This story reports on the results of a yet to be presented study on weight loss in two groups. There is a lot of discussion in the story about there not being negative consequences of the low-carbohydrate (high fat) diet on blood vessel health. However the measure used to judge blood vessel health has not been validated and the time frame for assessing change was too short to be meaningful. The study is too small in size, the outcomes too early to judge and the project too preliminary to affect the thinking in the field.
Weight management is a long term proposition certainly requiring more than 45 days before declaring victory. There is significant public concern about the global obesity epidemic and how to best help people lose weight and keep it off. People need high quality information not preliminary findings.
There was no information about costs but a motivated reader reader could calculate this. However, it’s worth noting that long-term costs of following a restrictive diet are not inconsequential.
The story described the rate of weight loss as being faster on the low-carbohydrate diet than the low-fat diet (45 days versus 70 days) though there was no information about how the two groups compared in terms of sustaining the weight that was lost or whether weight loss continued beyond the initial 10 pounds. The story also did not mention whether the difference reported was significant or if the range of time it took the two groups was overlapping.
The story indicated that there were no harmful effects on the blood vessels observed in either group. However – since people in the study were reported to have healthy vessels to begin with, combined with the short amount of time they were followed, it is very unlikely that any change would be seen. So it is really insufficient evidence about lack of harm.
The story lacks perspective on the problem of knowing whether a treatment is safe or not. We need thousands of people in a clinical trial to determine cardiovascular safety, not 46.
This is a story about preliminary study results yet to be presented and yet the story framed this with a conclusive-sounding headline and a suggestion that this would provide clarity – which it is far too preliminary to do. Our medical editor – one of three reviewers on this story – said it’s a shame that the NYT would even pick up such a preliminary study.
Yes, the story included a few caveats.
But it quickly overcame that notion and called the findings thought-provoking. And it ended with the researcher’s own anecdote about being a test subject.
The story did not engage in overt disease mongering.
Several individuals who were not connected with the study reported provided comments and context for thinking about the diets discussed.
We learn from this story that soon to be presented results suggest that overweight individuals with seemingly healthy blood vessels lose an initial 10 pounds of weight faster on a low-carbohydrate diet than a low-fat diet. So, while the story is about comparing two alternatives, it could have at least mentioned other diets and drug approaches.
The story referred to the diets studied in broad terms including avoidance of trans fats and indicated that study participants reduced their daily caloric intake by about 750 calories. The Atkins diet is broadly available and widely recognized.
The story was clear that the diets being compared were not new. The story tried to suggest that adding an exercise component was somehow a new wrinkle for managing the weight loss conundrum but exercise has long been included in the Atkins diet strategy.
We can’t be sure of the extent to which the story may have relied on a news release. We do know that that the work hasn’t even been presented at a conference yet, much less published.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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