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In a week of political defections and naked activists appearing on TV and radio to discuss the matters around Brexit, it's clear that divisions in the opinion of the electorate continue to pull apart established norms. The structural changes proposed by the UK's impending exit from the European Union are far more complex and convoluted than were proposed and ‘sold’ and outcomes far less clear than promised.
Yet entrenched views on both sides continue to hold ground and despite the ever-mounting evidence of economic disappointment rather than sunny uplands it seems only a small percentage of voters have changed their mind. Now you may be thinking why are we reading about Brexit in a newsletter about health?
Well there are a couple of analogies that bear close examination and understanding that reflect deeply held views in which the level of understanding is at best skimpy and the emotional hold disproportionately strong.
The first is the continued willingness of medical journals to seek to denigrate nutritional research and then watch the ensuing media discourse repeat questionable or strongly opinionated views across the various news landscapes. Recent attempts by the BMJ with their new nutrition focussed journal is to be applauded and certainly their detailed discussion on the methodology employed in determining nutrition related outcomes is an interesting read. However there continues to be a belligerent anti nutrition and especially an anti nutrition supplement community, which at times makes its way into respected journals without, it appears, considered review.
Whilst reporting failed trials as well as positive trials is something all research should encourage the role of peer review is coming under increasing scrutiny – yet as in Brexit, despite the evidence to the contrary, entrenched views are hard to challenge and achieve respectful change.
Colleagues Dr Alex Vasquez and Dr Joe Pizzorno have published an editorial in the Journal of Integrative Medicine, and it’s a must read. They explore the nature of some recent negative trials and the knowledge base of the intended audience with regard to nutrition, and in doing so open up a number of interesting points – for example what determines the level of comprehension needed to interpret research papers, and if the peer reviewers are conflicted as well as the researchers, what hope is there that the outcomes will be meaningful – or at least justify interventional reassessment?
The second area is in regard to the changing landscape of our planet, regardless of the cause, change is occurring at a pace that is affecting all of life from small insects to large mammals. Yet we know at senior government levels there is resistance to recognising the need for change despite the increasing wealth of evidence that confirms events are becoming unstoppable.
Biodiversity is being lost at a rate 100 times greater than background rates in pre-human times, because of, for example, deforestation, urbanisation, and climate change.[1] As a health care practitioner it can seem overwhelming in terms of what impact you as an individual can have as human health and natural systems are interdependent. Yet you do have a vital part to play in reducing the environmental impact of health services; increasing resilience to environmental change; by supporting healthy, sustainable behaviours; and advocating for policies to protect planetary health, favouring healthy foods and social interactions.
If we do not at least press back against these changes at a personal level, communicate to our charges a rationalised non-polarised view of what and why things are changing we are avoiding further responsibility. The driving forces that are behind intransigence and related long-term implications are all too insidious and pervasive. Yet at board rooms across the world many leaders are awakening to the need to change and are seeking ways to do it, driven by consumer demand and frustration with the existing models.
Some things need to change others just need to evolve, all need to be evaluated – for which we need access to scrupulous advisers and commentators – a state of affairs that rarely occurs as the last 2 years exploring the separation of the UK from the EU has revealed.
[1] De Vos JM, Joppa LN, Gittleman JL, Stephens PR, Pimm SL. Estimating the normal background rate of species extinction. Conserv Biol. 2015 Apr;29(2):452-62
