A useful (not perfect) model for evaluting health guidance

Recommendation: In order to know if advice you’re given is worth considering, consider using this 3-step model:

1. Is the advice relevant, based on your priority?
2. Does it leave really obvious/basic questions unanswered?
3. Does it include guidance on how to answer the questions it’s unable to answer for you, depending on your unique situation?

quality-model

Outline:

-Why we desperately need a model

-Benefits of this model

-Why this model works (well enough)

-How this model works

-Examples: three levels of quality

-Limitations of the model

-Alternatives for evaluating advice

Why we desperately need a model to evaluate health guidance

How do we know what advice to follow? Beyond health, have you ever felt like everyone has a different opinion of what’s best? There are 64 million Google instances of “resume tips”, 39 million results for “parenting advice”, and 35 million apparent experts on whether you should rent or buy. So… what about the people who contradict each other?

Furthermore, we all have friends or family with good intentions who give us advice. If you ask them for details on how or why their guidance works, can they really explain their recommendations?

With so many sources of health guidance, how can we tell which advice is reasonable or high quality?

Well, you’re “reasonable”, right? Sure, but the following are all potential definitions of reasonable, depending on your personal decision-making framework:

– “Like any reasonable person, I’m a realist.”

realist-view

– “Like any reasonable person, I only follow ‘unbiased’ sources like (insert for-profit content provider here).”

my-news

– “Like any reasonable person, I only follow reason and logic, not emotions.”

reason-over-emotion

– “Like any reasonable person, I go with what feels right to me. Everyone knows statistics are always manipulated.”

manipulated-stats

– “Like any reasonable person, I only rely on the advice of educated people, like doctors.”

pedestal

– “Like any reasonable person, I’m open-minded and gather various viewpoints before deciding what’s best.”

hooray-broccoli

Thus, not only are we given a huge diversity of advice on what to do, we’re each evaluating the advice differently. That’s why your news source is “more unbiased” than the opposite, regardless of which one you follow. I don’t expect this human nature to change soon. The good news is that we don’t need a model to tell us which advice to follow–that’s a personal decision based on our own priority. Instead, a model can help us recognize which advice to not follow by revealing a lack of quality in the advice. It’s not about knowing if what we’re told is true, it’s more about being able to tell if the advice is well thought-out and worth considering (and sharing) at all.

With this in mind, the best model for evaluating the quality of guidance we get is one that isn’t based on any one of the personal definitions above .

Benefits of this model

Remember, the purpose is to recognize a lack of quality in the advice we’re given. Therefore, there are a few benefits of a model which can do this:

1. You could truly help loved ones–What could be better than knowing you’ve helped those you care about? You’re ability to find and share quality guidance could be what helps you maintain a relationship over time with anyone, since health is one of the few topics that everyone cares about. This isn’t to say you are capable of curing their sickness, nor should you automatically become your friends’ and family’s only source of health advice. It’s just to say you can help reduce the stress they feel from not knowing what advice to follow/ignore.

2. Personal success–Defined by you, success is more likely achieved if you’re able to recognize and avoid poor guidance. It matters little how much self-discipline you can exercise, or how good you are at habit-forming if you aren’t basing them off of good information, first. Garbage in, garbage out as they say.

3. Better reputation–You wouldn’t share advice if you thought it lacked quality, right? Learn this skill and, over time, people you share advice with will start to notice your thoroughness and healthy skepticism. This doesn’t mean you should share everything you think is high-quality advice–remember you need to first consider what’s relevant to your audience. Still, you’re bound to make some suggestions here and there, so this model could enhance your reputation as a source of quality guidance.

There are probably others you could think of for yourself, but those are the earliest and clearest benefits I’ve noticed from approaching health advice in this way.

Why this model works (well enough)

Keep in mind, models are either useful or accurate. This one is surely meant to be more useful.

Usefulness is the intent here, if only because “accuracy” in the context of health advice is so subjective (and dynamic). It works because it is:

Simple; kids, non-experts, etc. can use it.
Applicable; you can use it when you’re given advice on any subject.
Quick; Try it out and see how quickly you can reach a conclusion about quality.

How this model works

Here’s how this model works for me:

(After reading/hearing advice)

1. Consider what the specific purpose of the advice is, and if that purpose is relevant to you (is it to lower blood pressure? To live longer? To feed kids healthy food?).

2. Consider what’s left unclear to you about how the recommendation could work, and form some questions to answer. There will almost certainly be something you don’t fully understand about it. Think specific mechanisms of action; the “when/how/why/for whom/where” details. You might wonder, “What’s in spinach that makes it ‘healthy’?” or “What happens inside my body that makes meat ‘unhealthy’?”

Then, consider how obvious or complex your questions are. If those questions you’re coming up with are super basic, congrats! You’ve found a lack of quality in the advice! It’s probably a good idea to move on, because if it’s actually good advice, then your continued search for answers will likely lead to you it again, right?

Note: the lack of quality could be in the communication, not in the advice, itself.

If that’s the case, seek a more thorough explanation, whether you ask the source himself or herself, Google search on your own, etc. Keep in mind: this deliberate approach does mean you need to allow the source enough time to explain their point! #qualitynotconvenience

If the questions you’re coming up with are more complex, or relate more to how to implement the advice, it’s more likely to be high-quality guidance. This is because the person recommending it has been thorough enough to address obvious concerns ahead of time, and likely has given enough thought to warrant your further consideration.

3. Finally, if the topic is relevant to you and the unanswered questions are non-obvious/complex, the last consideration to make is whether or not they’ve provided tips on how to answer those questions for yourself (see the examples in the next section). A well-written, high-quality piece of guidance will acknowledge it’s own limitations. In doing so, the helpful author shares his or her suggestions on determining how the advice might be applied to your own unique situation.

Examples: three levels of quality

Here are three very simplified examples of how this model might be used:

1. Advice that leaves obvious questions:

From a Quora/Medical Daily article on anti-inflammatory foods:

“Omega-3 and essential fatty acids are good, healthy fats that assist in preventing heart disease, joint pain, mental health issues, and inflammation. People typically consume most of omega fats from vegetable oil, however this is omega 6, and omega 3. Omega 3s are found in wild-caught fish, quality fish and krill oil, avocado, and olive oil.
The ideal anti inflammatory ratio of omega 6 to omega 3 is 1:1, currently the average American diet contains a ration of 20:1. With significant research demonstrating omega-3 fatty acids reduce inflammation and prevent significant health issues like diabetes and heart disease, it is recommended that 1,000 mg is consumed twice a day.”

Take a moment to think of what questions come to mind. What else would you want to know before following this guidance?

Here are some obvious questions I’d want answered:

How much is in each type of food listed?
Who recommends 1,000 mg twice a day and why that amount?
Can I take supplements to get the same benefit as eating those foods?

I think these are pretty basic, not complex questions. Therefore, it’s not high-quality advice and would get only to step 2 in the model. I won’t follow this guidance, nor will I share it until I see it somewhere else along with answers to these questions.

2. Advice that leaves mostly complex questions:

Also from a Medical Daily article, “30 foods to eat (and avoid) for better sleep”.

“For dinner…Skip: White Bread.
Resist the urge to just eat a PB&J for dinner. In general, carbs are a good idea pre-sleep because they help your body use tryptophan, an amino acid that acts as a precursor to the sleep-inducing neurotransmitter serotonin. But, without an added dose of fiber (as you’d get in whole grains, fruit, and vegetables), simple carbs can keep you up because you’ll digest them quickly, making it likely that you’ll be hungry come bedtime. So, although it may make one heck of a lunchtime sandwich, as a simple carb, white bread isn’t the best choice.”

Unlike the first example, this guidance begins to explain how the advice might work–in this case by helping with tryptophan and serotonin activity. When advice includes at least part of the underlying mechanism, it means the author put enough thought into it to move beyond the basics. However, it still falls a bit short of high-quality guidance since it lacks specific detail on the mechanism behind it, and it doesn’t provide guidance on how you’d determine if it might work for you, specifically.

For example, you might ask:
Will it help me fall asleep, stay asleep, or both?
How, exactly, do carbohydrates “help your body use tryptophan”?
Other than tryptophan and serotonin, what other neurotransmitters are needed for sleep that I might need to consider?

3. Advice that leaves mostly complex questions with tips on how to determine what’s best for you:

From a Woman’s Day article called “10 Healthy Foods That Can Seriously Hurt You”

“Seafood.
It can be a perfect source of protein and heart-friendly omega-3 fatty acids. Some kinds, though, come from water contaminated with large amounts of heavy metals, especially mercury, which can cause hearing, vision and movement problems. To stay safe, opt for fish from the open sea versus small bodies of water–. Look for “wild caught” on the label versus “farmed,” and choose smaller varieties, since the biggies accumulate more chemicals. Buy fish and shrimp from the U.S., and avoid imported farm-raised fish. It is under-inspected and tends to have excessive chemical residues. In general, stick to the FDA’s lists: Salmon, shrimp, light canned tuna and tilapia are some of the lower-mercury seafoods, while shark, swordfish and king mackerel are the higher ones.”

I’m not sure I agree with the advice, but it’s still worth consideration because of how it’s written. Even though I believe the benefit of seafood outweighs the risk for most people, I like the way this advice is given because:

– It is clearly relevant to a specific audience (seafood eaters)
– It covers obvious questions one might have (e.g. “why is mercury bad for me?”)
– It gives actionable guidance on how to implement it in your life (“stick to the FDA’s lists”).

Keep in mind, it could be completely untrue. But the model I use to evaluate quality is not about determining truth, which you can’t expect to confirm from a single article, video, or story.

Limitations of the model

As I said before, most models are either useful or accurate, not both. Here are some times this model might not work for you:

– If the advice is wrong but high-quality or right but low-quality

Obviously, the biggest reason this model could lead to a bad outcome is if the truth of the advice doesn’t match the level of quality. This must happen though, if only because of how knowledge and science progress over time–there must always be differing theories to test, and they won’t all end up being correct. Still, we can’t be expected to only hear advice which has reached the level of “proven fact”. This creates the reality that well-thought-out advice might end up being wrong–it could still be worth considering at the time we hear it, though.

– When the topic is highly specialized, or you’re not the target audience

If I were to seek advice on how to treat depression, I’d come across plenty of articles which might be relevant to the topic, but which are meant for psychiatrists. They would of course leave me with some very basic unanswered questions. However, this wouldn’t be due to the authors not putting enough thought into the guidance. It’s more likely that they assume their audience already knows the basics of psychiatry. Thus, it could actually be high-quality guidance but this model would conclude differently if I were to use it.

– When you’re reading old advice or if understanding of a topic has changed since the advice was created

Like the first limitation of the model, if you’re reading advice from 1980 on how to best lower cholesterol, it may be very well-written and high-quality. However, the topic of cholesterol control has changed vastly since that time due to ongoing research, and recommendations have changed accordingly.

Alternative options for evaluating advice

I wanted to provide some examples of other ways you can evaluate the quality of health guidance. My first thought is that they correlate with the personal definitions of “reasonable” I mentioned above (“Like any reasonable person…”). The weakness of each is that, in each case, there are contradictions even within that method of thinking.

Only follow doctors and science
For example, if you only follow the advice of educated people, what do you do when doctors disagree? There are incredibly smart, educated experts on all sides of most debates–that’s why there’s a debate. The model I’ve shared today helps this by taking the content on it’s own merit–regardless of who’s suggesting it. It helps you to get past the low-quality arguments on any side.

Stick with what works
Another alternative is to “stick with what’s worked in the past”. This might look like returning to the same website/magazine for your health tips over and over. This actually isn’t the worst way to go, as long as you truly adhere to sticking to what actually works for you. In other words, be careful of the “halo effect”–the unconscious tendency to overvalue something after finding it helpful in the past. Remain skeptical each time you read something from your favorite author.

Let me know how it works for you!

The purpose of this post was to enable you to feel more prepared in evaluating health guidance. Ideally, you’re now able to gauge the level of quality in guidance you see, especially when there’s a significant lack of quality. So give it a shot the next time someone tells you how to eat. In fact, my next steps are to see how my own recommendations hold up to this model. So let me know–leave a comment below if you’d add anything to the model, if you have a method of your own, or if you have any thoughts at all!

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Bio: guy sharing what he learns about effective health