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October 12, 2018
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Michael Joyce is a writer-producer with HealthNewsReview.org and tweets as @mlmjoyce
A message about health care can be polluted, diluted and distorted by many people as it passes researchers to newspapers, newspapers, press releases and ultimately in the news coverage.
Here is an example of what happens when it starts at the source with the grandiose language used by the authors of the study, perpetuates itself in newswire / releases and in the journal of the edition, and is finally picked up and amplified by the news agencies.
L & # 39; study
One reported case of 3 men (aged 40, 52, 67 years) who received food education and intermittent fasting for 10 months; all three were able to get out of their insulin, lose weight and have a very slight decrease in their A1C hemoglobin (average blood glucose over the past 2-3 months). In this study, "intermittent fasting" consisted of about three 24-hour periods each week during which subjects were restricted to water, coffee, tea, or bone broth.
The published conclusion: "Fasting regimens under medical supervision can help reverse type 2 diabetes "(and minimize the use of prescriptions" and possibly surgical interventions ").
Limitations
"The reverse language is unjustified and the evidence is extremely anecdotal," said Kevin Klatt, PhD, a researcher in dietetics and molecular nutrition at Cornell University.
"What is referred to as" reversal "with diabetes is unclear. But what is clear is that following a single test like hemoglobin A1C or not just getting out of insulin is not a reversal. Much more robust data is needed and no sort of clinical recommendation can be made from the results of just three subjects. "
The language of the author
The principal author (s) is / are quoted as follows:
- "This series of cases has shown that fasting 24-hour diets can significantly reverse or eliminate the need for diabetes medications "(authors quoted in the BMJ press release)
- "[this study] has the potential to completely reverse Type 2 diabetes … it changes everything in the way we should treat the disease … it's the ultimate power and ultimate savings for public health "(Author, Dr. Jason Fung, quoted in Newsweek )
The cover
Much of the media coverage was contradictory and therefore confusing, even indifferent. For example, HealthDay – who used the overthrow in his title and title, rightly pointed out that with "only three patients, it is impossible to draw definitive conclusions about the use of fasting to treat type 2 diabetes". Yet, in the following sentence, it is written:
Nevertheless, the results are remarkable, as one in 10 Americans and one in 10 Canadians have type 2 diabetes, investigators said in a press release.
So what is it? Can not draw conclusions? Or really remarkable or even worthy of interest?
Newsweek was also confusing by frequently using (indiscriminately) the overthrow language, but then providing the reasons why the study "does not address the true generalizability of diabetes care and treatment" … such as the need for much larger randomized studies, as well as the risks involved. potential for a steep drop in blood sugar levels with fasting.
In the end, it is irresponsible for researchers who know the science of the disease to imply that they can "reverse it" based on the responses of 3 men. Especially when such dramatic claims often lead journalists to adopt this erroneous and misleading language. This is a disturbing example of a message that has been polluted at the source and passed on to readers.
What is also disturbing is that this case report has been promoted in the "Myth Exploded" series of the BMJ, whose inclusion criteria are not carefully defined by the publishers. This raises two important questions. First, does a case report have the statistical power to explode a myth? One would think that only several randomized controlled trials are robust enough to do so.
And anecdotal case reports like this one could they not do the opposite? That is to perpetuate a myth?
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