Friday, July 29, 2016

Lessons from Theranos: Why We Need Scientists and Skepticism

If you've been following the story of Theranos (as I have) you might find this "Viewpoint" piece by Dr. John Ioannidis interesting. It's published in this week's Journal of the American Medical Association and it's revealing. Here is my take: 


  • There were scientists and journalists who were wisely skeptical. They did their due diligence instead of leaping onto the runaway Theranos bandwagon. They raised red flags early on. However, few people picked up that part of the story.
  • Scientists are the ones who should be doing the science. Everybody loves a good "college dropout gets rich with big idea" story. But these folks are often entrepreneurs - like Steve Jobs, Bill Gates and of course, Elizabeth Holmes. Sadly, in Holmes' case, she and many of the people who flocked to her were not scientists. Her big idea of using a finger prick's worth of blood on which to run big bunches of lab tests needed scientists to develop and test the technology. Scientists need to go to school to learn to be scientists. And scientific data needs to be published in established medical journals and tested to see if it can be repeated. The process is slow and deliberate - not exactly the stuff of flashy, attention-grabbing headlines.
  • This is classic cart-before-the horse, sensationalized health reporting. It happens way too much and it needs to stop. The only people who can really stop it are good health and medical journalists who are able to combine healthy skepticism, the right sleuthing skills, and an understanding of how science works.
  • Dr. Ioannidis is an unsung hero in this story. His skeptical, sciency brain was able to quell the pull of the Silicon valley spotlight that hijacked so many journalists, politicians, and businessmen. He questions whether we even need more available testing when the bigger problem in medicine right now may be unnecessary testing.
But read the piece yourself - because it teaches us all something about how to think. 

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Monday, July 25, 2016

Eat Vegetables, Be Happy?

A New Study Suggests a Link Between Increasing Fruits & Vegetables and Higher Life-Satisfaction Points 

A lower risk of heart disease or some types of cancer 20 years from now may not motivate you to eat more fruits and vegetables. Sure, improved health and a lower chance of getting a chronic disease should inspire us to eat healthy. But for most of us, they don’t. But what if eating more fruits and vegetables actually made you feel happier? Now, before you get too excited, the study I’m going to tell you about cannot show cause and effect. But, it does suggest that eating more fruits and vegetables could improve your life satisfaction.

Researchers in Australia analyzed the food records of over 12,000 adults in 2007, 2009, and 2013. They also measured their life satisfaction during those same years. People who increased their servings of fruits and vegetables from zero to eight a day reported higher life-satisfaction scores. The increase in their scores was equal to how you would feel if you found a new job. People who did not eat more fruits and vegetables reported a decrease in life satisfaction. The researchers controlled for the participants’ income levels and personal circumstances.

So will eating more fruits and vegetables make you happier?
·         This study cannot show that eating more fruits and vegetables actually makes you happier.
·         It does show that there could be some sort of link between the two. But remember, the people who increased happiness ate a lot more fruits and vegetables. It was a huge increase.
·         There could have been other things in their lives that explained their increased happiness.

But don’t let that stop you from eating more fruits and vegetables. It could be that as we start to take better care of ourselves, we improve our outlook on life! We definitely need more data on this topic. But don’t let that stop you from pursuing happiness and health through better eating!

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Source: 

Redzo Mujcic and Andrew J.Oswald.  Evolution of Well-Being and Happiness After Increases in Consumptionof Fruit and Vegetables. American Journal of Public Health: August 2016, Vol. 106, No. 8, pp. 1504-1510.doi: 10.2105/AJPH.2016.303260

Monday, July 11, 2016

Hyped Up Headlines: Eat Pasta! Lose Weight!

Here's what one of many headlines read last week: "Pasta Helps You Lose Weight, Study Reveals". I really want to love this headline. I really want to believe this headline. But this, and many, many other news outlets got this study so, so wrong. In full disclosure, I love pasta. I eat pasta - several times a week. I have an Italian-American mother and between her and my grandparents, we got fed a lot of pasta growing up. My grandfather used to say "A day without spaghetti is like a day without sunshine". 

But, as much as I want to, I can't love these headlines, because they have totally mangled the results of this study. The study is a "cross-sectional observational study". It used two different sets of data. In one study, researchers used a method called a "24-Hour Recall" to gather information about how people ate. This method sounds just like what it is: "What did you eat yesterday". So the researchers basically looked at how much pasta the study participants ate on one day and then looked at their body mass index (a measure of weight for height). Studies that asked people what they ate are prone to bad information because most of us aren't very good at remembering what and how much we ate. And one day of what you ate? Well, you can see how flawed that data is. 

And then we have the observational nature of the study. These types of studies are very limited in what they tell us. These studies cannot, I repeat CANNOT, show cause and effect. All they show is correlations or associations. Even if this data had been better, it still could not have shown that eating pasta caused lower body weights. Eating pasta could just be an innocent bystander and it was really something else that the pasta-eaters were doing that made their body weights lower. 

So, here's my take on pasta. If you eat too much pasta, it could pack on some pounds. If you eat pasta within the number of calories you need, you probably won't gain weight. Maybe there is something about pasta that helps keep weight lower. But this study does not tell us that. 

And yes, that is Audrey Hepburn eating pasta. 

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham