling out particular videos with ad hominem attacks.

Now, I realise that this is not the sort of clickbait content people yearn for. The negativity bias of the human condition craves personal attack and argument. But that’s not me. I’ve no desire to be part of the information wars in this way. Granted, my content will invite challenge, and critiques might, at times, be aggressive: that’s part and parcel of putting myself out there. In fact, I hope my ideas will provoke debate and disagreement. I welcome high-rung, articulate challenge: it might point to issues I’d previously failed to acknowledge, and when I’m demonstrated to be wrong, I’ll course correct. Sharing opinions through respectful disagreement is integral to science. Where I see fit, I’ll respond in the comments. When a challenge invites an in-depth response, I’ll do so in another video or an article in which I’ll weigh up the strengths and weaknesses of the counter claim.

By not going down the emotion-grabbing route, I might not get a high follower number. I’m more than ok with that. I’ve no wish to sacrifice my soul for ego. Although I wouldn’t have admitted it at the time, when I was previously creating content, I was chasing followers. After all, a larger audience enables a message to be shared widely, allowing it to be more effective while being a better use of my time. My team and I will work social media algorithms only where doing so doesn’t compromise the authenticity of the channel. We won’t manipulate the algorithm purely for the sake of acquiring followers. Of course, a higher number of viewers is desirable, but amassing followers is not the primary goal. My motivation is to share honest, enjoyable and educational content. Quality trumps reach.

A Broad Focus

While my educational background is in human nutrition, I’ll be covering a lot more than just food. The content will fall into three broad areas:

1. Food systems and wellness

This massive topic allows a lot of scope for me to chat about nutrition science, food policy, sustainability, food culture, the food industry, supplements, organoleptics, economics, longevity and food philosophy. The food system is the focus of my book, Well Fed.

2. Men’s mental health

The challenges many men go through haven’t, until recently, been spoken about to a sufficient degree. I’ve wrestled with my own issues in the past, so this lack of concern for men’s wellbeing bothers me. The issue is highlighted by the young men who look to bad actors in the manosphere for inspiration. Men need better role models. While I’ve no educational background in mental health, I feel compelled to share my own experiences – the good, the bad and the ugly – while being mindful to stay within my professional boundaries.

3. Health communication

Polarisation driven by dogma and tribal behaviour is potentially an existential problem. Sadly, so many academics and qualified clinicians who have a useful message to share are poor at communicating it. Instead, the floodgates have opened and faux influencers, skilled at audience capture, have been able to infect millions with their dangerous advice. I want to empower credible health communicators to be better at sharing their knowledge. As well as this, I’ll be providing tips to help scrollers nurture their critical thinking skills, helping them to discern the credible from the crap.

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Videos will be posted on both YouTube and Substack and will be free for all to watch. I’ll be continuing to post articles on Substack free of charge. However, I’m introducing a paid tier on Substack for those who want to support my work. Paid subscribers will also receive extra content, with actionable nutrition and health tips, and access to private chat with regular Q&As.

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Instagram, Facebook, TikTok and Threads will be for announcements and to promote YouTube and Substack.* By all means follow me there, but you’ll be missing out if you don’t subscribe on YouTube or Substack!

* My LinkedIn is for professional connections and to share links to the videos and articles.

“Why do it if you know you won’t like it?”

A friend asked me this when I told them I was planning to climb two mountains that I knew would be well outside of my comfort zone.

Most people I encounter don’t seem to grasp why it’s important to sometimes experience extreme discomfort. A few, however, get where I’m coming from.

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It’s useful to think of how we relate to physical activity in three ways. Firstly, there are activities we find relatively easy. Things like walking, kicking or batting a ball about, or having a light gym session. Obviously, what one person deems “easy”, someone else might find challenging. But engaging in exercise you enjoy and feel comfortable with a few times a week will be a boost for your wellbeing.

Next are activities that, despite being hard or challenging, we still enjoy. For me, this includes hard gym workouts and outdoor hikes. Others might enjoy long bike rides, martial arts or rock climbing. Even though most people don’t partake in activities at this level, pretty much everyone acknowledges that others glean enjoyment from them.

It’s the third perspective on how we can relate to physical activity that most folk find it hard to get their head around. This is when a task is so extreme that it’s highly unpleasurable – things like ultra-marathons and mountaineering, for example. While “adrenaline junkies” may achieve some sort of masochistic pleasure from these events – for these folk, their relationship to the task will be more akin to the second mindset – when exertion is intense and prolonged, for most of us, that will be an unpleasant experience.

Summitting Gran Paradiso

A few years ago, I made a pledge to myself. When presented with an opportunity that was likely to be beneficial, I would have to find valid grounds to decline. Should I fail to find a good reason to say “no”, I had to commit. So, in October last year when my friend Oli suggested we attempt to climb Mont Blanc, it was one of those moments.

Mont Blanc, a mountain in the Alps and the highest peak in Western Europe, was advertised as requiring no prior experience. With manageable commitments for the next nine months, I had ample time to improve my fitness. In any case, the additional cardio and outdoor training would be hugely beneficial. So, with no reason to turn him down, I agreed to be Oli’s climbing buddy, and we booked the trip for July 2026. Prior to Mont Blanc, the itinerary mandated attempting another of the Alps. At 4,061m, Gran Paradiso is the highest peak solely in Italy. Regarded as “accessible”, it’s seen as a great first step for those aiming at Mont Blanc, and is described as “suitable for beginners”.

Our climbing party consisted of the guide, two other guys, Oli and myself. Climbing and descending Gran Paradiso spans three days. On day one, we set off from the car park at around 1,800m and climbed 2.5 hours to the Federico Chabod Hut at 2,712m. Here we were given the necessary training to familiarise ourselves with harnesses, crampons and different terrains: useful skills that will definitely help in the future. That night, in an unfamiliar environment of bunk beds and sweat, situated at high altitude, I struggled to sleep. My WHOOP indicated that I barely achieved 3.5 hours of broken shut-eye. After breakfast and kitting up, we continued our climb at 4.45am.

The trails and rocks transformed into ice and snow, at which point we put on our crampons and the guide roped the five of us together. For the first three hours of the climb, I was super-confident, but, as our ascent steepened, I started to struggle. With significantly reduced oxygen at altitude, I experienced fatigue like never before. Consequently, I found the final few hundred metres of snow climbing extremely hard. Thankfully, at the base of the summit section, we took off our crampons for the final ascent over rocks. Despite the sheer drop, I didn’t find this section particularly difficult or scary. Maybe this was because the lack of oxygen made me somewhat carefree. The view from the summit was magnificent, but with other climbers waiting, we had little time for photos, and, as I was disorientated, I didn’t get to fully appreciate it.

I assumed the descent would be easier. How wrong I was. As it warmed up, the snow began to thaw, which made walking much harder. To avoid sliding, we were instructed to slam our feet hard into the snow. But, as my quads felt more fatigued than ever before, I couldn’t slam with any impact.

From the extreme tiredness and disorientation, I briefly passed out at one point and fell onto the ice, grazing my arm. The guide made me share the contents of my rucksack with the others. Despite being exhausted, I was incredibly uncomfortable with this: it reminded me of school sports when I was always one of the crap players. On reaching the rocky area, I started to find the descent less taxing, and eventually we arrived back at the hut, two hours later than expected.

After another night of crap sleep, the final leg back to the car park the next day took little more than 90 minutes.

Failure vs. Realism

As I struggled to cope with the altitude, attempting Mont Blanc was out of the question. My focus for the past nine months had been to summit the highest Alpine peak, so, naturally, I was hugely disappointed. While part of me felt like a failure, forever the realist, I accepted the decision.

At no point did I think I wasn’t going to reach Gran Paradiso’s summit, nor did I think I wouldn’t make it back to the hut. I would have, however, found it way less arduous had I been allowed brief stops to catch my breath and sip water. Not long: just a 20-30 seconds pause every 10 minutes or so. Frustratingly, the guide didn’t permit it, which may have been why I passed out. My body craved oxygen. Not allowing frequent pauses for just a few seconds seemed unnecessary to me, and my three co-climbers concurred.

Immense Privilege

I hated the experience. I spent seven hours in extreme discomfort. My relationship to the activity was the third perspective. Nevertheless, I look back on the experience with immense gratitude. What an absolute privilege it is to be able to summit Gran Paradiso. Not only do I have the time, financial means and support from my family, I’m in great health and fit enough to climb the Italian peak, despite physically struggling like never before. Not everyone has the means and ability to attempt these sorts of challenges. I’m lucky.

I don’t look back on the ordeal with much fondness. Yet, bizarrely, I’ve a yearning to experience that level of displeasure again. Maybe, as humans, we occasionally need to be reminded of where our limits lie: to push ourselves to see what we’re capable of. In a world of rapidly advancing technology, where the Law of Least Effort prevails, everything is too easy. Many of us hardly exercise at level one, let alone enjoy activities the second way. Encouraging people to do tasks they hate is well out of the question, especially as most can’t even grasp why we should.

In no way do I wish to appear elitist, showing off how tough I am. I’m anything but tough. But I do want to be tougher, and I do these things because I hope to build resilience. That is, of course, if resilience is something that can be built with volition. Experiencing discomfort the way I describe is, after all, personal choice. There’s a big difference between this and the extreme hardship that, sadly, too many people are forced to live through as a result of circumstances beyond their control.

I’ve intentionally undergone difficult tasks before, though never one as hard and sustained as when I climbed Gran Paradiso. While I enjoy hard exercise, what’s different here is my desire to return to the mindset I experienced when I was detesting every single footstep. Is that masochism? I don’t think so because pleasure is absent. Or is it? Maybe there’s pleasure in the memories that make me simultaneously shudder and yearn.

While pondering this paradox, I’ll be seeking my next uncomfortable task.

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I recently stumbled across a LinkedIn post with a graphic displaying the statement “NUTRITION IS A SCIENCE NOT AN OPINION”. The goal behind the eye-catching image was, no doubt, to encourage a reaction. It worked: at the time of writing, the post has had nearly 1,700 reactions and has been shared 234 times, and I’ve since seen other posts with the same graphic and text conveying the same theme.

Any regular consumer of my content would be forgiven for thinking that this phrase is something with which I’d be fully aligned. After all, I’m known to champion sound science and criticise ideas that lack the adequate level of evidence.

The individual who made the post is a “clinical dietitian”, and those who support its message are likely those who advocate for evidence-based science, support peer-reviewed research and value the scientific method over ideological assertions. These folk are, therefore, for want of a less polarising term, in my camp.

Yet, the statement “Nutrition is a science, not an opinion” is profoundly incorrect, and the fact that so many learned people seem to agree with it is highly concerning. Not only are those who support it confused, but I fear their actions might even be part of the problem when it comes to dealing with misinformation.

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“Whoah there a minute, James!” I hear you shout. “Aren’t you being a little arrogant? Should you not be championing those with whom you broadly agree rather than criticising them with such confidence? There is, after all, no shortage of low-hanging fruit when it comes to faux fitness influencers spouting shite on social media.”

Valid challenges, and, lacking qualification, these criticisms would be fair. So, please, read on …

The Highest of Standards

I’ve previously preached that we, as formally qualified health professionals, must hold ourselves and our peers to the highest of standards. Certainly to a much higher level than those pseudo influencers who dole out shoddy nutrition information. To fight health misinformation effectively, we have to behave way better than those we criticise. Holding ourselves to account is both a practical and moral imperative, and anyone who views themselves as an ethical content creator must strive to be intellectually on point with everything they communicate. We will still often get things wrong, inevitably. But when mistakes happen, we must openly acknowledge them and course-correct.

I make my critique as an ardent supporter of formally accredited dietitians, nutritionists and health practitioners, academics, doctors and clinicians of all types because I respect them. In particular, I celebrate peers who put themselves out there in the public sphere and share sensible advice. As I’ve said previously:

If more of us create quality content, we can crowd out the simplistic conspiratorial narratives. When more people hear consistent facts from multiple reputable sources, they’re more likely to challenge the charlatans. More voices please.

When a greater number of suitably qualified professionals share sound information, we can drown out the crap. But to be effective, we must ensure our message is clear. Indeed, this isn’t the first time I’ve banged this drum. For example, I urged my peers to stop using the term “evidence-based” as a descriptor, as it risks devaluing their otherwise sterling content.

Nutrition Is a Science and Opinion Is Key

Aside from the image and first line of the post, the remaining text is spot on. For example, the poster wrote:

The challenge is that nutrition advice is often influenced by personal experiences, social media trends and marketing messages. Science works differently. Nutrition science is built on research, clinical evidence, human physiology, and long-term health outcomes. Recommendations are developed by evaluating large bodies of evidence not individual success stories.

A single experience can be interesting. A scientific conclusion requires consistent results across many people and many studies.

The strongest nutrition advice isn’t the loudest voice in the room. It’s … advice supported by science.

Great points, eloquently phrased – the last, especially so.

My objection is only to the assertion “Nutrition is a science, not an opinion”. Opinions are integral to science. The sharing of opinions is a key component of the scientific method. Yet, the statement implies that “science” and “opinion” are zero sum, it’s either one or the other and “science” and “opinion” cannot exist together. The claim betrays the very essence of science.

Nutrition is a science, but opinion is very much involved.

Opinion as Part of the Scientific Method

The only thing in the universe of which I am 100 per cent certain is that I am conscious. Everything – everything – else I experience involves uncertainty. To reduce uncertainty, we need evidence. Science is the process of acquiring evidence to evaluate if something is real. It involves the acquisition of data, interpreting the data and drawing conclusions from it.

When researching an idea, we might formulate a theory. When the evidence behind a theory is really strong, we might say that we have “proof”. Strong theories require evidence built on previous evidence. Science is an ever-ongoing process.

When similar results arise from multiple independent peer-reviewed papers, we might consider there to be a high degree of replication. When meta-analyses and systematic reviews agree with highly replicated data, it becomes increasingly likely that something is true.

But evidence, data and information, no matter how robust, require interpretation. Different people will be privy to different information and might, therefore, draw different conclusions from it. Every piece of research, and even the critical appraisal of the totality of research available on a topic, relies on the opinions of experts. How these experts interpret the evidence may differ because each individual will have had different prior experiences with, and interactions with, the available research. Of course, we hope their ideas will converge. When the opinions of multiple experts concur, we consider there to be a “consensus”. When a consensus holds, a “paradigm” has evolved. A paradigm is when a set of ideas becomes established and we consider there to be agreement on how a concept appears in the universe. Paradigms serve as fundamental models or patterns that guide our thinking and set the boundaries of what’s considered possible. A paradigm can be dislodged only by another paradigm, as illustrated by Thomas Kuhn in his seminal book, The Structure of Scientific Revolutions.

Every single step of the process, from the creation of an idea to the development of a paradigm born from consensus, involves the opinions of individuals. Granted, for an idea to be valid, these opinions should be based on evidence and, better still, shared by others who have similarly relied on evidence. Nevertheless, every single idea requires opinion.

A quote from my article Stop Using “Evidence-Based”! is pertinent here:

Science is opinion and opinions can be plucked out of thin air. But credible opinions are based on evidence. The acquisition of evidence is progressive, meaning that opinions will be formed via different routes. We are all subject to different information: we read different papers, articles and books and we watch different videos. Consequently, we may arrive at different interpretations of evidence. And when we add in our own real-world experience, opinions will be diverse. Even the most acclaimed expert will, at times, be wrong. It’s how they respond when they discover their error that’s testament to their authenticity. This is why, when confronted with a serious medical condition – as, sadly, many of us will be at some point – we should seek a second, or even third, opinion. Science is a fluid process: our quest for the truth is reliant on the synergy of opinions built from ongoing evidence and experience.

Opinions will differ. Even an individual might be forced to alter her opinion on a matter. Indeed, someone who considers herself an honest adherent to scientific values should be open to changing her mind. This is where Bayesian reasoning comes in. Being a Bayesian means accepting nothing is certain and that we must rely on informed guesses, sometimes updating our assumptions on the fly. It keeps us open-minded, allowing us to change our opinions when new facts drop.

Reacting from Emotion

I like this reply someone posted: “Nothing is absolute, so often an interpretation of the available evidence will be required which would be an opinion.” Opinion is part of science. The fact that so many people don’t seem to grasp this fundamental point is what I find hugely concerning.

But am I being a little harsh? Might it be that when people hear the word “opinion”, their visceral response is that the word “opinion” sounds like the judgement of a single individual rather than something based on evidence?

People, especially qualified professionals, should think about what they read before they react. I can understand that often reactions come from emotion rather than contemplation. We all do this. I feel similarly frustrated when I see ultracrepidarians spouting bullshit. But this is why I’m suggesting people’s reactions are part of the misinformation problem. As ethical professionals, rather than reacting viscerally, we must pause and consider – contemplate – what we’re communicating. It’s our duty to be better.

Sharing Opinions

It’s important that different ideas – opinions – are shared. But those sharing their ideas should be open to debate. Rigour is increased when you seek evidence that runs counter to your claim and the failure to be convinced by opposing evidence strengthens your case. Nutrition science involves opinion. For an opinion to be credible, it must be based on an argument that involves evidence. Yet an opinion need not shun the real-life experiences of others, which may have led them to hold an opinion that appears antithetical to your views. Sound nutrition advice embraces different food cultures, and different cultures will involve different experiences.

Now, I need to be clear: science involves challenge, and what I write here is, after all, just my opinion. Some folk might, quite reasonably, disagree with my polemic or my interpretations of the first principles on which it’s built. Naturally, one can either embrace what I have to say or, instead, present a counter-challenge. A strong enough argument may force me – as a good little Bayesian – to accept its validity, revise my prior and maybe even write a response.

Debate is how we, as academics and citizen scientists, progress.

Well, that’s my opinion anyway.

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My life’s become a bit weird. As the co-founder of a successful company, people from a range of backgrounds frequently reach out to request my audience. Naturally, to preserve my own sanity, I’m super selective and more likely to schedule a chat with someone from the food and health space. Nevertheless, I’ve had some great conversations with business leaders from other industries, some of whom have invited me to online groups. One such forum consists solely of affluent men, many of whom are concerned with their health. I know this because they proudly announce “biohacking” as a key interest.

Now, “biohacking” is an interesting term. I’ve mixed feelings and it’s a topic I intend to deliberate in a future article. As a key feature of biohacking is having one’s blood tested for a range of blood biomarkers, I’ve been wondering if biohacking aficionados have really considered whether having their bloods tested through the most enticing online service that popped up in their social feed is a sensible choice.

This concern was cemented when a friend of mine, Dr Peter Scriven, a former surgeon and primary care physician whose current focus is on longevity and preventative medicine, recently asked me to sense-check an article before he posted it on LinkedIn. With Peter’s blessing, I’ve nicked his ideas and added to them.*

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Testing Is a Process, Not a Product

Private blood testing has become a product category: a feature service offered by wellness clinics, beauty lounges, weight loss centres, nutrition plans and pharmacies. Some are even offering same-day test results.

Full of promises and buzzwords, marketing copy overflows with promises of “insight”, “optimisation”, “prevention”, “empowerment” and, everyone’s favourite, “personalisation”. In the setting of competent medicine, of course, these words are meaningful. In the direct-to-consumer market, they serve as a glossy distraction from weak clinical oversight. The companies offering them hint at total clarity, yet remain deliberately vague about what their biomarkers actually measure.

Both tech bros and wellness aficionados alike treat blood tests like digital downloads. They’re not. A blood test is part of a high-stakes clinical chain reaction where every test requires context navigated and explained by a qualified professional. Justify: what’s the reason for the test? Select: order the correct panel. Interpret: are there any abnormalities? Explain: translate the results for the client. Manage: decide whether to treat, repeat or safely ignore. Every step is documented, including justifying if no action is taken. When a link in the chain breaks, there’s a risk to patient safety.

A lab report doesn’t neatly separate fun wellness metrics from heavy medical diagnoses. The machine simply spits out raw data, such as potassium, creatinine, ferritin, CRP, TSH, HbA1c and platelets. Some off-chart numbers are insignificant quirks while others could be early signs of chronic illness or medical emergencies. How is the client expected to know? Test pushers pocket the profit by leveraging the anxieties from the easy wellness data while dumping concerning medical realities onto an unprepared patient or an overburdened public health system.

Diagnostic Testing is Clinical Work

In clinical practice, blood result management is not simple administration. Any doctor who’s worked in general practice will tell you about the daily grind of assessing, actioning, filing and chasing tests. The process is clumsy and frustrating, with considerable room for improvement. Yet, it’s firmly underscored by sound principles. Blood biomarkers reveal clinical risk, which is why correctly structured systems include training, protocols, defined role boundaries, supervision, escalation, indemnity and audit.

This is why guidance from institutions like the NHS, British Medical Association and American Medical Association frames diagnostic testing as clinical responsibility. The clinician requesting a test is expected to understand why it’s being requested, what question it’s answering, what “normal” looks like, what an abnormal result would mean and who’s responsible for action. Crucially, this should all be established before the test is requested. Inside a clinical system, this is taken seriously. In parts of the private wellness market, the same work increasingly shows up as retail fulfilment with a lab report attached.

A stress test of any blood testing service could be the potassium result of 6.5 on a Friday evening. Who receives it? Who knows whether it might be haemolysis? Who checks renal function and medication history? Who knows whether the patient needs repeat sampling, an ECG, urgent assessment or even admission? Who contacts the patient, documents the decision, carries the risk and is indemnified for doing so? The same for falling eGFR, raised calcium, a low TSH, raised ferritin, etc. What’s benign noise? What could be a sign of early disease? What requires urgent action?

Escalation is a key part of the medical process. When a testing service reveals an out-of-spec result, the automatic suggestion “speak to your GP” is a cop-out: abandonment dressed up as escalation. A private provider cannot assume that the client’s GP has silently accepted responsibility.

Competence Over Confidence

Part of the problem is linguistic blurring. In private wellness, titles like “specialist”, “practitioner”, “therapist” and “clinician” are thrown around loosely. Diagnostic testing enjoys no such luxury: it demands precise language. Of course, diet, fitness and mental health therapy require genuine expertise – that, incidentally, is too often lacking – but they are not medical investigation. Improving health is not the same as investigating disease. Advising on lifestyle choices is not the same as interpreting complex blood panels. Labelling a pattern of symptoms is not the same as rigorous diagnostic training.

Medicine is the disciplined handling of uncertainty, consequence and risk: what to test, what to leave alone, what to repeat, what – and when – to escalate and what might be artefact. It asks, “What does this result mean for this individual, with this history, on this trajectory?”

In several previous articles, I’ve lamented the loss of trust in expertise in nutrition and healthcare (such as here and here). Areas of the wellness market are a manifestation of this phenomenon, where medical judgement is portrayed as friction, clinical caution as old-fashioned and professional boundaries as protectionism. Blood testing is vulnerable because the visible barrier has descended. A panel can be selected, a sample taken, a report generated and a recommendation attached. Something clinically meaningful appears to have happened. Rather, what’s happened is weaker than it looks.

The hard part of blood testing isn’t taking the sample, it’s deciding whether the test should be done, what the result means, what else could explain it, what must not be missed, what should be repeated, what should be ignored, what should be escalated and who’s responsible. Medicine has always been elitist in one important sense: it distinguishes competence from confidence.

Test Correctly, Not Casually

Our polemic should not be mistaken for an argument against private testing or preventive medicine. The numerous problems endemic to conventional healthcare are all too apparent to require a mention here. The future of medicine will rely on smarter, faster and more intelligent longitudinal testing. Used correctly, blood testing can reveal issues like metabolic drift, renal decline, inflammatory burden, subtle thyroid dysfunction, insulin resistance and cardiovascular risk before conventional crisis points are reached. Indeed, one could argue that the fact that we’re writing this critique is, itself, a medical celebration. Having these diagnostic tools so readily available is historically unprecedented. Appropriate testing enables precise, predictive, preventive and personalised care: a fabulous thing.

The difference is clinical ownership. Broad panels require deliberate selection, experienced interpretation, medical context and clear escalation pathways. Sold as standalone consumables, they detach from clinical responsibility, an approach that instils anxiety, sells supplements and shifts risk onto an overburdened NHS. Services without proper clinical scope provide quasi-diagnostic commentary, sell programmes on the back of abnormal results and send patients off packing when the potential consequences become uncomfortable.

A glaring double standard exists. Conventional medical institutions manage blood results through strict training, protocols, supervision and defined boundaries**. Many private aesthetics, IV vitamin, hormone and wellness optimisation markets dump caution and vanish with remarkable speed. Extensive inter-related biomarker panels are reduced to casual lifestyle conversations. Private payment doesn’t alter biology. Nor does it make complex clinical data easier to interpret.

A PDF Is Not a Clinical Pathway

Advocates of casual blood testing services – and, of course, the companies themselves and those working in them – will predictably accuse experienced doctors of medical protectionism. But Peter is comfortable with a degree of medical protectionism. Medicine mandates boundaries because the work has consequences … serious ones. Granted, doctors are human and will make errors, but imperfect doctors do not negate the need for medical competence.

Moreover, the fact that a laboratory is accredited doesn’t solve the governance problem. While it gives us confidence in analytical quality, it does not decide whether the test was indicated, know the history and context, manage the anxiety or own the pathway. A reference range is not a diagnosis. A PDF is not a clinical pathway.

Private blood testing has a legitimate place. Advanced testing has a legitimate place. Preventive medicine has a legitimate place. Longitudinal assessment has a legitimate place. But the standard has to be clinical, not cosmetic. Good testing begins before the needle goes in. Any service initiating blood testing should be able to answer basic questions. Why is this test being done? Who assessed the patient? Who reviews the result? Who acts? Who is indemnified?

Blood tests are clinical events. Whoever initiates them should be capable of owning them.

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Postscript

This article was co-written by Dr Peter Scriven. Peter is a Fellow of the Royal College of General Practitioners, and Co-Founder and Clinical and Scientific Director of LONGEVITY. He has a background in surgical oncology, proteomics, cell stress pathways, primary care leadership and healthspan medicine. Peter shaped the clinical argument behind the article: the distinction between credible medical interpretation and unregulated wellness testing.

* Hence opinions are relayed in the first-person plural.
** In the UK, any medical institution must demonstrate this for Care Quality Commission (CQC) registration.

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Most of my articles involve me delving into the complexities of nutrition, the food system, science communication and health more broadly, as I try to make sense of this nuanced, messy universe. As I…

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“I’m helping people. I’m healing people!” These are the words of prolific health influencer Eddie Abbew.

I conveyed my concerns about his style of food evangelism in my 2023 article Messiah Syndrome in Nutrition at the time when Abbew was experiencing exponential growth in popularity. Other social media demigods have similarly sermonised to desperate scrollers eager to lap up tips from their idols.

If you’re like me, you might be feeling that we’re living through a period of rising conspiratorial thinking. Yet research has indicated that conspiracies are no more prevalent than at any time in the past [1]. Rather, what’s making conspiracism appear more rife is that existing views are being heavily reinforced and circulated in online echo chambers.

Even if it is true that the level of conspiratorial thinking is not dissimilar to that of previous eras, this fact itself is disappointing. With ready access to genuine experts literally in the palm of our hand and the ability to fact-check at our fingertips, such dogmatic worldviews should be on the decline. This implies that there’s something else going on.

I introduced the term “dietology” – a portmanteau of “diet” and “ideology” – in my book, Well Fed: How modern diets are destroying us (and what we can do about it), which I summarised in an article. Dietology refers to dietary beliefs that are born from ideology rather than evidence [2].

While dietary beliefs have been around for tens of millennia, what’s particularly striking at this moment is the prevalence of nutrition populism, the ardent commitment to specific dietologies – such as the carnivore diet, the shunning of seed oils and the performative chugging down of raw milk – and the mistrust of contemporary medicine. Why is this?

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When something is lacking in people’s lives, health conspiracism offers meaning, and heterodox social media influencers suggest an alternative form of faith.

Seeking Alternative Faith

The reasons behind the current wave of distrust in science and medicine are numerous. Of particular note is the way disease mitigation policies were communicated during the COVID-19 pandemic, which did a lot of harm. Then social media, polarisation, right-wing populism and left-wing postmodernism have all fed this lack of trust. Yet, fundamentally, health conspiracism stems from something deeper. With increasing levels of secularisation, in the absence of traditional religion, people will look elsewhere for meaning in their lives, allowing dietologies to step in to fill the void.

We’re living through a moment of profound spiritual and cultural upheaval marked by widespread secularisation. Data suggests that the share of Americans identifying as Christian dropped from 78 to 62 per cent from 2007 to 2024 [3]. While much of this shift is driven by the growth of the religiously unaffiliated, related measures of religious practice have also declined, including the share of Americans who pray daily or attend regular services.

These trends are not isolated to the US. Global secularisation affects Christianity, Islam, Judaism, Buddhism and Hinduism alike. A 2023 analysis of the World Values Survey data found that age and income are among the strongest predictors for decreasing religiosity, confirming that modern economic and demographic shifts correlate strongly with this decline [4]. The drop in traditional religious structures creates a spiritual void. This vacuum can then be filled by alternative spiritualities, existential searches or other belief systems that offer meaning, structure and a sense of the transcendent and nature mysticism.

As younger generations grow up without strong religious roots, their search for meaning might shift towards political, psychological or identity-based frameworks rather than centuries-old orthodox religions. While these new frameworks are influenced by contemporary cultural anxieties, they tend to be less stabilising and reassuring than traditional faith and wisdom. Studies of the culture wars indicate that, instead of offering equanimous guidance, these ideologies frequently contribute to an “us versus them” mindset, demanding allegiance to a specific side rather than fostering broad acceptance or spiritual integration [5].

Roots in Religion

While it’s intuitively plausible that alternative dogma can be found in things like nationalism, UFOlogy and the paranormal, why food? It’s quite a leap to go from praising a deity to worshiping a diet strategy! I suggest two key reasons why people are turning to online dietologies. Firstly, people are emotionally invested in their food choices. Human cultural evolution has given rise to a vast array of eating practices. Those food traditions that prevailed enabled social groups to flourish where they’d otherwise have struggled to acquire safe and sufficient protein and calories.

The second reason is even less obvious. As with other types of in-group thinking, people find solace in alternative ways of thinking about the world and in online groups. Being exposed to a narrative that suggests that you might not be responsible for your health can be comforting. When a health influencer with a compelling message and a high follower count pops up in your feed, you’re instantly presented with convenient answers to your ills. The brutal simplicity of their content makes their message highly convincing. Highly complex issues conveyed through simplistic but enticing narratives provide lots in the way of comfort but little in the way of reality.

Complicated and nuanced issues boiled down to bite-sized chunks tempt people into conspiratorial thinking. Yet this weltanschauung coddles a reduced dependence on intuitive judgement and common sense. Moreover, humanity’s immersion in the online world over the past couple of decades, coupled with political instabilities and increased polarisation, has amped up the sensational volume.

When bombarded with alternative and conflicting facts, people are left assuming that there’s more than one “truth” or, indeed, no such thing as truth. Thrown into the toxic information arena armed with precious few skills to discern what truth is, they’re increasingly likely to be pulled towards a heterodoxical narrative. When people lack the necessary tools to help them distinguish the credible from the fallacious, they tend to accept the alternative version of events primarily because of the accompanying powerful cultural and ideological framework. Ideology stamps out reality.

To some extent, this is understandable. Our ancestors developed heuristics to enable rapid decisions in uncertain environments. By spotting patterns and threats and navigating social hierarchies, these shared mental shortcuts allowed groups to act cohesively, for such tasks like identifying foods that are safe to eat, interpreting emotional cues and cooperating in collective tasks like hunting and gathering. Endowed with social cognitive tools, prehistoric humans could rapidly infer intentions, predict behaviour and synchronise their actions with others, often without conscious awareness. In this way, common knowledge is adaptive, providing a shared framework that increases survival, cooperation and cultural stability. As the psychologist Steven Pinker argues, common knowledge is foundational to human society because it enables social coordination and complementary decision making [6].

Information Avoidance

While it may seem paradoxical, people often engage in elaborate efforts to obscure, ignore or deliberately avoid acknowledging things that should be common sense. Moreover, they mostly do so without being aware. This tendency to bypass accepting widely shared knowledge is known as “information avoidance”. People do it because it’s comforting as it allows them to preserve existing beliefs, and might even bump up their social standing. Information avoidance acts as a coping mechanism in situations of uncertainty or threat, reducing cognitive dissonance and emotional discomfort [7].

Moreover, engaging in information avoidance does more than merely protect beliefs. It helps people align with a group ideology to secure a sense of belonging. According to Social Identity Theory, individuals derive meaning, status and self-esteem from the groups to which they belong [8]. By rejecting information that threatens their worldview, people set aside their personal instincts or empirical scepticism to be part of a community that claims to possess special insider knowledge. Aligning oneself with a group that asserts access to deeper truths or a more “awakened” understanding feels more meaningful and elevating to one’s identity than simply accepting the mundaneness of life. This might explain how online fitness ultracrepidarians, despite spouting tons of fallacistic bullshit, manage to amass millions of followers.

In addition, people often sidestep common sense by relying on cognitively unfalsifiable ideas preventing evidence from contradicting a claim. Epistemic shielding makes a claim immune to challenge: any lack of proof is simply reframed as what’s expected, since the phenomenon supposedly exists beyond mainstream thinking [9].

Although such admonitions as “wake up!” might appear useless to a rational thinker, they function as an end point, preventing the need for evidence to back up a claim. By setting aside common-sense reasoning and suspending rational doubts, individuals can fully engage with the group, strengthening both cohesion and commitment to shared beliefs. A claim that “aspartame causes cancer”, for example, is so broad that it’s unfalsifiable. The term “cancer” covers numerous diseases each with complex aetiologies. Aligning causality to one simple substance is ridiculous, but impossible to adequately falsify.

System Justification

A concept known as “system justification” offers another cogent explanation for why people override instinct even without empathy-driven motives. This psychological process leads individuals to defend and reinforce their worldview, even when it may run counter to their own interests [10]. No longer should institutional authority like governments, academia or the medical establishment be trusted. Rather, the conspiratorial standpoint becomes the only way of viewing the world. Distrust of institutions becomes the cultural status quo, and accepting the cover-up narrative functions as a way of justifying and maintaining the belief system [11]. Scientists and, consequently, science itself are not to be trusted. Believing that the medical establishment is either run by an elite cabal deliberately hiding knowledge or by incompetent “sheep” blindly adhering to their outdated methods aligns you with the modern order of suspicion and provides a kind of social intelligence. Trusting official explanations, on the other hand, appears naïve or irrational.

In some current Western contexts, where scepticism and distrust of institutions are amplified, psychologically normal people are more likely to accept conspiratorial explanations. Such an environment rewards suspicion, dramatic interpretation, assumes hidden motives and nurtures a psychological profile where certain stories are uniquely meaningful. You see this with online personalities who’ve been shunned by conventional medicine or have lost a high status they previously held. Armed with a new narrative – and a platform to spread their word to the masses – they can claim to be “in the know”. After all, they were once part of the establishment so they “know” how the system works. With a new mission, they have renewed relevance by exposing secrecy or ignorance.

Yet, this powerful way of restoring identity and meaning has a sinister side: it creates a blind spot for rational facts or instinct.

Faith in Food

Faith in something helps to fill the emptiness left by a lack of meaning. Without faith in a larger cosmic order – something greater than ourselves – younger generations are more likely to become attached to an ideology introduced to them on social media. This leaves them unattached to an embodied instinctual reality. As food culture is based on belief, nutrition conspiracism is particularly vulnerable to this style of reasoning.

This way of thinking might be ideological or it could merely be a yearning to see something formed from previous biases. People’s beliefs are part of their identity. We’re built with an almost infinite capacity to believe things because those beliefs have been advantageous for us to hold. Firm beliefs can come with a wilful disregard for facts that might change minds, simply because people fear having to change their worldview. This can be especially dangerous because conviction feels like a positive attribute. Communicating with nuance, on the other hand, can make you sound like you don’t know what’s going on.

When someone challenges a narrative by asking a question, it implies that they’re not a believer. Detached from reality, it might be that, deep down, these health ideologues and their disciples are aware that there’s no evidence for their claims.

When there’s no evidence for the thing you believe, the best strategy might be to invent your own epistemology.

Dietology is comforting.

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References:
1. (a) Uscinski, J. et al. (2022) ‘Have Beliefs in Conspiracy Theories Increased Over Time?’, PLoS One, 17(7), e0270429; (b) Osman, M. (2023) ‘Conspiracy Theories Aren’t on the Rise – We Need to Stop Panicking’, The Conversation, 19 June. Available at: https://theconversation.com/conspiracy-theories-arent-on-the-rise-we-need-to-stop-panicking-208033 (Accessed: 1 June 2026).
2. Collier, J. (2025) Well Fed: How Modern Diets Are Failing Us (and What We Can Do About It). London: Thorsons, p30.
3. Pew Research Center (2022) ‘1. How U.S. Religious Composition Has Changed in Recent Decades’, Modeling the Future of Religion in America. Available at: https://www.pewresearch.org/religion/2022/09/13/how-u-s-religious-composition-has-changed-in-recent-decades/ (Accessed: 1 June 2026).
4. Jafarigol, E. et al. (2023) ‘Religious Affiliation in the Twenty-First Century: A Machine Learning Perspective on the World Value Survey’, Society, 60, 733-49.
5. (a) Castle, J. (2018) ‘New Fronts in the Culture Wars? Religion, Partisanship, and Polarization on Religious Liberty and Transgender Rights in the United States’, American Politics Research, 47(3). https://doi.org/10.1177/1532673X18818169; (b) Pew Research Center (2015) U.S. Public Becoming Less Religious. Available at: https://www.pewresearch.org/religion/2015/11/03/u-s-public-becoming-less-religious/ (Accessed: 1 June 2026); (c) Hon, K. et al. (2022) ‘Culture Wars: The Divide’, OxJournal, 21 December. Available at: https://www.oxjournal.org/culture-wars-divide/ (Accessed: 1 June 2026).
6. Pinker, S. (2025) When Everyone Knows That Everyone Knows…: Common Knowledge and the Mysteries of Money, Power, and Everyday Life. New York, NY: Scribner.
7. Sweeny, K. et al. (2010) ‘Information Avoidance: Who, What, When, and Why’, Review of General Psychology, 14(4), 340-53.
8. Tajfel, H. and Turner, J. C. (1979) ‘An Integrative Theory of Intergroup Conflict’. In: Austin, W. G. and Worchel, S. (eds) The Social Psychology of Intergroup Relations (pp. 33–47). Monterey, CA: Brooks/Cole.
9. Friesen, J. P. et al. (2015) ‘The Psychological Advantage of Unfalsifiability: The Appeal of Untestable Religious and Political Ideologies’, Journal of Personality and Social Psychology, 108(3), 515-29.
10. Jost, J. T. et al. (2004) ‘A Decade of System Justification Theory: Accumulated Evidence of Conscious and Unconscious Bolstering of the Status Quo’, Political Psychology, 25, 881-919.
11. Douglas, K. M. et al. (2017) ‘The Psychology of Conspiracy Theories’, Current Directions in Psychological Science, 26(6). https://doi.org/10.1177/0963721417718261

Share James Collier

Everyone looks so great. When I look around this room, I can’t but wonder, “Is Ozempic right for me?”
- Jimmy Kimmel [1]

Back in the 1990s, dietary support for weight reduction was typically “eat less: move more”. Simple!

I hadn’t long qualified as a dietitian. Patients would rock up at my clinic and jump on the scales. They’d leave with a tailored diet plan, three or four goals and a few words of encouragement. The expectation was for them to have lost some weight by their next appointment. If they hadn’t, that was … well … their fault.

Okay, this description might lead you to feel that the patient experience was more impersonal than it actually was. NHS dietetic outpatient clinics weren’t quite this insipid. A good dietitian would be understanding and sympathetic with a patient’s situation. Indeed, I would rarely, if ever, hold a patient to a specific weight target; with a few doable goals, the hope was for weight loss to be a positive side effect.

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Clinically Libertarian?

I purposely depicted the dietetic clinic setting this way to make a point: when it came to obesity and other diseases of lifestyle, the patient was seen to be in control of their own health outcomes. It was the kind of outpatient protocol I’d been taught in my training. No wonder dietetic intervention for weight management was seldom very effective. While a dietitian would fully acknowledge that some folk find it harder to control their weight, the onus was on the individual to do the necessary work. If this meant someone had to put in more effort than others, that was just tough luck. The dietitian’s role was to advise and, to an extent, motivate; that was it. The consultation strategy was somewhat clinically libertarian: work hard, and you’ll reap the rewards. If you don’t, that’s on you. After all, living with obesity is a choice, right?

Naturally, the majority of my patients failed to maintain much weight loss. While a good practitioner would be compassionate, success and failure were ultimately down to the individual. In fact, in one hospital where I worked, it became policy for clients who hadn’t lost weight for three consecutive visits to be discharged, with the exception being for psychiatric patients where the goal was to limit excessive weight gain.

These days, it’s widely acknowledged that, for the vast majority, living with overweight and obesity is not a choice. As obvious as it sounds, no one is responsible for their own genetics, physiologies, upbringing and social circumstances. Neither do we, to a large extent, have much of a say about our surrounding food environment.

There are a bunch of converging reasons why it’s harder for some people to control their weight and how much they eat. This includes the hormones involved in metabolism and appetite regulation, such as the more familiar insulin, glucagon and leptin, and, until recently, the less well-known ghrelin, peptide-YY (PYY), cholecystokinin (CCK) and the two incretins, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

Olde Physick

While laxatives and purgatives have been touted for weight loss for millennia, the first true weight-reducing medicine was likely thyroid extract in the 1890s [2]. Slimming drugs became more widely used during the 1930s initially with 2,4-Dinitrophenol (DNP) and amphetamine sulphate, the latter marketed as Benzedrine, which was originally licensed as a nasal decongestant [3]. Both were swiftly banned due to potential dangers but can still be found on the black market today.

When I first learned about medical treatment for type 2 diabetes at uni, there was insulin, of course, as well as sulfonylureas, such as gliclazide and glibenclamide, and metformin. Both insulin and sulfonylureas could cause weight gain, exacerbating the underlying problem. Metformin was first introduced in France in 1957 but wasn’t approved to treat type 2 diabetes in the US until 1994 under the brand name Glucophage. Metformin is a biguanide anti-hyperglycaemic agent which decreases liver glucose production and increases tissue insulin sensitivity [4]. When it comes to body weight, metformin is either neutral or might lead to slight fat loss. It’s still a popular prescription medicine today, not only for diabetes, but also polycystic ovary syndrome. Controversially and off-label, metformin is also used as a performance-enhancing drug and for its purported anti-ageing benefits.

For weight control, drugs like orlistat and sibutramine came and went. Orlistat inhibits lipase enzymes allowing undigested fat to pass through the body [5]. Sibutramine works by increasing serotonin and noradrenaline (norepinephrine) levels to curb appetite [6]. Although orlistat is still available, it’s unpopular due to unpleasant side effects like oily stools, urgency to open bowels, abdominal pain and headaches. Sibutramine, however, was withdrawn from European and US markets in 2010 due to increased risks of heart disease and stroke [7].

Skinny Lizards

For more than 170 years, scientists have been avidly exploring the physiology of blood glucose, appetite and weight gain [8]. During the second half of the 19th century, the mental framework for what’s now referred to as “the incretin effect” was first described [9]. The incretin effect is the observation that glucose taken by mouth triggers a much stronger insulin response compared to intra-venous glucose by increasing the production of pancreatic hormones. The gut senses food and produces the incretins GLP-1 and GIP to tell the pancreas to get ready to take care of the calorie hit that’s on its way. In type 2 diabetes, the incretin effect is blunted, leaving sugar to float around the bloodstream for much longer.

Initially, GIP received little interest because it doesn’t work well in diabetic treatment. GLP-1, on the other hand, was found to be very effective by stimulating insulin release, suppressing glucagon and slowing the rate of stomach emptying. There is, however, a major problem: GLP-1 is rapidly destroyed by the enzyme dipeptidyl peptidase-4 (DPP-4) [10].

The first drugs developed to control diabetes via this system were DPP-4 inhibitors known as gliptins, such as sitagliptin (band name Januvia) and saxagliptin (Onglyza). Taken orally, these medications allowed GLP-1 to last longer before being degraded. Although well-tolerated, their in vivo ability to lower blood sugar is modest, and they have little effect on body weight [11]. What was really needed was a way to engineer degradation-resistant versions of GLP-1.

In the 1980s, while observing hormone-like drugs, Dr John Eng discovered that the gila monster – a venomous lizard native to the American Southwest – had a hormone in its venom, exendin-4, that was remarkably similar to human GLP-1 [12]. What Eng found to be particularly interesting was that extendin-4 was able to resist breakdown by DPP-4. This was the revolutionary discovery that later gave birth to GLP-1 agonist drugs.

Incretin Mimetics

GLP-1 agonists – also known as “incretin mimetics” – are a group of drugs that mimic the effects of the natural GLP-1 hormone. They lower blood glucose, help regulate appetite and promote weight loss by telling the pancreas to release more insulin when glucose is high, slowing the rate of gastric emptying and signalling to the brain to promote satiety. The first GLP-1 agonist, exenatide (Byetta), approved in 2005, required twice-daily injections [13]. But there was an even cooler observation: not only was exenatide effective in controlling blood sugar, it also produced weight loss.

Sensing that they were on to something huge, researchers doubled down and the pharmacology rapidly evolved. Next came once-daily injection liraglutide (Victoza, Saxanda) in 2009 [14], then once-weekly dulaglutide (Trulicity) in 2014 [15] and semaglutide under the brand names Ozempic for diabetes in 2017 [16], and Wegovy for weight loss in 2021 [17]. The most recent injectable GLP-1 agonist to be approved is tirzepatide, marketed as Mounjaro for diabetes in 2022 [18] and Zepbound for weight loss in 2023 [19]. Semaglutide and its predecessors act on the GLP-1 receptor; tirzepatide also acts on the GIP receptor, making it considerably more effective. Ozempic, Wegovy and Mounjaro are pretty much household names these days.

And Next?

There’s an even more effective incretin mimetic on its way that’s likely to boost the popularity of these drugs even more. Retatrutide is a once-weekly injectable that, in addition to GLP-1 and GIP, also acts on the glucagon receptor. For this reason, it’s been termed a “triple-hormone receptor agonist” or “triple-G” [20]. Alongside reducing appetite and slowing digestion, by acting on glucagon, retatrutide also increases energy expenditure and fat breakdown. The expectation is for it to be superior for weight loss and metabolic control. Although still undergoing final stage trials, approval is expected by early 2027 at the latest.

Although not yet legally available for sale or prescription, retatrutide is easily obtained online under the guise of “research-grade”. There are obvious risks here. Not only is the safety and effectiveness of retatrutide unproven, but unlicensed counterfeits might be underdosed, overdosed or even contaminated. I have several friends who’ve obtained and seem to be successfully using retatrutide, claiming it to be way superior to tirzepatide.

Sticking a needle in yourself isn’t for everyone, so drug companies have an obvious incentive to create oral incretin mimetics. In late 2025, Novo Nordisk received approval in the US for a once-daily oral version of semaglutide, under the brand names Wegovy for weight loss and Rybelsus for diabetes [21].

And, as recently as April 2026, Eli Lilly got approval for a new compound called orforglipron under the brand name Foundayo [22]. Orforglipron is a once-daily pill that, like semaglutide, acts on the GLP-1 receptor alone. However, the drug’s chemistry is very different: it’s what’s known as a “small molecule” drug. Orforglipron’s low molecular weight means that it isn’t broken down by stomach acid, so, unlike oral semaglutide, it doesn’t need to be taken after fasting and with loads of water.

Other drugs under investigation, and possibly in the pipeline for the next couple of years, include CagriSema, based on cagrilintide (which suppresses appetite by targeting the amylin receptor) and semaglutide; survodutide, which targets the GLP-1 and glucagon receptors; and MariTide, a once-monthly GLP-1 and GIP agonist injection.

As the massive financial incentives for the drug conglomerates continue to entice, the weight loss drug market is set to continue its exponential growth trajectory. The multi-billion-dollar question is: what’s coming next?

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References:
1. O’Brien, S. A. (2023) ‘The Name on Everybody’s Lips at the Oscars: Ozempic’, The Wall Street Journal, 13 March. Available at: https://www.wsj.com/livecoverage/oscars-academy-awards-2023/card/the-name-on-everybody-s-lips-at-the-oscars-ozempic-YpUAWmnqxjCUAJOnfP0O (Accessed: 14 May 2026).
2. Bray, G. A. and Purnell, J. Q. (2022) ‘An Historical Review of Steps and Missteps in the Discovery of Anti-Obesity Drugs’. In: Feingold, K. R. et al. (eds) Endotext. Available at: https://www.ncbi.nlm.nih.gov/books/NBK581942/ (Accessed: 14 May 2026).
3. (a) Parascandola, J. (1974) ‘Dinitrophenol and Bioenergetics: An Historical Perspective’, Molecular Cellular Biochemistry, 5, 69-77; (b) ibid (2).
4. (a) Bailey, C. J. (2017) ‘Metformin: Historical Overview’, Diabetologia, 60, 1566-76; (b) Corcoran, C. and Jacobs, T. F. (2023) ‘Metformin’. StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK518983/ (Accessed: 14 May 2026).
5. Bansal, A. B. et al. (2024) ‘Orlistat’. StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK542202/ (Accessed: 14 May 2026).
6. Araújo, J. R. and Martel, F. (2012) ‘Sibutramine Effects on Central Mechanisms Regulating Energy Homeostasis’, Current Neuropharmacology, 10(1), 49-52.
7. (a) European Medicines Agency (2010) ‘European Medicines Agency Recommends Suspension of Marketing Authorisation for Sibutramine’, 22 January. Available at: https://www.ema.europa.eu/en/news/european-medicines-agency-recommends-suspension-marketing-authorisation-sibutramine (Accessed: 14 May 2026); (b) Lowes, R. (2010) ‘FDA Announces Sibutramine Has Been Withdrawn From the Market’, Medscape, 15 October. Available at: https://www.medscape.org/viewarticle/730515 (Accessed: 14 May 2026).
8. Karamanou, M. et al. (2016) ‘Milestones in the History of Diabetes Mellitus: The Main Contributors’, World Journal of Diabetes, 7(1), 1-7.
9. Rehfeld, J. F. (2018) ‘The Origin and Understanding of the Incretin Concept’, Frontiers in Endocrinology, 9, 387.
10. Holst, J. J. (2007) ‘The Physiology of Glucagon-Like Peptide 1’, Physiological Reviews, 87(4), 1409-39.
11. Cleveland Clinic (2025) DPP-4 Inhibitors. Available at: https://my.clevelandclinic.org/health/treatments/dpp-4-inhibitors (Accessed: 14 May 2026).
12. ibid (10).
13. Bond, A. (2006) ‘Exenatide (Byetta) as a Novel Treatment Option for Type 2 Diabetes Mellitus’, Baylor University Medical Center Proceedings, 19(3), 281-4.
14. The British Journal of Cardiology (2009) ‘Liraglutide: Novel Drug for Type 2 Diabetes Launched’, July. Available at: https://bjcardio.co.uk/2009/07/liraglutide-novel-drug-for-type-2-diabetes-launched/ (Accessed: 14 May 2026).
15. Fala, L. (2015) ‘Trulicity (Dulaglutide): A New GLP-1 Receptor Agonist Once-Weekly Subcutaneous Injection Approved for the Treatment of Patients with Type 2 Diabetes’, American Health & Drug Benefits, 8, 131-4.
16. Dhillon, S. (2018) ‘Semaglutide: First Global Approval’, Drugs, 78(2), 275-84.
17. Drugs.com (2026) Wegovy FDA Approval History. Available at: https://www.drugs.com/history/wegovy.html (Accessed: 14 May 2026).
18. Drugs.com (2026) Mounjaro FDA Approval History. https://www.drugs.com/history/mounjaro.html (Accessed: 14 May 2026).
19. US Food & Drug Administration (2023) ‘FDA Approves New Medication for Chronic Weight Management’, 8 November. Available at: https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management (Accessed: 14 May 2026).
20. Bradshaw, R. (2026) ‘What Is Retatrutide (Triple G)?’, Oxford Online Pharmacy, 26 January. Available at: https://www.oxfordonlinepharmacy.co.uk/blog/what-is-retatrutide-triple-g (Accessed: 14 May 2026).
21. (a) Novo Nordisk (2025) ‘Novo Nordisk A/S: Wegovy® Pill Approved in the US as First Oral GLP-1 for Weight Management’, 22 December. Available at: https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=916472 (Accessed: 14 May 2026); (b) Morales-Brown, P. (2026) ‘New Ozempic Pill May Offer More Affordable Alternative to Injectables’, MedicalNewsToday, 5 May. Available at: https://www.medicalnewstoday.com/articles/new-ozempic-pill-may-offer-more-affordable-alternative-to-injectables (Accessed: 14 May 2026).
22. Roy, S. (2026) ‘Lilly’s Obesity Pill Draws 1,390 US Prescriptions in Launch Week’, Reuters, 17 April. Available at: https://www.reuters.com/legal/litigation/lillys-foundayo-hits-1390-prescriptions-debut-week-2026-04-17/ (Accessed: 14 May 2026).

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You may have seen me banging on about how good fibre is and that we’re in a fibre crisis. Most of us underindex on fibre because it’s too often seen as a nice-to-have rather than the essential nutrie…

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When people thought the earth was flat, they were wrong. When people thought the earth was spherical, they were wrong. But if you think that thinking the earth is spherical is just as wrong as thinking the earth is flat, then your view is wronger than both of them put together.
- Isaac Asimov [1]

Let me tell you about my first run-in with a nutritionist who was giving out shoddy information.

It was early in my career, back in the late 1990s, while I was working as a dietitian at Northampton General Hospital. Ignoring the warnings from my colleagues, I attended a local seminar by a “nutritionist”. Much of the information the nutritionist relayed was highly questionable, and her claims lacked evidence. Although I was a young, unconfident and inexperienced dietitian, I felt compelled to call her out. So, during the Q&A, I spoke up and raised my objections. Silence fell across the auditorium! The other delegates turned to glare at this young, cocky guy who’d dare to challenge the expert.

Her response was defensive, akin to “I know what I’m talking about”, providing no justification for her claims. And to shut me down, the event’s presenter interjected with a blunt assertion: “[she] is one of the UK’s top nutritionists!”, as if to validate everything her colleague had said. No further rationale required – accuracy and truthfulness weren’t up for debate. The presenter’s comment worked: I felt my cheeks flush and I said nothing further. I crept away shortly after. Back at work the next day, I explained what had happened to my colleagues and was met with: “We told you so!”

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At the time, I hated the altercation; I felt uncomfortable, embarrassed and alone. Yet, even then, I was glad I spoke out. Indeed, the incident might have been pivotal in my career. This was around the time I first started to really acknowledge the importance of being sceptical, staying true to one’s values and noticing that even the qualified and seemingly credible are prone to sharing crap advice.

On Being Qualified

We should be wary of people when they rely on their qualifications and credentials to reinforce their credibility. It’s known as “appealing to authority”. But, what does “being qualified” even mean? Take me: I’ve a mere undergraduate degree in Nutrition; no PhD and I don’t work in academia. Should people take me seriously when it comes to food, nutrition and related health topics?

First, let’s look at what I’ve got going for me. I’ve a recognised qualification in nutrition. I’m a Registered Nutritionist: a title that rightly affords trust. I’ve worked in nutrition, healthcare, fitness and food for more than 30 years, including several years as a clinical dietitian in the NHS. I’ve worked with pro bodybuilders, strongmen and athletes, some of whom were household names. I’m co-founder and the original nutritionist at Huel, a hugely successful nutrition brand. I’m also a published author; my book, Well Fed: How modern diets are destroying us (and what we can do about it), was backed by a major publishing house: HarperCollins. I’ve been in the press and on major podcasts. Do these factors mean people should take me seriously?

While all of the above should support my credibility, nothing there should imply that the advice I share should readily be accepted as correct. I lack experience in many areas of the vast subject of food and nutrition. It would be incredibly arrogant of me to assume people should accept my word just because I have a nutrition qualification, am a Registered Nutritionist, have years of experience, have worked with pros, am a food business co-founder, am a published author and have had a bit of media attention. Indeed, it would be dangerous for people to unquestionably accept my word as gospel. Sure, credentials, experience and portfolio are important, but each piece of nutrition-related information should be judged on its own merits. My credibility and trustworthiness should be based on people’s experiences of me through the authenticity of my information.

I’m no expert. Indeed, when it comes to nutrition as a whole, I’m not sure anyone can be. It’s just too massive a subject. True experts spend decades mastering one niche within nutrition science. My skill is in knowing quite a bit about a wide range of different areas of food and nutrition. True expertise takes years and requires thousands of hours of experience to acquire the depth of knowledge required.

Yet, there are “experts” – qualified nutritionists, dietitians and health advisors – who give highly questionable advice. Conversely, challenges made by unqualified people often lead to further examination of a line of enquiry, with experts later revising their position.

This perspective isn’t restricted to nutrition science; it applies to any discipline. One doesn’t need qualifications or even much experience to be able to contribute to any subject. Expertise and credentials are important, of course, but less so than intellectual honesty, integrity, humility and open-mindedness.

While I’ll continue to avidly urge people to heed the advice of true experts – I’ve previously lamented the loss of expertise which, after all, indicates considerable experience in a field – contributions from non-experts can also be taken seriously when their opinions are backed by a clear rationale and, where appropriate, evidence and references. Nevertheless, where I feel I can add value, I will share my opinions on topics outside of the realm of food and nutrition. While I hope a lot of what I share will be correct, I equally hope to get some things wrong.

Being Wrong

Conversation is a beautiful thing: a gift from evolution that’s enabled our species to share ideas and progress. While expressing opinions can be polarising – particularly in the current climate – sharing ideas encourages other perspectives. Disagreement shouldn’t be about one-upmanship or winning a debate. It’s about seeking clarification and urging others to elaborate. Reason and rationality are the road to truth. My goal is to promote broader thinking and to encourage others to think more critically, irrespective of whether they agree with another perspective.

People can be wrong in different ways and to different degrees: “wrongness”. We will all get things wrong. Assuming that we’re right about everything all the time isn’t being confident or bold; it’s arrogant and concerning. Refusing to accept when we’re wrong isn’t a virtue; it’s dangerous. Not acknowledging when you’re wrong in the face of evidence to the contrary in many ways is akin to the behaviour of a malevolent dictator. Autocrats refuse to be wrong, are self-deluding, expect their subjects to adhere to their rules, forbid disagreement and punish those who object. Pig-headedness might not be as consequential, but it still feeds polarisation.

When people disagree with my views, I want to know why. Naturally, a flippant “you’re wrong” comment will be readily dismissed. But if I were to state something that’s demonstrably false, I should be corrected.

Changing your mind as a response to new evidence is virtuous. Learn from your errors and embrace the quest for wrongness.

Knowledge Equals Four Times Pi Times Radius Length Squared

The more we learn, the more we realise just how much we don’t know. As scientific discovery progresses, there are things we now know that hadn’t even previously been considered. Not only did we not know them, we were unaware that they were things that could be known. This shows us that there’s even more out there that can be known.

Let’s use an analogy. Assume the surface area of a sphere is what you know: your current knowledge. The amount of knowledge could be represented by the following equation:

Knowledge = 4𝜋r²

Your current knowledge state is the surface area (𝜋) of a sphere. What you’re aware that you don’t know is what’s inside. Your learning line is the sphere’s radius (r). As you learn more, the radius gets longer, which expands the surface area by squaring it. Because by knowing more, the surface area expands, the increase in volume is cubed, and you realise that what you don’t know is bigger:

Awareness of Lack of Knowledge = (4/3)*𝜋*r³

Scale up this metaphor to all the knowledge that humankind has acquired. That’s one massive sphere: there’s a lot that we don’t know.

Knowledge can be the fear of the unknown. Some who fear knowledge instead leave ideas to faith. To quote the biologist and science writer, Richard Dawkins: “Faith is belief in spite of, even perhaps because of, the lack of evidence” [2]. People fear change. Not only does change bring uncertainty, but it also reveals an awareness of it.

But isn’t it better to embrace what we don’t know and use it to drive us to want to know more?

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Realise Your Biases

The act of writing and publishing an article forces me to carefully consider my ideas. It helps to hold me to account, forcing me to acknowledge my biases. We all have biases. All we can do is be aware of them and realise that we will fall foul of them.

Let’s combat bad ideas, not through censorship, but with better ideas. Let’s try to be more objective and question our own biases. Let’s use reason and rationality to increase our knowledge and accept that there will be more that we don’t know. Let’s share ideas and judge their credibility on their own merit. Let’s aim to value objective truth above all else but accept when we’re wrong. Let’s accept that being wrong can be beneficial and that there’s no such thing as “losing an argument”. Let’s embrace wrongness.

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References
1. Asimov, I. (1989) The Relativity of Wrong. Oxford: Oxford Paperbacks.
2. Dawkins, R. (2006) The God Delusion. London: Black Swan.

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Bread gets a bad wrap*. Back in the nineties, during the anti-carb era when the Atkins diet was the dominant dietary ideology, I’d often hear people slating bread. Then things seemed to die down a bit and bread enjoyed a brief boost in popularity. But just when I thought bread loathing had been relegated to the past, TikTok and Instagram reels introduced a new wave of conflicting dietologies – many of the nutrition populism persuasion – and bread was back on the slicing board. This time, however, bread hostility isn’t just being spread by starch sceptics, but by grain-shunning carnivores and paleo diet advocates too. As well as this, bread hesitancy stems from the fact that many modern loaves contain more than four ingredients, a feature that places them neatly into the category of “ultra-processed food”.

If you’re unfamiliar with my work, you may not have come across “dietology”. In Well Fed: How modern diets are destroying us (and what we can do about it), I introduce the term. A portmanteau of “diet” and “ideology”, “dietology” refers to particular dietary beliefs that are based on ideology rather than evidence [1]. (Read more.)

Is there any merit to these bread-bashing fashions, or is bread fearmongering simply dietology?

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More Than Four

Shop-bought breads, whether white, brown, wholemeal or seeded, are snubbed due to their long ingredient lists that include words that, it’s claimed, “your grandmother wouldn’t recognise”. On multiple podcasts and interviews, in several articles, like A Processed Mindset, Unprocessing the Ultra-Processed Mindset and Processing Terminology, and in Well Fed, I’ve voiced my objections to the flippant use of the term “ultra-processed food” and how the NOVA categorisation is used Bread provides a useful example to highlight the problem of classifying foods using labels.

Food conservatives assert that bread “should” be produced with just four ingredients: flour, water, salt and leaven (yeast). While the claim is a valid historical generalisation, most modern loaves include additional ingredients, such as preservatives, emulsifiers and added micronutrients. Preservatives boost a bread’s shelf life, allowing it to be stored for longer. This helps economies of scale in manufacture and efficiency in supply chains, helping to lower production costs, making bread cheaper to produce and more affordable for consumers.

Emulsifiers also help to prolong shelf life, but their key function is to aid the baking process enhancing the mouthfeel of the final product. Vitamins and minerals are added to make up for unavoidable losses from the grain during milling and baking, or because research-backed food policy recommends or mandates their inclusion, such as the fortification of flour with folic acid. These modern developments should be celebrated rather than demonised; being able to choose from a diverse range of pleasant and affordable breads with a longer shelf life is an all-too-often unappreciated marvel of modern science. While some brands add flavour enhancers, sweeteners and emulsifiers to enhance a loaf’s organoleptic qualities making it more enjoyable, there is a valid concern that encouraging overconsumption might contribute to weight gain with the associated health risks. Nevertheless, just because a loaf has more than four ingredients doesn’t mean that there’s anything unhealthy about it.

For some reason, sourdough breads seem to get a pass, successfully sidestepping much of the anti-bread fervour, at least from some dietological factions. Most sourdoughs only require an active starter, flour, water and salt in the baking process, and a sourdough loaf made with a strong flour and then covered and stored at room temperature can remain edible for a few days, negating the need for preservatives. Yet plenty of sourdough loaves are baked with more than four ingredients: some contain preservatives, vinegar and sugars. Such loaves might be referred to as “sourfaux”.

What History Tells Us

No one knows for certain when the first bread was eaten, but its essential role in society has existed since prehistoric times, predating farming. Evidence that our ancestors were grinding grains between stones – what we now call “milling” – dates back at least 30,000 years [2]. The oldest known bread has origins around 14,500 years ago, discovered in Jordan’s northeastern desert [3]. The first leavened bread – using yeast to make it rise – is credited to Mesopotamians as early as 6,000 BCE [4], though bread-making didn’t really take off until the ancient Egyptians started baking around 5,000 years ago [5]. Early breads were dense, rustic flatbreads, likely very different to the puffed-up loaves we enjoy today. By the peak of ancient Egypt and during the Roman Empire, bread was firmly a staple of most people’s diet.

Even the Ancient Greeks and Romans were making multiple varieties of bread by incorporating additional ingredients like honey, oils or seeds [6]. And during the Middle Ages, people were baking with more than the main four, such as eggs, milk, butter and a range of spices, to aid in flavour and shelf life [7].

Bread fortification began in the 1940s as a strategy to combat malnutrition [8], and the Chorleywood process in 1961 revolutionised mass production, by using emulsifiers, fats and enzymes to amplify production and extend shelf life [9].

What Language Tells Us

Early word lists compiled by Anglo-Saxon monks reveal a number of bread-related references. Breadru, for instance, translates Latin frustra meaning “bits, pieces, morsels”, and manna, found in the bible, is translated by the phrase heofenlic hlaf: “heavenly bread”. Today, the word hlaf would be recognised as loaf, as the h stopped being pronounced at the end of the Anglo-Saxon era, and the long “ah” sounds morphed into “oh” during the Middle Ages [10].

Bread’s importance is illustrated by Old English terms. The head of a household was known as a hlaf-weard (“bread-warden”), i.e. the individual who provides bread for everyone. A hlaf-œta (“bread-eater”) was the term for a dependent, and a hlœfdige (“bread-kneader”) was a lady – the -dige ending evolved into “dough”. During the 14th century, hlaf-weard morphed first into something that sounded like “lahrd”, then to “laird” in Scotland and eventually to “lord”, giving us a modern English term related to high status that has its origins in humble bread [11].

The prominence of bread is also demonstrated in religion. Hlaf, for instance, is found in a number of Christian settings, such as hlaf-mœsse (“loaf-mass” became Lammas, the first day when eucharistic bread was baked from the harvest), hlaf-gang (“bread-going”, walking to the altar to receive communion), and hlaf-hus (“house of bread”: Bethlehem, where Jesus was born) [12].

In modern English, the word “bread” is used for much more than foodstuffs, as reflected in a range of compound words and idioms, such as breadwinner and give us this day our daily bread. Cockney rhyming slang has supplied “bread” to mean “money” (from bread and honey) and “loaf” for “head” (from loaf of bread). It can identify a state of mind, as in knowing on which side one’s bread is buttered, or how we rate something: the best things since sliced bread. The term to break bread is to sit and share a meal and to reconcile past ill feelings.

What bread’s history and the etymology of bread-associated terms tell us is that the impact of bread as a staple in human diets has been so huge that its influence stretches to non-food-related language, religion and hierarchy. Bread has been crucial to human physical, social and cultural evolution for millennia.

What Genetics Tells Us

Another common claim made by bread bashers is that Homo sapiens aren’t evolved to digest large amounts of starchy carbs. But if humans aren’t supposed to consume much starch, how do we explain the AMY1 gene?

Starch digestion involves the enzyme amylase, secreted both in saliva and from the pancreas. Amylase breaks down the long polysaccharide chains that make up starch to the disaccharide maltose, which, further along the alimentary canal, is itself broken down into two molecules of glucose. Glucose is the form of energy preferred by our brains and bodies, and starchy foods are a predominant feature of the vast majority of people’s diets across the globe, whether from rice, corn, wheat, potatoes or other cereals.

The number of copies of the AMY1 gene – which codes for salivary amylase – varies across populations and individuals. The more copies of the AMY1 gene that are expressed, the more salivary amylase is present and the more efficiently someone is able to break down starch [13]. Populations who grew to depend more and more on growing their calories in the form of cereals and grains benefited from a mutation where more AMY1 was expressed. With more salivary amylase present, more starch can be hydrolysed in the mouth, making it easier to extract its valuable calories. This mutation proved beneficial for our forebearers as they became increasingly dependent on starch for nourishment. Those with the ability to digest starch more effectively benefited and had a reproductive advantage.

Fibre Opportunity

The health benefits of fibre are well-known [14], yet most of us aren’t consuming anywhere nearly enough. Only nine per cent of UK adults get the recommended 30 grams per day, with most failing to meet the amount a five-year-old needs [15]. In the US, only five per cent of men and nine per cent of women are getting sufficient amounts [16]. Moreover, studies have shown that fibre-rich wholegrains are associated with a lower risk of chronic disease [17].

Wholegrain breads can be really useful for bumping up your fibre intake. In the UK, bread contributes 17 to 21 per cent of daily fibre intake [18], and in the US, it makes up roughly 12 per cent [19]. I opt for wholemeal or seeded breads where possible. I do, on occasion, eat other types, but when the only breads available are white, I see it as a lost opportunity to consume beneficial fibre.

Food Fearmongering

Influencers whose content involves fearmongering foods – such as by claiming that a food “contains toxins”, “causes inflammation” or “spikes insulin” – seek only to prompt outrage through clickbait. Whether they do so for financial gain, to gain notoriety or to push their nutrition ideology, this type of content is potentially dangerous. These folk don’t care if they’re promoting disordered eating, pushing suboptimal diets, encouraging less sustainable eating or confusing their audience. And they’re oblivious to the fact that by posting scaremongering content, they’re displaying their lack of awareness of any historical, cultural and real-world significance of the foods they’re dissing. The bread example exposes this detachment from reality.

Bread is by no means essential in most modern societies, at least from a nutritional point of view. But, by exploring bread’s history and etymology, we can demonstrate the futility of bread fearmongering. Even my very brief summary reveals how the flippant denigration of bread fails to acknowledge the integral role bread has had in human cultural – and physical – evolution.

In the same way that anti-bread dogma is based on little more than ideology, we can apply this mindset to other foods and dietary patterns. When you come across someone vilifying any food, demand evidence for their assertion, and be mindful that the food in question might have a protracted history and significant cultural relevance. Rather than accepting what you hear, pause and ponder that there’s likely a lot more to the food. Use your loaf!

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* I couldn’t resist an early pun!

Notes & References:
1. Collier, J. (2025) Well Fed: How Modern Diets Are Failing Us (and What We Can Do About It). London: Thorsons, p30.
2. Revedin, A. et al. (2010) ‘Thirty Thousand-Year-Old Evidence of Plant Food Processing’, Proceedings of the National Academy of Sciences, 107(44), 18815-19.
3. Arranz-Otaegui, A. et al. (2018) ‘Archaeobotanical Evidence Reveals the Origins of Bread 14,400 Years Ago in Northeastern Jordan’, Proceedings of the National Academy of Sciences, 115(31), 7925-30.
4. Paulette, T. (2020) ‘Fermentation in Ancient Mesopotamia, Beer, Bread, and More Beer’, Fermentology, 18 June. Available at: https://fermentology.pubpub.org/pub/ae89zkf2/release/1 (Accessed: 4 April 2026).
5. Samuel, D. (1994) An Archaeological Study of Baking and Bread in New Kingdom Egypt. PhD thesis. University of Cambridge. Available at: https://www.repository.cam.ac.uk/items/900e5220-60cf-47b3-b640-3126121cf5cf (Accessed: 4 April 2026).
6. (a) Monaco, F. (2018) ‘Baking Bread with the Romans: Part IV – An Ancient Roman Recipe for Cato’s Grape Must Cakes (Mustacei)’, Tavola Mediterranea, 22 September. Available at: https://tavolamediterranea.com/2018/09/22/baking-bread-romans-part-v-grape-must-cakes/ (Accessed: 4 April 2026); (b) Chrysopoulos, P. (2026) ‘The 72 Breads of Ancient Greece You’ve Never Heard Of’, Greek Reporter, 31 January. Available at: https://greekreporter.com/2026/01/31/ancient-greek-bread/ (Accessed: 4 April 2026).
7. Medievalists.net (2024) ‘Bread in the Middle Ages’, 6 March. Available at: https://www.medievalists.net/2024/03/bread-middle-ages/ (Accessed: 4 April 2026).
8. BakeryBits (2023) ‘So What Is Flour Fortification in the UK?’, 25 January. Available at: https://www.bakerybits.co.uk/bakers-blog/what-is-flour-fortification (Accessed: 4 April 2026).
9. BBC News (2011) ‘Chorleywood: The Bread That Changed Britain’, 7 June. Available at: https://www.bbc.co.uk/news/magazine-13670278 (Accessed: 4 April 2026).
10. Crystal, D. (2011) The Story of English in 100 Words. Profile Books, pp10-13.
11. ibid (10).
12. ibid (10).
13. (a) Perry, G. et al. (2007) ‘Diet and the Evolution of Human Amylase Gene Copy Number Variation’, Nature Genetics, 39, 1256-60; (b) Mandel, A. L. et al. (2010) ‘Individual Differences in AMY1 Gene Copy Number, Salivary α-Amylase Levels, and the Perception of Oral Starch’, PLOS ONE, 5(10), e13352; (c) Carpenter, D. et al. (2017) ‘Copy Number Variation of Human AMY1 Is a Minor Contributor to Variation in Salivary Amylase Expression and Activity’, Human Genomics, 11, 2.
14. Examples: (a) Chen, J.-P. et al. (2017) ‘Dietary Fiber and Metabolic Syndrome: A Meta-Analysis and Review of Related Mechanisms’, Nutrients, 10(1), 24; (b) Barber, T. M. et al. (2020) ‘The Health Benefits of Dietary Fibre’, Nutrients, 12(10), 3209; (c) Ramezani, F. et al. (2024) ‘Dietary Fiber Intake and All-Cause and Cause-Specific Mortality: An Updated Systematic Review and Meta-Analysis of Prospective Cohort Studies’, Clinical Nutrition, 43(1), 65-83.
15. (a) British Nutrition Foundation (2023) Fibre. Available at: https://www.nutrition.org.uk/nutritional-information/fibre/ (Accessed: 4 April 2026); (b) Kehoe, L. et al. (2023) ‘Food and Nutrient Intakes and Compliance with Recommendations in School-Aged Children in Ireland: Findings from the National Children’s Food Survey II (2017–2018) and Changes Since 2003–2004’, British Journal of Nutrition, 129(11), 2011-24; (c) Boyle, N. B. et al. (2024) ‘Increasing Fibre Intake in the UK: Lessons from the Danish Whole Grain Partnership’, British Journal of Nutrition, 131(4), 672-85.
16. ASN Staff (2021) ‘Most Americans Are Not Getting Enough Fiber in Our Diets’, American Society for Nutrition, 9 June. Available at: https://nutrition.org/most-americans-are-not-getting-enough-fiber-in-our-diets/ (Accessed: 4 April 2026).
17. Examples: (a) Aune, D. et al. (2016) ‘Whole Grain Consumption and Risk of Cardiovascular Disease, Cancer, and All Cause and Cause Specific Mortality: Systematic Review and Dose–Response Meta-Analysis of Prospective Studies’, BMJ (Clinical Research Ed.), 353, i2716; (b) Benisi-Kohansal, S. et al. (2016) ‘Whole-Grain Intake and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies’, Advances in Nutrition, 7(6), 1052-65.
18. Lockyer, S. and Spiro, A. (2020) ‘The Role of Bread in the UK Diet: An Update’, Nutrition Bulletin, 45(2), 133-64.
19. (a) Hoy, M. K. and Goldman, J. D. (2014) ‘Fiber Intake of the U.S. Population’, Food Surveys Research Group Dietary Data Brief, 12. Available at: https://www.ars.usda.gov/arsuserfiles/80400530/pdf/dbrief/12_fiber_intake_0910.pdf (Accessed: 4 April 2026); (b) Ribet, L. et al. (2025) ‘The Nutritional Contribution and Relationship with Health of Bread Consumption: A Narrative Review’, Critical Reviews in Food Science and Nutrition, 65(28), 5698-725.

Ideally, we should be making rational decisions when choosing what to eat rather than being blindly led by food cues.

Having some understanding of the food-related issues outlined in my book Well Fed:…

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It’s been almost 170 years since the German statistician Ernst Engel analysed the budgets of Belgian working-class families and came up with a fundamental economic principle. Now one of the oldest measures of economic development, Engel’s law tells us that as household income increases, the percentage of that income spent on food decreases, even if the absolute amount spent on food increases.

“As family income increases, the percentage spent for food decreases, that spent for clothing, rent, heat, and light remains the same, while that spent for education, health, and recreation increases” [1].

Engel identified his measure using data that had been pulled together by others in the 1850s. Édouard Ducpétiaux, a Belgian journalist, compiled household budgets from 199 families across all nine provinces of Belgium, and the French sociologist, Frédéric Le Play, collected comparable information from 36 families around Europe. Engel later remarked that Ducpétiaux and Le Play had “provided the pearls”, but not “the string” [2]. What connected their data, he revealed, was a reliable pattern between household income and spending on food. When this principle was revisited 150 years later, US economist Richard Anker found that the same relationship remained visible across more than 200 countries [3].

The United Nations (UN) uses the Engel coefficient – the ratio of food spending to total spending – as a measure of a nation’s standard of living. A high coefficient indicates a lower standard. From this, the UN categorises thresholds ranging from “wealthy” (less than 30 per cent of household expenditure spent on food), to “poverty” (over 59 per cent) [4]. Nigeria records the highest Engel coefficient: households doled out 59.3 per cent of their total income on food in 2023. Other big spenders include Myanmar, Bangladesh, Laos, Venezuela, Kazakhstan and Angola. At the other end, the US is the world’s lowest spender at just 6.4 per cent of income in 2023, followed closely by Singapore at 7 per cent. The UK sits at around 8.7 per cent; Ireland at 8.6 per cent [5].

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Digging Deeper

This widely accepted notion that, as wealth increases, the proportion of income spent on food decreases is worth a deeper examination. On a macroeconomic level, Engel’s law predicts that as countries grow wealthier, their agricultural sector will decline as a share of total economic activity while services and manufacturing expand. This implies that the income elasticity of demand for food is between 0 and 1, categorising it as a “necessity” rather than a “luxury”, which has an elasticity >1 [6].

On the one hand, this makes sense. As food takes up a smaller share of the budget, families can increase their spending on things like education, recreation and health. We buy food for sustenance and when we have enough, we shouldn’t need to spend much more on it. However, the reality of the modern world isn’t so simple. As income increases, mindsets alter with wealthier households shifting towards higher-quality, more expensive items, like swapping cheaper grains for protein-rich meats and fish or buying more convenience foods. And people tend to eat more.

Modern Limitations of Engel’s Law

With this in mind, the Engel coefficient has drawbacks when it’s used to compare the food spending of nations.

Inflation:
Engel’s law is vulnerable to inflation. Food constitutes the largest share of a low-income family’s budget, making them disproportionately affected by rising agricultural prices, which can cause the coefficient to spike even if their nominal income stays the same.

Dietary Shifts:
The law is sensitive to changes in dietary shifts. For example, an influx of expensive processed foods or fancy produce imported from abroad can keep the coefficient high even as real income rises, potentially masking improvements in wealth. Studies in some Central and Eastern European countries have shown a stabilisation or slight increase in food share despite rising incomes, likely due to the rapid adoption of Western-style diets [7].

Dining Out:
Another wrinkle in Engel’s law is dining out. When people eat at a restaurant, café or stall, they’re buying more than food: they’re also paying for the cooking, washing-up, being waited on and ambience. A recent article in The Economist reports on a US researcher who bought noodles and steamed buns in street markets in Xi’an, a city in western China, then visited McDonald’s and Outback Steakhouse in Massachusetts. He weighed their ingredients, estimated their cost and calculated that the Chinese street food cost up to 30 per cent more than a similar meal at home. McDonald’s cost 150 per cent more and the steak 233 per cent extra [8]. This tells us that when restaurant meals are included in calculations of Engel’s law, the weight of food spending may be overstated, yet excluding them risks the opposite danger.

How different countries report out-of-home food spending therefore adds unreliability to comparisons of Engel’s coefficients. This could only be solved by estimating the weight of food at restaurant and catering services to provide a more reliable coefficient comparison. Not an easy task.

Food Waste:
Then there’s the food that’s thrown away. People don’t eat all the food they buy. When it comes to food waste, the Maldives is the worst offender, with each household wasting a whopping 207 kg per year in 2024. Mongolians are way more frugal, wasting just 18 kg. The UK and US fair moderately at 76 and 73 kg a year, respectively. And considering that they spend a huge amount of their dosh on food, Nigerians waste a lot: 113 kg per household per year [9].

Reasons for the huge variation in food waste are numerous. Policies, prevailing industries (tourism wastes a lot of food, and the figures are reflected in per-household figures, which may explain the humongous Maldives figure), cultures and attitudes all play a role. The Engel coefficient doesn’t account for food waste and assumes consistency between nations, which is not the case.

Diet Quality:
The law says little about calorie consumption or overall diet quality. Americans may spend less of their income on food but eat way more calories than Nigerians. When people have plenty of money, they typically eat more, especially when food is readily accessible. Moreover, Engel’s law says nothing about protein and other nutrients in relation to income.

Food Satiety:
Another overlooked factor is how satiating food is. Americans might be used to wolfing down thousands of calories a day, but someone who’s not used to that amount of food will stick to smaller meals. Diets high in ultra-processed junk foods may be cheap on a per-calorie basis, but they are often way less satiating than those rich in wholefoods.

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An Engel Paradox?

Ernst Engel was definitely onto something when he tied all that 19th-century data together, yet his “string” is looking a little frayed by modern standards. His law has stood the test of time for good reason: it’s a handy way to assess the gaps between countries like the US, where food gobbles only a fraction of the budget, and Nigeria, where it’s the main event. But the math gets a lot wonkier in the real world. The paradox of modern development is that while we spend a smaller share of our income on food, the true cost of our diets – measured in wasted resources and the premium paid for convenience – has never been higher.

Engel’s law is a solid starting point, but to see how countries’ food spending is reflected in their diets, we have to look past the percentages and check out the prevailing policies, cultural quirks and lifestyle shifts that define modern diets. To get the full story, we should look beyond the receipt and consider the behavioural and industrial realities that define modern plates.

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References:
1. Merriam-Webster (2026) ENGEL’S LAW Definition & Meaning. Available at: https://www.merriam-webster.com/dictionary/Engel%27s%20law (Accessed: 9 March 2026).
2. The Economist (2026) ‘Why Chinese People Spend So Much on Food’, 26 February. Available at: https://www.economist.com/finance-and-economics/2026/02/26/why-chinese-people-spend-so-much-on-food (Accessed: 9 March 2026).
3. Anker, R. (2011) Engel’s Law Around the World 150 Years Later. Political Economy Research Institute. https://peri.umass.edu/wp-content/uploads/joomla/images/publication/WP247.pdf (Accessed: 9 March 2026).
4. ROM Economics (n.d.) Engel’s Law Explained. Available at: https://www.romeconomics.com/engels-law-explained/ (Accessed: 9 March 2026).
5. Ritchie, H. (2023) ‘Engel’s Law: Richer People Spend More Money on Food, but It Makes Up a Smaller Share of Their Income’, Our World in Data, 19 January. Available at: https://ourworldindata.org/engels-law-food-spending (Accessed: 9 March 2026).
6. Houthakker, H. S. (1987) ‘Engel’s Law’. In M. Vernengo, E. P. Caldentey and J. Ghosh (eds) The New Palgrave Dictionary of Economics. London: Palgrave Macmillan.
7. Olipra, J. (2024) ‘Does Engel’s Law Work in Central and Eastern European Countries? The Role of Aspirations in Determining Food Expenditures’, Structural Change and Economic Dynamics, 71, 26-34.
8. ibid (2).
9. World Population Review (2026) Food Waste by Country 2026. Available at: https://worldpopulationreview.com/country-rankings/food-waste-by-country (Accessed: 9 March 2026).

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Do you have a favourite food and nutrition influencer? You’re spoiled for choice, with health-related content popping up whenever you scroll. But have you ever pondered what it is about your prized prophet’s material that draws you in? Crucially, have you considered whether the information they share is credible?

Sadly, much of what we watch is more pseudoscientific rhetoric than useful advice based on evidence. Online clickbait has made it easy to be lured in by creators who blurt out unrealistic, polarising or even dangerous information. When intellectual rigour is absent from someone’s agenda, they can rapidly create content. Why be bogged down with the burden of having to fact-check everything? Just whip out your phone, record yourself saying whatever’s in your head and upload it to your socials. Research ignored. Easy-peasy. Job done. But even worse than creators who don’t care about evidence are the charlatans who cite research but lazily or purposely misrepresent it, cherry-picking data to back up their narrative. This troubling trend makes it understandable that genuine experts and credible content-makers want to make their profiles stand out from the crowd.

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I used to include the phrase “evidence-based” in my social media profiles. I displayed the term to signal that the information I was sharing was based on sound research, to distinguish myself from the uninformed opinions doled out by quacks. Indeed, I’ve noticed numerous other accounts also include this descriptor. However, a while back I removed the term. Why?

Suboptimal Slogans

While attending the Nutrition Society Winter Conference in January, I noticed their slogan: “The home of evidence-based nutritional science”. I’m not sure how long the Society has had this tagline, but it was only during the event that it dawned on me that the phrase is a tautology.

The term science is defined by Google (via Oxford Languages) as:

the systematic study of the structure and behaviour of the physical and natural world through observation, experimentation, and the testing of theories against the evidence obtained [1].

By the Oxford English Dictionary as:

a branch of study dealing with a body of facts or truths systematically arranged and showing the operation of general laws, particularly obtained and tested through the scientific method [2].

And by Merriam-Webster:

knowledge or a system of knowledge covering general truths or the operation of general laws especially as obtained and tested through scientific method [3].

I opened a previous article with a description of science that I’m particularly fond of: “Science is the continual pursuit of the truth while being content in the knowledge that you’ll not find it”. I also cited Thomas Kuhn: “Science doesn’t march steadily towards truth, but advances through conceptual models – theories – that change, not only through evidence, but also through social forces” [4].

What all these definitions and descriptions have in common is that they include terms like “study”, “experimentation”, “testing”, “theories”, “truth” and “evidence”. There’s also reference to the scientific method, the tool that humans use to test hypotheses and draw conclusions (discussed in Nutrition and Enlightenment Values). Evidence is part of the scientific method.

The Nutrition Society’s slogan is tautological because it includes both “evidence-based” and “science”. The former is superfluous and devalues the latter. By its very definition, the scientific method requires empirical evidence to formulate, test and validate hypotheses. If something isn’t based on evidence, it simply isn’t science. I make this criticism as a member and ardent supporter of the Society and what it stands for – i.e. championing high-quality research in nutrition. But it’s an important point as science involves challenge, and this is, after all, just my opinion. The reason why institutions have slogans is to succinctly highlight their roles and values. A slogan should, therefore, be wholly resonant.

Tautologies are generally considered poor style because they are uninformative, provide no new information and violate communication norms. Granted, some folk might argue that they add strength to a statement when one part serves to affirm the other, and they can be integral to critical thinking [5]. However, this has more relevance to their use in assertions or debates. When a tautology is present in a snappy phrase, it risks devaluing it.

Devaluing Descriptions

In this era of persuasive health conspiracism, words like “truth” and “fact” don’t necessarily point to objective reality. Just because someone claims they’re sharing “the truth” or “facts” doesn’t mean what they’re saying is true or factual. Likewise, when someone describes himself as “trustworthy” or “honest”, it doesn’t prove that they are trustworthy or honest. After all, no influencer, whatever his experience or educational background, thinks he lacks credibility. Even the most confident, science-shunning zealot believes he’s a reliable source of information and will frequently use words like “truth” and “fact”.

The same applies to “evidence”. When qualified and experienced nutritionists and dietitians include “evidence-based” in their profiles, it risks making them appear to lack confidence, devaluing their credibility. It’s an unnecessary barrier that inhibits the bona fide from shining bright.

Science is opinion and opinions can be plucked out of thin air. But credible opinions are based on evidence. The acquisition of evidence is progressive, meaning that opinions will be formed via different routes. We are all subject to different information: we read different papers, articles and books and we watch different videos. Consequently, we may arrive at different interpretations of evidence. And when we add in our own real-world experience, opinions will be diverse. Even the most acclaimed expert will, at times, be wrong. It’s how they respond when they discover their error that’s testament to their authenticity. This is why, when confronted with a serious medical condition – as, sadly, many of us will be at some point – we should seek a second, or even third, opinion. Science is a fluid process: our quest for the truth is reliant on the synergy of opinions built from ongoing evidence and experience.

Anecdotes might hold little clout in scientific circles, but they can be incredibly useful tools, as real-life experiences often resonate better with audiences. The use of anecdotes should be embraced, as long as they’re conveyed honestly and transparently. Proclaiming to be “evidence-based” makes using them tricky.

Using the term “evidence-based” to describe one’s material is both nonsensical and devaluing. When someone’s content includes honest citations of research, the fact that they’re an evidenced-based creator will be self-evident, negating the need for the descriptor. Credibility will be apparent from the quality of the content and the honest way in which it’s communicated.

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Stand Out

I get it – credible health commentators are up against tough competition: those super-charismatic mountebanks who’ve amassed millions of followers by providing bite-sized, compelling content. It feels like we should utilise every means necessary to drown out their misinformation. If you’re a health commentator, this world of fake news and pseudoscience might tempt you to use “evidence-based” to double down on your credibility. Yet, proclaiming to be “evidence-based” risks opening you up to criticism when you later have to back-track as you discover new evidence; and, rest assured, if you’re someone who values evidence, there will be times when you’re forced to course-correct.

Ethical content makers have to be held to the highest of standards. I say this as I aspire to be a member of this select group. I share this criticism with the utmost respect and do so only because I champion those who produce high-quality content. I want them to stand out during a time when we need them more than ever. I want you to stand out.

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References:
1. Google and Oxford Languages (n.d.) Science. Available at: https://www.google.co.uk/search?q=define%3A+science (Accessed: 2 March 2026).
2. Oxford English Dictionary (2014) Science, n. Available at: https://www.oed.com/dictionary/science_n (Accessed: 2 March 2026).
3. Merriam-Webster (2026) SCIENCE Definition & Meaning. Available at: https://www.merriam-webster.com/dictionary/science (Accessed: 2 March 2026).
4. (a) Collier, J. (2025) ‘The Rise of Nutrition Populism - Part 2’, Substack, 26 November. Available at: https://substack.com/@jamescollierrnutr/p-179811958 (Accessed: 2 March 2026); (b) Kuhn, T. S. (1962) The Structure of Scientific Revolutions. Chicago, IL: University of Chicago Press.
5. Patterson, S. (2015) ‘Tautologies Must Not Be Dismissed’, Steve Patterson, 13 December. Available at: https://steve-patterson.com/tautologies-must-not-be-dismissed/ (Accessed: 2 March 2026).

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To be clear: it’s not people having their mobile phones with them in the gym that pisses me off; it’s the lack of etiquette exhibited by some folk when they use them.

A couple of years ago, I posted a video on several social channels of me sitting in my car after a workout in one of the gyms I regularly visit. In the clip, I describe how someone had been using a piece of equipment I’d been wanting to use. I say “using”: essentially he’d been blocking others from using the machine, as his brief sets were separated by a few minutes of him staring into his phone. Peering over his shoulder, I noticed him mindlessly scrolling on social media. I created the video because, as a regular gym-goer, I found this behaviour somewhat frustrating, while acknowledging that, these days, bad phone-related manners are not uncommon.

My articles are usually about food and nutrition stuff, but I have previously warned that I’d be posting more gym-related experiences. My content is about urging people to pause and think about anything that influences their health. With this in mind – similar to when I write about, say, what influences your food choice or why calorie counting might not be as accurate as you think – I hope people will consider their behaviour when using their phones in the gym.

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Scrolling Social Media in Between Sets Is Not Okay

The guy had been sitting at the lat pulldown machine staring into his phone. I politely interrupted: “Excuse me, mate. Have you got much longer on there?” To which he replied, “Three sets,” and then proceeded to go back to scrolling Instagram. I’d no wish to stand waiting, so I moved on and trained with another bit of kit.

After he’d been made aware that someone was actively waiting to use the machine – bear in mind that he’d already been sitting there for a few minutes – he merely continued with his mindless scrolling. Aside from the fact that he seemed to care little about inconveniencing others, when someone’s focus is in Smartphoneland, are they truly putting any appreciable effort into their workout? If, as soon as someone puts down their weights, they grab their phone and stare into its screen, are they really focussing on their training?

Is looking mundanely into your phone in between sets of any use to your workout? Would your life be negatively impacted if you were to forgo social media for an hour? Is the endorphin buzz from exercise providing insufficient fulfilment so that an additional dopamine hit from social media is warranted? I’d argue that, if you’re training correctly, it isn’t. You’ve made the effort to go to the gym – which, by the way, is amazing as so many don’t get this far – so, while you’re there, why not put in a tad more effort for a lot more benefit?

I guess this social media addiction – “addiction” does seem to be the right word – speaks to a larger societal problem. So many people are so attached to their devices that they’re struggling to shun their phone for even a few seconds, instead choosing to eschew more fulfilling pastimes in favour of a mindless scroll.

What Does the Science Say?

While common sense suggests that anything that distracts your focus in the gym is going to be counter-productive, we should validate such a claim. Although research is scant, there have been a few papers. One study found that social media use before a set reduces lifting performance. Strength-trained men worked out to failure after either being on social media for 30 minutes or after a control condition. The researchers found that social media use led to a significant increase in mental fatigue and decrease in how many reps they could do, resulting in a 15 per cent lower volume load [1]. What’s also interesting is that the control condition was watching a NASA documentary, indicating that it matters what type of content you consume. Maybe educational content isn’t so fatiguing.

Another randomised crossover trial that assessed jump ability in male volleyball players showed that using social media on smartphones immediately before training sessions caused mental fatigue and impaired their attack efficiency [2]. However, a small trial on just 10 participants that assessed the effects of 30 minutes of social media use on reaction time, agility, anaerobic capacity and salivary cortisol was less conclusive [3].

Why might scrolling socials cause fatigue? Social media activity can be cognitively demanding. When your brain is blasted with intense stimuli to get your attention, you’re hit with negative stresses, such as being concerned about your social status, reputation and FOMO*. Political or ideological content that’s not aligned with your worldview is likely to get you all riled up causing you to think about what you’ve just watched, rather than working your muscles. As well as this, when you see the fake ultra-amazing lives of others on display or their aspirational physiques, it can be depressing, because these images can make your own body and life seem less appealing, at least to yourself.

Is It OK to Have a Phone in a Gym?

Of course it is. Some gym-goers log their workouts. Others view online routines. Some folk use the stopwatch to time their rest periods. Many people have their device at hand to listen to music through their headphones. The modern world, with its numerous pressures, is stressful. It can be therapeutic to don some headphones, listen to some tunes and shut off from the outside, and to signal that you’d rather not be disturbed. Music can be a great way to avoid distraction and to help you to “get in the zone”. A phone can be especially useful when using cardio machines: listening to or watching a podcast can help mitigate the tedium of a long zone 2 session. And a phone camera can be a useful tool when assessing your training form. Filming yourself performing a set to watch later can help you improve your form, build strength and reduce the risk of injury. Are you cheating when you squat?

It’s not just hogging the machines for unnecessarily lengths of time that irks me. Another impropriety that gets on my nerves – one that tends to be committed by more serious gym-goers – is this: when training in the free-weights area, why do some folk have their phone lying on the floor? After I’ve struggled to complete a set of stiff-legged dumbbell deadlifts and I attempt to re-rack a pair of 50k dumbbells, having to gingerly navigate an obstacle course as I step over a phone, towel, water bottle and sweaty hoodie – reminiscent of Challenge Anneka – is not something I want to be doing. It begs the question: who would be liable – legally and morally – if I were to accidentally stand or drop a weight on their phone?

And do I even need to rant about those vainglorious wannabe influencers who constantly snap selfies and film themselves, getting in your way as you push through a gruelling workout?

Personally, for weights sessions, I typically don’t have my phone with me. I leave it locked in the car so there’s no risk of it distracting me. I focus on my workout. I want my gym visits to be as constructive a use of my time as possible. Only on those rare occasions – maybe once every few months – when I’ve been expecting an important call do I have it with me. Otherwise, only during cardio or circuit sessions do I use my phone and earbuds to help distract me from the monotony.

During the late 1980s when I first frequented bodybuilding gyms, mobile phones weren’t a thing. We listened to whatever music was blasting out of the speakers, and we logged our workouts with a pencil in a notebook. And that was just fine. Make no mistake, I’m no luddite – you’re reading this on Substack, after all – and I’m well aware that the world has changed massively since the 80s. We live in a time that urges us to embrace modern technology even in the dingiest of spit-and-sawdust gyms. My gripe is born out of the lack of etiquette surrounding these useful technologies.

A Distracted Workout Is Never a Satisfying Workout

I posted the video on several social platforms and the range of responses is interesting. On Facebook, people tended to agree with my rant; not particularly surprising as many of my connections were made when I worked in the bodybuilding scene. The LinkedIn responses were also typically agreeable, possibly because professional people are more likely to be adverse to rude behaviour. Many on Instagram also concurred, although someone made a very reasonable comment: “Sometimes it’s actually a coping mechanism for anxiety … I feel awkward enough at the gym as it is, so when I’m taking a break, I will look down into my phone, pretending to be busy.”

Some of the comments on TikTok, however, are worth countering. Take “Am I supposed to look at the wall for 3 minutes between each set?” and “How about we let people do what they like when they’re resting?”, for instance. These comments are typical of the GenZ mindset, so as a wise GenXer, I should respond. Firstly, the guy had been blocking the equipment for an unacceptable length of time. Sure, anyone can rest for as long as they want. But it’s not okay if sitting on the machine for an excessive length of time precludes others from using it. I could have asked to “work in”, but the machine in question was a lat pulldown and I wanted to use a different handle, and changing it between each set would have further added to the ridiculously lengthy rest periods I’d have had to endure.

Secondly, why don’t people take advantage of these valuable seconds and grab some mindful moments? Pause, reflect, be in the now. Why is it that the urge to be preoccupied is so overwhelming? This is gym time, so focus on your next set; psyche yourself up: you’ll get a lot more out of your session.

Thirdly, all I’m doing is giving helpful advice, similar to when I share ideas about nutrition. I’ve more than 35 years of gym experience, so I don’t think it’s too arrogant to claim that I’ve gleaned a deal of wisdom along the way. (Yes, I know I’m always banging on about the importance of evidence and genuine expertise, but that doesn’t mean we should ignore the wise.) People follow my work to learn from my learnings, insights and experience. This is just me doing that, by sharing tips on how to train effectively. All I’m suggesting is that it’s probably suboptimal to scroll through social media while working out.

One response to the video was, “A distracted workout is never a satisfying workout.” This is spot on. If the first thing you do when you plonk your weights down is grab your phone, then you’re not being present, you’re insufficiently engaged and the mind-muscle connection will be absent. Without your phone, you can better focus on your next set and you can be in the moment. Or, at the very least, you can use this time to ponder all the wonderful things you’re going to do later on. When else might you be able to grab precious minutes of undistracted downtime?

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* FOMO = fear of missing out

References:
1. Gantois, P. et al. (2021) ‘Mental Fatigue from Smartphone Use Reduces Volume-Load in Resistance Training: A Randomized, Single-Blinded Cross-Over Study’, Perceptual and Motor Skills, 128(4), 1640-59.
2. Freitas-Junior, C. et al. (2025) ‘Effect of Daily Social Media Use on Smartphones Before Training on Attack Efficiency and Repeated Vertical Jump Ability in Young Male Volleyball Players: A Randomized and Crossover Trial’, European Journal of Sport Science, 25(3), e12258. https://doi.org/10.1002/ejsc.12258
3. Stenson, M. C. et al. (2026) ‘Effects of Social Media Use Before Short, High-Intensity Exercise Tasks’, Exercise, Sport, and Movement, 4(1), e00057. https://doi.org/10.1249/ESM.0000000000000057

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