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Have you been ‘Gish Galloped?’

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This is when you are in discussion with someone, or some people, whose debating method or simply their pursuit of verbal dominance is known among philosophers and rhetoricians as the ‘Gish Gallop’. The aim is simple: to defeat their opponent by burying them in a torrent of incorrect, irrelevant, or idiotic arguments.

Named after one of the most vocal ‘creationists,’ Duane Gish, who notoriously used a rapid-fire approach during a debate, presenting arguments and changing topics very quickly and in a manner intended to be extra impervious to reason. Arguably wisely, considering none of his individual statements would stand up to closer scrutiny. A technique also used by some politicians, friends, frenemies, family and generally annoying humans.

Brandolini’s law” developed in response explains “The amount of energy needed to refute bullshit is an order of magnitude bigger than to produce it.”

The Gish Galloper’s entire strategy rests on exploiting this advantage. By the time you’ve begun preparing your rebuttal of the Galloper’s first lie, they’ve rattled off another dozen. They want to trick the audience into believing that the facts and the evidence are on their side. (They have so many examples!) The technique is based on delivery over depth. Some call it “proof by verbosity.”

Why do we need to recognise this?

Working with the understanding that non-communicable diseases (NCDs) are the world’s greatest threat to human health, albeit infectious diseases are also a great risk, they are amplified by poor lifestyle. The emphasis that is placed on nutrition as a defining factor in the creation and resolution of the related conditions can become lost in Gish Galloping noise. Nutrition when optimal, plays a decisive role across geographies and societal groups in contributing to human health, strengthening resilience and extending the period of being free from NCDs and increasing the quality of life.[1]

Nutrition Gish Galloping is frequently presented as ‘all nutrition messaging’ being contradictory, that humans should be able to eat what they want and that the ‘nanny’ state is a great threat to individualism etc. A position favoured by those seeking to determine that a small state is in all cases good for the population. Yet the evidence is exactly contrary, lack of central and science based, not industry based, guidance leads to poor decisions and ultimately loss of access to healthy foods and a decline in people’s health and productivity.

A recent JAMA paper confirmed that British children under 5 have the highest consumption of mass-produced ready-made food, creating the risk for long-term habits and increased risks of NCDs.[2] It comes amid record levels of childhood obesity, with a depressing four in 10 children obese or overweight by the time they finish primary school.

Nutrition science and policies can, and in some countries, have evolved to become more holistic, with a better understanding of the role of nutrition in the broader context of dietary patterns, and ultimately the complex interactions between nutritional, dietary, social, behavioural and environmental factors, including how nutrition impacts health maintenance and promotion.[3]

Unfortunately, our well-established, system(at)ic healthcare reaction still incentivises disease care rather than prevention (e.g. healthcare cost reimbursement; regulatory frameworks; patent protection). This approach has long been reflected in an effort to uncover the magic nutrition bullet, and accordingly scientists have inappropriately studied nutrients in a drug-like context. Unlike drugs, nutrients do not function in isolation and have beneficial effects on multiple tissues and organ systems; a narrow focus on a single or ‘primary’ outcome measure is not practical and does not fit the nutritional therapy context.[4]

Perpetuated by a reductionist approach on single macro- and micronutrients, scientists have similarly spent countless resources satisfying the demand for the nutrition ‘villain’ and ‘hero.’ Heroes include substances such as antioxidants, fibre, protein and probiotics, while the maligned villains include saturated fat, refined carbohydrates, trans-fat, salt and sugar. This constant pursuit of conflict creates an opportunity for those people seeking to diminish the importance of nutrition, and/or those seeking to elevate their interpretation of nutrition – the necessary resources for the Gish Galloping outpourings.

Nutrients interact

In studying the effects of nutrients in isolation, premature conclusions have been reached, resulting in the inevitable ‘flip-flopping’ on whether particular nutrients are beneficial or harmful. This, in turn, has led to enormous consumer confusion and frustration. The problem with this reductionist approach is that, in emphasising specific nutrients, it fails to take into account that food components interact in complex ways to give rise to emergent properties of diets that are not explicable at the level of individual chemical parts.

Functional medicine teaches that individual nutrient application and utilisation is an important part of overall care. By recognising dynamic and highly intertwined connections and interactions, a systems approach is advocated, which incorporates transdisciplinary models for food and nutrition security. Such an approach aims to reduce complexity by revealing key interactions that influence the outcomes of care. In other words, a systems approach can help to identify common causal factors underlying the otherwise seemingly opposing challenges of malnutrition and obesity (population is undernourished but overfed), which are occurring with more regularity around the world as well as many of the complex NCDs and related loss of function we see so often. Areas such as behavioural, lifestyle, social, cultural, economic, geographic, occupational, and environmental factors impact food and life choices.

Vitamins and Minerals

Most of the world’s population has inadequate intake of one or more of the essential vitamins and minerals. While vitamin and mineral deficiency and inadequacy are often seen as problems in developing countries it is less recognised as an issue in developed countries.[5]

Vitamins and minerals are cofactors for proteins and enzymes of metabolism and have other essential functions in our body. A varied and balanced diet should provide enough of all of the vitamins and minerals; however, an unbalanced diet provides calories but not enough of the vitamins and minerals. Insufficient vitamins and minerals result in a deficiency disease, while the consequences of inadequacy are more difficult to diagnose.

The Triage theory by Dr Bruce Ames posits that, because of recurrent shortages of vitamins and minerals during evolution, natural selection developed a strategic-rationing response to moderate shortages so that the scarce nutrient is preferentially retained by proteins that are essential for short-term survival and reproduction.[6] In contrast, proteins needed for long-term health and to defend against the diseases associated with aging, are starved for vitamins, and thus are disabled. Since the damage from moderate deficiency is insidious, its importance for long-term health is not clinically apparent.

Mechanistic, genetic, and epidemiological evidence suggests that the metabolic trade-off accelerates aging-associated malfunctions and diseases, such as cancer, cardiovascular disease, immune dysfunction, and cognitive decline (NCDs). The implications being that appropriate supplementation will augment a healthy diet to prevent or reduce the incidence of such.

Appropriate micronutrient intake (vitamins and minerals) as part of a balanced diet and in combination with fortified food and supplements encourages health and well-being.

Training

The Institute for Functional Medicine offers highly specialised post graduate training for health care practitioners, teaching evidence-based approaches to lifestyle medicine in a systems orientated framework, and the role of nutrition in health generation and recovery. Training occurs internationally, and in the UK Clinical Education is the IFM’s international education partner. If you are interested in understanding more about how a systems-based approach can act as both prevention and recovery, consider undertaking their introductory training programme, Applying Functional Medicine in Clinical Practice.

Next time you are Gish Galloped about lifestyle, functional or nutritional medicine, you can take their weakest argument – highlight and debunk it, and you will be amazed how the narrative changes.

 

References

[1] Ruthsatz M, Candeias V. Non-communicable disease prevention, nutrition and aging. Acta Biomed. 2020 May 11;91(2):379-388.

[2] Chang K, Khandpur N, Neri D, Touvier M, Huybrechts I, Millett C, Vamos EP. Association Between Childhood Consumption of Ultraprocessed Food and Adiposity Trajectories in the Avon Longitudinal Study of Parents and Children Birth Cohort. JAMA Pediatr. 2021 Sep 1;175(9):e211573.

[3] Shao A, Drewnowski A, Willcox DC, Krämer L, Lausted C, Eggersdorfer M, Mathers J, Bell JD, Randolph RK, Witkamp R, Griffiths JC. Optimal nutrition and the ever-changing dietary landscape: a conference report. Eur J Nutr. 2017 May;56(Suppl 1):1-21.

[4] Heaney RP. Nutrients, endpoints, and the problem of proof. J Nutr. 2008 Sep;138(9):1591-5.

[5] Krebs-Smith SM, Guenther PM, Subar AF, Kirkpatrick SI, Dodd KW. Americans do not meet federal dietary recommendations. J Nutr. 2010 Oct;140(10):1832-8

[6] Ames BN. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. Proc Natl Acad Sci U S A. 2006 Nov 21;103(47):17589-94.

The post Have you been ‘Gish Galloped?’ first appeared on Clinical Education.


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