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Study: Monthly fasting may help heart

Rating

4 Star

Study: Monthly fasting may help heart

Our Review Summary

This report on findings about heart disease in a mostly Mormon population of once-a-month fasters is solidly done. It presents data fairly and quotes one independent source.

It also includes the essential caveats that the study is "far from proof" that fasting cuts heart disease risk, that monthly fasting may be a marker for personal self-discipline generally, and that fasting doesn’t necessarily lead to weight loss. 

The article’s major shortcoming is that it is based on a fairly low quality of data source subject to bias–an unpublished presentation of information gathered from self-reports of healthy people about lifestyle behaviors linked to their religious beliefs.

The question here is not with the reporter’s execution of the story, but whether it should have been published at all.

Despite its prominent acknowledgment of caveats, the story’s length and very existence invite the inference that fasting is an effective method to reduce heart disease risk. The researchers themselves admit their study can in no way responsibly answer that question–that their study at best raises questions that may justify further study. 

When making assignments, editors would be wise to ask the questions:

  • Will this report invite an inference about a recommended change in personal health behavior?
  • If so, does the data justify this inference?

In this case, the answer to the former is yes. The answer to the latter is no. Viewed from this perspective, an argument can be made that the story should not have been published.

(An abstract of the presentation appears as a meeting supplement to the journal Circulation.)

 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

There are no financial costs associated with fasting one day per month.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The article generally presents data well: While at the top it uses the phrase "40 percent less likely to be diagnosed with heart disease," later in the text it explains that 67 percent of the non-fasters were diagnosed, compard to 59 percent of fasters. Providing both measures is useful.

The article also lays out the study’s methodology in considerable detail. 

 

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The article cites the two important safety issues regarding fasting: That it can be dangerous for diabetics, and that it can depress metabolism and possibly make weight gain more likely.

It should also have said that anyone who wants to fast should consult their doctor first.  

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

While the article reports that the study was presented at an American Heart Association meeting, it did not explain that this means the data has not been peer-reviewed or published – and as such carries less credibility until (or if) it is published in such a journal.

The article also failed to point out an observational study of self-reported behavior is a less powerful type of evidence than a prospective clinical trial.

The risk in this study of "Healthy user bias" – the fact that people who choose to fast may have healthy characteristics that others do not – should have been emphasized. 

The article also permits the researchers to overinterpret some data. It quotes the researchers as saying the results apply to non-Mormons too. But only 8 percent of the survey group of 515 – or 41 people – were not Mormons. Conclusions of disease prevalence based on such a small sample size are premature.

Does the story commit disease-mongering?

Satisfactory

The article does not exaggerate the consequences or prevalence of heart disease.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

This article was based on a presentation at a medical meeting. It included interviews from two sources: The study’s author, and an independent expert on the subject of diet and heart disease. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The article states that quitting smoking also reduces heart disease risk.

But it fails to indicate that a more common approach to reducing heart risk is controlling what and how much you eat rather than when. It would have been useful to know how much benefit this group of fasters saw compared to a similar group that used more common dietary measures to reduce heart risk.

The article also fails to mention other common and effective ways to reduce heart risk, such as controlling high blood pressure and lipids, taking aspirin, etc.   

Does the story establish the availability of the treatment/test/product/procedure?

Not Applicable

The activity studied, refraining from food and drink one day per month, is available to anyone.

Does the story establish the true novelty of the approach?

Satisfactory

The article correctly implies that little research has been done on the cardiac benefits of once-a-month daily fasting.

Does the story appear to rely solely or largely on a news release?

Satisfactory

There is no evidence the article is based on a press release.

Total Score: 6 of 8 Satisfactory

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