There were no independent perspectives on the research, and information on costs and availability was lacking. The story also failed to make it clear that we’re talking about a surrogate marker of cardiovascular disease–not actual heart attacks. The competing story from the LA Times had some of the same shortcomings, but did a better job overall giving readers the information they need to make decisions.
We sympathize with bloggers who say that our criteria are difficult to satisfy within the confines of a short blog post. (But who says it has to be this short?) Nevertheless, examples abound of stories that are able to check most or all of our boxes in posts not much longer than this one. There’s just no good excuse for stories that fail to help readers interpret complicated health research and make informed decisions about their care.
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.
The story tells us how much the diet reduced cholesterol, providing the actual values from the lab report. It could have also estimated the expected reduction in 10-year cardiovascular risk that this would correspond to.
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.
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.
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.
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.
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.
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.
The story makes it clear that this study is a follow-up to previous studies of this diet conducted under more controlled conditions. This is nicely explained.
The story has a quote that is taken from a phone interview, which tells us the story wasn’t entirely based on a news release.