There was a time, in the distant past, when studying nutrition was relatively simple science.
For instance, in 1747, physician James Lind ran the first modern clinical trial on sailors with scurvy. The sailors were divided into groups and given different treatments. The men who ate oranges and lemons eventually recovered — a striking result that pointed to vitamin C deficiency as the culprit. Unfortunately, studying nutrition is no longer that simple.
The biggest predisposition in nutrition science is the belief that research is only valid if you do an extensive randomized controlled trial (RCT)or have applied the latest statistics to generate lots of data and fancy graphs, which can barely fit into a PowerPoint slide. In many areas of science, the RCT is considered the gold standard for evidence, but when it comes to food, food choices and general eating habits, these are complex phenomena and cannot be reduced to numbers. As said by Ben Gold acre (British physician and epidemiologist), “in an ideal world, I would take the next 1,000 children born, randomize them into two different groups, and have half of them eat nothing but fresh fruit and vegetables for the rest of their lives” But, Gold acre adds, “I would have to imprison them all, because there’s no way I would be able to force 500 people to eat fruits and vegetables for life.’”
We, as researchers, believe in numbers – measuring, counting, and calculating, in the hope of capturing some truth through our measurements. But there is an invisible measurement which not many focus on – the power of the unseen – a variable that is measurable but significant in the path to change. Methods like Focus Group Discussions, community engagements and observations of the group/population have the power to reveal hidden facts. A tiny piece of information disclosed during such sessions which has a huge impact on the data collected and its analysis.
One such instance took place with me while conducting an FGD on food habits with a group of women in a small village in Rajasthan. I was interrupted by a strange question from one of the women, whether I groom my eyebrows or not. This totally amazed me! When I asked her why she had asked me such an unrelated question; her answer led me to the discovery of a series of answers to questions that were most helpful to define a strategy. I found that in that small village a woman had a makeshift parlor in her backyard. In the afternoons, this place was used for women to meet, exchange food, recipes and treats. I also learned that they spend INR 15 on grooming their eyebrows; which made me realize that they cared about how they looked and were willing to spend on it.
What I learnt from this discussion was that between the results of an RCT and an intervention strategy there is a big black box that reads ‘HOW’ and that how; especially when you study populations, can only be answered when you not only collect data but also the stories and the experiences that define that individual, population and the nation.
If you want to make a sustainable behavioral change or want to start a movement and exceed beyond publishing a paper; you have to acknowledge the power of the unseen!