An Open Letter to All Science Bloggers, Tweeps and Facebookers

Photo by Will Lyon, Via Flickr

Dear Colleagues,

That photo up above? That's the state of information on the internet. And us? With our tweets, blog posts and Facebook updates, we're effectively our readerships' valves where our jobs are to turn the torrent into something drinkable.

And being a valve I think comes with a simple obligation.

Before we tweet, post or update with links to, or commentary on, a press release, newspaper article or scientific abstract, I think it's our valvular duty to our readers and followers to read the source story's actual study and evaluate it critically to determine whether or not we're publicizing worthwhile information.

Sadly - and at times we're all guilty of this - many readers and followers don't get past the headline, or the 140 characters, or the update, let alone even make it through a story's first paragraph, and I'd venture nearly none pull and read the source study. Instead they take our link, retweet, or update as confirmation that we agree with the piece and feel that the study was a valuable addition to the literature, and as you all know, despite the existence of peer review, simple publication by no means guarantees quality.

And I know it's incredibly tempting to retweet a press release, news story or a blog post about a study that neatly confirms our own confirmation biases, but please, before we do, it's that much more important for us to first read the actual study and evaluate it just as critically (if not more so) as we would those studies that don't complement our own personal beliefs and narratives.

Now I'm not suggesting that we all have to come to the same conclusions, nor that we're all going to do a bang up job in our critical appraisals, I'm just suggesting that we owe it to our readers to ensure that the information we provide is information that we've personally and carefully curated (or at the very, very, least disclose right off the bat we haven't actually read or evaluated the study at hand).

The fact of the matter is, people follow our work because they trust us and it's up to us to ensure that we're deserving of that trust.

Simply put, you've got to read it before you tweet it.

(P.S. - because this blog post doesn't in fact refer to a particular study, please feel free to share it far and wide without the need for further review)

Warmly,
Yoni Freedhoff

Why This Pear Makes Me Wary of Food Frequency Questionnaires

I'm skeptical of food frequency questionnaires.

For those of you who don't know what they are, an FFQ serves in many research studies as the underpinnings of diet history whereby research subjects recall what they've eaten which serves as the basis for the diet aspect of the study at hand.

That pear up above?

It wasn't an exotic variety - it was a Bartlett. It weighed 0.9lbs (60% more than a "large" pear is supposed to) and contained more calories than a Mars bar.

I've also had oranges larger than grapefruits, plums larger than apples, and grapes the size of golf balls.

Coupling the facts that we often forget what we've consumed, that our eyes are terrible scales, and that food has grown dramatically over the years (even foods like fruits), I can't help but question the veracity of FFQs.

Has made me wonder whether or not a photo diary to go along with an FFQ would reduce error.

Might make for a good study.

The American Board of Obesity Medicine Must Choose: Quackery or Quality?

Since 2005 I have been a certified Diplomate of the American Board of Obesity Medicine (ABOM) - now a joint venture between the American Society of Bariatric Physicians and the Obesity Society - and in a few more years I'll be faced with the choice of re-certifying, or letting my credentials lapse.

Part of my decision no doubt will be whether or not I feel the ABOM and I are on the same page in regard to science, medicine, ethics, and values when it comes to obesity medicine and I'm not convinced right now that we are.

You see a few months ago the ABOM put out a press release (that's a screenshot up above) highlighting the upcoming appearance of one of their board members on the Dr. Oz show. Her name is Dr. Denise Bruner and she was on Dr. Oz to promote the use of 5-HTP as an appetite suppressant. The ABOM also showcased her upcoming appearance of their Facebook page:

Both the press release and the Facebook update were quickly removed after I pointed out that given the ABOM's ultimate aim to be accepted as a credible medical organization it might be best to not promote 5-HTP supplementation for obesity given that the evidence base on its utility is anything but robust (here's a pubmed search that includes the 25 total citations that mention 5-hydroxytryptophan and obesity whereby the most generous take on the research would be that in the late 1980s and early 1990s two small studies suggested the possibility that 5-HTP supplementation might help ever so slightly with weight management).

But that's not the end of the story. While I was heartened that the ABOM saw fit to rapidly remove their endorsement of a nationally televised promotion of a non-evidence based supplement, I still struggle with Dr. Bruner's ongoing inclusion on the ABOM's board.

I struggle not simply consequent to Dr. Bruner's at best highly preliminary promotion of 5-HTP to literally millions of members of a very trusting public, I struggle because Dr. Bruner is currently a provider of the, "HCG Diet Protocol". Below is a screenshot from her office's website, and because I found it so incredulous that a board member of the ABOM was an HCG diet provider just to be sure I called her office yesterday and confirmed that if I paid Dr. Bruner $200 for an initial consultation, and then an additional $800, that she would inject me with HCG daily for a month.

The evidence base to date on the hCG Diet is clear. It's quackery.

The Obesity Society put out a position piece on the hCG diet last year. In it they state,

"We conclude that the scientific evidence does not support the use of HCG for the treatment of obesity. This position is in agreement with the U.S. FDA. The Obesity Society is committed to advocating the use of therapies for the treatment of obesity that are evidence-based and rejects those that have been shown to be ineffective."

The American Society of Bariatric Physicians also has a position piece affirming their non support of the HCG diet and in a 2011 press release supportive of the FDA's removal of "homeopathic hCG" from the market noted succinctly,

"Obesity is a chronic disease which is best treated by a physician who specializes in weight loss and practices medicine based on sound scientific principles. Unfortunately, hCG does not live up to those standards."

Dr. Bruner's practices, both in what I see as a markedly overhyped promotion of 5-HTP on national television and her use of hCG on her patients, run contrary to my take on what represents evidence-based obesity medicine, and the fact that she sits on the ABOM's board gives me great pause as to the value of that certification. So too does the title of one of the ASBP's upcoming webinars, "Controversies Concerning HCG for Weight Loss". Malpractice isn't controversial, it's malpractice.

Perhaps with this post the ABOM will see fit to consider whether or not Dr. Bruner represents their organization's aims, and moreover, whether or not there should be some mechanism to de-certify physicians whose practices belie the ABOM's standards of practice.

At the end of the day if the ABOM is hoping to be deemed credible it's going to have to choose to stand strongly against quackery and it's going to have to do so without external blowhards like me needing to point that out.

Saturday Stories: Self-Obituary, Running and GMOs

Canadian journalist/publisher icon Peter Worthington's self-penned obituary. Quite the life lived.

The story of Bret - he's a runner.

Nature covers genetically modified crops along with some scary truths and some myths.

Is This the Future of "Child Size" Drinks at McDonald's?

I do loves me Parks and Recreation.

I had tried to put this clip up before but it was an unofficial version and NBC yanked it down....but now they've put it up themselves. So sit back and enjoy the future of child-sized in today's Funny Friday feature.

Have a great weekend!

(Email subscribers, head to the blog to watch)

Coca-Cola Never Ever Markets to Kids and Is Part of Obesity Solution iPhone Edition

So yesterday I downloaded Santa's Helper - an iPhone game produced by Coca-Cola.

Apple's app folks determined it was for users aged 4+ (see that little symbol I circled in the top right corner)

And you should know too that Apple also has a 12+ designation which according to their guidance system means,

"Applications in this category may also contain infrequent mild language, frequent or intense cartoon, fantasy or realistic violence, and mild or infrequent mature or suggestive themes, and simulated gambling which may not be suitable for children under the age of 12."

And while I realize there's no violence in the game, the age of 12 is where Coca-Cola claims to draw the line at advertising,

"We have historically not placed – and continue the practice today of not placing – advertising for any of our beverages on any media that is primarily directed to, and has an audience of 50% or more, children under the age of 12."

So who is this game for, this game where the goal is to help a Coca-Cola drinking Santa drop presents down chimneys while little Coca-Cola trucks pass by on the streetscape below?

Aside from Apple's suggestion it's for children above the age of 4, it doesn't explicitly say, but after spending a few minutes with it I can tell you this - the gameplay's dead simple.

So simple in fact that even a young child could play it.

So simple in fact that only a young child would want to.

But don't you fret. Coca-Cola's part of the solution, not part of the problem.

State of Ohio Partners up with McDonald's and Coca-Cola to Promote Tourism.

Thanks to fellow physician Dr. Tony Almazan from Dayton, Ohio for letting me know about how Tourism Ohio has partnered up with McDonald's and Coca-Cola to help promote visiting one of America's heaviest States.

And what a partnership it is! Not only does the partnership steer people to visit McDonald's, but it also steers them explicitly to a large beverage from Coca-Cola whereby consumers who buy a large Coke (not small or medium Cokes) at McDonald's can trade the cup it came in for discounts at various Ohio tourist destinations.

Brilliant!

And clearly a salient example of just how important obesity is to the Coca-Cola corporation who now promote themselves as being partners in trying to create a healthier America. Maybe they'll also give them all soccer balls?

[For those who like numbers, a large Coca-Cola from McDonalds? At 30oz it's just 1/4 of a cup shy of a litre and it packs 280 calories coming from its 19 teaspoons (76g) of sugar.]

Coca-Cola's Newest Anti-Obesity Contributions Include Soccer Balls and Permission Marketing

The inspired altruistic work of the Coca-Cola company continues! In case you're wondering what I'm talking about, I'm talking about a beverage company that is pretending to care about fitness to be part of the "solution" to obesity and they've just announced their latest round of "help".

What sort of help?

• Distributing thousands of "Coca-Cola soccer balls" at major sporting events.
• Encouraging people to sign up for myCokeRewards to get a chance at winning a pedometer....and enjoy an immersive Coca-Cola centric marketing experience on their website and give Coca-Cola permission to market to them directly.
• A new campaign calling on Americans to vote for their favourite parks so Coca-Cola can give them a grant to build something.
• Coca-Cola "Happiness" trucks to roll through more neighbourhoods and towns to inspire people to "move to the beat"....and drink a Coca-Cola bottled beverage.

Hurrah?

Sigh.

Just a few quick quotes to keep in mind as to what's in it for Coca-Cola when considering these interventions. Here's Coca-Cola's marketing chief Joe Tripodi chatting about the value of getting people voting and involved with "charitable" programs like myCokeRewards from last year's Wall Street Journal

"If we can get 40 million-plus fans, or even some subset of them talking positively about the things we’re doing, ultimately that’s a good thing for us”

And by "good thing" Mr. Tripodi means sales,

"I think it’s probably a leading indicator of potential sales."

And what kind of sales does Mr. Tripodi hope for? He told CNBC in 2011,

"We want to double our business in basically a decade."

Somehow I don't think a doubling of Coca-Cola's business is going to help obesity much, do you?

Probably not soccer balls or permission marketing either.

Guest Post: 9 Year Old Boycotts Coca-Cola Sponsored School Dance

A little while back I received an email from a blog reading grandparent. He wanted to let me know about his 9 year old granddaughter's response to learning that her school dance was to be funded by Coca-Cola,

"Dear Dr Freedhoff,

Thought you would like to know that my granddaughter Frances (9) has refused to participate in a Cola-Cola dance which her school has arranged as part of some sports sponsorship thing, this without any prompting from me. She must have been reading your blog. She wants to wear a t shirt with "water " written on it."

I reached out to him and asked if his granddaughter might want to write a short comment regarding her decision as well as send along a photo of her protest shirt.

She obliged!

"I did not want to be in the coca cola dance, because little children shouldn't be dancing in the favor of a soda company. Also my sports teacher shouldn't be encouraging small children to drink it. You need to stick to healthy foods like fruit,vegetables,meat,and occasionally oils and sweets.

-Frances-"

And for those public health folks who think partnerships of their organizations with the food industry are a-ok now you know that even some 9 year old kids perceive them as problematic conflicts on interest.

Granddad - I imagine you're darn proud of your granddaughter. Good on her!

Saturday Stories: Parental "No" Insufficiency, School Lunches, and Depression

Fantastic piece from Anna Lappe in Civil Eats on why the argument that parents can simply educate and say "no" to combat predatory food industry kid targeted marketing is nonsense.

Why the New York Times dubbed Grade 4 student the Michael Moore of the Grade School Lunchroom.

Hyperbole and a Half's Allie with an incredibly personal, insightful, artistic, and cuss word filled look at the current state of her depression.

[And if you don't follow me on Twitter or Facebook, this week's US News and World Report piece is on how desk jobs probably aren't responsible for societal weight gain, and here's an interview I did with Global when I was in Halifax on the issue of parental "No"s and healthful eating.]