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Issue #04 (February 2015)

From the Editor

Let’s play a little game of Choose Your Own Adventure, Health Research Edition. It’ll only take a few minutes, but I hope it gets you thinking.

You’re going to be playing the role of someone scouring the web for evidence on a condition you’ve just been diagnosed with. The title is “The Case of the Misleading Abstract.” Foreshadowing? Yes.

On a random weeknight, you’re supposed to be sleeping but are instead doing health research (hey, it should pay off eventually, right?). Since you haven’t read the February issue of NERD, you don’t yet know how nighttime web-browsing is affecting your brain. Anyway, you stumble across an interesting abstract on pubmed. Apparently, alpha lipoic acid can help treat symptoms of a certain autoimmune disease. Not only is p less than 0.05, it’s less than freaking 0.001! Boom.

This is quite the useful bit of knowledge, because you’ve just been diagnosed with that autoimmune disease, and your doctor wants to put you on an unpleasant medication. Should you (A) go buy the supplement on Amazon, or (B) try to pull the full paper?

(A) You buy the alpha lipoic acid on Amazon

It arrives in two days. You don’t mention this to your doctor because he’s a bit close-minded, but you’re sort-of banking on the supplement helping, and hence delay starting your medication for a few weeks. A few weeks later, the pain hasn’t gone away, you’re still fatigued, and you have a new-found hate for alpha lipoic acid.

(B) You pull the full paper

You can’t actually access the full paper. Your significant other is a student, so eventually you pull the full paper and get all the details. The researchers used three different questionnaires and took some blood draws, and out of all those measurements, only one was significantly better in the alpha lipoic acid group. You look up one of the references mentioned in the paper, and it actually concludes that alpha lipoic acid isn’t likely to impact autoimmunity by itself. Also, the most convincing studies have been conducted on diabetic mice.

You don’t buy the alpha lipoic acid. You have a little bit of “nonbuyer’s remorse,” but forget about it the next week. The $25 you saved becomes $436 by the time you retire.

Neither of these scenarios is uncommon. Most of us have bought way too many supplements based on either anecdotes or tantalizing p-values. Granted, it’s really tough to face a health condition without an easy treatment, and that can make an abstract sound more promising than the full paper or body of research reveals. Money spent on ineffective supplements can really add up, and sometimes it may be a better idea to focus on high-yield lifestyle habits like plenty of sleep and methods to combat stress. Don’t take abstracts and their p-values as gospel, and best of luck on choosing your own adventure.

Kamal Patel,
Editor-in-chief, Nutrition Examination Research Digest

See other articles in Issue #04 (February 2015) of Nutrition Examination Research Digest.