Juice Gives You Cancer (Or, How To Be Smart About Health News)
Juice doesn’t give you cancer, actually. But you could (maybe) be excused for believing it does. If you Google “Does juice give you cancer?” the top result is a 2011 Daily Mail health news article with the headline: “The cancer risk in your ‘healthy’ glass of fruit juice which has so much sugar it could bring on tumours.”
Say what you will about the Daily Mail, but it’s indicative of where most of us get our health news. And this article is indicative of the abundant problems with medical and health news – it’s not until three paragraphs from the end (a point most readers will never get to) that the article acknowledges the study doesn’t quite match its headline.
Articles like this – warning of the health risks of an everyday item or reporting a new cure – are widespread and garnering public backlash: British comedian John Oliver recently dedicated a segment of his show to flawed health news (watch it for his skewering of chocolate’s effect on pregnancy), and Vox published an excellent article that included this infographic displaying all of the food items that have been reported to somehow both cause and prevent cancer.
The problem has its roots in the scientific community itself, says Manav Bhushan, co-founder of the Bangalore-based healthcare start-up Fourth Frontier. Bhushan, who holds a PhD in biomedical engineering from Oxford University, says academics face strong pressure to publish, especially to publish positive findings. The result is a glut of studies in obscure journals that claim to find a cure, but “if you actually look at the study, it’s next to impossible to verify what they’re saying is true,” he says.
And according to John Oliver’s meticulously reported bit of comedy, there’s little incentive to do so; funding to repeat someone else’s experiment in order to corroborate or refute findings is low, even though that is how science is supposed to work.
“A scientific claim is most valid when it’s been independently confirmed by multiple groups, and the studies are well-designed,” says Nipun Chopra, who researches Alzheimer’s disease as a PhD candidate in neuroscience at the IU School of Medicine in Indianapolis in the US.
But even assuming a finding has been verified and published in a reputed journal like The Lancet or Nature, Chopra says, it’s likely written in such unnecessarily technical language the average person would struggle to understand.
Which is where journalists come in. But in the age of clickbait, the result is, at best, a boring but accurate article that few people read; at worst, the proliferation of pseudoscientific outlets like the widely discredited Food Babe or Natural News blogs.
More common is the article that misses or twists the point.
Chopra compares health reporting to a game of Chinese Whispers and says he sees an article that is “objectively inaccurate” doing the rounds on social media every three to four days.
“If you go through my Facebook timeline, it’s filled with people asking me about the latest ‘cure’ to Alzheimer’s,” he says.
While inaccuracy is a problem everywhere, India is particularly susceptible to confusion over what is legitimate new knowledge, Chopra says. A cultural preference for natural remedies and homeopathy, which flourish from anecdotal evidence rather than rigourous testing, allows many people to be led astray by poor research or reporting even when they embrace allopathy.
In the age of clickbait, the result is, at best, a boring but accurate article that few people read; at worst, the proliferation of pseudoscience.
And today’s adults grew up in an era of few trusted news sources, which could make the cacophony of the Internet – where fact is easily mistaken for fiction, and fiction for fact – difficult to sift through.
“Growing up in Calcutta, 15 years ago, I got a lot of my science news from the Telegraph supplement on Mondays,” Chopra says. “That was a trained scientific writer reporting the data. Now, that has been replaced by untrained science writers reporting on things they don’t quite understand – which is fine. But then, you have people who read [that] stuff on a blog or Facebook and believe it to be true.”
How to be a smart reader of health news
While health reporting has garnered much criticism lately, it’s unlikely to change overnight. So how can a reader of health news know what and what not to believe?
Check the numbers
“People just look at numbers as numbers,” says Pooja Ochaney, a statistics professor at St. Xavier’s College in Mumbai.
But numbers come with context. Because there’s no way to study an entire population, most research is carried out on a small group of subjects and then extrapolated to apply to the population at large. But if the group examined is too small – as was the expert criticism of the study in the Daily Mail article – the results become meaningless.
Even when the extrapolation makes sense, consider the number of people affected. A headline like “15 million Indians at risk for X disease” sounds scary, but “15 million in a country of a billion becomes a small number (1.5%),” Ochaney says.
Finally, she says, consider the number of other things that could have affected the conclusion – were all of the people in the study the same age? Do they live in the same geography? Do they have family histories of the condition being studied? Just because a “link” or “association” has been found between two things, doesn’t mean there’s proof one causes the other. (Still confused? The data crunchers at Fivethirtyeight.com have a hilarious and clear explanation.)
Ochaney says watching for the phrase “when X was accounted for,” ahead of the conclusion is a good way to tell if these other possible influencers have been considered and ruled out in order to reach the conclusion.
If an article is claiming a miracle cure, disregard it immediately, Chopra says, because scientific advancement requires independent confirmation and progress is incremental. He also advises checking the claims of other articles on a site.
“If everything is anti-GMO, anti-medicine, anti-pharma, then it’s kind of a red flag,” he says. “It’s a narrative-driven blog, rather than a website with legitimate health news.”
Check the source
Reputed news sources like the The Indian Express, the New York Times, the BBC and others get health news right more often than not, Chopra says. And Bhushan adds that finding a volume of articles that say the same thing from different, respected publications also lends credence.
But Chopra urges people to go to the academic journal that published the study and read its abstract whenever possible. It may take a few readings to make sense of any jargon, but abstracts are short, and it’s worth the effort, he says.
Journals that have a peer review process are most trustworthy. Peer review is like a trial by jury, for a study, wherein experts consider its methods and conclusions and rule them valid or invalid. (Here’s a good guide to determining if a journal conducts peer reviews of articles.)
“If everything is anti-GMO, anti-medicine, anti-pharma, then it’s kind of a red flag.”
Check the methods
The methods of the study are more important than its conclusion, Chopra says.
“Did they find their cure in cells? If so, it’s not applicable to you yet,” Chopra says. “Did they find their cure in mice? If so, it’s not applicable to you yet. For example, Alzheimer’s has been ‘cured’ in mice many, many times. But the truth is, mice don’t get Alzheimer’s [naturally], so it’s just not valid. Humans, especially when it comes to neuroscience, are infinitely more complex than mice.”
Check the funding
Last year, a wave of reporting covered a new study that found eating dark chocolate can boost concentration. What many articles failed to include, however, was the fact that Hershey’s funded the research. While that doesn’t make the results automatically untrue, it does mean researchers had more incentive to craft the methods a certain way to yield certain results. At the very least, Bhushan says, such funding makes him skeptical of results.
“A lot of the articles related to what you should eat are very suspect because they’re usually backed by industry affiliation,” Bhushan says. “They [low-fat foods industry] backed a lot of these low-fat studies for a long time that are now found to be complete bullshit.”
Check your own bias
Last but not least, if you’re searching for a specific answer, you’re likely to find it, Bhushan says. The Internet gives life to misinterpretations, half-truths and even blatant lies long after science has moved on.
He points to antioxidants, which until just a few years ago was the hottest trend in cancer prevention, thanks to a 2004 study that found antioxidants that occur naturally in food had shown anti-carcinogenic properties. The resulting rush for antioxidant supplements allowed researchers last year to find compelling evidence that antioxidants can worsen the disease.
This last is difficult advice to follow. Hope is fundamental to the human condition, and is, perhaps, what drives much of the research into the topics of health and medicine to begin with – the belief that answers and solutions can be found. But while scientists are trained to temper that belief with patience, process, and skepticism, for the rest of us, it’s not so easy to hold hope in check, particularly when there is much to lose – the well-being or life of a loved one, perhaps, or ourselves.
Which is why considering the context and big picture of medical and health news is so important, Chopra says.
“People are desperate for knowledge,” he says. “But people are also desperate for a quick buck and for clicks on their blog.”