Science vs. Sound Byte
Vetting the nutrition studies behind the headlines.
Gone are the days when nutrition professionals could monitor the scientific literature and consider how research might translate into clinical recommendations for their patients. Fresh research results hit the newswires daily and are disseminated to the general public almost instantly by online news outlets and bloggers. Today, you’re just as likely to hear about the latest research from your patients or readers as the other way around.
Despite a seemingly insatiable appetite for information on health and nutrition, the public doesn’t necessarily benefit from this ceaseless and largely un-curated flow of information. The 24/7 digital news environment thrives on drama and novelty—not nuance and complexity. As a result, statistics are often manipulated to sound more sensational, associations or preliminary findings are rendered into premature conclusions, and complicated results are boiled-down into click-worthy headlines: “Red meat shortens life span,” “Chocolate makes you thinner,” or “White rice linked to diabetes risk.”
Whether counseling patients, blogging or giving interviews to the media, part of the role of nutrition professionals is to put attention-grabbing headlines into perspective and to help consumers understand how (or whether) to respond to research findings. “Most of the media coverage is taken—sometimes verbatim—from press releases written by an institution’s PR department. Their job is to get publicity, so they’re going to spin the results to make them sound as impressive as they can,” says obesity expert and author Yoni Freedhoff, MD. “It may be an observational study that doesn’t definitely prove anything. But if all you read is the press release, you’re going to think that this was a landmark study that changes everything. As nutrition professionals, we can’t just re-tweet the press release! It’s our job to find out what the researchers actually found—and to use our training and expertise to think critically about research. I hate to say it but a lot of really poorly designed studies make it into peer-reviewed journals.”
The Busy Nutritionist’s Guide to Assessing the Research
Although being well-informed makes RDs of greater service and value to their patients and communities, there are only so many hours in a day. To that end, here are some tools and strategies that will help you stay up-to-date on the latest research in most efficient ways.
Stay in the Know. The easiest way to keep tabs on breaking research news is to subscribe to the Daily News, a free daily digest of nutrition-related headlines from major media outlets published Monday through Friday by the Academy’s Knowledge Center. The Daily News gives you a quick overview of the day’s biggest and most important nutrition news stories, links to the original stories as well as links, whenever possible, to the abstract or research study being reported on, guidelines from governmental and international agencies (such as the U.S. Food and Drug Administration, National Institute of Health, U.S. Department of Agriculture or the World Health Organization) and major health associations (such as the American Diabetes Association, American Cancer Society and American Heart Association), and further resources from within the Academy, such as practice guidelines, toolkits, or position papers. (Friday’s Daily News edition also includes a round-up of the week’s journal articles.)
Assess the Details. Once you’ve located the original paper (or at least the abstract), Erica Gradwell, MS, RD, a lead analyst for the Academy’s Evidence Analysis Library, and Patricia Splett, PhD, MPH, RD, FADA, who trains EAL analysts, suggest the following short list of questions as a way to quickly assess the strength of a new study:
- What was the sample size? A pilot study of a dozen people may point the way to areas for further research but does not yield definitive results. (When conducting a systematic review of evidence on a given topic, for example, the EAL doesn’t consider studies with a study population of less than 10.)
- Which population was studied? A study showing that chocolate reduces blood pressure in healthy, college-aged volunteers may not be relevant to overweight, middle-aged hypertensives, nor can laboratory mice research necessarily be applied to human health.
- How long was the intervention or observation? Did the study track outcomes for years or just a few days or weeks? A brief study may indicate that a longer study is warranted, but may not itself be conclusive.
- What was the dose? If a certain food or compound was found to produce an effect (either positive or negative), it’s important to note whether the effective dose is one that is likely to be consumed under non-experimental conditions.
- What was the size of the response? “A result may be statistically significant without being clinically meaningful,” says Gradwell. “It’s also important to distinguish between relative and absolute risk,” adds Splett. Although a 20% increase in relative risk may sound like a lot, it could be that the absolute (or baseline) risk increased from 5% to 6%.
- Are there any risks associated with benefit? “Sometimes the benefit is doubtful or marginal,” says Splett, “but the intervention is basically harmless. Other times, while there may be a clear benefit, the attendant risks warrant caution.”
Dig Deeper. If a study directly impacts your field of practice, or you’re going to be writing or speaking to the media about a study, you’ll want to get a hold of the full text of the article. (See sidebar for tips on obtaining full text articles.) Even if you don’t have time to slog through all of the technical details, Splett suggests focusing on the Discussion section of the paper. “The authors frequently include a lot of information about contradictory findings, possible confounders, objections others have raised, and even cautions about application of the findings—things that never make it into the abstract or the press release but have a lot of bearing on how the findings should be interpreted,” Splett says. She suggests checking to see whether the result highlighted in the media answers what the researchers set out to study. Occasionally, an incidental or unexpected finding is more “interesting” than the study’s primary result and is given top billing in media reports. “An unintended discovery can be exciting, but it’s also a red flag,” says Splett. Unanticipated results are often plagued by validity flaws and poorly controlled variables—simply because the researchers didn’t design the study with those issues in mind.
Put it in Context. “A new study may be getting a lot of attention,” says Gradwell, “but before you’d change the way you practice, you’d want to see how the new study aligns with existing research on the same issue.” Here, the Evidence Analysis Library—a free benefit to Academy members—is an invaluable and time-saving resource. Research related to food and nutrition is assessed by a rigorous and objective methodology, graded, and synthesized into evidence-based practice guidelines and conclusions on questions of key relevance to the nutrition professional. These reviews and conclusions are produced for Academy members by Academy members with expertise in various content areas.
In the end, the expertise and judgment of the nutrition professional is essential to translating information overload into sound advice for patients and consumers. Although study results may be marketed to the general public, much of the nutrition-related research in the news is really of more relevance to researchers and clinicians than to consumers.
Get Your Hands on the Studies
Assuming the research in question has been published (news stories are sometimes about research presented at conferences or even case studies, in which case additional details may not be available), there are a few ways you can obtain a copy. Although an increasing number of medical journals offer full-text articles online for free, many still require a subscription. If you’re not affiliated with a public university or teaching hospital, here are some tips for getting your hands on journal articles.
- Remote access to your alma mater’s electronic journal collection may be available for the price of joining your alumni association.
- Larger public libraries may offer remote access to electronic journals to card-holders.
- Even if you’re not affiliated, check with the reference librarian of your local university library. Sometimes, guest access is granted.
- Journal articles can be ordered for $10 through the Knowledge Center. Turn-around time for electronic copies is often less than 48 hours.
- Some journals (such as New England Journal of Medicine) offer free, full-text access through their own websites for registered users.
- As an Academy member, you have access to the electronic archive of the Journal of the Academy of Nutrition and Dietetics.