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The True Health Initiative: Truth in an Age of Confusion
By Hadley Turner

We see it all the time on talk shows and the mainstream media: Coffee causes cancer one week and prevents it the next week. Insert almost any food into either of those two phrases, and it most likely has been a headline. As RDs know all too well, this dichotomy regarding what's healthful and what's not creates undue confusion and, often, misinformation for consumers.

But health care professionals have taken a stand to mitigate this confusion through a movement for preventative medicine. The True Health Initiative, a leader in this movement, is the effort of a coalition of health experts, including physicians, RDs, public health scholars, and healthful food advocates. David L. Katz, MD, MPH, founding director of Yale University's Yale-Griffin Prevention Research Center and president of the American College of Lifestyle Medicine, founded the nonprofit True Health Initiative in late 2014. Katz wants consumers to know that there is a truly healthful pattern of eating for chronic disease prevention—one that, unfortunately, doesn't typically make for thrilling headlines—and that health experts largely agree on what that pattern is: essentially, minimally processed, mostly plant-based foods.

The Media Problem
The media's (and food industry's) exaggeration or sensationalism when it comes to health and nutrition headlines has received increased attention lately. John Oliver covered the issue on an episode of Last Week Tonight to broad positive reception, and most major media outlets have been reporting on the issue as well.

A recent True Health Initiative press release announced results of the organization's review of several health headlines. It found that the "media headlines exaggerated the findings routinely and, at times, distorted them entirely." The headlines, the organization says, rely on outdated evidence or evidence from just one study, neither of which should result in scientific claims to certainty that the headlines suggest. The release concluded with a statement of the True Health Initiative's commitment to "encourage learning and understanding based on the overall weight of scientific evidence [and] not necessarily the latest study or sensational headline."1

According to Katz, media-propagated confusion prevents real change from occurring. "A talk show will, for example, pit a Paleo health expert against a vegan one, and people watching think that these two diets couldn't be more different and that no two health experts must agree," he says. "When people see so many conflicting headlines and experts on TV, they generally just throw their hands up and say, 'I give up!' and neglect to do anything to improve their health."

Nancy Collins, PhD, RDN, LD, FAWPCA, FAND, a dietitian in private practice in Las Vegas specializing in wound healing in diabetes who has been a spokesperson for and member of the True Health Initiative since its conception, agrees: "When I talk to patients, they're very confused," she says. "With access to the internet, Twitter, Facebook, all these things, it's just ridiculous the amount of noise someone gets each day that relates to lifestyle and the areas we emphasize."

"We know how to prevent as much as 80% of chronic disease in the United States—diabetes, heart disease, obesity, even cancer," Katz says. "But we don't make the necessary changes to do that, in part because of this perceived confusion."

Cutting Through the Noise
While the media tend to focus only on the differences between diets and present conflicting headlines and evidence, Katz chooses to focus, through the True Health Initiative, on the agreement between health professionals as to what a healthful dietary pattern is. Katz brought more than 100 experts together from roughly 30 countries to say, "We agree." Members of the invitation-only coalition come from different diet camps (from Mediterranean to vegan to Paleo) and include renowned experts such as T. Colin Campbell, PhD; Dean Ornish, MD; Mark Bittman; and Garth Davis, MD.

"The True Health Initiative is really trying to be this reliable voice" on social media outlets and across the web "that cuts through this clutter, misinformation, and contradictory information," Collins says. She says the goal of the True Health Initiative is "spreading the correct information—what Dr. Katz refers to as 'the truth'—about how lifestyle can really reduce the impact of chronic disease."

Katz agrees and adds that although the media like to pretend otherwise, "we've known the right thing to do the whole time" to prevent most chronic disease. The initiative focuses on time-tested, evidence-based principles of nutrition, such as eating mostly plant foods full of fiber and phytonutrients, maintaining regular exercise, and other markers of a healthful lifestyle.

"It's not just about diet," Collins says. Indeed, the True Health Initiative focuses on six pillars of a healthful lifestyle, not simply on dietary choices. The six areas are the following:

  • Forks: "minimally processed, generally plant-predominant foods";
  • Feet: "routine physical activity at moderate intensity, frequency, and duration";
  • Fingers: "the avoidance of toxins, particularly tobacco and excess alcohol";
  • Sleep: "adequate in both quality and quantity";
  • Stress: "the effective mitigation of psychological stress"; and
  • Love: "the cultivation of meaningful, supportive relationships and strong social bonds."2

"If you eat a perfect diet, but you're totally stressed out and you hardly sleep," that's still out of balance and will impinge upon your health, Collins says. "We try to advocate that it's the whole lifestyle—of these six healthy core principles—where people should be headed rather than getting stuck on one tiny little point," such as whether to include butter or eggs in one's diet. "I don't think that's really the point."

RDs' Role
"This movement really started with RDs and the particular ways in which they have to disseminate information to their clients," Katz says, so they absolutely have a role to play in the True Health Initiative.

Collins says that RDs can mitigate their clients' media confusion by helping them identify what a reliable source is. "In these days, one of the most important things is knowing where your information comes from—if it's a biased source or an independent source, or if there's evidence surrounding the claims," she says. "So much is forwarded on social networks that people don't even know where the information originated."

As a nonprofit and independent organization, the True Health Initiative itself is a reliable source RDs can point clients to, according to Katz and Collins. RDs also can sign up on the initiative's homepage to receive e-mails particularly tailored to them as health care professionals. Consumers are placed on a separate e-mail list but are sent similar information that, ideally, cuts out some of the media noise.

There's also a pledge that those signing up for e-mails—health-conscious consumers and health care professionals alike—can take to commit to live according to the six pillars of a healthful lifestyle and share and promote evidence-based, time-tested ideas about healthful living. RDs can take the pledge themselves and encourage clients to do the same.

To learn more about the True Health Initiative and how to get involved, visit www.truehealthinitiative.org.

— Hadley Turner is an editorial assistant for Today's Dietitian.

References
1. Wild diet headlines? Leading experts of the True Health Initiative don't swallow them. True Health Initiative website. http://www.truehealthinitiative.org/news/wild-diet-headlines-leading-experts-of-the-true-health-initiative-dont-swallow-them/. Published May 17, 2016. Accessed June 10, 2016.

2. The solution. True Health Initiative website. http://www.truehealthinitiative.org/#/the-solution. Accessed June 10, 2016.
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