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Read Original Story

Low-carb diet trumps low-fat on ‘good’ cholesterol

Rating

3 Star

Low-carb diet trumps low-fat on ‘good’ cholesterol

Our Review Summary

The story makes it seem like the HDL cholesterol effect was the main thrust of the study, and it was not. Overall the story appears to slant in favor of the low-carb approach (e.g., "a low-carb diet works just as well … and it might be better for your heart"), despite the main result of the study finding essentially no difference between the two diets on most outcomes. Why emphasize that "The key difference was in HDL" without explaining the absolute differences and without explaining if that surrogate marker resulted in any difference in endpoints that matter, such as fewer heart attacks? 

 

Why This Matters

Americans are already overly obsessed with "scores."  Emphaszing the HDL difference without adequately explaining its real significance in peoples’ lives feels like more scoreboard-watching without knowing the rules of the game.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

 There was no discussion about how the different food consumption patterns compared in terms of price. Doesn’t cost matter in this decision?

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

Satisfactory

 The story indicated that the 15 pound average weight loss observed at 2 years was the same for the two groups.  The information about weight loss would have been better had it included insight about the variability in weight loss across the two groups.  

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

Not Satisfactory

 There was no mention of any issues or problems that might arise from either of these diets.

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

Not Satisfactory

The story opened by informing readers that the two dietary approaches to weight loss resulted in similar weight loss but that the low-carb approach might be better for your heart.  The first piece of this statement is founded on the actual weight loss in the two groups; the contention about heart health is merely speculative.  It is based on a difference in HDL levels between the two groups, but as the story indicated,  neither of the groups had cholesterol problems to begin with.  So it is really less clear that the difference in HDL was clinically meaningful.

It failed to report on the percentage of individuals who dropped out of the study.

Does the story commit disease-mongering?

Satisfactory

 The story did not engage in overt disease mongering.  But the story’s emphasis on the surrogate endpoint of HDL cholesterol is borderline.

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

Not Satisfactory

 One clinician who headed up the study reported on was quoted in this story along with a clinician who was not involved in that study. But that clinician, Dr. Yancy, has a long-standing history of research favoring the low-carb diet approach. That was not disclosed, and he is not a truly independent commenter in this case.

The story should have included comments from independent experts to help readers understand the take home messages from the study reported on.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story did not include a comprehensive list of evidence-based methods for weight loss.   The story lacked a discussion about the essential role of caloric intake, even within the low-carbohydrate diet group.  

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

Satisfactory

It’s fairly clear from the story that these two diets have been in use for a long time by lots of people.

Does the story establish the true novelty of the approach?

Satisfactory

 The story was clear about the fact that the dietary approaches for weight loss that were compared are not new or novel.

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

Satisfactory

 Does not appear to rely exclusively on a news release.

Total Score: 5 of 10 Satisfactory

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