Bran, soy help cut cholesterol

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Same problems here as with the competing LA Times story: The post doesn’t address how much it will cost to maintain this diet, which includes some pricey soy-based components and expensive fortified margarines.

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

Not Satisfactory

There was no discussion of the safety of the diet. The study paper notes that there were some potential allergic reactions in the portfolio diet group.

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

Not Satisfactory

In contrast to the LA Times, which clearly established that this study looked at the surrogate outcome of LDL cholesterol, this blog post made it sound as if LDL cholesterol reduction were totally synonymous with heart disease prevention. Although the two are closely linked, we can’t say without further study whether this diet will result in a reduction in actual cardiovascular events. (This is the kind of detail an independent source might have provided.)

Also, the study never mentioned the important role of margarine fortified with plant sterols for achieving the LDL reductions seen in the study. As the study authors note in their paper, sterol-fortified margarines are the greatest single contributors to LDL cholesterol reduction in this portfolio diet. These impressive cholesterol-lowering results cannot be achieved simply by eating more oat bran, soy burgers, and by replacing a standard lunch with fruit and nuts–which is what readers might think based on the story.

Does the story commit disease-mongering?

Not Satisfactory

This story tripped our disease-mongering detector by failing to discuss or even mention why someone would care about their cholesterol levels. High LDL cholesterol is not a disease, it is a heart disease risk factor. The LA Times, by comparison, reported: “Cleveland Clinic’s Nissen stressed that researchers did not directly measure rates of coronary heart disease — just LDL cholesterol — so the health effects of the portfolio diet are not yet clear.”

The CNN post makes it sound like lowering cholesterol is an end in and of itself. That’s the kind of mindset that leads to more medical treatment instead of better medical treatment.

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

Not Satisfactory

The story quotes the lead author of the study, but includes no truly independent perspectives. It also does not disclose that many of the study authors have ties to organizations (e.g. Unilever) that might benefit from wider adoption of this diet.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story does not clearly explain that the control group in this study was eating the “standard” diet recommended to reduce risk of heart disease — an important detail. It also does not discuss how the results compare with those of statin drugs.

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

Not Satisfactory

There’s no discussion of the difficulty people in poor urban and rural areas may have finding some of the vegetarian foods called for in this diet, which includes some fairly exotic soy products (e.g. soy deli slices) as sources of protein. Also, considering the lack of physician reimbursement for dietary advice, patients may have trouble finding a health professional who can counsel them on this approach.