Author and science communicator Timothy Caulfield joins us to discuss why gut hype has become so widespread, the gulf between the claims and the science, how mainstream media reporting and social media have helped create hype about gut health, the role of scientist-influencers, how to tell if you’re in the presence of gut hype vs. more accurate reporting about the gut microbiome, and more.
Timothy Caulfield is an author and professor at the Faculty of Law and School of Public Health, University of Alberta. He has won numerous academic, science communication, and writing awards, and is a Member of the Order Canada and a Fellow of both the Royal Society of Canada and the Canadian Academy of Health Sciences. He contributes frequently to the popular press and is the author of two national bestsellers: The Cure for Everything: Untangling the Twisted Messages about Health, Fitness and Happiness (Penguin 2012) and Is Gwyneth Paltrow Wrong About Everything?: When Celebrity Culture and Science Clash (Penguin 2015). His most recent book is Relax, Dammit!: A User’s Guide to the Age of Anxiety (Penguin Random House, 2020). Caulfield is also the co-founder of the science engagement initiative #ScienceUpFirst and was the host and co-producer of the award-winning documentary TV show, A User’s Guide to Cheating Death, which has been shown in over 60 countries, including streaming on Netflix in North America. Find him at the University of Alberta, and on social media @CaulfieldTim.
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Transcript
Disclaimer: The below transcription is primarily rendered by AI, so errors may have occurred. The original audio file is available above.
Christy Harrison: Welcome to Rethinking Wellness, a podcast that offers critical thinking and compassionate skepticism about wellness and diet culture, and reflections on how to find true well-being. I'm your host, Christy Harrison, and I'm a registered dietitian, certified intuitive eating counselor, journalist, and author of three books, including Anti-Diet, which was published in 2019, The Emotional Eating, Chronic Dieting, Binge Eating & Body Image Workbook, which will be out on February 20th, and The Wellness Trap, which came out in 2023 and is the inspiration for this podcast. You can learn more and order it now at christyharrison.com/thewellness trap or find it wherever books are sold.Hey there, and welcome back to Rethinking Wellness. I'm Christy, and my guest today is author and science communicator Timothy Caulfield, who I'm really excited to talk with because he's someone who is a noted skeptic of all things wellness culture, and he has an interest in something that is a huge interest of mine these days too, which is gut hype. So we're gonna talk about it in this episode. We're gonna talk about why gut hype has become so widespread, the gulf between the claims about gut health and the actual science, how mainstream media reporting and social media have helped stoke the hype machine, and the role of scientist influencers and university press releases in creating gut hype. We'll also talk about how to tell if you're in the presence of gut hype versus more accurate reporting about the gut microbiome and more.
Christy Harrison: It's a great conversation, and I can't wait to share it with you shortly. Before I do, a few quick announcements. This podcast is brought to you by my second book, The Wellness Trap: Break Free from Diet Culture, Disinformation & Dubious Diagnoses and Find Your True Well-Being, which is available wherever books are sold. The book explores the connections between diet culture and wellness culture, how the wellness space became overrun with scams, misinformation, and conspiracy theories, why many popular alternative medicine diagnoses are misleading and harmful, and what we can do instead to create a society that promotes true well-being. Just go to christyharrison.com/thewellness trap to learn more and order the book. That's christyharrison.com/thewellness trap, or just pop into your favorite local bookstore and ask for it there. This podcast is also made possible by my paid subscribers on Substack. Not only do paid subscriptions help support the show and keep me able to do this content for free, but they also get you great perks like bonus episodes, including one I did with this week's guest, Tim Caulfield, biweekly bonus q and a's and other bonus essays and episodes, subscriber-only comment threads where you can connect with other listeners, and lots more.
Christy Harrison: Just go to rethinkingwellness.substack.com to learn more and sign up. That's rethinkingwellness.substack.com. And thanks so much to everyone who's already become a paid subscriber. It really means the world to me that you support this work and help me keep doing what I'm doing. Now without any further ado, here's my conversation with Timothy Caulfield.
Christy Harrison: So, Tim, welcome to the show. I'm so excited to talk with you today.
Timothy Caulfield: Oh, I'm thrilled to be here.
Christy Harrison: Yeah. So I'm a huge fan of your work. I'm sure many of my listeners will be too. And there's so many things we could talk about in terms of wellness culture in general, lots of different areas we could go to, but I specifically wanted to focus this episode on gut hype. Because it's a personal interest of mine. It's definitely of interest to many of my listeners. And you've done some great research and writing on the topic, so it seems like it's really an interest of yours as well. So I'd really love to get into all that. To start off, I'd love to hear how you define gut hype and how you got interested in the subject in the first place.
Timothy Caulfield: Well, for for me, gut hype really is closely tied to microbiome hype. And I got interested in this because I've long followed various science trends. But actually, my whole career kind of maps a lot of the big science movements. So you think about things like The Human Genome Project, and then we were all focused on the role of our human genome and genetics in wellness. And then we had the stem cell regenerative medicine trend, you know, and both of these those trends continue. And we saw the wellness community really embrace that kind of language of regenerative medicine and stem cell products for antiaging purposes, et cetera, et cetera. And then we had the precision medicine, personalized medicine movement. Again, that's still continuing. And you saw the wellness industry also embrace that language.
Timothy Caulfield: Then emerges the microbiome trend. Right? And what's fascinating about all of these is it's real science. You know, it's real exciting stuff. It's big science. Lots of resources have been funneled into these areas,.I've been involved with scientists and science projects in all of those areas. In fact, I still have a genome grant now. I have a microbiome grant that I'm involved in. But what we're seeing across all of those domains is the emergence of unproven claims in the wellness space.
Timothy Caulfield: And the microbiome area is the latest, and I think it's one of the best examples of science hype being exploited to market unproven products. So that's, I guess, the big picture reason why I'm interested in this. But in addition to that, I think it's just a really, really good example of of unproven products that sort of have taken off in a variety of ways. Right? I mean, if we went out on the street and interviewed 1000 people five years ago, I wonder if you agree with me on this, if we interviewed a 1000 people, I bet most people wouldn't really know what microbiome is, or they'd have sort of a vague idea what the microbiome was about. Now everyone knows, and in fact, there are so many products with the word "microbiome" on the label. Right? Andso think of that remarkable shift that has happened in just a couple of years.
Timothy Caulfield: It's been completely normalized, this idea of having a healthy microbiome. I'll give you 2 more reasons why I'm interested in this topic. The other reason is I think it's often used in a very exploitive manner. So there's been some wellness trends that some people can go, oh, well, it's kind of, you know, benign. Who really cares if people are using crystals blah blah blah. But here, this is often being marketed to people who are, I hate to use the word, desperate because it kind of makes it sound like they don't have agency. But they're often people who are desperate or have, you know, serious problems or perhaps they're frustrated with the conventional system, you know, or they are people, you know, looking for answers, like parents with children who have autism. Right? So I'm frustrated that it's often also used in those kinds of domains, you know, the issue of gut health and and the microbiome.
Timothy Caulfield: And the last one, and there's many I could go on with, but the last one I'll raise right now is personal interest. You know, this is, an issue that is relevant to my personal lif,e to my family. I've asked permission, you know, from my family to mention that, you know, they have gut issues, and and so it's relevant to my personal life.
Christy Harrison: Yeah. That resonates for me too. I personally struggle with IBS and a bunch of other gut issues. And it's something that, you know, I feel like I'm the target market in many ways, and yet also very much not because I'm so skeptical of it. But, you know, I find that kind of marketing so insidious and so harmful because, you know, in my most desperate moments, I too still am like, "I wonder if there's anything to this." You know? And I think it just really is seductive. I'm curious, why you think that this kind of marketing has emerged? Because I agree, I think within the last 5 years, it's just exploded. And I've done a little research on it for some pieces I've written, and I'm doing kind of an ongoing series about gut health and, you know, have seen the Google Trends data that, like, in the last 10 years or so, it's really had a steady upward climb, but I think really in the last 5 years, it's, like, exploded. And just curious why you think that is? It's like, what has happened in the last 5 years or so that's, you know, caused this big explosion and interest in gut health and the microbiome?
Timothy Caulfield: Well, I think a couple of things. And I, you know, touched on some of them already, but I think it's the real research that's going on that kind of ignited it. Right. And then as I said, we saw that with genomics, we saw that with stem cell research, and now we're seeing it with the microbiome. And this is real exciting research. It seems very likely that the microbiome is connected to a variety of of illnesses, and and there's great potential to both understand diseases and, you know, what causes ailments and perhaps create microbiome-related therapies. And so that has gotten a lot of attention in the popular press, and it also, I think, is intuitively appealing.
Timothy Caulfield: It seems like it's something that people can understand. We have these organisms in us, and if we learn how to impact them, it's gonna have beneficial outcome to our health. So there's that, you know, I call it "scienceploitation." Right? You take real science, and you spin it to sell products. And we know research tells us that this strategy works. This scienceploitation strategy gives credibility to the claims. It makes it seem more legitimate.
Timothy Caulfield: Even if you don't really know what the science is about, research tells us this scienceploitation strategy can work. It just gives, as I said, this blanket of legitimacy to whatever claim you're making. The other thing that's happening here, which is a little bit paradoxical, is fixing your microbiome kinda feels like it's a "natural" cure. Right? I'm putting natural in quotes, by the way. So it it plays on that allure that if something is natural, it's better for you. It's not a chemical. It's not, you know, made by some evil industry. It is a "natural" approach to your health. Even though the strategies that people use to alter their microbiome, like supplements and colon cleanses and, you know, et cetera are hardly natural. But that appeal to nature fallacy is powerful in this area. And the other reason I think it's taken off is because a lot of the therapies that are being marketed are for ailments that have been around for a while and and people are desperate.
Timothy Caulfield: You know, we don't have simple solutions for them, and so people are looking for anything that's going to help them. And when you have a product like this that, again, has that intuitive sciency appeal, I think it's gonna take off. And, of course, the other thing is straight up marketing, you know. For example, I think alternative medicine practitioners, and this is an area where we've done a lot of research, they're always looking for new ways to to spin their their products, that, you know, have new products that they can sell. And so they're exploiting the rise of the microbiome research to sell products. So I think that that's enough. You know, those are four reasons I think that that we're seeing this explosion over the past couple of years.
Christy Harrison: Yeah. That's so interesting. One thing I was struck by too in your research is the role of media and mainstream journalists in this process. Right? You found in a recent study that huge number of media reports are published about the microbiome every year and that very few of them have any sort of caveats about how early stage this research is and all of that. Could you talk a little bit about that research, and what you found in sort of looking at the media on this?
Timothy Caulfield: Yeah. And we're continuing to do research on this, by the way. We have a study now looking at gut health on TikTok. In fact, hopefully, it's gonna get submitted maybe today.
Christy Harrison: That's exciting!
Timothy Caulfield: But we are looking at, as you point out, how the popular press represents this. And this, you know, is part of that kind of hype pipeline. Right? So you have the popular press side of the equation. And, you know, people like stories on health issues and they like those stories to be to be positive. And, we found when we looked at over 800 articles in the popular press, I think around 95% of them made claims about the microbiome and in relation to health, and almost without exception, they were positive. But they often did not talk about what the science was actually saying, you know, how uncertain the science was, how this was still very, you know, early days. And so it just helps to create this this atmosphere of hype that can be exploited by those selling products.
Timothy Caulfield: Add to that what's happening on social media, on Instagram, on TikTok, on Facebook, and you get an environment where it seems like there's just upside to the microbiome and, you know, probiotics, and no downside. And the science you know, the complexity of the science is very much underrepresented.
Christy Harrison: Yeah. Completely. I'm so curious if you can share anything, you know, any of your findings about gut health on TikTok or sort of early impressions anyway before the research is published.
Timothy Caulfield: Yeah. So this is, you know, my impressions looking at this stuff. You know, it's funny because I have this wonderful research team, and they send me these videos to watch to, you know, help the intercoder reliability. It is amazing how much is out there. And you get these influencers making really strong claims about about gut health. Right? And, you know, I'm sure you've seen these kinds of videos. They, pop up on Instagram, very much on TikTok. And by the way, we know that TikTok is becoming a very influential source of health information. And a lot of it is misinformation.
Timothy Caulfield: So you get these influencers, you know, talking about about supplements, talking about special diets that they'll use, talking about, you know, things like colon cleanses. A colleague of mine just posted a video mocking the video, not supporting it of, you know, a coffee enema. And the person actually, you know, videoed themselves getting the coffee enema.
Christy Harrison: Oh my god.
Timothy Caulfield: Don't do this, by the way. That's the headline. So you definitely get this very positive vibe about gut health and the microbiome and these unproven interventions on TikTok. And we know that this can have an impact on health behaviors and beliefs.
Christy Harrison: Yeah. I mean, my background is I'm a dietitian specializing in disordered eating, and I have my own history of an eating disorder myself. And so I got interested in this area and and sort of in, you know, skeptical takes on nutrition research in general because of this background, because of seeing so many of my clients and myself in the past just falling down these rabbit holes of misinformation and getting so obsessive about food. And so kind of linking this idea of, like, eating perfectly to thinness, to longevity, to, you know, all of these things. And I see so much of that on the TikTok, and you know, in the TikTok wellness influencer space. But I think especially when it comes to gut health, it's like you'll see these people who are, quote, unquote, "gut health coaches," like, telling people what to eat and take, you know, telling them to take out all these foods or drink bizarre things and, you know, concoctions of things and to take supplements and stuff, and then they show themselves before and after. And it's like a bloated belly getting thinner. And the implication is, like, you're gonna shrink. You're gonna lose weight by doing this. And I think it's such a recipe for disordered eating for so many people and just so unrealistic really in terms of what we actually know about gut health or, you know, the microbiome and and the real evidence there.
Timothy Caulfield: I couldn't agree more. And I believe one of the big things we saw is this idea about bloating and weight loss. Right? And it's funny. Or I shouldn't say it's funny. It's probably not surprising to you that almost all of the representations. I'm gonna be careful. I don't wanna overemphasize this. Many of the representations suggest that one of the goals is weight loss either explicitly or implicitly. And, you know, this is a theme that we have found, I think, for decades.
Timothy Caulfield: You know, when we looked at direct-to-consumer genetic testing, which was a very similar trend. Right? You know, leveraging the excitement around genetics, you have the emergence of all these direct-to-consumer genetic testing in the context of diet. And we were surprised at the degree to which weight loss was one of the main themes there, and we're seeing the exact same thing with gut health in the microbiome. So the entry point will often be language about wellness, but either implicitly or explicitly, you know, weight loss is also put as a benefit to it. And the other thing I find infuriating about a lot of this messaging, and I'm curious if you agree with this given, you know, your expertise. It's often represented again either explicitly or implicitly, or sometimes it's just even the imagery that this is a noble thing to do. This is almost your responsibility to do this. This is what people do when they take action for their own health if they do things like this.
Timothy Caulfield: And if you're not doing this, you're kinda doing something wrong. Right? It's kinda on you. So these are the actions that you should take in order to, you know, tackle your health and your general well-being. And if you're not doing this, you know, it's on you.
Christy Harrison: Yeah. I very much see that sort of blaming the individual for their health problems. And even people who've, like, had their own issues with, you know, gut stuff will be like, "I used to struggle with this, and then I discovered this diet. And now, you know, I realized that everything that I thought I just had to live with..." And it's, like, said so derisively too. It's like, "oh, I thought I just had to live like this and, like, this was just gonna be my life forever. And then I realized, you know, that I actually could have this whole new world of, like, being symptom free or, you know, not having this bloated belly every day, like, all I had to do was cut out however many foods or do this special gut health protocol that you have to DM me to get" or whatever. I also have noticed a lot of supposed gut health coaches, like, don't really give a lot of information away about what they actually do. It's like DM me for more information or like a link in bio or something, you know.
Timothy Caulfield: Yes. And that and that is another big theme that we've seen in a number of our studies is there's also often the commercial tie in. Right? I can't remember how many of the videos are linked to a commercial product. We saw this also in the context of, like, immune boosting on Instagram. On the surface, it looks quite benign and very positive, but it often links to a product. Right? And this is all about, you know, moving product. You know, it's about selling stuff. And the other theme I find kind of infuriating is they also exploit the frustration that patients may be having with the conventional health care system.
Timothy Caulfield: And I totally get that. You know, the conventional health care system has a lot of problems, and they often don't treat these issues in a respectful manner. Right? And especially for women and people of color, there's a long history of of not being treated appropriately. And, you know, there's the famous study that tells us that after 11 seconds health care providers stop listening, you know, something like that. And there have been other studies that have talked about that, and you see this language by a lot of these providers, these gut health coaches and oh, the word "coaches," we could have a whole conversation about that. But they exploit the legitimate problems of the health care system to sell products. Right? And yeah, that's really a maddening trend because it in a way, it tries to make them paint themselves as the heroes. When in in reality, what they're doing is they're exploiting a real issue with the health care system to sell misinformation and unproven products.
Christy Harrison: Yeah. Absolutely. That's such a pet peeve of mine too as someone who has also struggled with the conventional health care system and sees so many clients who've gone through the same. It's like, of course, people want answers and want relief and want something other than, you know, a five-minute or 10-minute meeting where the provider, you know, assumes they know everything they need to know about you and dismisses your concerns. I mean, I have written about this and talked about this and dealt with this for so long, and I just like two days ago or something as we're talking or last week, I had another one of these situations with a digestive issue I was having. And I thought, you know, for some reason, I thought I was past having to deal with that because I had found a decent set of providers, but I ended up seeing a different provider that day because my normal one wasn't available. And it's just like, here we are again, you know, back to square one, back to having to advocate for myself and go through a bunch of hoops to get the kind of care I need.
Timothy Caulfield: And you're a knowledgeable patient. Right? Imagine what it's like for people that don't have your background. And then when they see these individuals, these providers, these coaches who allegedly have answers, you can see why it's so seductive.
Christy Harrison: And there's so much empathy sometimes that is offered in those spaces that you might not get. Or just time, you know, that you might not get from a conventional provider.
Timothy Caulfield: So true. You know, I've gone to a host of alternative providers as an experiment for my own research. And I mean, you name it, I've gone to see them. And I can say almost without exception, and there are a few exceptions, it was a positive experience. You know, they spend sometimes an hour with you listening to your problems and, you know, suggesting personalized solutions. And my experiences with the conventional system have almost uniformly been terrible. So I totally get it, and by the way, my wife is a physician, my son is a physician, my sister-in-law is a physician, my brother-in-law is a physician.
Timothy Caulfield: You know, I am very connected, and I research in this space, and I collaborate with physicians. And despite all of that, it's almost always terrible. So I get it. I get why people are attracted and I get what they're selling. Right? And the other thing they're selling is this personalization phenomenon. I'm sure, you know, that another big gut health story that's really starting to take off now. You have these direct-to-consumer testing companies, you know, they test your poop.
Timothy Caulfield: Like, maybe I won't use the name. And even though there's very little evidence to support what they're providing, that personalization, that precision approach to your wellness journey. Again, we know that that can be very, very persuasive, very, very seductive. Even though, again, no evidence really supports that at all. There was a a fascinating study that came out this year that found that just telling someone. So you have two absolutely identical protocols. Right?
Christy Harrison: Mhmm.
Timothy Caulfield: It's a clinical trial, and on our arm of the study, it's the standard protocol. The same protocol is given to the second arm of the study, but you just tell the patients that this is personalized. Right? So it's not any different. Just tell them it's personalized. They get a larger placebo effect just if you believe this was tailored for you. And that's, of course, one of the things that's happening here.
Christy Harrison: Yeah. That's so interesting. And it's one of the reasons it might seem like these, quote, unquote, "personalized" gut health approaches are actually effective, even though they're not or they don't have any real good evidence behind them.
Timothy Caulfield: That's right. And in fact, I think that again, I'll ask you if you agree with this, I think gut health is and maybe even the word "microbiome" is emerging as as a health halo.
Christy Harrison: Totally.
Timothy Caulfield: You know, you're a dietitian, so you see health halos all over your world, your universe. But, you know, we've had "natural," we have "organic," you know, "GMO-free," you know, all these health halos that have been around for a really long time and remain very, very powerful. I kinda think "gut health" and "microbiome" and "personalized," these are new health halos. And what I find fascinating about health halos is the literature around health halos is really interesting, but it becomes almost a conversation stopper. Right? People take it for granted that this is better for me. They don't necessarily investigate much further, and I think we're starting to see that with the phrase "gut health."
Christy Harrison: Yeah. I agree. I think it has become very much a health halo, this idea of probiotics are good for your microbiome, good for your gut, gut healing, like all the supposedly gut healing drinks that you see now at, like, the health food stores and, you know, the whole mainstream ones like Whole Foods and stuff like that. And one thing that I've noticed too is, like, this sort of gut brain access research that is also pretty early stage and emerging and exciting in so many ways. But, you know, I feel like that's one of the big areas like revving this engine of gut health hype, because it's like, you know, now it's not just about your gut. Which not everybody has digestive issues, you know, but everybody probably wants to feel better and think better and maybe address, you know, depression and anxiety and things like that. And so there's a sort of added pressure. It's like it's become an extra health halo in a way that now you can think about, like, not just improving your gut health, but that your gut is connected to your brain or your immune system. You know, it dovetails with that immune boosting literature as well.
Christy Harrison: And that idea of immune boosting that, like, now there are all these other things supposedly connected to your gut health. I'm curious sort of what you think about the research connecting you know, research on the gut brain axis and, like, how much hype there is versus the actual reality of the research and sort of, you know, the quality of the research.
Timothy Caulfield: Yeah. I think that's an excellent point. And in fact, I would put this on my list of, you know, why has it become so popular, and why has this taken off over the past couple years. I put this phenomenon on that list, and it really is this idea that the microbiome research, you know, gut health is really about total health. Right? It's not just about having problems with your gut, but it's, you know, anti-cancer. It's good for cardiovascular health, and it's good for your mental health, you know, et cetera. It's just this magical realm that we're tackling now, and it makes gut health such an appealing topic despite the fact that the research in almost all of these areas is incredibly preliminary. Even though, yes, it's genuinely exciting.
Timothy Caulfield: So as I said, I work on a big grant right now, a big microbiome grant with a fantastic team at the University of British Columbia, at the University of Alberta. We've had this grant for for years. And, you know, these researchers would be the first to say. And this is their life, right? But they'll be the first to say it's early days. We're still unpacking. And we know it's going to be a complex interaction if it turns out to be real. We know it's going to be complex. It's not going to be something, you know, where there's an easy fix even if this pans out to be a robust connection. So I think it's early days.
Timothy Caulfield: And this is a pattern, again, we saw with genetics, we saw with stem cells, where the excitement around early discoveries, early association research was immediately transmitted into marketing for products that were unproven. And sometimes, what you're seeing is not even a specific product, but they'll you just use that microbiome language to facilitate the building of a brand, of a wellness brand or to facilitate making an alternative practice seem more legitimate. And, unfortunately, right now, it's still early days. We're still at that point where we need to, you know, kind of patiently watch how the science unfolds.
Christy Harrison: Yeah. I mean, it's so interesting to think about how early stage it is versus all the hype. And one thing that has been really interesting to me is the notion of how scientists and clinicians can kind of play the role of influencers. Like, you know, I think there's a number of these "scientist influencers" in the gut health space. And I recently talked to someone who is, I won't say their name, but it's a respected researcher in this field who used to be a collaborator of one of these people that I'm kind of terming "scientist influencers" who said that this person is incredibly charismatic. They're really a kind and, you know, good person, but their research is really bad. And that most people in the field know that, but that it's not really known outside the field. And so, like, in the lay public, this person's research has influenced so many people that think it's legit and have, you know, carried the torch and sort of helped stir up gut hype.
Christy Harrison: And I'm just curious if in your research, you've come across any stories like this or, you know, any sort of "scientist influencers" and what you make of that or think we should do about that when scientists start to have a public profile that maybe outpaces the rigor of their research?
Timothy Caulfield: Yeah. It's a frustrating phenomenon, and we've definitely seen this play out in a range of domains. Right? We know that just a few voices, especially if they're MDs, especially if they're scientists, can have a huge impact on public discourse. To use a dramatic and obvious example, you know, the anti-vax phenomenon. There's been numerous studies, and we've done research in this space too, that have found that just dozens of individuals can have this outsized impact on how the public thinks about an area of science. You know, I I recently wrote a piece where I suggested that our current information ecosystem is a massive false balance machine, right, where you have a handful of contrarian, fringy scientists or MDs having this outsized impact on how we think about climate change, vaccines, the microbiome, you know, genomics. I could go just on and on and on. You can go down this list. And there's actually been really interesting studies that have shown that the public can really be influenced by this false balance.
Timothy Caulfield: There was a study that was done in Europe over the summer, published over the summer where they found that 90% of the public thinks that the clinical community is split on the efficacy of vaccines. And of course, the opposite is true. Right? The same researchers found that over 90% of MDs think the COVID vaccine is safe and effective. And I think it was like 1 or 2%, you know, had any real concerns, then there was a very small portion that was in the middle. So there's almost complete consensus. Right? But the good news is that same research shows that if you explain that scientific consensus to the public, you can make a a difference. The same thing's happening in the realm of gut health where you have a few of these voices having, an outsized impact. And, of course, in this realm, we also have marketing creating this impression, right, that that is contrary to the to the scientific consensus.
Timothy Caulfield: And I do find it very frustrating. There are these number of scientists that come from very good institutions, and I'm not gonna use any names either, but they come from very good institutions. Some of them have millions of followers. And they'll even sometimes sound like they're representing the research pretty accurately. Right? So they'll say, "oh, this is an animal study that was done," or they'll say "this small study that was done" or "this is emerging research in this area." But the take home message is still, "this works." Right? Whether they're talking about, you know, taking a cold shower or taking some kind of weird sleep supplement or whatever, even though the science is uncertain, the take home message is "this works. "And unfortunately, I think it does real damage. And I see it play out.
Timothy Caulfield: This is anecdotal. I'm being a hypocrite here, because I just used a couple anecdotes for my own life. But I get a lot of hate mail, and these scientists are often in the hate mail. Right? They'll use it as proof that the scientific consensus is wrong or that I'm not representing the science accurately because this podcaster said x, y, and zed.
Christy Harrison: That's so interesting. Yeah. It's like the outsized influence making people think that that represents a much bigger viewpoint than it actually does.
Timothy Caulfield: That's right. And it is frustrating when it comes from, you know, these scientific voices or from MDs. There was a study in In JAMA very recently, and I'm gonna use the vaccine example. I know vaccines are so controversial, but there's a lot of interesting research emerging in that domain. But this study in JAMA claimed that about 50 or just over 50 physicians really directed the anti-vax noise in the United States. And think about that. It's really just a handful of of doctors. Now I'm not sure if it was just 50. It might be more than that, but I think that the overall point is completely accurate that this very small cohort of individuals with impressive credentials can overwhelm the public discourse regardless of what the actual scientific consensus say. And we see it happening all the time, you know. Climate change just being one other example.
Christy Harrison: Oh my gosh. There's so many interesting directions we could go there because I'm so curious, like, to think about what we can do to counter that. And I hear from people sometimes who say, "well, you know, it's all well and good to say, like, the science doesn't support this or whatever," but people ultimately don't care what the science says. They just want to feel better. And if they think something is making them feel better, like, you know, if they think their probiotic is making them feel better, or if they think not being vaccinated makes them feel better, you know, whatever it might be, that's what they're gonna go for and not you know, they're not gonna necessarily care that something is science-based or not. It takes a certain kind of person or maybe a person at a certain point in their life who's gone through certain things to, like, really wanna dig into the science. You know?
Timothy Caulfield: Yeah. And as you can imagine, I hear that a lot also. And I totally sympathize with that perspective. But I think at a minimum, we want the public representations of the science to be accurate. Right? So then if someone adopts that perspective in their own life, you know, people have autonomy. They can make choices about their body. Obviously. But you want that decision to be informed by accurate information.
Timothy Caulfield: To push unproven therapies and to spin science and to push misinformation, that's not enhancing autonomy. On the contrary, it's taking autonomy away from individuals. So at a minimum, we want to make sure the science is represented accurately, and I think everyone can agree on that. And the interesting thing is that there is evidence that if you represent science accurately. I know it doesn't feel like it because there's so much noise out there and it just seems endless. But it does make a difference. Right? The study around scientific consensus, for example. Even for individuals that are skeptical of a field, if you explain what the scientific consensus is, it can alter their perspective. It's not a magic wand. Of course, we're talking about moving the needle, but it it really can make a difference.
Timothy Caulfield: I also think it's important to highlight what the scientific consensus is. This is not about groupthink or being overly conservative or trying to shut down controversial views. You know, contrarian and controversial views are core to science. Right? But they have to be supported by the evidence. You have to listen to what the evidence says as it emerges. What's so frustrating in the gut health space, and I know you realize this, but if you talk to the experts, to the people who are actually doing the cutting-edge research, they're gonna be the first ones to tell you that the research is still preliminary. Right? It's still early days. Wait for the exciting stuff to emerge in the future.
Christy Harrison: It's so interesting how that doesn't get translated to the public. And I sometimes wonder if one step in there is the university PR office, you know, that's, like, trying to translate the findings into something that's gonna be really interesting and exciting to the press and stripping out some of the nuance there.
Timothy Caulfield: Oh, you're 100% correct. For sure. For sure. In fact, I would be careful here. I don't wanna overstate...
Christy Harrison: Right. No. You're at a university.
Timothy Caulfield: I'm gonna do it anyway. I think you could argue that when you're talking about science hype, one of the points where the most hype happens is in the university press releases. I call it the "hype pipeline," because hype happens all the way along that pipeline. From getting the research grant in the 1st place. Right? You kinda gotta overstate, you know, where you think the science is going to go. To publishing it in a peer reviewed journal. You know, often there's a little bit of hype, especially in the abstracts. Right? In the conclusion and the abstract, sometimes there's a little bit of hype there. And then you get hype in those press releases.
Timothy Caulfield: And there's been a lot of studies that have shown exactly that. A lot of those press releases have a whole bunch of hype, and then that's picked up by the popular press, and then that's picked up by the social media, and then you get marketing. So you can see how all the way along that knowledge translation pipeline, you get a little bit more hype that builds on the hype right before it. So it's kind of a worst case scenario in that hype creation.
Christy Harrison: It also feels like the skepticism gets diluted as you go further down that pipeline. Right? Like, there might be a lot of skepticism or caveats and appropriate critical thinking about the science in the paper itself. Maybe not so much in the abstract or the conclusion. And in fact, sometimes I see, like, things in the abstract that really aren't represented in the paper, which is interesting. But for the most part, I feel like there are still, you know, caveats in the paper itself. But then, you know, you get to the abstract, and there's less. The press release, and there's less. And then the media, which, I mean, my original background, like my first career and still, you know, current career alongside a dietitian is I was a journalist. And, you know, when I first started out, I was reporting on health and nutrition and food and was not trained in science. I majored in rhetoric and French literature.
Timothy Caulfield: Oh, I love that.
Christy Harrison: I was on the path to go, you know, be writing and doing things with language. And that was what I loved, and I got interested in science because I mean, I was always kind of interested in science, but I got really interested in it because of my own eating disorder because it made me obsessed with food and nutrition, and I just wanted to research that all the time and sort of get to the bottom of things. And I wasn't eating enough, so I was curious about food and wanted to report on that. So, you know, I came in through such a different, like, backdoor than some people come in. But I have found that within the world of nutrition reporting, especially, that is kind of a door that a lot of people come through and not so much the science door, like being an undergrad in a science field and knowing a lot about how to read papers and stuff. So, you know, when I was reporting on stuff, I was doing things based on abstracts or press releases. Or sometimes I would try to read a full study that a source would send me, but it'd be like, "well, I don't really understand this. Let me, like, defer to the expert who's telling me what they think the study means." And, you know, they might have some hype going on there and wanting to hype up their own research. Or what the abstract says is gonna have some amount of hype and lack of nuance. And so I was transmitting that. So I definitely know that it's easy for journalists to do that. And the profession, especially now, I think, is not geared toward giving journalists the time and certainly not the budget for, like, continuing education on how to do science reporting or anything like that. And not even the time necessarily to really delve in and think critically about what research says. You know?
Timothy Caulfield: Oh, I agree with all of the above. You're, you know, you're absolutely Spot on. And one of the first studies that I did on on science representation with my colleague, Tanya Bubela, who's at Simon Fraser University now. And we looked at science hype in the context of genetics, and we found that when there was an article about a genetic discovery in the popular press, most of the hype came from the mouth of the scientists. So in other words, it was a quote from the scientist. And I don't want to sound like I'm pointing fingers at scientists and blaming them. You know I'm part of this community. There's tremendous pressure to make whatever work you're doing sound like it has immediate relevance and that it's really exciting. And then you have a journalist that is trying to make that work sound exciting too.
Timothy Caulfield: There's pressure to make it sound like this is worthwhile article and something you should read. Put those two together and the inevitable result is hype. And then, of course, you have the headline, which both you and I know, they don't write. The editors write it, and that's often even more hype. We've done a little bit of research on, you know, that, the disconnect between the headline and the actual science article, and there's often a huge amount of distance there. Maybe it was an animal study. That's not represented. Maybe it was a very preliminary study. That's not represented. Maybe the "n" in the study, which is very common, the number of people involved in the study in in the nutrition space is often very small. Often that's not represented.
Timothy Caulfield: So I think the point that you made about, you know, how each at each stage, a little bit of uncertainty is sucked out, you know, as though it becomes less and less uncertain along that knowledge translation process is so on point. And the other thing I think happens is people love stories. People love anecdotes. They love a powerful story. And, you know, how many times do you see an article about a new gut hype intervention where it starts with a story about someone who benefited from it?
Timothy Caulfield: And in fact, this happens on social media. All social media is just a sea of little stories. Right? And research tells us that one powerful anecdote, one powerful testimonial, and this is something we've studied, can overwhelm hundreds of millions of data points on efficacy and safety. Right? People remember the story. We're kind of hardwired to respond to stories. And, of course, that's the other thing that happens. So as science communicators, we need to figure how to use those stories, to use those anecdotes in an accurate way that still makes it engaging, that draws people in, but still reflects the iterative nature of science and the uncertainty. And I think we can do it. Just because it's hard to do, you know, to translate science accurately doesn't mean we shouldn't try to do it.
Timothy Caulfield: I think we can. And by the way, I also think it's a good reason why we need to put more investment into science communication and into partnering with artists and with people who come from literature and with comedians and, you know, et cetera, et cetera, et cetera. We've got to figure out how we can make accurate, nuanced science stories engaging.
Christy Harrison: Yeah. Well, that's a good segue into a question I have, which is, how do people know when they're in the presence of gut hype or science hype in general? Maybe versus more accurate reporting about the microbiome or whatever other aspect of science is in question.
Timothy Caulfield: You know, this is gonna sound cynical, but I'll start with this and then end with a little more positive, less cynical recommendation. The first one is just recognize that the hype exists. Right? You know, I actually think that really is a good starting point. You know, recognize that there is this scienceploitation phenomena out there and that there is a lot of science hype. And it's a systemic pressure. Sometimes there isn't, you know, a nefarious force at play here or some kind of agenda. It's just a systemic phenomenon that happens as a result of the way that science is funded and the way that it's translated. So just recognizing that, I think, is a really good starting point, because it gives you the skepticism that allows you to realize, "okay, there's real science happening here, but, you know, maybe it's not gonna be ready tomorrow."
Timothy Caulfield: The second thing you can do, again, it's obvious, but I still think it's valuable. Do they do they reference any actual science, any actual studies? And this is one of the things we found from our research, often isn't there. Right? Stories will often talk in vague terms about the articles, about health benefits, or about where the science is without actually referencing any studies. And if they actually reference some studies and talk about the limitations and talk about what stage the science is at, more likely, it's going to be an accurate study. The other thing, of course, you wanna do is you wanna see how various domains talk about this. You know, if they represent it as a "breakthrough" or as "revolutionary," be very, very skeptical. Unless you see that repeated by other respected sources. Right? I always say, if this stuff worked, if it really was a breakthrough, then you'd know. I promise.
Christy Harrison: That's a great way to cut through a lot of the noise. Well, I'm curious. You know, I'm incredibly skeptical of everything to do with gut health because of recognizing all this hype and, you know, looking at some of the actual literature and talking to people and seeing how early stage it is. But I'm also trying to be open to any place where maybe there's justification to the hype because, you know, I do personally want to feel better. I have come a long way since my disordered eating days when I was struggling with digestive issues really intensely, but, you know, not everything is 100%. I'm not symptom free just because I'm not disordered with food anymore. So, you know, there's little things that I would love help with. And I know there's a lot of people listening in the same boat.
Christy Harrison: So I'm curious, you know, from your research, if there are any areas of gut health science where you think maybe some of the hype is warranted? Or where there's at least promise for things that are they're actually gonna be helpful for people in the near term, not just a possibility?
Timothy Caulfield: So it sounds like you probably know this already. There are a couple domains where we know that things like probiotics can help. And, of course, you wanna be very careful where you get your probiotics. Many probiotic supplements, for example, aren't regulated as robustly as we'd like them to be and often over-the-counter supplements are contaminated, et cetera, et cetera. But for example, when you're on an antibiotic and you get diarrhea, there's, evidence that probiotics can help in that space. And for some inflammatory bowel diseases, there is some evidence that probiotics can help in certain circumstances.
Timothy Caulfield: But more big picture, and this is, you know, a boring response. And I bet this is advice that you're in a better position to give than me, but I'm gonna say it anyway. I think that a lot of the microbiome research really emphasizes the value of a healthy diet. Now I told you it was gonna be boring and obvious, but I think it does. You know eating a a variety of foods, lots of fruits and vegetables, healthy fibers, you know, fermented foods. I think it it backs up the value of doing that, and I think that is not trivial. Right? I think that's meaningful. And I also think there's some interesting, you know, research in the context of fecal transplants. Now when I say fecal transplants, I mean this in a clinical setting when you're being supervised by a physician. We already know fecal transplants, for example, can be very helpful in the context of C. diff, you know, really severe gut infections. And we're seeing interesting research, speculative research around things with fecal transplants and ulcerative colitis and, you know, other inflammatory bowel ailments.
Timothy Caulfield: We're still at wait-and-see stage. Right? We we don't wanna encourage people to do do-it-yourself fecal transplants, which people are doing out there, you know.
Christy Harrison: I know, it's terrifying.
Timothy Caulfield: There's real danger with those procedures, you know, including infection and/or introducing other kinds of illnesses into your system. But I think those are areas where we are seeing more near-future benefits. The research team that I'm working with is looking at the role of the microbiome in asthma and in allergies, and whether it'll be possible to tweak the microbiome in the future, again this is future treatment, to help those kinds of conditions. So there is real research that's happening, and I'm excited about the area, but it's gonna be complex. And we have to wait and see how it unfolds.
Christy Harrison: Thank you. That's really helpful. I think, you know, in terms of the diet piece too, I've come such a long way from becoming a dietitian to sort of specializing in eating disorders. And now my thinking about diet has become so, I guess, anti-diet from the stance of, you know, diet culture and of putting people on restrictive diets and that sort of thing. But thinking about variety and pleasure and, you know, not being disordered with food and not having a ton of rules that prevent you from eating enough and, you know, making sure that you're eating diversity of things. I think the diversity piece really shows promise in some of the microbiome research.
Timothy Caulfield: I agree with that. And and it is so maddening when the microbiome gut health language is used to market restrictive diets.
Timothy Caulfield: I find it infuriating. And you do see that. Right? You see that microbiome language being used to justify things like extreme detoxes and crazy restrictive diets, And it's just no, no, no, no. There's no evidence to support the use of the microbiome in this context. And by the way, research tells us it's actually quite difficult to change your microbiome. I think there's this idea that if I go on this restrictive diet, if I take this, you know, crazy elixir, I'm gonna change my microbiome.
Timothy Caulfield: I don't know if you've done it. I actually for one of, my documentary projects, I actually did, you know, the test, the poop test. And I went on Gwyneth Paltrow's extreme, extreme diet to find out if my microbiome changed. And you could probably guess what happened. Right? You know, I did it before and after, and it does change. But it goes back. Right? Unless you maintain this unhealthy, restrictive diet... it's almost like a fingerprint. I don't want to overemphasize the degree to which that's the case, but you do kind of go back to what your microbiome kind of portfolio is after you stopped, and no one can maintain nor should you maintain these crazy diets.
Christy Harrison: Yeah. Absolutely. Well, thank you so much for everything you shared. My last question for you is something I've been asking everyone, which is: this podcast is called rethinking wellness, and in light of all your work, I mean, your work on gut hype, but also just years years of studying different wellness interventions and wellness hype in general, I'm curious how you've rethought wellness in light of all that work?
Timothy Caulfield: Yeah. It's interesting because the word wellness has really evolved in a very unhealthy manner, hasn't it? You know, I think it was a very positive term in the past where It was really about how health is more than just your physical health, it's your mental health, it's your community, and I love that kind of view of wellness. But it now it's just become a term that's used to sell unproven products, to make you feel guilty, to make you feel anxious. And the reality is you focus on those science-informed basics. Right? You focus on those science-informed basics of, you know, don't smoke, exercise, eat healthy. There's no magic there. You do the basic preventative steps, you know, vaccines, wear a seat belt, surround yourself with people that you love. There's really not much more that you can do, other than pick your parents, you know, socioeconomics, and the big stuff. But that's really what we've got to focus on. You know, don't fall down that wellness whole.
Christy Harrison: That's well said. Well, thank you so much, Tim, for everything you shared. I really appreciate talking with you. Can you tell people where they can find you online and find your books and learn more about your work?
Timothy Caulfield: I'm easy to find on the web and on social media platforms. It's almost always @caulfieldtim. And I'd love to have you join my conversation.
Christy Harrison: We'll put links to those in the show notes, so people can find you and really appreciate you being here. Thank you so much.
Timothy Caulfield: Thank you.
Christy Harrison: So that's our show. Thanks to our guest for being here and to you for listening. If you've enjoyed this conversation, I'd be so grateful if you could take a moment to subscribe, rate, and review the show on Apple Podcasts, Spotify, or wherever you're listening. You can also support us by becoming a paid subscriber for just a few bucks a month on Substack. With a paid subscription, you unlock great perks like bonus episodes, subscriber-only q and a's, and much more. Sign up now at rethinkingwellness.substack.com. That's "rethinking wellness dot substack dot com."
Christy Harrison: Got burning questions about wellness trends, diet fads, or anything else we cover on the show? Send them my way at christyharrison.com/questions for a chance to have them answered on an upcoming episode. And if you're looking to heal your relationship with food and break free from diet and wellness culture. I'd love for you to check out my online course Intuitive Eating Fundamentals. You can learn more and enroll now at christyharrison.com/course. Rethinking wellness is produced and edited by Softer Sounds podcast studio. Julianne Wotasik does our website production. Our album art was created by Tara Jacoby. Theme song was written and performed by Carolyn Pennypacker Riggs.
Christy Harrison: And I'm your host and executive producer, Christy Harrison. Thanks again for listening, and take care.
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