Today's busy consumers are often told they need to be "savvy," "informed," and "proactive" when it comes to their health. So, with less time to spend seeking advice from their doctors and other health care professionals, consumers are turning to other sources of health and nutrition information-namely, the mainstream media.
Although the plethora of health and nutrition news stories in newspapers and magazines, and on television, radio, and the World Wide Web may seem like a boon for consumers who want to know which spread to use on their toast or which supplements to take for optimal health, many people may not realize that they need to be just as savvy about what they see on television or read in the newspaper as they are about which physician or health plan they choose. In short, they need to be able to distinguish accurate, balanced reporting from inaccurate, unbalanced, and even sensational reporting-and that's not always easy to do.
How Research Becomes News
In many cases, media reports are based on the latest studies published in scientific journals. Researchers conduct studies, draft manuscripts that detail their methods and their results, and submit them to scientific journals for publication. Many journals require submitted manuscripts to undergo a critical and important process called "peer review," in which other scientists ("peers") in the field review the studies to evaluate their strengths and weaknesses and to determine if the papers are acceptable for publication. Published papers are generally meant to reach an audience of other scientists in the field, add to the body of scientific evidence, and advance the intellectual discussion surrounding a particular topic or area.
Consumers Drive Demand for News
In many cases the research published in peer-reviewed journals is not intended for the lay public. The reality, however, is that consumers are interested in health and nutrition news and have created a demand for it in the mainstream media. According to a Princeton Research Associates study conducted for Rodale Press, of the news coverage that adults say they follow "very closely," health news ranks higher than news about events or people in Washington, D.C., local events, and even sports.
This would not be a problem if all health and nutrition studies were reported clearly and in a way that best serves consumers. That isn't always the case, however. According to the same Princeton Research Associates study cited above, when it comes to the types of health stories that most adults say they find confusing, stories about vitamins and supplements are the most confusing, followed by stories about nutrition. Additionally, a 1997 National Health Council survey found that 68 percent of consumers agreed with the statement, "When reporting medical and health news, the media often contradict themselves, so I don't know what to believe."
Delving Beyond the Headlines
Many would argue that the responsibility for improving consumers' understanding of medical news lies with the media outlets that report it, yet consumers can take several steps to become more savvy about their "consumption" of health and nutrition news.
First Ask, "So What?"
"The first question consumers should ask themselves [when reading or viewing media reports of health and nutrition] is, 'So what? Does this mean I ought to do something or not?'" says Jeanne Goldberg, PhD, Director of the Center on Nutrition Communication, and Professor of Nutrition at Tufts University. More often than not, Goldberg says, the answer to that question is likely to be no, because the results of just one study are usually not enough to warrant a change in health behavior.
JoAnn Manson, MD, DrPH, Chief of Preventive Medicine at Brigham & Women's Hospital in Boston, and Professor of Medicine at Harvard Medical School, agrees. "It's rarely the case that you would change a behavior based on a single study," she says.
Goldberg points out that it's also important for people to think about how the results of the latest study may actually positively reinforce their existing health behaviors. "The one thing I think nobody ever says is, 'Wow, reading this makes me feel good about what I'm already doing.'"
Understand What Study Results Really Mean
It's also important for consumers to understand a little bit about how the studies being reported are designed and what their results do-and don't-mean.
Epidemiologic studies, which are often the source of nutrition news, are usually based on large groups-sometimes tens or hundreds of thousands-of people. Researchers observe certain behaviors, such as food choices, and track whether certain outcomes, such as the development of disease, occur. The important thing for consumers to understand about the results of epidemiologic studies is that they are observations of associations-they do not prove cause-and effect.
For example, an epidemiologic study of diet and cancer may find that people who ate a certain number of fruits and vegetables each day had a lower risk of developing cancer. That is, the study found an association between eating fruits and vegetables and a lower risk of cancer. But these results do not prove that eating fruits and vegetables was the cause of the lowered cancer risk. The people with the lower risk of cancer may have had other traits or engaged in other behaviors that also contributed to their lower incidence of cancer.
This isn't to say, however, that the results of epidemiologic studies are meaningless. In fact, such studies can be useful, particularly in their ability to analyze such large groups of people. Epidemiologic studies often add valuable information to the existing literature on a particular topic, which helps scientists design future research studies, including clinical trials.
In clinical trials, researchers give a group of people a certain "treatment," such as a particular diet, and then measure their response as it relates to certain outcomes, such as development of disease. Randomized, double-blind, placebo-controlled trials are considered the "gold standard" of medical research (see Glossary). Clinical trials generally involve smaller groups of people than epidemiologic studies, and often need to be repeated to confirm their results.
In addition to the type of study, other methodologic factors that can influence the results of a study and their applicability to the general public are such things as the number of subjects studied, the specific population being studied, and the length of time that the subjects were monitored.
Look for Context
A crucial element of media coverage of a new study is context. How do the results of this latest study relate to the larger body of scientific evidence on a particular topic? A well-reported news story will include that information; unfortunately, many do not.
According to the IFIC Foundation's Food for Thought III and its "hot off the presses" Food for Thought IV, the majority of news stories about quantitative and qualitative research on diet, nutrition, and food safety lack context. In 1999, only 18 percent of advice or warnings given in stories about diet, nutrition, and food safety in the media were linked to scientific evidence. The 2001 Food for Thought IV research (see the January/February 2002 issue of Food Insight for full coverage of this new study) again found that nutrition advice presented in the news provides little context. In many cases, reporters used only vague references, such as "studies show." What reporters should provide are the details about the results of those prior studies and an explanation of how the new study's findings relate to those results.
Understand What the Numbers Really Mean
News reports on health-related topics often cite statistics, percentages, and proportions related to risk. It's important that the report give not only the relative numbers in terms of the risk for a particular outcome, but also the actual (raw) numbers.
For example, in a study of diet and health, the relative number might indicate that cancer developed in half as many people who took a certain food component as the number of people who took a placebo. That sounds pretty dramatic. But the actual numbers may be much less dramatic. It could be that 5 of 10,000 people in the treatment group developed cancer, whereas 10 of 10,000 people in the placebo group developed cancer. Therefore, the actual numbers show that, although the risk for cancer may indeed be double in the placebo group, the number of people who actually developed cancer in that group is still quite low.
Take Sensationalism with a Grain of Salt
Headlines are meant to grab a reader's attention quickly, but they often don't tell the whole story, and, in many cases, they are downright sensational. Loaded terms, like "scientific breakthrough" and "medical miracle" are red flags for sensational headlines-and perhaps sensational reporting to follow.
Goldberg cautions: "Ask yourself, 'Does this sound too good or too bad to be true?' If the answer is yes, the likelihood is that it is."
