Smoke this and be happy

Sigmund Freud is a name that is at least familiar to most of us these days as a brilliant pioneer and doctor of such topics as dream interpretation and psychoanalysis. What you may not know is that he was once paid by pharmaceutical company Parke Davis of Detroit to endorse what was later to become a very well-known drug. Freud was not a fool, he had looked into the research, citing seven papers supporting the drug in his own academic review of its many applications. Unfortunately, all those papers were published in the Therapeutic Gazette, a journal that was in fact owned by Parke Davis. The drug was cocaine and Freud’s endorsement (and personal use) of it was to overshadow his career. Parke Davis was at the time America’s only importer of cocaine (to be soon followed by Merck), and they gained tremendous commercial advantage by writing ‘credible’ scientific articles and associating them with reputable figures. This story and the emergence of cocaine as a medical treatment and elixir for many ills is a glorious example of how smart people can believe daft ideas (one of cocaines prime early uses was to ‘cure’ addiction to Morphine, later to ruin the career of america’s most brilliant surgical pioneers William Halstead).

It would be safe to say that there has been an explosion of information available to the trainee and the trainers in the fitness industry over recent years. A quick search of the net also reveals that it is very rare to see this information presented in a balanced format, and all too often it is blatantly used inaccurately or misleadingly to support a particular point of view. This Daily Mail style of reporting the facts, while often well-meaning tends to muddy the waters for those with an enquiring mind or serve as gospel for those who will believe just about anything they are told. Harmless enough? Maybe yes, a lot of the time it is. Very little research supports several well-known urban myths (eight glasses of water a day anyone) yet little harm would come from following them and indeed many will actually benefit. However, when that information strays into medical benefits, supplement claims, or other areas where there is money to be made things aren’t quite as innocent. While it is not likely anything quite like the cocaine story above is likely to happen again, it is a reminder that we should always try to gain a balanced point of view when reviewing the claims made for new products and medicines…

Now, if you really want to get a handle on this research then there are some fairly arduous books that you can pick up on the topic, but here are a few things to ask when you see the next claims for why a very specific intervention can radically cure or prevent a condition or why it is the next miracle answer to fat loss. This is by no means an exhaustive guide to reviewing scientific claims (there are people out there who do this for a job and it is far better to let them do it! See below) but it should help you avoid some common mistakes.

The red pill or the blue pill?

Commonality versus Causality:

Here is a mistake we see in the papers and on the net all the time. Recently I highlighted a recent Daily Mail piece on bootcamps where they showed some stunningly good examples of confusing the two issues. Cum hoc ergo proptor hoc is the latin for this mistake and it is all too common. So, how to spot it? Well the common use of this is observing a general outcome (for example that many former soldiers suffer from back pain) and then attributing that to a very specific cause (for example their style of fitness training) while failing to account for other factors (such as the drill movements performed, loads carried, job roles, etc etc). This is also often seen by people accounting for the superiority of a particular training or nutritional approach when used with a beginner, assuming that the success was entirely attributable to the system used when in fact they simply made an observation rather than measured an intervention. Without ruling out other variables it is difficult to establish direct cause and effect, yet this happens all the time. Commonality can be a reason to look closer for possible reasons behind the observation but on its own, it doesn’t indicate cause and effect. The European Food Safety Authority has recently spent several years addressing the many claims for food supplements and has seen around 80% of them not approved by failing to show cause and effect. Next time you see a claim look for concrete proof of causation not just commonality.

Human or Animal, in vitro or in vivo:

Another thing worthy of consideration is the study group. Often nutritional products are supported by a real lack of evidence in human subjects. Observing the interactions of a nutrient isolated in a test tube or petri dish does not guarantee that these actions will be reproduced the same in humans – again so many other factors can prevent this (digestion, absorption, interaction with other foods, cooking methods etc). Now, this doesn’t mean of course that this sort of evidence should just be disregarded or that it won’t uncover valuable information, but it does mean that if the results have not been replicated in humans that they may well not actually occur. While looking at the population, it is also good to look at whether or not the population group studied is relevant to your own. For example, if a study only looked at those with a certain condition then the results would only really be applicable to those with that condition – not necessarily to the general population. Similarly if a research study showed a method of training to be effective in experienced trainees who are male and between the age of 19-24 then it may well not be suited to an post-menopausal female and may even be harmful to other population groups.

Cherry picking and who pays the bills?

Sounds cynical doesn’t it, but as our example at the start of this piece goes to prove, people will often go to all sorts of lengths to establish an evidence base for their products. Large commercial business will often fund studies and this can inevitably lead to questions over how information is gathered and interpreted. Pressure or a desire to achieve a given outcome can sometimes lead to selection bias where unfavourable findings are not included, this was beautifully demonstrated by Gary Taubes dissection of the Ancel Key’s research that led to the development of a 30 year obsession with low-fat diets. Alternatively, studies are often selected to support a product where not all the research has been flattering, something known as cherry picking. So, how do you find out the truth without trawling the journals yourself?

A good place to start is the Cochrane Review, an independent group of academics and scientists who look at the many various claims and findings and then do all the hard work for you by assessing all the evidence (being sure along the way to rule out those studies that don’t match up in the strength of their research methods) and putting together a tidy conclusion for you. They even write it up in non-scientific lingo so that you can forward it to your non-geeky clients and friends without just confusing them further!

There is a great saying that you should not believe all you hear, or only hear what you want to believe and this is particularly true when reviewing spurious claims for products or pills that sound a bit too good to be true. With all the overwhelming information that is in the media about what pills or foods cure which illness it is all too easy believe the claims at face value when the reality is all too often just a little bit more complicated. Now at least you will be a little better prepared to ask those questions and make those decisions for yourself.