Spin Doctors – How the Media Reports on Medicine

Spin Doctors – How the Media Reports on Medicine
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Even if journalists are doing their due diligence, they still run the risk of deceiving their readers, due to spin present in the medical journals themselves.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In a study of the dietary advice given by newspapers in the UK, “no credible scientific basis” was found for most claims. The “[m]isreporting of dietary advice” was found to be “widespread and may contribute to public misconceptions about food and health.” And, potentially, not just the public.

Scientists like to think they’re not influenced by popular media, but this study decided to put that to the test. Each week, The New York Times reports on scientific research, and the studies they report on end up being cited more often than those they don’t report on. Ah, so, the popular press does have an impact.

Not so fast. That’s just one potential explanation. Maybe, outstanding articles are both more likely to be picked up by media, and independently more likely to be cited. Maybe, the newspaper was just earmarking important science, and their publicity didn’t really have any effect on future studies.

How could you disentangle the two? An event in 1978 made it possible. There was a three-month strike, in which they continued to print copies, but could not sell them to the public. So, a natural experiment was set up. If the paper was just earmarking important articles, then the strike would have no effect on the studies’ impact. But, that’s not what happened. The studies highlighted during the strike months, when no one could read them, appeared to have no impact.

The next question, of course, is: are they just amplifying the medical information to the medical community, or distorting it, as well?

Systematic studies suggest that many stories about new medicines, for example, tend to overstate benefits, understate risks and costs, and fail to disclose relevant financial ties. Overly rosy coverage of drugs may also result from financial ties between drug companies and the journalists themselves, who may be susceptible to Big Pharma perks.

Scientists and physicians often blame the press. In fact, the famous physician William Osler was quoted as saying, “Believe nothing that you see in the newspapers” and “If you see anything in them that you know is true, begin to doubt it at once.”

But, both parties share in the blame. Reporters may only have an hour or two to put together a story; and so, they may rely on press releases. And, it’s not hard to imagine how drug company press releases might be biased. But, surely, press releases from the scientists themselves, and their institutions, would present the facts fairly, and without spin, right? Researchers decided to put it to the test.

Critics blame the media. But, where do you think they’re getting the information from? One might assume that press releases from prestigious academic medical centers would be measured, unexaggerated—but they suffer from the same problems: downplaying side-effects, conflicts of interest, and study limitations, and promoting research that has uncertain relevance to human health.

For example, most laboratory or animal studies explicitly claimed relevance to human health—yet lacked caveats about extrapolating results to people. For example, a release about a study of ultrasound reducing tumors in mice, was  titled “Researchers study the use of ultrasound for treatment of cancer”—failing to note “for your pet mouse.”

Apparently, it’s been estimated that less than ten percent of animal research ever succeeds in being translated to human clinical use. Overselling the results of lab animal studies as a promised cure potentially confuses readers, and might contribute to disillusionment with science.

Although it’s common to blame the media for exaggerations, most times they don’t just make it up. That’s what the research institutions are sending out in their own press releases. And, medical journals, too. Sometimes, medical journal press releases do more harm than good. An analysis of press releases from some of the most prestigious medical journals found the same litany of problems.

I don’t think most people realize that journals sell what are called reprints, copies of the articles they print, to drug companies, which can bring in big bucks. Like, drug companies may buy a million copies of a favorable article. Sometimes, the company will submit an article, and promise to buy a certain number in advance—which is effectively a bribe, notes a long-time editor-in-chief at the prestigious British Medical Journal. He remembers once when a woman from a public relations company rang him up, and stopped just short of saying she would go to bed with him if they published the paper.

Another medical journal conflict of interest relates to advertising—a major source of income for many journals. Most of the advertising comes from pharmaceutical companies. And, so, if they don’t like a study, they can threaten to withdraw their advertising—potentially leaving editors faced with the stark choice of agreeing to bury a particular piece, or seeing their journal die.

Even if journalists have time to skip the press releases, and go straight to the source, and try to read the studies themselves, they may find them utterly incomprehensible gobbledygook. But, even if they do understand them, scientific articles are not simply reports of facts. Authors often have many opportunities to add “spin” to their scientific reports—defined as ways that can distort the interpretation of results, and mislead readers, either unconsciously, or with willful intent to deceive.

What these researchers did was look at randomized controlled trials with statistically nonsignificant results—meaning some drug, for example, was compared to a sugar pill, and the difference between the newfangled treatment and placebo was essentially nonexistent. Would the researchers just lay out the truth, and be, like, well, we spent all this time and money, and in terms of our primary outcome, we got nothing. Or, would they try to spin it? In 68% of cases, they spun. There was spin in the abstract, which is like the summary of the article. And this is particularly alarming, because the abstract is often the only part of an article people actually read.

And so, no wonder the media often gets it wrong. Spin in the abstracts can turn into spin in the press releases, and results in spin in the news. Therefore, even if journalists are doing their due diligence, using the original abstract conclusion in good faith, they still run the risk of deceiving their readers.

Researchers presenting new findings should always be careful to stress how preliminary the findings may be. But, let’s be serious; powerful self-interests may prevail.

Finally, though, I think the biggest problem with the way media reports on medicine is the choice as to which stories are covered. In 2003, SARS and bioterrorism killed less than a dozen people, yet generated over a hundred thousand media reports—far more than those covering the actual greatest threats to our lives and health.

In fact, ironically, the more people that die, the less it appears something is covered. Our leading, #1 killer is heart disease. Yet, it can be prevented, treated, and even reversed with diet and lifestyle changes. Now, that is something that deserves to be on the front page.

Please consider volunteering to help out on the site.

Image thanks to PDPics via Pixabay

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In a study of the dietary advice given by newspapers in the UK, “no credible scientific basis” was found for most claims. The “[m]isreporting of dietary advice” was found to be “widespread and may contribute to public misconceptions about food and health.” And, potentially, not just the public.

Scientists like to think they’re not influenced by popular media, but this study decided to put that to the test. Each week, The New York Times reports on scientific research, and the studies they report on end up being cited more often than those they don’t report on. Ah, so, the popular press does have an impact.

Not so fast. That’s just one potential explanation. Maybe, outstanding articles are both more likely to be picked up by media, and independently more likely to be cited. Maybe, the newspaper was just earmarking important science, and their publicity didn’t really have any effect on future studies.

How could you disentangle the two? An event in 1978 made it possible. There was a three-month strike, in which they continued to print copies, but could not sell them to the public. So, a natural experiment was set up. If the paper was just earmarking important articles, then the strike would have no effect on the studies’ impact. But, that’s not what happened. The studies highlighted during the strike months, when no one could read them, appeared to have no impact.

The next question, of course, is: are they just amplifying the medical information to the medical community, or distorting it, as well?

Systematic studies suggest that many stories about new medicines, for example, tend to overstate benefits, understate risks and costs, and fail to disclose relevant financial ties. Overly rosy coverage of drugs may also result from financial ties between drug companies and the journalists themselves, who may be susceptible to Big Pharma perks.

Scientists and physicians often blame the press. In fact, the famous physician William Osler was quoted as saying, “Believe nothing that you see in the newspapers” and “If you see anything in them that you know is true, begin to doubt it at once.”

But, both parties share in the blame. Reporters may only have an hour or two to put together a story; and so, they may rely on press releases. And, it’s not hard to imagine how drug company press releases might be biased. But, surely, press releases from the scientists themselves, and their institutions, would present the facts fairly, and without spin, right? Researchers decided to put it to the test.

Critics blame the media. But, where do you think they’re getting the information from? One might assume that press releases from prestigious academic medical centers would be measured, unexaggerated—but they suffer from the same problems: downplaying side-effects, conflicts of interest, and study limitations, and promoting research that has uncertain relevance to human health.

For example, most laboratory or animal studies explicitly claimed relevance to human health—yet lacked caveats about extrapolating results to people. For example, a release about a study of ultrasound reducing tumors in mice, was  titled “Researchers study the use of ultrasound for treatment of cancer”—failing to note “for your pet mouse.”

Apparently, it’s been estimated that less than ten percent of animal research ever succeeds in being translated to human clinical use. Overselling the results of lab animal studies as a promised cure potentially confuses readers, and might contribute to disillusionment with science.

Although it’s common to blame the media for exaggerations, most times they don’t just make it up. That’s what the research institutions are sending out in their own press releases. And, medical journals, too. Sometimes, medical journal press releases do more harm than good. An analysis of press releases from some of the most prestigious medical journals found the same litany of problems.

I don’t think most people realize that journals sell what are called reprints, copies of the articles they print, to drug companies, which can bring in big bucks. Like, drug companies may buy a million copies of a favorable article. Sometimes, the company will submit an article, and promise to buy a certain number in advance—which is effectively a bribe, notes a long-time editor-in-chief at the prestigious British Medical Journal. He remembers once when a woman from a public relations company rang him up, and stopped just short of saying she would go to bed with him if they published the paper.

Another medical journal conflict of interest relates to advertising—a major source of income for many journals. Most of the advertising comes from pharmaceutical companies. And, so, if they don’t like a study, they can threaten to withdraw their advertising—potentially leaving editors faced with the stark choice of agreeing to bury a particular piece, or seeing their journal die.

Even if journalists have time to skip the press releases, and go straight to the source, and try to read the studies themselves, they may find them utterly incomprehensible gobbledygook. But, even if they do understand them, scientific articles are not simply reports of facts. Authors often have many opportunities to add “spin” to their scientific reports—defined as ways that can distort the interpretation of results, and mislead readers, either unconsciously, or with willful intent to deceive.

What these researchers did was look at randomized controlled trials with statistically nonsignificant results—meaning some drug, for example, was compared to a sugar pill, and the difference between the newfangled treatment and placebo was essentially nonexistent. Would the researchers just lay out the truth, and be, like, well, we spent all this time and money, and in terms of our primary outcome, we got nothing. Or, would they try to spin it? In 68% of cases, they spun. There was spin in the abstract, which is like the summary of the article. And this is particularly alarming, because the abstract is often the only part of an article people actually read.

And so, no wonder the media often gets it wrong. Spin in the abstracts can turn into spin in the press releases, and results in spin in the news. Therefore, even if journalists are doing their due diligence, using the original abstract conclusion in good faith, they still run the risk of deceiving their readers.

Researchers presenting new findings should always be careful to stress how preliminary the findings may be. But, let’s be serious; powerful self-interests may prevail.

Finally, though, I think the biggest problem with the way media reports on medicine is the choice as to which stories are covered. In 2003, SARS and bioterrorism killed less than a dozen people, yet generated over a hundred thousand media reports—far more than those covering the actual greatest threats to our lives and health.

In fact, ironically, the more people that die, the less it appears something is covered. Our leading, #1 killer is heart disease. Yet, it can be prevented, treated, and even reversed with diet and lifestyle changes. Now, that is something that deserves to be on the front page.

Please consider volunteering to help out on the site.

Image thanks to PDPics via Pixabay

Doctor's Note

Well, if you can’t even trust the medical literature on its face, where can you turn? We’re talking life or death information here! What you need is someone who will dig deep into the data for you, and translate the gobbledygook into actionable tips on keeping you and your family healthy. Hmm, if only there was a website… :) If you appreciate the work we do, please consider supporting us. NutritionFacts.org relies solely on individual donations from users like you!

If you think just a little spin is bad, there is a much deeper rot in the medical literature. See my recent videos Disclosing Conflicts of Interest in Medical Research, and Eliminating Conflicts of Interest in Medical Research.

No wonder Physicians May Be Missing Their Most Important Tool.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

81 responses to “Spin Doctors – How the Media Reports on Medicine

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  1. One can trusdivulgantion(only when is not conflict of interest) but not in science divulgantion, unfurtunatly.
    Furtunated us that have a web donation based! Actually accesible to every one.

    The format of the site is great i will ask for even more!! Is posible to make a link database with the studies in favor and agains saturated fat for exsample? I mean all the studies in a table with a coment a side with the fundings, if it was interventional , observational studie etc.. mean we talk of a big volumen of vidence saying what this site is reporting but it will great to have it in numbers.. in fact i was looking with a friend studies in favor of saturated fat(he was convince by media that butter was just fine and many other books).. and we found them but all meta analisis with misleading conclution, and non clinical trials… just some abstracts.. for me this is from a great relevances for all health issues.. to have studies with meat and cancer (for exsample)all toguether even thouse that may repeat or not be the best studie for highlight in this site, but to get a sense of the volume and quality of cience in both sides. To have them in some kind of table with notes and the links here at nutrition facts.
    And thouse studies with misleading conclutions maybe with a not the eason way..

    A think this site is educating to the people to go to the source.. and now many of us are interest. Also some basic information of how to read a studie may be usefull, eve if we have learn alot with the videos already.




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    1. I mean if we are living in a moment when media make people think that science is divided , is important to show the facts in that way. Not only peakin the best studies but puting all toguether accasible for everyone,, and also put the one in favor .. to see the whole picture.
      Thank you




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  2. Thank you! Dint say it here but a old friend have been diagnose with skin cancer .. he have change his diet, and aply curcumin in the skin and when the time of the sirgury arrive the doctors cudnt even find the scar.. after the operation it was cero malignant cells in the biopsia… significant!!




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      1. I dont remember but the most commun one, canciroma. Is one that is not very agresive, and doctors can take few month to make the intervention. Not like melanoma.




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  3. The last minute of the video has more truth in it than most people in modern society would be able to handle. Truly tragic that our society has degraded to the will of a mass who’s heart strings are readily pulled by social media, media and the like, of which the prevailing narrative is one of an agenda set forth by a very select few. That agenda is no other than one to keep you and this planet as a profit source. To keep the status quo you could say.
    “Realize that everything connects to everything else.” – Leonardo da Vinci




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  4. Doesn’t Dr. Gregor use many of these type of studies and reports to make his case, spinning the benefits of a plant based diet? Looking at the graph in this video, “Misrepresentation of health risks by mass media,” I see that physical inactivity is right up there with smoking. Where would an unhealthy (animal product heavy) diet fall on this chart? I often get the impression that Dr. Gregor insinuates that a vegan diet is a substitute for exercise. By the way I am a vegan, I’m just pointing out that most people, no matter how well intended, have an agenda. Better to be a vegan than a cigarette smoking meat eater, but even better to be a vegan athlete than a vegan couch potato.




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      1. 17 miles a day? Really? Seems excessive to me. I read that the optimal amount of moderate exercise was only 450 minutes a week, or half that amount for vigorous exercise. https://www.ncbi.nlm.nih.gov/pubmed/25844730 and also https://www.ncbi.nlm.nih.gov/pubmed/25844882 Ironically, I first read this in the New York times so beware of the spin doctors. However from what I understood, additional exercise doesn’t bring additional benefit and may even increase risk of injuring the joints or causing other athletic injuries. Perhaps Dr Greger walks so far simply because he enjoys walking. But I think he would be a better example if he showed more moderation.




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          1. hi Ron, thank you for your links and article. I’ll read them with interest. I dont know if 17 miles is excessive or not, but a couple of thing come to mind. One is that there are videos showing the harm we do to ourselves by sitting all day , at home, or at the office. Even short breaks are said to be beneficial. (if I find the video I will post a link..
            The other thing is that one of my favorite stories of Dr Greger’s is the one about his grandma who was wheelchaired into the Nathan Pritikin center .After undergoing a couple of bypasses and being sent away to die, the Pritikin center was her last chance at life. She walked out of there doing 10 miles per day ! So, I think it really runs in the family. For me, this is a truly inspirational story. I underwent a quad bypass, and now I walk and swim daily.. 2 hrs /day, because I like it, and because I CAN. ty again




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        1. I’ve wondered about that, also. He isn’t running, he’s walking at a brisk pace – so he’s not generating as much reactive oxygen species (ROS). OTOH, it may be that a big dose of ROS every other day from exercise would be better as a hormetic stressor. I’ll try to read the articles you linked (thanks for them, by the way). I’m trying to figure this out for my own workout schedule.




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        2. “But I think he would be a better example if he showed more moderation. ” So from a questionable figure of 17 miles a day, you rant about what somebody should do and then talk about him being a questionable example. This is just unclear thinking and then judgemental on top of that. Greger can do what he likes and contributes something valuable to the community. He needs to be thanked and critiqued when appropriate but just jumping on unconfirmed premises and then being judgemental is just silly.




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            1. That’s all good. My point is the extrapolation from that figure that led to pronouncements of Greger being a poor example is unfair.




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              1. guest: Thanks so much for finding that! I just hate to misquote someone. I feel a lot better now.
                .
                re: dog walking. That’s awesome. Working exercise into your normal day (just like Dr. Greger really) seems like the ideal way to go to me. Lucky you that you get to do it with our 4 legged friends.




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                1. It so funny you guys mentioned dog walking. I just recently got a dog. I used to have trouble getting in my 10,000 steps each day, mainly because I wasn’t making it a priority. Now that I have the dog either I walk him or I have a mess to clean up. Funny how easy it is to change priorities. I’m now averaging 13,000 to 15,000 steps a day. Thanks to my “Oliver”.




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                  1. payoung: Yeah Oliver!!
                    .
                    FYI: I read an article some time ago about some study that showed that people who owned dogs were healthier because they exercised more. They may not get their behind out the door for themselves, but when puppy dog eyes are pointed their way, time for a walk! ;-)




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                    1. Thanks and he’s a great dog! A 65lb 18 month old pitbull mix that was a rescue except I haven’t yet figured out if I rescued him or if he rescued me. He thinks he’s still a puppy and long walks are the only way to tire him out.




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            2. I believe he uses a walking desk at low speed to rack up these miles.

              Maybe, Dr. Greger is inspired by the long-lived Sardinian shepherds who walk many mies, hilly terrain with their bread and cannonau wine.

              What is he eating and drinking while he’s on that treadmill?




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              1. deanna: I don’t know if Dr. Greger eats and drinks while on the treadmill, but we have a pretty good idea of what Dr. Greger eats throughout a typical day. He explains his diet in detail in the second part of his book, How Not To Die. If you want the cliffnotes, you can look up ‘Daily Dozen’.
                .
                I bet those Sardinian shepherds are in pretty good shape!




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    1. Rick: To echo what WFPBRunner said, exercise is one of Dr. Greger’s Daily Dozen. It is not an accurate representation of Dr. Greger’s views to say that a vegan diet is a substitute for exercise. In addition to the Daily Dozen, every time Dr. Greger points out the power of diet when compared to exercise, he always says (as near as I remember) that doing *both* is better!
      .
      In my opinion, Dr. Greger sometimes highlights the power of diet when compared to exercise in order to a) highlight the power of diet and b) combat the disproportionate emphasis that some people in our society place on exercise. It’s not that exercise is not important. It is and Dr. Greger is the first to recognize that. But exercise will not make up for an unhealthy diet, as some would have us believe.




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      1. Rick: As a follow up to my post and to highlight what guest was talking about: Dr. Greger takes exercise so seriously that he models daily exercise for us as often as he can. He uses a walking treadmill desk for interviews and as guest said, has been reported to be up to about 17 miles of walking a day. That is not the actions of a person who, “insinuates that a vegan diet is a substitute for exercise.”




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    2. “…most people, no matter how well intended, have an agenda”
      Dr Gregers agenda seems to be to present the best available science based data about what to eat to stay healthy, live long lives, avoid disease, free of charge, to everybody in the world, who wants to spend 5 minutes 5 times a week, and not earn a penny doing that. Talk about a bad agenda…… :-)




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    3. I think you should think about agendas yourself Rick. People who spent years believing media spin until they were ancient and found NF are often not exactly “athletic” material, no matter how much desire they have. As for Dr G’s take on exercise, he makes it pretty clear in many of his videos, or watch any of his video interviews and you will see him doing his 17 mile a day treadmill trip. Exercise is always important, but you have to get the diet right first, (Jim Fixx?) and THAT is in the title of this website.




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    4. Rick, please remember that this is called Nutrition Facts. Not Basic Health Facts. That is why Dr G emphasizes the importance of nutrition. He certainly promotes exercise where appropriate (see other comments). He also points out the importance of a whole foods diet from plants. There are many who are vegan but perhaps don’t yet understand the importance of quality food, so they eat junk like french fries and cokes.

      I find his video explaining how thoroughly he searches sources to be sure the studies he quotes don’t have a commercial agenda most impressive. See the one titled Behind the Scenes at NutritionFacts.org.




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  5. I love how in depth this video is, covering the complexity of the situation. This is definitely information that is both not understood by many and for those that do understand it, often not taken seriously enough (in my opinion).

    My solution: I think the media should be responsible and aware enough to recognize these problems. The solution in my opinion is for the media to stop reporting on this information or get together and essentially hire a team like NutritionFacts’s team, including a “Dr. Greger” who can look at actual studies, not just abstracts, etc and to ferret out the true news. If they aren’t willing to do that, then they have no business reporting on it.




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    1. Thea,
      agree, but the problem is that media is about business. Nobody wants to read that broccoli is a health food – people want to read that a pill or genetic science will save you.
      And there is no end to it – how many times have we read that saturated fat isn’t that bad, cholesterol is not the villain, its okay to be a little overweight and so on. It has been debunked several times, but every year the same stupid breaking news pop up again.




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      1. Plantstrongdoc M.D.: Yeah. What you said.
        .
        To clarify: I get that media is about business. I just have an idealistic view in my head that media can be both about business and also have journalistic integrity/standards. Without the dual objectives, the media is failing in their extremely important role of being a check on government, large corporations, and any other “big” entities. Put another way: Media can be about making money AND be a force for good. Alternatively, media can be only about making money and end up being a force for bad. While option 2 is in play now, I’d rather have option 1, and I think there are ways to get there. That’s just my take on it. :-)




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        1. Well, as far as I can tell government and large corporations are the same thing now. (Citizens United, etc.) And the media is just their marketing department: both “commercial media” and the USDA for example. Once you decide that profits are the number one priority, they seem to rapidly become the only priority. That’s just capitalism, materialism and consumerism I guess.




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  6. What you don’t see can be more important than what you see. Here is a scientific article titled “Metabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood “Villains” of Human Metabolism” by Anssi H Manninen.

    But here are some googled pictures of the author of the mentioned scientific article:

    http://kuvat.kaleva.fi/default/21a351e6-2c16-11e2-8586-12313b053908/large-D-vitamiini.jpg
    http://files.fitfashion.fi/wp-content/uploads/sites/8/2012/09/Anssi%2BManninen.jpg
    http://i.ytimg.com/vi/1SCPXP66w-c/0.jpg

    Draw your own conclusions ;)




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    1. “There is no Clear Requirement for Dietary Carbohydrates for Human Adults” This guy should do stand up. I haven’t laughed that hard for years. He looks very unhealthy in that picture BTW.




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  7. Interesting analysis. I was recently looking at the Join WHO/FAO expert consultation on Diet Nutrition and Chronic Disease (WHO Technical Report Series 916). On page 5 it says “Although more basic research may be needed on some aspects of the mechanisms that link diet to health, the currently available scientific evidence provides a sufficiently strong and plausible basis to justify taking action now”. This definitely would not make front page news! The newspapers are in the business of selling newspapers. The academics face “publish or perish” in order to keep their jobs…and so on! Not much going on in the public interest. I always refer people to this website, the books of Dr Ornish, Dr Esselstyn, etc, Physicians Committee for Responsible Medicine—and hope for the best!




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  8. Good video.Thanks to Dr Greger for tackling this subject and shedding light on a serious issue. It seems as though true journalism has gone by the wayside. I for one, have lost all faith in the mainstream media and question everything I read or hear and always look for the bias. And with all the revelations we’ve heard about recently, it’s no wonder large numbers of people no longer trust the media. Hopefully, one day we’ll get true journalism back again.

    “The further a society drifts from the truth, the more it will hate those who speak it.” George Orwell




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  9. WFPBRunner: re: sitting is bad option. I totally agree! I don’t have a walking desk, but I have a standing desk and while it is not nearly as good, I notice an improvement in my health just making that one change. I think Dr. Greger is a good example. If I had a place that would let me do the treadmill desk, I would totally do that.




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    1. Exactly. Those walking desks are so expensive. I think the one Dr Greger uses is a converted treadmill. Or at least appears that way. Standing desks are great too.




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    1. “Unless you have a medical condition that dictates otherwise, there’s no reason to cut anything – not butter, ice cream or Porterhouse steak — completely from your diet”
      OK – the point is to wait to cut out the bad foods, until you get a medical condition caused by butter, ice cream and Porterhouse steak……
      I don’t get the logic – but that’s probably just me…..




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        1. It is.
          The evidence that a WFPB diet (and running! :-) ) is the best diet for humans is overwhelming. No doubt about that.
          This article leaves the impression that if you eat your vegetables fruit and other health foods, then you can also indulge in butter, ice cream and Porterhouse steak. Nonsense and nonscience.




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  10. For those who haven’t already read it, T. Colin Campbell’s book, “Whole” includes a very detailed look at how media, academia, and monied interests create a perfect storm of information bias.

    At the same time, as one who has only just emerged from the paleo/lowcarb echo chamber, I am hypersensitive to confirmation bias, to the point where I have trouble seeing anything *but* spin from any and all sources. I begin to feel like I’m Fox Mulder in the nutritional X-Files, where the only rule is “Trust no one.”




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  11. Is it possible in the Sources Cited section for the studies in question to be cross-referenced to the video by, perhaps, a time stamp in front of the study to show when it first appears in the video?

    EG: (8:24) McCartney M. Research press releases need better policing. BMJ. 2014 Apr 28;348:g2868.




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    1. Mike Quinoa: You are not the first person to make this type of request. Regardless of how they do it, I agree that that type of feature would helpful. I just don’t know how much additional work it would be…
      .
      Another option would be to use a numbering system. So, each study shown on screen shows a number that can be cross referenced in the Sourced Cited section. I like that option because then each time a study is shown, you would automatically know which study to review if you wanted more information.
      .
      Hopefully staff will read these comments and put this idea on the to-do list. :-)




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  12. I know it would mean less time spent highlighting valid/good research. But I think there would be a lot of value debunking and specifically pointing out the flaws and concerns in bad research such as http://ajcn.nutrition.org/content/early/2010/01/13/ajcn.2009.27725.abstract (biased/industry funded for starters) Because people use this kind of research as a reason not to adopt a healthy diet. They of course can then claim that there is “evidence” that cholesterol is not associated with heart-disease, and that this one study makes all of the others null and void.




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    1. Hank Schkorio: I get your point and think it is an awesome idea in general. I have a slightly different take on it myself though. While I totally agree that debunking bad studies is incredibly valuable, I think that addressing all of the bogus studies and pseudo-science blogs etc that come up would detract from NutritionFacts as it is currently designed.

      So instead, I would love to see this functionality on another site. Alternatively, it would make a great sub/new/parallel area of NutritionFacts if we can grow into it in the future. In other words, we have videos, blogs, topic pages etc as main areas of the site. It might be nice at some point to have a new section called something like “debunked.” But that would be a big enough effort that I don’t see it happening any time soon.

      In the meantime, I will point out that NutritionFacts has spent a few videos and blog entries on the topic of debunking bad science. Here is just one example: http://nutritionfacts.org/video/bold-indeed-beef-lowers-cholesterol/ . Also, if you are interested, there is already a site that looks in-depth at the cholesterol denialist arguments and debunks them one by one. It is a time investment to go through the videos and the videos will not be covering every single study, but it is a great scholarly work if you are interested. Here is the website: http://plantpositive.com/ Also, *sometimes* the very knowledgeable readers of this will be able to help people and analyze studies or articles if people ask. It is just one more potential resource to have in our back pockets for now.

      Hopefully your idea will be added to the ‘list of things to do’ since this is not the first time this type of request has come up.




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  13. Dr. Greger, if you upload your videos to YouTube in advance, and unlist them, and then make them public, it prevents the video from showing up in my newsfeed. I think I’m not the only one. Your videos will have significantly less views if you continue with this method.




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  14. The author Sam Harris (https://www.samharris.org/) is trying to adopt a plant-based diet, but is having some trouble. Could Dr. G or a representative of NutritionFacts go on his podcast? :-) Sam Harris has a big following of “thinkers” so I think it would be an accepting audience which would hopefully spread the health message further! He’s quite active on twitter I believe.




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      1. Hank: Did you see my reply from earlier? Sam just has to reach out to Dr. Greger. Here is my reply from earlier:

        “I passed on your idea to the staff at NutritionFacts. They thought it was a great idea. The way the process works is that Sam Harris would have to ask Dr. Greger to do an interview. Here is the reply I got back from staff: “If Sam Harris invited Dr. Greger onto his podcast, Dr. Greger would be very happy to do the interview! Maybe if enough people message/tweet at Sam Harris to ask Dr. Greger to go on the podcast, then he’ll invite Dr. G on!”

        If you have any connection to Sam Harris or can get people to convince Sam Harris to ask Dr. Greger on, then I’m pretty sure it would happen. If Sam tries and is not sure how to get through, let me know.”




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  15. I would love to here from Dr. Greger and the research team about how they avoid this issue? If so many studies publish non-significant results claimed otherwise, or spin their info in the study, what is to say that this site doesn’t contain a number (if not many) of those studies? There are no doubts in my mind about a WFPB diet being the best option, so that doesn’t need to be defended. Just curious how they get around issues with studies, themselves. Or, do they just use those that support WFPB eating in general. It is of course possible




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    1. I can’t speak for them, but one thing you have to do yourself to avoid it is to dive into the study yourself and look. and unfortunately yes this means being able to somewhat understand the “gobbledegook” but basically, look to see if what the discussions and conclusions of the study match or line up with the data that they display. For instance the example in the video given is how some studies will have data collection results that have nonsignificant differences but they will describe said results in misleading ways. That in particular is a relatively easy to interpret but also easy to miss if you don’t look, kind of ‘spin’. Look to see if the discussions or conclusions are trying to grasp at straws to explain why their results came out the way that they did; use your own knowledge of nutrition to analyze the results of a study for why it may or may not have had a certain outcome. Of course a lot of this is more to do with experience rather than any one particular method, you just have to start learning what to look for – I myself wasn’t very good at this until I recently started noticing these things in studies. Of course it’s frustrating if you don’t know if you should or should not take someone’s word for something, but the fact that Dr. Greger is fairly transparent about why he interprets studies the way that he does by citing actual text from the studies directly is certainly helpful.




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    2. @angustolhurst:disqus A recent video from Pam Popper has criticized this site (not by name, but recognizably) on this very point. Her complaint is that, although she herself follows and recommends a totally vegan diet, she recognizes that this goes beyond what the science strictly warrants. She also criticizes the use of relative risk numbers in cases where the absolute numbers are very small, a practice which people in the WFPB community correctly criticize in others.

      Only this morning I was reading an article about a recent meta-analysis of egg consumption indicating that a single egg a day “reduces the risk of stroke by 12%”. I didn’t read the actual report, so I have no way to assess the significance of this “finding”, assuming it’s even accurate. If this means that only eight people instead of nine *in a thousand* will have a stroke, that’s a 12% reduction in relative risk but not terribly interesting.

      It can be very confusing. A few months ago, a friend told me that the choline in eggs increases the risk of prostate cancer. I did some searches and readily found the studies that reached this conclusion, as well as other studies suggesting that the choline in eggs is protective against dementia. I’m not eating eggs or other animal food these days, but I can’t say I have a lot of confidence that this is the best course.

      My “paleo” hunch is that since eggs are a widely available food, readily foraged, they have always been eaten by human beings. I can’t prove that, but I see no reason to doubt it. Even chimps eat eggs, when they can get them (http://nationalgeographic.org/media/chugging-chimp/). It’s interesting to me that in terms of animal foods, the chimp diet closely resembles the Okinawan “blue zone” diet: about 5% animal food. In terms of plant foods, the human diet is more starchy than the chimp diet, presumably because so many starches, especially legumes, must be cooked to be edible.




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    3. Angus Tolhurst: Here’s my take on this topic: Nobody is wrong about everything and nobody is right about everything. The problem comes when people are habitually wrong. In that case, they are not credible and I generally stop listening to sources like that. But even people (this site) who are habitually right are going get some things wrong. I keep that in mind when I review any source.
      .
      Given the situation described in the above video, how does this site generally make sure it is living up to the goal of accurately presenting what the body of scientific evidence says regarding nutrition? NutritionFacts has a nice intro video which covers this topic: http://nutritionfacts.org/video/behind-the-scenes-at-nutritionfacts-org/ You can see in that video the due diligence that this site goes through in order to minimize “spin” as much as possible. The staff and Dr. Greger are not just reading abstracts. They are studying the studies and then looking at all the studies that the studies reference, etc.
      .
      I also want to share that I was at a live talk from Dr. Greger once where someone asked a similar question. Dr. Greger shared one of his psychology tips/tricks that he uses to help him properly evaluate studies. First the human problem: There are some interesting studies of human behavior where they found out that if people read about conflicts of interest *after* reading an article, they will be less judgemental than if they read about the conflict of interest before reading the article. Also, even when people find out later that an article was false/propaganda, they are less likely to change their opinion on the topic if they read the article first without knowing the source of the article.
      .
      Hence, one of the steps/due diligence that Dr. Greger takes is to always *first* go straight to the bottom of a study about to be evaluated and read who funded the study, which scientists worked on it, and any conflicts of interest. Based on that information, Dr. Greger’s subconscious brain can know to be especially critical if necessary as he reads through the study. Pretty cool I think.
      .
      Finally, I’ll share the following quote from an Ask The Doctor page on this site which I think puts the issue into perspective:

      “…what’s the worst that can happen? Even if this data was pulled out of someone’s tush and kiwifruit don’t actually help with sleep, the worst case scenario if someone follows this advice is that they eat a really healthy fruit and only get all its other benefits. That’s the wonderful thing about plant-based research!
      .
      And industry influence is rarely about outright fraud but about nuanced study design. One just has to be mindful about study sponsors to make sure the study wasn’t constructed in a way to bias the results. That is something for which I am indeed constantly on the lookout.” from: Aren’t all studies funded by corporations biased?http://nutritionfacts.org/questions/arent-studies-funded-by-corporations-bias/
      .
      What do you think?




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    4. One more bit I meant to comment on. You wrote: “…Or, do they just use those that support WFPB eating in general.” No, the people doing this research, including Dr. Greger look at all studies, not just the ones that support WFPB eating. You can see evidence of that on this site in several videos and articles. If Dr. Greger feels that a pro-animal product study is relevant, he shares it (such as fermented dairy may not have all the negatives as other dairy products). Similarly, NutritionFacts has a set of pages which show how pro-animal studies have fatal flaws. The existence of those pages on this site shows that Dr. Greger is reviewing the pro-animal studies. He just can’t say that the studies are indicative of the body of evidence regarding nutrition. The studies do not pass muster, but they are being reviewed.




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  16. I think this is one of the most important videos that Dr. G. has done all year. I am a family physician in private practice, and also have a master’s degree in epidemiology from Harvard (School of Public Health), so I have been trained in how to critically read papers to look for sources of bias. I also have published several scientific papers, and I am well aware of the temptation to find ways to get statistically significant results (e.g. by excluding “outliers” from the study, which I might convince myself have legitimate reasons to be excluded).

    This relates to another bias that Dr. G. didn’t specifically mention, called “publication bias”. This is the fact that (as cited in Wikipedia’s definition of the term): “statistically significant results have been shown to be three times more likely to be published than papers with null results.” Researchers know that, and the temptation is there to find a way to get “significant” results, because we want to get our papers published, and receive the accolades that follow.

    One big problem for physicians, even the somewhat-uncommon physician like myself who has some training in critical reading of medical literature is that we are very busy taking care of patients, and often don’t take the time to go to the original article and read through it slowly 2-3 times, to be sure we understand the possible study limitations.

    Confession: The sources of my medical knowledge include talks at conferences (by physicians who are supposed to be “experts”), consulting informally with physician colleagues, and unfortunately, even press releases on the internet — which I do not always take the time to investigate thoroughly. The number of original articles that I read in a year can usually be counted on one hand.

    So, that partly explains why I wasn’t even aware of the huge body of literature supporting whole-foods plant-based diets until about three years ago.

    The comments by Angus, Todd, and Nalani, below, are also important. I believe that Dr. G. does a great job of being objective: he will often discuss alternative explanations of results, even when they don’t support a WFPB diet. However, he is not immune from the tendency to “push his own agenda”.

    So, the bottom line is that we need to always have some skepticism of ANY purported new health information. But the fact is that we simply don’t have the time to read all the original studies, so we have to learn which sources we trust. I trust most of what comes out on this site, yet I know that even what we think of as “facts” today will evolve as more studies come out.




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  17. Dr Greger – so timely as ever. Today’s headline in the Times (London) is “An egg a day can cut chances of suffering a fatal stroke.” Can you guess, who paid for the study, go on guess … yes its the American Egg Board. The original article published in the Journal of the American College of Nutrition, collated the results of seven studies published between 1982 and 2015.

    For a really big bang for your Dr Greger buck (or should I say pound sterling) an erudite letter from you to the editor is very likely to be published. Just email letters@thetimes.co.uk to debunk this.




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  18. What about the “Coconut Fat is *Good* for you” bulls- er, cra-, er, tripe?
    Without even going back to watch your video yet again to refresh my memory, as far as I have been able to tell after hours online, reading this site, Dr. McDougall’s site, and studies, thee are only TWO (um, that’s 2) studies showing that coconut “oil” harmed Filipino women’s cholesterol slightly less than did….. beef fat and butter.
    That’s it!
    WDDTY came out with an article in May 2016 saying “Low-fat diet advice one of the biggest blunders in modern medicine, says charity”. They quoted “the National Obesity Forum and the Public Health Collaboration, a UK-based charity.”
    In frustration I sent it to Dr. McDougall, who replied with articles he has written about this board of fat-selling businesses, drug companies, and doctors who need a steady supply of heart patients.
    I am (fortunately, only figuratively) sick of my fellow *vegans* and their endless, tiresome, litany of coconut fat recipes and “coconut oil is good for you” bullsheet.




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    1. I don’t worry about the fat in coconuts or any whole plant food and I do use coconut oil occasionally in certain recipes, but I do so sparingly as it is a pure fat. But there has been so much glorifying the use of coconut oil that I know of people who on top of eating animal fats, add tablespoons of coconut oil to their diets! Not through a recipe replacing butter or something, but as a SUPPLEMENT! I always tell non-vegans that as a butter replacement for cooking, instead of using palm oil ridden margarines, just use a bit of coconut oil and that (based on all I’ve gathered) it does raise cholesterol when added to the diet but may lower it a bit when using it to replace butter, making it a bit better than butter, but certainly nothing they should be spoon feeding themselves.
      I actually notice that the paleo crowd seems to be more enthusiastic about coconut oil than fellow vegans. But I do think the misguided advice and over enthusiasm goes both ways. I get sick of seeing people recommending staying away from some of the healthiest whole plant foods, such as nuts, seeds, and legumes, due to fat content! It’s fine if one person believes in something, but I hate to see the way they often aggressively present these things as facts to trusting listeners.




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  19. I do believe, Dr. G. mentioned that there’s no reason vegans cannot do both, exercise and eat healthy whole plant foods, at the end of video.

    The point I believe, he was trying to make was food is the most important element in reducing the plaque build up. This absolutely needs to come first. Breaking the myth: its ok to eat the fries, coke or hamburger, as long as you have had your morning workout.




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    1. Hi Deanna do we have research that demonstrates that food is the “most” important element? We have the marathoner study. I believe they are doing 100 plus miles for years. They kinda kick butt. But maybe I missed it?

      Both are important. We need to eat WFPB and exercise or be a marathoner. None of the programs we are aware of whether it’s Dr. Pritikin, Dr. Ornish, or Dr. Esselstyn are food alone.

      This is a nutrition site. Not an exercise site so we should expect it to seem bias. According to the WHO
      “Benefits of physical activity for adults

      Overall, strong evidence demonstrates that compared to less active adult men and women, individuals who are more active:

      have lower rates of all-cause mortality, coronary heart disease, high blood pressure, stroke, type 2 diabetes, metabolic syndrome, colon and breast cancer, and depression;
      are likely to have less risk of a hip or vertebral fracture;
      exhibit a higher level of cardiorespiratory and muscular fitness; and
      are more likely to achieve weight maintenance, have a healthier body mass and composition.”

      http://www.who.int/dietphysicalactivity/factsheet_adults/en/




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