Cristina Galafate
Updated Friday, March 22, 2024-02:17
Study Yesterday 10,000 steps a day, today 3,967: is it enough to be healthy?
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Fasting is associated with 91% mortality, making a macronutrient such as protein responsible for cardiovascular risk or that it only takes 3,967 steps to be healthy. These are just three examples taken from information published with great fanfare in numerous media and social networks in recent months. Experts highlight the
potential harms of medical misinformation
, which has become increasingly complex and difficult to identify, as well as misinterpretations of studies.
Everything is changing so quickly and it's even harder for the average person to filter it. Health warnings that are not backed by science have spread widely across all platforms.
The New York Times
warned in a report published in recent days that the same type of
conspiracy theories
that helped fuel vaccine hesitancy during the Covid-19 pandemic are now undermining confidence in vaccines against other diseases, including measles, as more people have lost trust in public health experts and institutions. And rapid advances in
artificial intelligence
have made it even harder for people to know what is true and what is a lie.
INTERPRETATIONS WITHOUT A SOLID BASIS
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To this we add the impulse to attract attention in a fast-paced world, both in an Instagram and TikTok video and in the need for a journalist to appear on Discover to be read. A feedback loop in which
we lose the trust
of users/readers.
"All studies must be taken into account, but
it is irresponsible not to consider the limitations of each study
and, above all, to give false headlines," explains Marcos Vázquez, health popularizer on the podcast, website and social networks under the name Fitness Revolucionario. , which was very critical after the publication of a teletype from the Efe Agency published by this same media outlet and others, triggering searches on the subject instantly.
According to this expert, whom we turn to for his great reputation and rigor, as he is among the most important health communicators in Spanish, if one day an article is published talking about the benefits of intermittent fasting and the next day another talking about the " serious dangers", people will begin to
ignore the rest
of the health messages.
"Starting with the headline, an observational study, no matter how well designed,
will not be able to conclude causality
, only correlation. That is, we could not affirm that the cause of the higher mortality is fasting. There could even be reverse causality, that is , that people
forced
to fast are due to medical tests, pathologies... and that prolonged fasting was the consequence of the greater risk and not the cause," he warns.
But, in addition, the study has many limitations. "At first it is a preliminary publication, it has not been reviewed. If more problems are found in that review,
it will not even be really published
. In addition,
it did not control other variables
, so we do not know in what other aspects the people who fasted were different from those that don't." When it came to cross-referencing data, for example, we did not know what habits the people in the study had. "It is based on self-reported data and only for two times in many years, so those two samples tell us little about how they really ate during the follow-up years," emphasizes Vázquez.
DANGEROUS APPROACHES
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"Fasting has shown certain benefits in
controlled clinical trials
, which give us much more information than observational studies as limited as the one in this news," clarifies the health communicator.
Let us remember that
Yoshinori Ohsumi
won the Nobel Prize in 2016 for his research on autophagy. And he is related to fasting because, during it,
the body uses its own energy reserves.
"In many cases, shortening the eating window facilitates calorie control and can also improve glycemic control. That said,
it is not necessary to do so nor is it anything magical
. Messages that glorify fasting as if it were a pillar of health can also lead to confusion. It is an interesting tool that we have at our disposal, but it is neither the key to health nor will it harm it (as long as we talk about short fasts of 14-16 hours)", explains Marcos Vázquez.
We must remain alert to cases in which statements jump to conclusions without evidence or appeal to emotions. The case of the
3,967 steps from which there is a health benefit
does not mean that we banish the 10,000, but rather, the study said the opposite: that from that minimum amount, the benefits were much greater. Therefore, it is dangerous to tell a sedentary society that the myth of 10,000 steps is dismantled. In fact, health professionals insist that walking alone is not enough to stay fit.
Regarding the fact that "eating more than 22% protein in the daily diet increases cardiovascular risk", as stated in another of those alarmist headlines, nutritionist Ismael Galancho was blunt with ZEN in a recent interview, where he expressed himself about demonizing a macronutrient: "They are accused of being responsible for overweight and obesity, for diseases such as diabetes, cardiovascular or cancer and this is not the case. All of these are
multifactorial
problems ."
OBSERVATIONAL STUDIES
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In the field of food, this happens especially, says Juan Bola, nutritionist and Physical and Sports Activities technician, who is informed about observational studies that show
biased statistical coincidences
and not causalities and can be very easy to manipulate if the scientific method is known. . "They are studies with food frequency and habit questionnaires where statistical data is correlated." They are done through questions and follow-ups, usually phone calls. "It's really impossible to determine in an objective and quantifiable way what a person eats over years or decades. Do you remember what you ate 10 years ago? How many half-cup servings of peanuts did you eat per week last year?" he exemplifies about the model. .
That is, people can say that they eat less of 'X' because they do not consider it healthy or vice versa, I am going to say that I consume more of 'X' because I know it is healthy, Bola questions. "And of course, most scientists who do an observational study expect results that validate their theory; if those results are not what they expect, it is as easy as
not publishing it
."
In a study published in the Journal
of the Royal Statistical Society
in 2011, the authors dramatically state: "Any statement that comes from an
observational study
is probably incorrect." For this reason, Bola concludes: "It is a shame but the scientific evidence is increasingly less rigorous and little by little the main objectives are to obtain shocking headlines or favor some industry. Observational studies are easily manipulated statistics that tell us little about the true human nutrition. Before believing any headline or video, read the study calmly and bring out your reflective and critical side,
skills in danger of extinction
," he recommends.
CRITERIA OF A GOOD STUDY
At ZEN we ask health and well-being experts for help to identify when to trust and when to question information. Our intention, knowing that we are part of this solution, is for the reader to reflect and actively get involved in the process of filtering what comes to them in the overabundance of content.
Peer review:
"Other experts have evaluated the study before it was published."
Representative and unbiased sample
: How many people are we talking about? How long? In the analyzed case of fasting, barely 20,000. Can we extrapolate to the entire population? "It is important to read the methods of the study to understand if it is really well supported, do not stay at the headline."
Funding of the study:
"It is very suspicious if a study that talks about how beer improves cardiovascular health is funded by Anheuser-Busch InBev, a company that produces global brand beer. Always look for where the money for the study comes from and read the conflicts of interest of the authors," advises Bola.
Look for high-quality studies with scientific weight
: "Randomized controlled clinical trials and if they are double-blind, the better. In these, two groups are selected at random and assigned a different variant, usually blindly (they do not know which variant they have). For example: Group A is given sunflower oil for cooking and Group B is given olive oil. Everything else about their diets and lifestyles remains unchanged. A well-designed randomized controlled trial is indeed a good study. to create dietary guidelines and to affirm that certain foods or nutrients can have an 'X' impact on the body. The problem with these studies is that they are very expensive, they are long and there is a principle of ethics that weighs them down," Bola explains.
Look at "false experts
," says Sander van der Linden, a professor of social psychology in society at Cambridge who researches misinformation. These are people making health claims without any medical credentials, or doctors making claims on topics in which they are not experts. "You wouldn't want to go to an ENT doctor to have heart surgery."
Misinformation also often uses
polarizing language:
"Bad actors take advantage of intense and extreme emotional reactions, such as fear and outrage, an 'us versus them' mentality, and scaring people." Images and videos designed to provoke concern, such as crying babies and huge needles, are likely to be used. Better to stay in the grays because almost nothing is completely good or as bad as it seems.