Today Newsweek brings us yet another cover story on health — in particular on the widespread public confusion that ensued in the wake of the Women’s Health Initiative study earlier this year. And senior editor Barbara Kantrowitz and senior writer Claudia Kalb think they’ve found the culprit — in a word, themselves!
Yes, under the headline “DIET HYPE: HOW THE MEDIA COLLIDES WITH SCIENCE,” this story explains that the problem is, too damned many newsweekly cover stories on health. At Newsweek alone, there were 10 such covers last year, Newsweek disapprovingly tells us.
Think of it as a “Stop us before we kill again!” twist. Or, more precisely, “Stop us before we kill again! … Oops, we just did!”
The problem, say Kantrowitz and Kalb, is simple: Too many medical journalists and too much information. Patients no longer get most of their medical knowledge from their doctor. That worthy advisor has been replaced as the source of all wisdom by a tangle of Web sites, cable and network TV, medical reports, and magazine and newspaper stories heralding — or misinterpreting — one breakthrough after another. Thus, the Women’s Health Initiative study on low-fat diets is the latest in what appears to be a series of dietary flip-flops. All fat was bad; now some fat is good. Nuts were frowned upon; now, their fats are benevolent. Meanwhile, we the people buried under this onslaught of uninterpreted or misinterpreted medical bulletins are fatter than ever.
Newsweek notes that, from 1977 to 2004, the number of newspaper front-page stories on science tripled, from one to three percent — at the same time that foreign-affairs coverage plummeted from 27 to 14 percent, according to the Project for Excellence in Journalism. In news magazines, the number of pages devoted to health and medical science has quadrupled since 1980. Those 10 (out of 50) Newsweek cover stories ranged across issues as diverse as lung cancer, autism, and heart disease. (Not for nothing, Kantrowitz and Kalb reveal, does the pharmaceutical industry spent $1.3 billion in magazine advertising per year now.)
We’ve noted ourselves that even prominent health writers Gina Kolata (New York Times) and Tara Parker-Pope (Wall Street Journal) don’t seem to agree on what conclusions can be drawn from that notorious WHI study. Partly that’s because headlines can’t capture the complexity of the research, says Newsweek. “Most science isn’t a breakthrough,” says Dr. Judah Folkman, the widely-known cancer researcher at Children’s Hospital Boston, who was involuntarily thrust into the spotlight by a 1998 New York Times story about his research. “It’s incremental, brick by brick.”
Even though different studies on the same topic can vary wildly in terms of sample size, demographics, data, and length, “[t]he media reports all studies as if they have the same degree of certainty,” says Dr. Elias Zerhouni, director of the National Institutes of Health. “There’s no real label of quality.”
From the beginning, the WHI was controversial, report Kantrowitz and Kalb. Scientists especially questioned the diet trial, which enrolled 48,835 women. On average, the participants weighed 170 pounds at the outset and ate 1,700 calories a day. By the end, they reported eating 1,400 to 1,500 calories a day. “They should have lost loads of weight,” eating 300 fewer calories per day for years on end, says psychologist Kelly Brownell, director of Yale’s Rudd Center for Food Policy and Obesity, who was on a committee to review the WHI. But that didn’t happen. Women in the test group lost only three or four pounds. “That screams out to me that the dietary records were inaccurate,” says Brownell.
The diet study was also a victim of its time. Fifteen years after it started, we understand that some fatty foods, like olive oil, fish oil, and avocados are actually beneficial, and that plenty of processed foods labeled “fat-free” are actually loaded with calories.
Newsweek’s point is that not so long ago, this debate would have been confined to scientific circles. Medical journals filtered and printed new research, and doctors read the journals, discussed studies with colleagues, and then figured out how to translate the data into their clinical care. Now even the most respected journals have had to adapt to the voracious and growing demand for health information. When the Journal of the American Medical Association (JAMA) and The New England Journal of Medicine were launched in the 19th century, they had no concept of a “publicity” department. But today, JAMA, which has published several WHI studies, spends $1 million annually on its media and communications program, says Dr. Catherine DeAngelis, the editor.
In short, as silly and as cannibalistic as the Newsweek story appears at first glance, it seems that Kantrowitz and Kalb are actually on to something.