It's easier than ever to spread bogus health information online. Here's how to help your clients figure out what's real.
Reviewing health and fitness news on the internet can produce a minefield of misinformation. Anybody can open a social media account, build a polished website with DIY templates and set up shop as a self-appointed health and fitness expert. And people who do this can lend their work an air of authority by mimicking the design and presentation of authoritative health-news sources.
These so-called experts can publish anything they wantand they do. They're not bound by a journalist's professional standards—checking facts, using reliable evidence, providing balanced coverage—much less the demands of peer-reviewed research.
Even those who mean well can go astray online. Professional journalists, longtime bloggers and social media stars can bow to the pressure to publish quickly and consistently, leading to sloppy misinterpretations of the facts or irresponsible misinformation derived from little more than anecdote or opinion.
All this yields a flood of faulty health information online that has surged in the past few years, experts say. Fitness pros are hardly immune. Did you see that clickbait headline suggesting that eating ice cream for breakfast makes you smarter? The story went viral despite its dubious claim and lack of adequate citations pointing back to the research (Letzter 2016). While skeptics may dismiss such a story as unlikely (ice cream? I wish!), others may take it at face value (pass the Häagen-Dazs, please).
Our clients, friends and families expect us to be experts who know how to separate the factual health information from the false. How do you live up to those expectations? For starters, arm yourself with skills and strategies for confronting the fire hose of health and fitness content online. We can't stop the spread of faulty health information all on our own, but we can teach ourselves to get better at spotting it and correcting it whenever possible.
It's Getting Harder to Tell What's Real
Have we always been so susceptible to cyber snake oil? Perhaps the sheer volume of information on the web today makes it harder to dig out the truth.
"I think there is an increased risk that people viewing health-related information online today might be more easily duped or misled than 10 years ago," says Gary Schwitzer, associate professor at the University of Minnesota's School of Public Health. Schwitzer is also the publisher and founder of HealthNewsReview.org, which evaluates healthcare journalism, advertising, marketing and press releases to help consumers critically analyze healthcare claims.
While the internet is a great way to stay connected and informed through a variety of sources, it's becoming much more difficult to verify the accuracy of information online, Schwitzer says. "There are many vested interests plying online to lure new followers and create new markets for their products and ideas. The democratization of the web is a double-edged sword."
Joel Breakstone, PhD, agrees. Breakstone, director at the Stanford History Education Group, recently co-led a study looking at young people's ability—or inability—to judge the credibility of information they view online (see the sidebar "How Young People Decide What to Believe Online"). "It's difficult to discern legitimate websites from fraudulent ones," Breakstone says, "partly because it's much easier to create an incredibly polished-looking site now than in the early days of the web."
He makes a good point. A website with awful design and typos everywhere quickly reveals that it's not a trustworthy source of health and fitness news. However, an attractive website (or a large social media following) can signal credibility that may not be deserved: All it takes is a few dollars to create a site that appears quite reputable—perhaps even resembling trusted, well-known associations or news sources.
"As a result," says Breakstone, "everyone needs to be more careful in determining whether or not to trust a particular site."
Checking Our Biases
We all have assumptions and biases that color our online experiences. Fitness pros often have staunch views about diets and fitness trends, and holding such strong opinions can lead to confirmation bias—seeking out or endorsing information that confirms what we already believe to be true.
"The biggest trap or seduction with online 'news' is wanting to share what we wish were true," says Kymberly Williams-Evans, MA, IDEA author, former faculty member at University of California, Santa Barbara, and co-owner of a blog for baby boomers called funandfit.org. This kind of wishful thinking helps ridiculous health and fitness claims gain momentum. Who wouldn't want to get in shape with little effort or lose weight with a magic pill?
"People today, like people from every era, want simple solutions to complex problems," says Yoni Freedhoff, MD, assistant professor of family medicine at the University of Ottawa and medical director at the Bariatric Medical Institute. "Consequently, I think people are happy to be misled by predatory messages that speak to their own personal beliefs and/or promise shortcuts and [easy ways] for living healthful lives."
Social media has become a notorious breeding ground for precisely these kinds of messages. Anyone with a Facebook, Twitter or Instagram account has probably been exposed to bogus ideas that can take on a life of their own through shares and retweets. Since social media's culture is so intimate and interactive, ill-advised fitness info can easily go viral. People who hear health news from an Instagram "guru" might assume they're receiving trusted guidance from someone in the know, prompting them to share the news with their own networks. And seeing something posted from an actual friend can strengthen others' trust in that information.
"If I belong to an online community or follow a social media 'expert,' it can be easy to become caught up in a cult of personality and take whatever he or she says as gospel," says Pete McCall, MS, personal trainer, fitness educator and adjunct faculty in exercise science at Mesa College in San Diego.
Perhaps you know a few clients or class participants who jump on the bandwagon of questionable health crazes they learn about on Facebook or the evening news. This can be vexing for fitness pros who prefer evidence-based exercise protocols and health initiatives. Fortunately, education can help you advise your clients on how to review health claims with a more critical eye.
Embracing Critical Thinking
Evaluating the credibility of health/fitness information and taking responsibility for the accuracy of your own social media posts are crucial tasks.
Where to begin?
Step 1: Exercise critical thinking. Ask questions and objectively analyze what you're seeing, whether it's a headline, a video, a news report, a photo or a Facebook rant. "The initial move of just asking the question 'Do I trust this?' is a really good first step," says Breakstone.
Step 2: Question the source of the information. "Asking basic questions is a powerful shift away from what people are often doing now, which is simply accepting information at face value," says Breakstone. Thinking critically does not require an hourlong research project. Do a quick Google search, and surf around the website in question to get a sense of who's behind it. Breakstone recommends looking beyond the website's "About" page, though. "There are lots of sites that are seeking to obscure their identity," he says, "so leave the site you are on, and quickly do a separate Google search to see what other people say about that website or that individual."
On Facebook, Twitter and Instagram, look for a blue verified badge (which looks like a checkmark), confirming that an account—belonging to a media outlet, popular brand or public figure—has been deemed authentic by the social media channel itself. The badge does not mean everything posted from that account is true or fact checked, but it does verify that the individuals/associations are who they say they are.
Step 3: Dig deeper. Double-check when articles and studies were first published. People sometimes post what they think is breaking news on social media when in fact the item is many months or years old.
After all that, be ready to investigate further. Freedhoff suggests asking these questions to uncover who is promoting the information and why: "Do they have a vested interest, especially if monetary, in a particular outcome or message? Do they have the appropriate background to have evaluated the claims they're making—meaning, is there confidence they've actually read and understood the claim's source?"
Evaluating Credibility Online
Once you understand the information's source, it's time to figure out what the news is trying to convey (and why). Williams-Evans reminds us to consider whether new information validates or refutes our knowledge base.
"If it goes against accepted practice or seems too good to be true, or if I simply want the info to be right [because] I agree with it, then I need to trace the links to the primary or original source," she says.
Try this test next time you see health-related news online:
The Jellybean Credibility Test
Imagine seeing an article on Facebook promoting a groundbreaking theory that eating a handful of jellybeans right before exercise promotes weight loss. You might dismiss it right off the bat because it sounds implausible and you don't want to promote candy. But a message you don't like could still be true.
So, in the interest of critical thinking, you click through to the article, which is one-sided. This is a clue. "If you ever see a healthcare story that only discusses the potential benefits of an idea, run for the hills," says Schwitzer. "If harms aren't discussed, it's an incomplete discussion. There are always tradeoffs—something you might gain but also something you might lose. Something that might offer benefits also offers potential harms. If you're not hearing about both sides, move on or dig deeper."
What else about this news item hints that it's either a lie or legit? The article is posted on a health blog you've never heard of, and a quick Google search finds no major media sources corroborating the jellybean claim.
Not a good sign.
"A fitness pro should always consider the publication or blog, the credentials of the author, and whether [the article] is based on valid research or firsthand experience," says McCall.
Here lies another red flag: A theory does not constitute evidence. Are you looking at an opinion piece or a news article? (This distinction also applies to online videos, where somebody might appear to be reporting from a newsroom, when in reality the broadcast is entirely opinion-based.)
When it comes to concrete support for a health claim, anyone who mentions "research" better have citations to back it up. "Often times, you might see people make large claims on the internet, and there is no solid information to support the claim being made," says Breakstone. The phrase "research suggests" is insufficient without a citation.
What is the research? Does the author link the claim to a study? Is the study described at all, or is there nothing more than a nebulous reference to "research" in general?
Let's say there was in fact one study associated with that jellybean assertion, but the web article doesn't link to it or report where the research was conducted or published (this should raise an eyebrow). What can you do? Track down the study, if possible, using keywords in Google Scholar or PubMed. Get as close as you can to the primary source—that is, the research itself. Was the study published in an established, peer-reviewed journal and associated with a major university or medical center?
These would be positive signs, but what about the study design? A small sample size or lack of a control group could undermine the experiment's authority. Also, were the subjects even human, or were they sugared-up lab rats? All these variables could affect reliability. For a more in-depth look at interpreting research, see "Understanding and Translating Research" (Kravitz 2016).
Don't forget to consult the abstract or full paper for disclosures about whether the study was commissioned (funded) by a third party, as that could cloud credibility. For example, if a candy company funded our jellybean study, the results and interpretations could be skewed.
After reviewing all the facts, you conclude that this health-related news item is not trustworthy—best hold off on the jellybeans for now. A single study may not warrant a sudden behavior change anyway. Research is a body of evidence that builds on itself. "In health care," says Schwitzer, "newer is not always better. Choosing to watch and wait . . . choosing conservative pathways can be rational choices."
Stay Vigilant as a Health/Fitness Watchdog Online
Of course, not all claims are as obviously suspicious as the jellybean example. That's why you need to lean on critical thinking every time you visit social media or scan the web for fitness info to share with clients. Facebook, Twitter, etc., should be considered places where you might get a lead on health and fitness news—but that's about it. That said, Facebook has announced a feature to alert users when third-party fact-checking organizations have disputed information. If users try to post an article that has been flagged as "fake news," they'll get a warning (but they can still post the article) (Mosseri 2016). Google offers a similar fact-checking feature (Schroeder 2017).
Even with such safeguards, you should challenge your clients (and yourself) to look more deeply into claims, studies, trends and other items that appear on social media.
Headlines or rants rarely tell the whole story, but they can still make an impact. For example, your conclusion about the legitimacy of eating ice cream for breakfast might depend on whether you just glanced at the Facebook headline or actually clicked through and read the full story and more. A quick Google search would illuminate that most of the published news stories about this ice-cream claim only referenced other news stories—failing to reassure readers with an adequate primary source.
You certainly don't have to follow every lead when scrolling through social feeds, but you should resist storing health "news" in your memory as true, false or a conversation starter with clients unless you've vetted it. And always repost with caution. "Before sharing, pinning or retweeting anything, read the whole post first," says Williams-Evans. "Read first, share second (or not at all)."
Relying on critical thinking and evaluating evidence can help you become a more vigilant health and fitness watchdog online—for your own sake as a professional and to help lead and educate fitness consumers. "As fitness pros," says Williams-Evans, "we can play a standout role in cutting down on inaccurate info by leaving thoughtful comments, engaging in online discussions and offering sourced rebuttals."
Weigh new health/fitness information against the current body of evidence. "Honestly," says Freedhoff, "the easiest litmus test is the age-old 'If it sounds too good to be true, it probably is.' The inconvenient truth of healthy living is that it requires a great deal of effort." Fitness pros know this, which means we have a powerful responsibility to help our colleagues and fitness consumers better evaluate health and fitness claims in thoughtful, informed ways.