Tuesday, February 24, 2009

Eat Me (My name is calcium)

Hey look, the NY Times is touting a recent study published in the Archives of Internal Medicine that suggests an inverse relationship between one's calcium intake and risk of colorectal cancer (just for women, not men). Isn't that terrific? Just start pounding the Oscal and you'll be home free, right?

Of course, articles like this are absolute junk. It's the equivalent of retrospectively reviewing all the baseball games you've watched over the past five years and noticing that your favorite team seemed to be more likely to win whenever you ate exclusively hot dogs while watching the game rather than an amalgam of hot dogs, chili dogs, nachos, hot pretzels et al and based on that observation, deciding that, in the future, you will eat only hot dogs, sans chili, at live baseball extravaganzas in order to optimize your chances of cheering on a win. It's absurd.

But these are the kinds of articles that ALWAYS end up in the health/lifestyle sections of local and national newspapers. Eat more calcium! Broccoli will cut your prostate cancer risks by 60%! Snack-sized vanilla pudding is significantly more efficacious at lowering gastric cancer risk versus daily consumption of a vat of whole milk chocolate pudding! Simply biting off the head of your Flintstones daily vitamin will decrease childhood oral cancer rates just as much as those children who chow down the whole body (but not as efficacious as sweet toothed kids who sneak a second Wilma after Mom goes upstairs to put her curlers in)!

This particular article is buried in the back of Archives of IM. It isn't even featured on the on-line table of contents. And that's because the editors of A. of IM know it's complete junk. So why is this garbage the one article from the medical literature that the NY Times feels the need to highlight?

Obviously, every newspaper in this country now has a "Health" section and something has to fill that space. I understand that part. But choosing to print faux science like the calcium paper for a wide audience is an act of contempt directed against that audience. It's incredibly condescending and demeaning, if you think about it. There's plenty of material for health page editors to choose from. But they feel this need to dumb down the discourse to the level of vague dietary admonishments. Eat your vegetables! You'll get tumors otherwise! There's this underlying implication that our purveyors of journalistic excellence believe that the American public cannot handle anything more complex. It's like opening the sports section and reading about how basketball is this new sport where you bounce a ball and the object is to "shoot" it through a basket-like apparatus. Or flipping through the business section and getting a primer on the fundamental differences between a dime and a nickel (in bullet-point form, color graphics included, of course).

I browsed through this months AofIM and there's some decent material in there. A randomized controlled trial on determining ways of improving colorectal cancer screening. A 25 year cohort study on risk factors for end stage renal disease. The relationship between male infertility and testicular cancer. None of it overly complex. Certainly a professional journalist ought to be able to utilize sources/research in order to break down the gist of the articles in layman's terms. I think the American public just might appreciate the effort. Let's leave the fluff pieces on magic calcium ingestion to US Weekly and Cosmo. Newspapers still have some lingering prominence in the realm of American discourse, right?


Anonymous said...

how bout we address the 30% general prevalence of vitamin D deficiency and the 20 billion we spend a year on osteoporosis related fractures. Heck you barely even have to change the dietary recommendations!

Joseph Sucher, MD FACS said...

Who should we blame? The lay press or the peer reviewed professional journals? I lay the blame on us (the peers).

The problem is two-fold. First, we have built a system that demands advancement through publication (it makes sense and its simple). Second, it is financially lucrative to sell journals. Sum -> a whole lotta poeple writing about stuff that may not have any scientific merit.

Yup. I blame it on us. We should demand a more rigorous peer-reviewed process that at the very least points out if the conclusions of an article hold water based on the data presented. Until then, the lay press will understandably continue to read the abstract and simply parrot the results. I don't blame them. I find it rather difficult to critically evaluate much of what I read.


albatross said...

As an aside, is there any particular reason to believe the journalists/editors choosing the articles are trying to dumb down their coverage? My guess would be they're reporting at their level of understanding. ("Stop acting stupid!" "I'm not acting!")