Tuesday, March 27, 2012

What Reading That Eat Chocolate be Thinner Article Actually Told Me

It told me that the University of California in San Diego's PR department is beyond shameless, and that the Archives of Internal Medicine will publish pretty much anything.

Here's the press release in its entirety (highlights are mine),
"Regular chocolate eaters are thinner

Katherine Hepburn famously said of her slim physique: "What you see before you is the result of a lifetime of chocolate." New evidence suggests she may have been right.

Beatrice Golomb, MD, PhD, associate professor in the Department of Medicine at the University of California, San Diego, and colleagues present new findings that may overturn the major objection to regular chocolate consumption: that it makes people fat. The study, showing that adults who eat chocolate on a regular basis are actually thinner that those who don't, will be published online in the Archives of Internal Medicine on March 26.

The authors dared to hypothesize that modest, regular chocolate consumption might be calorie-neutral –in other words, that the metabolic benefits of eating modest amounts of chocolate might lead to reduced fat deposition per calorie and approximately offset the added calories (thus rendering frequent, though modest, chocolate consumption neutral with regard to weight). To assess this hypothesis, the researchers examined dietary and other information provided by approximately 1000 adult men and women from San Diego, for whom weight and height had been measured.

The UC San Diego findings were even more favorable than the researchers conjectured. They found that adults who ate chocolate on more days a week were actually thinner – i.e. had a lower body mass index – than those who ate chocolate less often. The size of the effect was modest but the effect was "significant" –larger than could be explained by chance. This was despite the fact that those who ate chocolate more often did not eat fewer calories (they ate more), nor did they exercise more. Indeed, no differences in behaviors were identified that might explain the finding as a difference in calories taken in versus calories expended.

"Our findings appear to add to a body of information suggesting that the composition of calories, not just the number of them, matters for determining their ultimate impact on weight," said Golomb. "In the case of chocolate, this is good news –both for those who have a regular chocolate habit, and those who may wish to start one.
Holy awesomesauce batman! Eat chocolate, get thinner! If you're not eating it already, maybe you should! Chocolate is a magic fairy food that has unknown substances that not only cause chocolate's calories not to count, but actually makes chocolate a net negative calorically!

Only they're not, and they don't, and there is no growing "body of evidence" suggesting there are magically calorie neutral or negative foods (though there are certainly differences indirectly consequent to different foods' impacts upon satiety).

So what did the study actually show?

The study looked at 975 men and women aged 20-85 who filled out a single food frequency questionnaire as part of their enrollment in a study that was meant to look at the non-cardiac impact of statin drugs. Included in the questionnaire was the question, "How many times a week do you consume chocolate?". The authors then looked at the relationship between chocolate frequency and BMI controlling for:

  1. Fruit and vegetable intake
  2. Saturated fat intake
  3. Mood
  4. Number of days of week active for at least 20 minutes.

That's it, that's all? Nothing else?

Ummmmm, last time I checked people ate more than just chocolate, fruits, vegetables and butter.

Honestly I seem to recall reading or learning somewhere, maybe it was in med school, that people sometimes eat things like beef, fish, chicken, nuts, lentils, pulses, dairy products, and candy. Oh, and don't they also sometimes have breads, pastas, and cereals? And does anyone other than me drink alcohol?

Would how much they ate or drank of those things matter in a study looking at their weights?

And do you think a question like, "How much chocolate do you consume?", would have been helpful in assessing its effect? And are the only non-food related variables that affect weight mood and exercise? How about maybe controlling for medications and medical conditions that affect weight, socio-economic status, education, sleep duration, marital status, smoking, etc., those other pesky things that have been shown to actually impact upon BMI?

Here's part of the authors' conclusions from the paper,
"The connection of higher chocolate consumption frequency to lower BMI is opposite to associations presumed based on calories alone, but concordant with a growing body of literature suggesting that the character - as well as the quantity - of calories has an impact on metabolic syndrome factors"
Really? A growing body of literature suggests that there are foods whose calories don't count? I notice that there are no actual references provided for that particular statement.

So to recount - basically here we have a study with no controls whatsoever rendering conclusions impossible, authors who rather than mention their study's pretty much insurmountable methodological limitations instead made up a "growing body of literature" on magic calorie neutral or negative foods, a press release that spins it all as fact and as a result, as of early this morning, less than 24 hours after publication, there were already 443 chocolate makes you thin stories on the newswire to further misinform an already nutritionally confused world.

Once again I'm left scratching my head trying to understand how this could possibly have made it to - let alone passed - peer review, and why it is that ethics and accuracy don't seem to matter to the folks who write press releases, or to the respected researchers who are drawing these unbelievably irresponsible and over-reaching conclusions despite undoubtedly knowing better. It also makes me wonder just how exactly they all manage to sleep at night.

[Even more amazing? This study was NOT funded by the chocolate industry]