March 26, 2008

Easy, Simple, and Wrong

It's already happening. My email box is starting to fill with letters that say things like this: "My [Mother, Brother, Friend--choose one] told me they heard on NPR that lowering blood sugar kills people."

The story they are referring to is the one that reported "excess mortality" in the ACCORD study. This was the study where they took a group of older people with Type 2 diabetes who had already had heart attacks and lowered their average A1c to 6.5% by pumping them full of every diabetes drug known to man. They hired dietitians to phone the study subjects on a regular schedule and nag them to eat a low fat/very high carbohydrate diet full of "healthy whole grains." To counteract the effects of all those "healthy" grains they added the high doses of insulin.

Unfortunately, the people who report on medicine in the media rarely do more than repeat what they read in press releases. They don't ask the hard questions they should ask--like, in this case, "What exactly were the researchers doing to lower blood sugar?"

And because most of their audience is scientifically illiterate, reporters have to dumb down everything they say until someone who has no understanding of physiology or medicine can grasp it. Hence a complex story about a group of seriously ill people who were attempting to lower one of the more complicated measures of blood sugar function, who were given a toxic mixture of drugs whose interactions are not well understood, and who ended up experiencing very slightly more deaths per thousand than expected turns into this: lowering your blood sugar will kill you.

A second large study, ADVANCE, found no excess deaths associated with lowering average A1c to 6.5%. Sometime this summer when that study's results start to be published we will find out if their subjects' health actually improved. I've blogged about the differences in these two studies HERE.

But the media, having come up with the Man Bite's Dog story--lower blood sugars kill--did not spend much time on the ADVANCE story. Too Dog Bites Man.

But if my mail is anything to go by, it is likely that all over America people with diabetes have taken the dumbed down message they heard on the news and translated it into more carbs on the plate and less blood sugar testing. Mothers are calling their grown up kids and warning them not to keep their A1cs too low. And toes are dying, eyes are dimming and kidneys are clogging up. All because journalists translated a complex story into something the dumbest third grader could grasp.

I call it the "Brody Effect" in honor of The New York Times' Jane Brody, who built her career promoting another over-simplication that has had a toxic effect on people who get their health education from the media, the mantra: "Eating fat makes you fat."

Real science is complicated. Be very skeptical about any single sentence that purports to give you all you need to stay healthy. Be even more skeptical of health stories that get a lot of play in the media. The really interesting stuff rarely does. Especially if it takes more than thirty seconds to explain.

Thank goodness for the many folks online--most of them unpaid--who DO do the research, do report it accurately, and make it possible to find out the truth about what is really going on in the world of medical research!


Anonymous said...

One of the scariest things I've ever heard was when someone said to me "Well I know it's true, I saw it on television!"
My other comment would be that the reporters are not so much dumbing down the information, I don't think they,themselves, are smart enough to understand it.
It seems that nowadays the media thinks it is their job to scare the public any way they can. The truth be damned!

Anonymous said...

Adding to the problem is the fact that people are, for the most part, *really* reluctant to give up their carbs. Permission to eat pasta? Yes please!

*bangs head against wall*

meanderings said...

Hi Jenny,
At least people are finding you and questioning the reports.
My husband, patient soul that he is, is now very used to me screaming at the TV everytime a "diabetes" report is made.

Anonymous said...

I have a friend who "helpfully" forwards me every diabetes-related article she comes across, regardless of the source. After the ACCORD study hit the news, I had to tell her, "This study is total crap. I assure you I know more about diabetes, and probably more about science, than Gina Kolata." Suddenly I stopped getting things about how a low-fat diet can assist in weight loss and lower blood sugar. Good riddance.

I am so so so so glad there are people like you who can cut through the nonsense. I don't watch TV, but if I did, I'd be like Colleen, screaming every time the word diabetes is mentioned.

The Old Man and His Dog said...

Like the big billboard I saw near my house:

Contact us about 5 ways to PREVENT diabetes.