miércoles, 16 de noviembre de 2016

Red and Yellow Flags to be Aware of When Reading About Health & Fitness

One of the great things about the internet is the sheer amount of information available to us at a click of a button. If we want to learn about a particular topic we can find thousands of websites and articles fairly easily. However, we must also be careful with what we read as often the content of a particular article can be utter nonsense. Unfortunately the world of health, nutrition and fitness is plagued by articles that have little or no scientific merit but because they offer the cure to all our ills or some kind of controversy they are often lapped up by the public and then become pretty hard to argue against. 
With this post we are going to offer you a few signs to look out for when reading an article about health and/or fitness which should help you decide whether what you just read is worth remembering or disregarding.  

The Red Flags 

"Studies Show"

This is a particular favourite of ours and appears often in newspapers and magazines, they will write an article about the latest diet or “super” food and support the claims they have made by writing “studies show” but they will not provide a reference list so you can see exactly what studies they are referring to. At first glance this may not seem like a big deal but if they don’t tell you what these studies were you cannot check to see if they were a load of rubbish or didn’t even exist. One of the first things we learned at university was that if you make a claim about a food or a nutrient but do not back it up by a reference then what you have said is basically worthless.
So rule number one, if they say “studies show” but don’t tell what studies they were you can take the article with a fairly big pinch of salt. 

“The Anecdote” 
This is another frequent flyer in the blogs and websites of the pseudoscientists. Usually the writer of the article or someone they know will have had success with either a diet or training regime and then they extrapolate it to mean that the entire human race must follow this diet or regime. Of course the opposite is also true, if they have had a bad experience with a food/diet etc. then absolutely no one must eat this food! There’s two reasons why we can’t trust the anecdote, the first reason is how can we be sure that the positive effect reported is not just the placebo effect? And the second is that just because it works (or doesn’t) for them, one individual, it doesn’t necessarily mean it will work (or not) for you or every single other person on planet earth.

The Yellow Flags

The “studies show” and “the anecdote” are what we call the “red flags” and can usually be dismissed immediately. But the next three often appear in credible journals. Therefore, they can be useful if they are part of an extensive literature review but alone they should be treated with caution and be careful not to draw too many conclusions from them. We’ll call these the “yellow flags”

“Small Sample Size”
Studies that have a small sample size can be useful as a starting point when investigating the effect of a nutrient or food. Research is expensive so often investigators will start with a small sample group and then if the results are promising will eventually expand to a large population based study. That said, as with “the anecdote” just because a nutrient had a positive outcome with 5-10 people it doesn’t necessarily mean it will with everyone. The participants in scientific studies are usually from the same demographic, most often, male, young and physically active. If the study worked for them, it may not work for an old lady with health problems. So if you come across an interesting study with a small sample size do some further digging and you may find some research built upon that study, or if not, keep a note of it and wait for following studies that may follow.

“The Association”
We were tempted to place the association under the red flag section but thought that was possibly a bit harsh. The reason we wanted to do this is not necessarily because of the studies themselves but usually because the media, confusing association with cause, will take the headline and run with it, then before long people think that the television causes diabetes (yes that actually happened).

An example of an association would be alcohol consumption and prostate cancer. Researchers would take two samples of the population, one group would be heavy drinkers and the other group would not be. They would then look at the incidence of prostate cancer in the two groups. The incidence of prostate cancer is higher in the group of heavy drinkers and therefore you would say that heavy alcohol consumption is associated with a higher incidence of prostate cancer. What you could not say, and this is where it usually goes wrong, is “alcohol causes prostate cancer”. We just don’t know that for a fact based on this research, the heavy drinker group may also have smoked, taken less exercise, had a poor diet, all of which could contribute to the higher incidence of cancer. More research would be required to confidently say that alcohol causes prostate cancer. So the important point is don’t confuse association with cause.

“Studies on Animals”
Usually investigations will start in vitro, in other words cells in a test tube. Then if a positive or interesting result follows the investigation will move on to the next step, animals and then finally (but not always) humans. As with studies with a small sample size, animal studies are usually a stepping stone to more research in that area so be careful not to draw any concrete conclusions from a study where the subjects were animals (usually rats). That said do not dismiss them out of hand, a lot of very useful research involves animals because ethical approval for human subjects is not possible.  

“Funded by Industry”
This may seem an obvious one but what we are going to say is don’t just dismiss a study because it was funded by a large corporation. Unfortunately, we live in world where governments are less willing to give money to universities for research and the only people who can afford it are the food/drink/supplement industry. Obviously if the study was funded by a food company it will show that food in a positive light that is why it is important, as with all these “yellow flags”, not to use them alone but along with several other studies that may or may not agree with the industry funded one. Of course if you find a study funded by Coca-Cola that says their drinks don’t contribute to childhood obesity, you can be fairly certain that you will be able to find thousands of studies that give the opposing answer and therefore disregard the industry funded one. The point is don’t be too quick to dismiss them, always do a bit more research.

It should be noted that while we are not necessarily opposed to industry funded research (within reason), sponsorship of professional bodies by food/drink/supplement companies is something that we are very strongly against. Dietitians and nutritionists should feel confident that their representative association is a model of professionalism and at the forefront of research and not just a vehicle to advertise food and drinks that often conflict with the message that dietitians and nutritionists are trying to give.

Hopefully this article has been useful so next time you read about a diet or food or exercise programme you can be more confident in whether it is worth remembering or not.

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