The Researcher's Promise

I've had one of those days where I'm questioning whether researchers should even be allowed to present their findings to the general public.

It started with the report on the increase in autism rates. I don't want to minimize the devastating effects of autism on families. But it reaches a point that it defies credulity. A jump from 1 in 88 to 1 in 68? In two years? And with a nearly fourfold variation between the lowest and highest states? (Alabama and New Jersey. Can you think of some differences between Alabama and New Jersey to explain that?)

Another study reported that a third of school-age kids have borderline or high cholesterol. These were kids between 9-11, a time we know cholesterol increases naturally--and is probably a necessary increase. And we have no clue how or if this affects them as adults. (By the way, this was just a meeting abstract, not a peer-reviewed paper.)

And, of course, there's the study showing that toddler obesity plummeted, one with significant issues I've already written about. Another writer posted about it recently, raising a different set of (equally valid) problems. An interesting tidbit there was that the author of that piece was not giving media interviews. (And I'm trying to not be bitter that no one cared when I made my arguments a month ago!)

As a researcher, I've had to learn to understand the media, and learn to understand how to present my findings. I'm sure I've stumbled. But this is something we, as researchers, absolutely HAVE to learn--how to explain what we've found. And we have to be absolutely sure what we are presenting is accurate, not just statistically, but in how it gets presented.

Why is this so important? These three studies tell me 1) autism is increasing at a rate that will eventually make it the scourge of the US, 2) a third of kids need intensive cholesterol interventions, and 3) obesity is all better. None of these things are true. Autism prevalence is still a mystery tied up in diagnosis rates and societal norms for "disorder". The only kids who really have cholesterol problems are a small group with genetic hypercholesterolemia--the rest are probably just growing. Obesity, or whatever we want to call this increase in body size, is pretty much unchanged.

Our studies, when promoted in the media, are the foundation of public discourse. They determine the policies that get developed, the programs that get funded, how the public perceives health problems. Carefully putting information in the public domain is our responsibility. We work so hard to do good work and get it into the journals. But that is only the first step. Of course we don't have complete control over the media--but too many of us denigrate journalists as not understanding researchers. That's not true at all, in my experience. We, the researchers, seem to not understand the rest of the world.

I think we need a researcher's promise (with some inspiration from the Girl Scouts).

"On my honor, I promise to always try to ensure my work serves the people of this world, to take an active role in translating the message to non-researchers, and to generously offer my knowledge and time in making research have only a positive impact."

I'm willing to consider edits on that promise!

Be Wary of the Headlines: Has Toddler Obesity "Plummeted"?

Yesterday, a study was published showing the prevalence of obesity in children and adults over the last decade.

The headline that was commonly seen was "Toddler Obesity Plummets". This insinuates that the main story out of this study is that we are winning the "battle against obesity".

Let's look at two things: What the study says about toddler obesity and what it says overall.

First, the study did indeed find that toddler/preschool (ages 2-5) obesity in 2011-2012 is much lower than it was in 2003-2004. However, what it also showed is that the drop happened right after--in 2005-2006. In fact, if you look at the authors' previous work, you can see that it was much lower in 2001-2002. For some reason, 2003-2004 was anomaly in NHANES, or in obesity rates. The rates went from ~10% to ~14% to immediately back down to about ~10%.

To say that toddler obesity has plummeted in the last decade in disingenuous at best. It has only decreased when making the very specific comparison of one two-year cycle. The trend over the last decade is not significant. The authors do acknowledge the importance of the comparison, but do not discuss the very important difference in 2003-2004.

Second, although obesity in young children dominated the headlines, the paper actually examined children and adults at all ages. The real story of this paper, in my opinion? Nothing has changed. It hasn't changed for young children or teenagers, for young adults or older adults.

Don't let a shocking headline distract you.

Love Song of the Headless Fatty

So, I got a paper published today, one I'm quite proud of. It's a viewpoint in JAMA Pediatrics, and is accompanied by a contrasting viewpoint from Daniel Callahan.

My basic premise is that we must stop stigmatizing children, even in small ways, because the thing that can be seen--the fat--is not what we should hope to change. Callahan, on the other hand, argues that "the main and simple message is that obesity is bad, not to be accepted or delicately evaded or minimized".

I would never argue that we should minimize the health effects of obesity, but we can not shame anyone into thinness. And we should never view obesity as solely the result of individual decisions, an (unstated) assumption that we know is faulty. 

I'll let everyone read them and make a decision for themselves. If you are at an academic institution, you likely have full access. If you are not (and are not on a mobile device), you will get to see a first-page preview, which is the majority of both articles. Shoot me an email at asheley@unc.edu, and I can share a full PDF if you like.

(The titles below link to the JAMA Pediatrics page.)

The Love Song of the Headless Fatty and Other Observations

Children, Stigma, and Obesity