They are almost absent from this boastful release touting vague neurological benefits of a specific chocolate milk. The release says high school football players, including some who suffered concussions, who drank the milk improved their scores on a computer-based concussion evaluation, but the release not only doesn’t say how much improvement was seen, it doesn’t even say which of the 36 measurements in the test improved. The release highlights the protein, calcium and electrolyte content of the milk, without ever mentioning each serving also contains the equivalent of eight teaspoons of sugar. Perhaps the most worrisome aspect of this case is the status of the “study” it is based on. The study does not appear to have been independently reviewed or published.
This review and a related blog post calling attention to the issues raised within have sparked much news coverage and led to a University of Maryland investigation into policies surrounding research quality, conflict of interest, and public relations. More links to our coverage can be found here.
This quote from the release eloquently demonstrates why it matters:
“There is nothing more important than protecting our student-athletes,” said Clayton Wilcox, superintendent of Washington County Public Schools. “Now that we understand the findings of this study, we are determined to provide Fifth Quarter Fresh to all of our athletes.”
There are real consequences to PR spin of health research.
If this story were to gain traction, it may further the health haloing of a beverage that drop per drop has more calories and nearly as much sugar as Coca-Cola.
[Editor’s note: This review initially stated, incorrectly, that 5th Quarter Fresh has more sugar, drop per drop, than Coca-Cola. This milk in fact has 3 g of sugar per ounce, compared with 3.25 g per ounce for Coca Cola. However, children would ingest more total sugar from a bottle of the chocolate milk compared with a can of Coke because of the larger serving size (14 oz vs. 12 oz).]
The price of the chocolate milk product used in this study is not mentioned, even though it is being sold to schools.
The release says that high school football players who drank the chocolate milk had higher scores after the season on nine of 36 measures in a computer-based concussion evaluation, and that among the players who suffered a concussion, those who were drinking the milk had improved scores on four measures compared to those who didn’t drink the milk. But the release doesn’t say how much difference there was or even which measures showed positive changes.
Potential harms are not mentioned. While a chocolate milk product may seem benign, the release could have referred to the fact that each serving of this product contains as much sugar as the total daily intake of added sugar recommended for an adult man (and almost twice the amount recommended for women) by the American Heart Association. The release, which touts the protein, calcium and electrolyte content of the product, and notes that it is “fat-free”, should not have hidden the sugar content.
Then there is the harm of believing that downing chocolate milk could protect a teenager’s brain from harmful effects of a concussion. Concussions in high school football games and practices are especially dangerous, sometimes even fatal, when a player gets hit a second time within a few days after an initial concussion. If a belief in protective effects of chocolate milk lead to teenagers being put back in the game too soon after a hard hit, the consequences could be devastating.
Product label: http://dairymaiddairy.com/products/fifth-quarter-fresh/
AHA “Sugar 101” information sheet: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Sugar-101_UCM_306024_Article.jsp
CDC Sports Concussion Policies and Laws: http://www.cdc.gov/headsup/policy/
The news release not only fails to explain the quality of the evidence, it misleads readers by highlighting claims that were not tested. For example, readers are led to believe that this chocolate milk product is somehow superior to other varieties of milk, but the study did not measure intake of other milk. The release does not even say whether the study included a placebo control. And about that “study”… according to a representative Maryland Industrial Partnerships (MIPS) program, the research has not been peer-reviewed or published, so it has not been examined by any independent experts.
This release might be the opposite of disease-mongering. As mentioned in the “harms” section, promoting belief in a protective effect of chocolate milk could lead someone to minimize the danger of a concussion.
It’s safe to assume that the Fifth Quarter Fresh company was closely involved, but the release does not explain the nature of the relationship. The release says the study was made possible by the Maryland Industrial Partnerships program, but it does not say whether Fifth Quarter Fresh provided any additional funding or free product. There are no disclosures about any relationships between the researchers and the company, including whether they could profit from any sales boost following the use of research results in marketing campaigns. Also, did the company have any involvement in the design, conduct or reporting of the study and its results? The release doesn’t say.
The release promotes the belief that this chocolate milk product provides benefits that other products do not… yet the study did not actually compare this product to any others. The release mentions an earlier study that compared this product to “commercial workout recovery drinks”, but those drinks apparently did not include any other types of milk.
The release says the product is bottled by Dairy Maid Dairy, but there is no information about whether it is available in stores. Other news reports indicate that it is sold only to schools.
There are other studies listed on www.PubMed.gov that look into the potential effects of chocolate milk on athletic performance. None of this background is mentioned in the release.
Even so, we fail to see how other athletic performance studies (conflicted as many are) and the lone study linked which looked at the effect of dietary branched chain amino acids on mice cognition, bolsters the claims of a study purportedly designed to look at concussion recovery in high school athletes.
The release paints a picture of benefits that goes far beyond any specific research results that are provided. The most troubling comment comes from a local school official who says that based on this study the school district plans to provide this commercial milk product to all athletes, because “There is nothing more important than protecting our student-athletes”.