In the modern world of social media and media giants with agendas, chiropractors are not just treating patients, they are navigating a landscape saturated with lies, half truth and truth without context.
Social media, headlines, and even mainstream health messaging are often driven by simplicity (and click bait) rather than accuracy.
This creates a fundamental problem, best explained by Brandolini’s Principle:
The effort required to refute misinformation is far greater than the effort required to create it.
Understanding this principle is useful if we are to communicate effectively with patients and claim clinical authority.
Nutrition sits at the intersection of:
- biochemistry
- lifestyle
- chronic disease
- personal belief systems
This makes it highly susceptible to oversimplification, common examples you might hear in clinic:
- “All supplements are unnecessary”
- “You can get everything from diet alone”
- “Cholesterol is the cause heart disease”
- “Carnivore (or vegan) is the best diet”
Each of these statements contains a fragment of truth, but stripped of context they become misleading.
Biology and indeed humans are inherently complex.
Take something as simple as magnesium:
To explain its clinical relevance properly, you must consider:
- Intracellular vs serum status (remember 99% of magnesium is INSIDE the cell, only 1% is in the serum)
- Co-factor roles in ATP production (and it activates ATP once made) and in DNA polymerase (the enzyme used to make all DNA and cells).
- Interaction with calcium channels and the glutamate receptor (it blocks them to help stabilise cell membranes), hence it is good for pain, musclce tension and cramps.
- Relationship with vitamin D metabolism (you need magnesium as a co-factor at two different steps to make active vitamin D)
Yet the easy slogan is often:
“Magnesium supplements do not work” or “you can get all the magnesium you need from food”
One sentence versus an entire lecture.
This is the asymmetry Brandolini described.
Patients are not irrational. They are time poor, with limited baseline knowledge.
Simple messages are:
- Easier to understand
- Easier to remember
- Easier to share
And they get clicks and attention.
In contrast, nuanced explanations:
- Require effort, trust and time
- Require actual learning and understanding, hard for both patient and practitioner.
This means that even well educated patients can default to simplified narratives.
Dodgy statistics do not just create confusion, it affects outcomes.
You may see patients who:
- Avoid nutrient dense foods like eggs due to outdated cholesterol fears
- Dismiss supplementation despite clear deficiency or at least sub-optimal status
- Follow restrictive diets that worsen gut or metabolic health
Over time, this can lead to:
- Persistent inflammation
- Recurrent issues with collagen like tendonitis
- Poor mental health
- Suboptimal clinical progress across the board
Consider choline, a nutrient we have recently explored.
It is required to produce acetylcholine, which drives the parasympathetic nervous system tone via the vagus nerve (this is a topic I will do a deeper dive again soon, it is crazy how important it is).
Remember, it is also a neurotransmitter crucial for focus, attention and memory (that is why the dementia drugs are acetylcholinesterase INHIBITORS.
It also plays a central role in:
- Liver function (makes phosphtidylcholine which keep bile slippery, without this you get fatty liver)
- Lipid transport (phosphtidylcholine is needed to make VLDL, which moves triglycerides out of the liver, without this you get a fatty liver)
- Methylation (turns homocysteine back into methionine)
Yet many patients actively avoid the richest sources:
- Eggs
- Liver
Why?
Because of simplified messaging around egg, cholesterol and heart disease that has persisted for decades.
The result is a population with chronically low choline intake, contributing to:
- poor vagal tone (poor digestion, anxiety, poor sleep, lack of resilience)
- Impaired recovery
- Poor memory and focus
- Sustained inflammatory signalling via poor vagal tone (this is known as CHOLINGERGIC ANTI-INFLAMMATORY PATHWAY)
Note, the UK does not have an RDA for choline, this is why it is a blind spot for many people and especially an issue for vegans who have very little natural intake.
The European standard uses an “adequate intake” (AI), which is when they do not have enough strong evidence to give an RDA which would be set for 97.5%of the population to be not deficient (let alone optimal).
For adults, that is 400 mg, pregnancy 480 mg and breastfeeding 520 mg.
I would argue those a little on the low side and aim for 600 mg (x2 CHOLINE capsules from IN health), and x3 (9900 mg) in the third trimester of pregnancy.
If misinformation is easy to create and hard to refute, then long, complex explanations are not the answer.
Instead, we use a simple, direct and, if needed, layered approach.
Start with a simple, accurate statement:
“Eggs are one of the most nutrient dense foods you can eat, containing nutrients that are hard to get in other foods, and avoiding them often creates deficiencies leading to symptoms and potentially disease rather than preventing disease.”
This counters the myth without overwhelming the patient.
If needed, add in details
- Explain choline making acetylcholine – focus, memory and learning
- Link to vagal tone and inflammation – Low acetylcholine may be linked to a sustained inflammatory response
- Choline makes phosphatidylcholine, which is 50% of all of the cell membrane, without adequate amounts, you can get cell membrane fragility – in muscles that can lead to breakdown of cells as they contract, leading to muscle pain (and raised creatine kinase in some cases)
- Personalise to their symptoms (memory, focus, liver health/fatty liver, poor muscle tone)
Patients respond to:
- “This is why your digestion is not improving”
- “This is why your recovery is slow”
- “This is why you cannot relax”
- “That is why your muscles hurt”
- “That is why you have fatty liver”
We are currently talking to digital creators about a whole suite of patient education videos, to make the job of education easier – watch this space