Social Media Pseudoscience
By Carrie Dennett, MPH, RDN
Vol. 25 No. 3 P. 40
Here’s what dietitians need to know about the spread of nutrition misinformation—and how to fight back.
It’s no secret that there’s much misinformation shared on social media, most of which claims to have a basis in scientific fact. Some of this misinformation—that climate change isn’t real or the earth is flat—is as much conspiracy theory as it is pseudoscience. But as any dietitian on Twitter, Facebook, Instagram, or TikTok knows, there’s abundant nutrition information being passed around that’s questionable, patently false, or sometimes even dangerous—such as the idea that alkaline water and/or an alkaline diet will cure cancer and a host of other health problems.1-3
Pseudoscience is a claim for or explanation of an observed phenomenon that’s presented as science despite lacking scientific rigor. If there’s any research supporting a pseudoscientific claim, it doesn’t adhere to the scientific method, the process of objectively establishing facts through testing and experimentation in a way that can be repeated by other researchers. This can include research based on faulty premises, a flawed experimental design, or bad data.
Some pseudoscience has no science to support it. For example, claims about the health benefits of celery juice by Anthony William, aka the “Medical Medium.” William has no medical or scientific training and claims he communicates with the “Spirit of Compassion” to get “extraordinarily accurate health information that’s often far ahead of its time.” Writing on Gwyneth Paltrow’s website Goop, William calls celery juice “a miracle juice” and “one of the greatest healing tonics of all time,” and says he’s seen “thousands of people who suffer from chronic and mystery illnesses restore their health” by drinking celery juice daily on an empty stomach.4
Other pseudoscience is based on cherry picking published research results, anecdotal “evidence,” or unreasonable extrapolation of cell- or animal-based research to benefits in humans, even when research on actual humans is nonexistent, preliminary, or inconclusive. For example, health claims about coconut oil are largely based on clinical research on specially designed medium chain triglyceride oil, even though coconut oil has a different fatty acid composition.5
In a 2018 analysis of the state of nutrition science in The BMJ, Dariush Mozaffarian, MD, DrPH, and Nita Forouhi, MD, PhD, professors at the Friedman School of Nutrition Science and Policy at Tufts University and University of Cambridge School of Clinical Medicine, respectively, wrote, “Almost everyone seems to have an opinion on food and nutrition. We speculate this may relate to the deeply personal, palpable, and cultural aspects of food. We all eat, interacting with our food multiple times each day over a lifetime, making food and nutrition seem tangible and accessible. Yet, opinion is not always based on science, and often the loudest, most extreme voices drown out the well informed.”6
The authors of the analysis also emphasize that many purveyors of pseudoscience are making money on it by selling goods or services, stating, “In a digital era, stories need clicks and instant comment, and sensational headlines promising miracle breakthroughs or ‘new’ findings that overturn established dogma generate traffic, advertising revenue, and sales.”
New York–based dietitian Shana Minei Spence, MS, RDN, CDN (thenutritiontea.com and @thenutritiontea on Instagram, TikTok, and Twitter), says evidence-based advice to eat a balanced diet or get enough sleep comes across as boring, and that fear is what sells and increases engagement on social media. “I notice the trend of walking around grocery stores, picking up items and stating that they are ‘toxic’ is a trend that will never die down,” she says. “Most of the influencers who do this are not science experts and do not understand or care that the products they are putting down are perfectly safe, and that just because ingredients are hard to pronounce it doesn’t mean they are harmful.”
What’s Driving the Pseudoscience?
In a 2022 editorial on the psychology of pseudoscience, the authors wrote, “We must ask not just about how individuals hold mistaken beliefs, but how misbeliefs spread from one mind to the next. This propagation of misinformation is how pseudoscience becomes a cultural phenomenon.”7 Pseudoscience has been around as long as science has, but if it seems to be more prevalent today, dietitians aren’t wrong.
“Absolutely it is getting worse. Social media has made everyone an ‘expert,’” says Toronto-based media dietitian Abbey Sharp, RD, of Abbey’s Kitchen (abbeyskitchen.com and @abbeyskitchen on Instagram, TikTok, and Twitter). “Trustworthiness is no longer reserved for those with education or credentials. Because social media is so visual, our bodies are our business cards. The result is that anyone with a socially desirable body has a very strong platform to spread dangerous misinformation to the masses.”
The ever-changing and evolving nature of science—thanks to the scientific method—itself becomes fuel for some sellers of pseudoscience, who claim that researchers, dietitians, and other science-based nutrition professionals are changing the story, making things up, or don’t know anything to begin with. Some even claim that it’s the current, evidence-based information that’s actually pseudoscience.
Spence thinks pseudoscience is becoming more of a problem, in part because the progression from blogs to social media has made it easier to say and spread anything. “Now, you can just tape and upload a video and that’s it. Yes, it takes a certain amount of time to build an audience, but information is much more readily available,” she says. “The disinformation that’s being spread can be easily done and even when someone with a science or health degree tries to correct it, they are often ignored or told that they work for ‘big pharma,’ which is hysterical. Hysterical because it’s actually the exact opposite and the people that are accusing us in the field of working for big pharma are often selling products themselves for exorbitant amounts of money. It’s hypocritical.”
Toronto-based media dietitian Abby Langer, RD, author of Good Food, Bad Diet (abbylangernutrition.com and @langernutrition on Instagram, TikTok, and Twitter), also says nutrition pseudoscience is getting worse. “I see a lot of people giving their opinion like it’s fact, and more and more of these people are in the wellness space,” she says. “It’s like the posttruth era—I mean, how in the world do people ever believe things like fiber is unhealthy for us, or that some random influencer can help with your cortisol levels? It’s absurd.” She says she’s noticing a lot of hormone-related content from people who are unqualified to discuss hormones. “I’m also seeing stuff about Ozempic [a name brand for the diabetes medication semaglutide] and weight loss, and things from CarnivoreMD that are absolutely ridiculous.”
Sharp says more extreme versions of nutrition pseudoscience seem to be popping up each year. “What once felt extreme a few years ago, like keto, has now morphed into something even more fringe, like carnivore,” she says. “There’s a never-ending supply of new diet ‘tribes’ online. We’ve definitely seen a rise in the carnivore communities, and the extreme intermittent fasters, such as OMAD [one meal a day] or biohackers [people who try to improve the qualities or capacities of human biology].” She points to TikTok star Brian Johnson, the “Liver King,” as an example. “He’s a leading proponent of an ancestral carnivore diet who has made a $100 million business off of his programs. In the past, he swore that his body is the result of his unusual diet, but it has now come to light that he has in fact been on a number of anabolic steroids to achieve his body.8
“In general, I find the worst offenders are social media ‘doctors,’ some of whom use the title but may actually be chiropractors, and not medical doctors,” Sharp says. “When people see ‘Dr’ at the beginning of a name, they automatically trust their content.” She mentions one chiropractor who pushes a very strict and unusual carnivore-style intermittent fasting diet. “His content is riddled with sensationalism and pseudoscience. But people believe everything he says because he is a ‘doctor.’”
The Misinformation Landscape
Considering that it’s hard enough for social media companies to take down inflammatory and even dangerous posts on nonnutrition topics, the idea that they might understand the nuances of which nutrition information is based on science and which isn’t and clamp down on the latter is a pipe dream. All social media platforms—Twitter, Facebook, Instagram, YouTube, TikTok—are breeding grounds for nutrition pseudoscience, but Langer says TikTok is the worst: “It’s like the Wild West on that platform.”
Sharp agrees that while there’s misinformation everywhere, TikTok is the main hub. “The algorithm on TikTok is such that a lot of young impressionable people are being fed one piece of misinformation, and if they interact with it at all (even if they watch it), they become trapped in an echo chamber that continuously reinforces this narrative,” she says.
Spence also points to the particular impact of TikTok on impressionable young people but adds, “All platforms are ‘bad’ in the sense that it’s very easy to get on and say anything even if it’s not true. Many people are just interested in building a platform, not really informing.”
In March 2013, the Federal Trade Commission (FTC) published guidance for businesses on digital advertising and marketing, and in November 2019, published a plain language brochure with guidance for social media influencers who have a financial or personal relationship with a brand.9,10 This includes information on how to disclose these relationships, as well as the statement, “You can’t make up claims about a product that would require proof the advertiser doesn’t have—such as scientific proof that a product can treat a health condition.”10 But not all nutrition pseudoscience comes from advertisers or paid influencers.
The rise of social media has blurred the line between authentic content and advertising, leading to an explosion in fake online reviews and other deceptive endorsements. The FTC started taking action on some of these offenses in 2021, and in 2022, seeking public comment on ways to modernize its approach to preventing digital deception, but this is restricted to advertising, not general misinformation.11,12 While congress has held hearings on concerns about misinformation spread via social media, the US Supreme Court has largely upheld regulation of false speech only if they involve defamation or fraud.13,14
Facebook allowed advertisers to specifically target users interested in pseudoscience until April 2020, when the platform removed “pseudoscience” from its detailed targeting list as part of its attempt to police COVID-19 misinformation.15 Also in 2020, TikTok blocked users under age 18 from seeing ads for weight loss products and put stronger restrictions on weight loss ads—specifically on irresponsible claims and on content that promotes negative body image—but critics say that many “weight loss” ads slip through the cracks of TikTok’s algorithm.16 Many ads promoting weight loss usually aren’t for products intended for weight loss—for example, ads for one PMS vitamin talk about “keeping the weight off for good.” Other products use euphemisms such as promoting “healthy” or “mindful” eating instead of marketing themselves as “weight loss” products.17
Dietitians Fighting Misinformation on Social Media
Langer, Sharp, and Spence all take on nutrition pseudoscience in their own ways. Langer says she tries to comment only on what she feels qualified to debunk and is most likely to take aim at information that’s “absolutely incorrect and potentially harmful to peoples’ relationships with food.” Some of her social media posts have taken on celery juice, “hormone-balancing” carrot salads, fiber supplements with weight loss claims, collagen supplements, the everything-old-is-new-again idea that drinking beverages with meals interferes with digestion, and spurious cancer claims made by celebrity doctors.
When deciding which nutrition myths to debunk, Sharp says she considers how that content might affect the audience watching. “Content that I feel is dangerous for health is always a priority, but I also think it’s equally important to debunk the seemingly benign suggestions because these often cause people unnecessary anxiety around food and their bodies,” she says. “I love to unpack wellness culture self-care ‘rituals’ because most of these rituals are positioned by influencers as being key to good health, but they really just reinforce an elitist privileged version of wellness.”
When deciding whether to debunk something, Spence considers her own knowledge of it. “If I’m not an expert, I make sure to follow someone who is, such as a food scientist, doctor, or dietitian who specializes in the topic,” she says. “I’m always ready to talk about the importance of convenience foods because people will be very quick to say processed foods are unhealthy. They are not,” Spence says. “Even the ultraprocessed food group contains tofu, milk alternatives, fiber/protein bars, organic frozen meals, etc. We can stop demonizing the name altogether.”
A few other pseudoscience-debunking dietitians to follow include researcher Kevin Klatt, PhD, RD (@kcklatt on Instagram and Twitter), who regularly takes on shoddy science and misinformation spread by health and wellness influencers. Cara Harbstreet, MS, RD, LD (streetsmartnutrition.com, @streetsmart.rd on Instagram and TikTok, and Streetsmart.RD on Twitter), sprinkles some misinformation debunking into her feed, including reminders that nutrition science is always changing and how to tell which Twitter accounts are truly verified. In that latter post, she says that Twitter was “growing misinformation faster than egg salad in the danger zone grows listeria.”
Stepping Into the Fray: What RDs Can Do
In a 2019 perspective piece on the evidence-based framework in nutrition and dietetics, Australian dietitian researchers Elizabeth Neale, PhD, and Linda Tapsell, PhD, wrote: “To address growing challenges in combating pseudoscience, nutrition researchers, policymakers, and practitioners must work together. … A key component is embracing and communicating the changing nature of the evidence.”18 Because pseudoscience often makes sense, in theory, and is accompanied by a mix of jargon and buzzwords that sound science-y, it’s no surprise that clients and patients who are seeking solutions for real or perceived nutrition and health problems fall for the misinformation.
“Talk to your clients about how to think critically about what they see online,” Sharp says. This includes checking the credentials of the person who’s talking, looking for references, and, if possible, bringing those references to a professional, like a dietitian, to help unpack them. “Not all ‘science’ is great science, and it’s our job as dietitians to guide people on how to interpret it,” she adds.
As for whether and how to push back against nutrition pseudoscience, Spence says that everyone is different in their approach and there’s no right or wrong, adding, “I prefer to just make my own posts on topics that come up and give information vs battling someone head on.” As a Black woman, Spence adds, “When you go head to head with someone, especially when you’re in a marginalized identity, such as myself, you need to prepare for the backlash. Some people are fully prepared, but I don’t personally wish to engage. If my own clients have questions on what they’re seeing, that’s another way to answer questions and debunk myths.”
Dietitians who do feel fully prepared may want to take a page from Langer’s book. “I think the gloves have to come off,” she says. “Long gone are the days where the RDs tiptoe up to the doctor with our research to back up what we’re recommending. If audiences are now only responding to shock and edginess, that’s where we need to go.”
— Carrie Dennett, MPH, RDN, is the nutrition columnist for The Seattle Times, owner of Nutrition By Carrie, and author of Healthy for Your Life: A Holistic Guide to Optimal Wellness.
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12. FTC looks to modernize its guidance on preventing digital deception. Federal Trade Commission website. https://www.ftc.gov/news-events/news/press-releases/2022/06/ftc-looks-modernize-its-guidance-preventing-digital-deception. Published June 3, 2022.
13. Congressional Research Service. Social media: misinformation and content moderation issues for Congress. https://crsreports.congress.gov/product/pdf/R/R46662. Published January 27, 2021.
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