Positive Health Online

I should be deliriously happy, as a qualified research scientist, that research now appears to occupy media headlines, shouldn't I?

"Vegetarians less likely to develop cancer"
www.guardian.co.uk/science/2009/jul/01/vegetarians-blood-cancer-diet-risk  

As my comments in the Research Updates indicate, the results of the above paper are considerably more complex, mixed and nuanced than the headlines above suggest. The authors themselves state that "the aim of this report is descriptive.....these results should be interpreted cautiously...A potential weakness of this type of study is the accuracy of the assessment of vegetarian status. The diet group was assigned on the basis of the answer to four questions...this study suggests that the incidence of all malignant neoplasms combined may be lower among both fish eaters and vegetarians than among meat eaters." The actual published paper presents an entirely different picture of cancer risk than the headlines. Please read the research update in this Issue 161, which provides a link to the full published paper.
www.positivehealth.com/research-view.php?researchid=3967  

"Organic food no better for health than factory-farmed food"
www.timesonline.co.uk/tol/news/environment/article6732520.ece  

As we publish this August Issue 161, the above headlines have been reported from the following review Nutritional quality of organic foods: a systematic review by Alan D Dangour et al in The American Journal of Clinical Nutrition which has not yet been published in print; full pdf copies are available to purchase at: www.ajcn.org/cgi/rapidpdf/ajcn.2009.28041v1

The researchers are from Nutrition and Public Health Intervention Research Unit, the Medical Statistics Unit, Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, and the Health Services Research Unit, Department of Public Health and Policy; funding for this study was supported by the UK Food Standards Agency.

Considerable critical discussion and comments have already been generated regarding the above study. For example, out of 52,470 published articles over the past 50 years, regarding nutrient content comparisons between organic and conventional foods, the researchers "identified 162 studies, only 55 of which were of satisfactory quality". It appears that the meta-analysis only considered nutrients across a whole range, not within individual crops, so that the authors could not state whether carrots or milk or any individual crop contained greater amounts of vitamin C or omega-3 fatty acids.

The authors also did not consider any health benefits from pesticide-free food, nor soil quality, nor animal or crop management. There were apparently differences in nutrients such as bio-flavonoids and beta-carotene; however the researchers discarded these findings as they were outside the margins of error. They also did not consider taste as a criterion in their nutrient quality. There were accusations that the paper pre-empted a Brussels study by Carolo Leifert, Professor of Ecological Farming at Newcastle University, due to be published later this year.  Hence the sweeping headlines without any of the real substance behind why people and farmers grow organic crops and husband animals organically.

One of the main reasons I started Positive Health PH all those [15] years ago was that I became aware of the dearth of research information being communicated to health professionals and general readers. There were thousands, possibly tens of thousands of research papers published every year; however, I am probably safe to say that the majority of these findings never saw the light of day beyond the journal in which they appeared.

About the same time that my partner and I launched PH, the Cochrane Group were beginning to develop their protocols for systematic searches of the literature [meta-analyses], and the journal Cochrane Database of Systematic Reviews is a publication of such research. The terms 'randomized controlled trials' (RCTs),  'evidence-based medicine' and 'gold standard' have been in the ascendancy, and therefore the norms for research throughout the entire medical, scientific and healthcare professions have adopted Cochrane-type criteria.

The problems which have arisen is that, rather than somehow consider and accommodate within the research results the various research studies according to their quality or lack thereof, the majority of meta-analyses researchers discard all the studies which don't meet the quality standards.
 
RCTs may be superbly suited for studies testing drugs in animals or in vitro cells, where every parameter of the study can be controlled, i.e. environment, food, water, drug amounts, etc. However, designing and conducting research becomes considerably more complicated with people, who are, apart from identical twins, genetically, biochemically, environmentally and physically unique, and who notoriously complete food frequency and lifestyle questionnaires incorrectly. Honestly, how accurately can you recall what you ate for lunch 3 months ago?

This is a problematic shortcoming particularly with Nutrition research in Cancer, Heart Disease, Diabetes and many health conditions, where Nutrition is not genuinely included in the treatment protocols for these patients, who generally are submitted to surgical, chemical or other medical interventions. Nutrition, despite the overwhelming research body of evidence, does not form part of the treatment plan. In fact, most medical professionals still repeat the by now familiar dictat: Eat a balanced diet.

So the reason that I am not deliriously happy about research being on the headlines is that the headlines are far too simplistic and frequently distort the real conclusions of the research. The reasons for this may lie with journalists who are unable to understand the complexities of the research published, or that the Press Releases which go out to the media already distort the findings.

I also urge PH readers to look at the Letters to the Editor in this issue in which "The future of one of the UK's most innovative food supplement manufacturers is held in the balance by a Welsh Magistrates Court. ...claims that a species of ryegrass contained in the natural sleep aid product Asphalia is an unauthorised 'novel food'. The prosecution is arguing that Asphalia contained a novel food ingredient which had not been submitted for authorisation... Asphalia as one of the biggest breakthroughs in natural sleep aids. The product has no known no side effects, is sold in over 400 UK health food stores and was the winner of a Highly Commended award for best New Food Supplement of 2008 at the premier natural products trade show, Natural Products Europe.  The product was developed by Roger Coghill and colleagues at Coghill Research Laboratories of Pontypool, Wales. The defendant company removed the minor ryegrass ingredient in Asphalia in January 2009 when first advised of a Prosecution Notice; therefore present Asphalia supplement stocks do not contain the ryegrass ingredient. After a day of deliberations, and expert evidence provided by both sides, the magistrate adjourned the conclusion of the case until 5th August."
www.positivehealth.com/article-view.php?articleid=2638