In 2007/08, the work of Nicholas Christakis and James Fowler revealed that human behaviors, and even states of mind, tracked through social networks much like infectious disease.

Or put another way, both obesity and happiness worm their way into connected communities just like the latest internet meme, the best Charlie Sheen rumors, or the workplace gossip about Johnny falling down piss-drunk at the company’s holiday party.

But according to a new research study, incorrect medical facts may be no different, galloping from person to person, even within the confines of the revered peer-reviewed scientific literature. And by looking at how studies cite facts about the incubation periods of certain viruses, a new study in PLoS ONE has found that quite often, data assumed to be medical fact isn’t based on evidence at all.

How many glasses of water are we supposed to drink each day? Eight – everyone knows it’s eight. But according to researchers from the schools of Public Health and Medicine at Johns Hopkins University, this has never been proven true. In fact, they argue there’s not one single piece of data that supports this claim.

Digging a little deeper, the research team dove into scientific papers looking for places where researchers quoted the incubation period of different viruses, from influenza to measles. Every time a claim was made, they traced the network of citations back to the original data source (and provided a cool visualization of the path, to boot). For example, many studies will set the stage for their own research by saying that it’s commonly known that the incubation period for influenza is 1-4 days, and next to that statement, they’ll put a small reference in parenthesis, which signals where they obtained that information.

The problem is, many articles cited another study, that cited another study, which in turn cited yet another – you get the picture. It’s like a really bad version of the “telephone game” played by kids. And 50% of the time, the researchers found no original source of incubation period data when they started backtracking. Scary stuff.

By factoring in review articles, which are supposed to be a comprehensive analysis of a field of research, the team found that 65% of viral incubation data never gets cited again after its first publication. 65%! Granted, review articles have to factor in the quality of the research done in individual experiments. So is that much crappy research being done, or is the majority of science in this particular arena simply falling into the growing chasm of “dark data”?

I’ve been chewing on this article for a while, waiting for the right time to write something about it. Today, a tweet by Nieman Lab caught my attention, and spurred me into action.

The tweet pointed to a post on Doc Searls’ blog asking media outlets to do a better job linking to original sources (I, like Searls, get super-frustrated with the NYT, when they either don’t link to a source, or you click on the underlined blue text thinking you’ll be enlightened by profound insight, only to find you’ve been swept away to some vaguely-related post authored by another NYT staffer).

Time to add scientists to your list of offenders, Doc.

Photo via Flickr / Dan Zen

Citation: Reich NG, Perl TM, Cummings DAT, Lessler J, 2011 Visualizing Clinical Evidence: Citation Networks for the Incubation Periods of Respiratory Viral Infections. PLoS ONE 6(4): e19496. doi:10.1371/journal.pone.0019496

** Update, 18 May 2011: The statistics cited in this post (50% of original data not traced back to source, 65% of studies never cited again) apply, in this case, to viral incubation data only. The authors didn’t extrapolate these findings to other medical claims. I updated the statements above to make this explicitly clear. -bjm

Little known fact: The first diesel engine was able to run on peanut oil.

With petroleum putting the squeeze on the environment and our pocketbooks, the push to create sustainable biofuels with commodity crops is increasing.

There’s an intriguing prospect in the March issue of The Atlantic by Nicholas Schmidle about efforts to turn the poppy fields of Afghanistan into a source of biodiesel fuel that will not only benefit the gas-guzzlers of the world, but the Afghan people themselves.

Michael Bester, a former Army soldier, is leading a team of visionaries trying to sway poppies away from the traditional opium trade, and towards the sustainable energy domain. Their project, not surprisingly, has met with a bit of resistance.

During the Bush administration, the White House felt that the only way to beat the opium trade was to raze the poppy fields. When Obama took office, the government’s commitment to aerial spraying of the poppy crop ceased, but Bester has yet to convince the military brass that his program will work for the US Department of Defense.

As The Atlantic reported, Marine commandant General James Conway and his Colonel (ret.) Bob Charette are committed to finding alternative fuels to sustain military operations in the Middle East. But they aren’t convinced that poppies are the way forward.

But even for Charette, poppy’s political problems loomed too large. “It just doesn’t sound good, the United States using poppy oil,” Charette told me.

Even though poppy oil is far more efficient, and its production would directly aid the people of Afghanistan, the Marine Corps aren’t buying what Bester’s selling. But to their credit, they have instead agreed to mix 20% cottonseed oil with JP-8 jet fuel. Granted, this is a huge step forward for biofuel acceptance and utility, but it’s irksome to see preconceived notions once again trump reality, science, and data.

Photo via Flickr / Christopher_Hawkins

The US government used the need to treat battlefield infections to seize control of penicillin production, along with the intellectual property and patents behind the drug.  But Uncle Sam’s questionable tactics paid off: from 1939 to 1944, penicillin went from an expensive laboratory experiment to a battlefield staple in every soldier’s medic kit.

Having lost their patents and potential financial gain to the government, drug companies began the quest to develop other types of drugs that were similar to penicillin, thereby launching a billion dollar antibiotic development industry.

NPR had a segment on ‘All Things Considered’ this week discussing the full story of bringing penicillin to market, which appears in a new book, ‘A Fierce Radiance’, by Lauren Belfer.

For quite some time, SEED Media (the parent company behind ScienceBlogs.com) has sold advertising space on contributors’ sites.  But as PalMD describes in his post, the center panel of each site is always under the direct control of the author.  With the launch of the PepsiCo blog, SEED Media is in grave danger of blurring the line between advertising and content.

I don’t think there is anything inherently wrong with selling ad space on the periphery of popular blog platforms.  Everyone has to pay the bills, and SEED Media needs a revenue stream to distribute and market its content.  But I’m not exactly sure how PepsiCo will use its newly launched blog, now that it has control of that valuable “center panel”.  Only time will tell whether the PepsiCo blog will become a PR platform for the food conglomerate, or whether they’ll actually contribute to scientific discourse.

Whether we like it or not, the prepared food industry will be a major player in our food supply in the near future.  We need to find novel ways to engage these companies to improve health and nutrition in society.  Hopefully, PepsiCo takes this opportunity to contribute in the exchange of scientific information, and doesn’t just focus on improving sales.

I’ll be watching this site very closely over the next few months, and I’ll report on what I find.

Over at Neuron Culture, David Dobbs has some nice insight into the ongoing debate between renowned science/tech writers Stephen Pinker and Nicholas Carr.

Carr apparently states in his new book, The Shallows, (which I have not read), that the internet might be killing our brains with increasing distractions. Pinker, on the other hand, thinks that while many people are initially panicked by new media technology, one day society will see the internet for what it truly is: a way of richly organizing the ever-increasing abyss of information.

A second showdown, this time between writers Jonah Lehrer and Clay Shirky, tackles the question: Is the internet better for creating a ‘Cognitive Surplus’ than television? Shirky believes the era of the mindless television sitcom moved us away from social interaction and deep thought, but the advent of online social exchange – even in the form of inane material such as the lolcats at icanhascheezburger.com – is once again bolstering our feeble brains. Lehrer fires back, saying that television and internet alike can fuel passionate offline discussions and detailed analysis.

From a neuroscience perspective: Is the never-ending online information flow good or bad for our brains? (Or, for that matter, is technology good for our brains?) Is one technology (television) better or worse than another (the internet)?

Just like all aspects of life, I suspect brain growth is all about balance. For me, Twitter serves as a filter for my information stream. I follow people whose insight and opinion I respect (whether I agree with them or not doesn’t matter). But sitting down to write a blog post takes me away from the cacophony of Twitter for a moment to think critically about a particular topic. Often I engage my colleagues and friends in a discussion, either in person or over email/chat, regarding the ideas in my head long before I publish anything online. I balance the real-time information flow with real-life conversations.

One could argue that any information stream – be it reading a book, watching a movie, or surfing the net could deaden our brain if we don’t pause for reflection. Intelligently analyzing, as opposed to passively experiencing, the information that enters our brains is no doubt one of the distinguishing factors that makes us human. So don’t be afraid of technology, and don’t quibble over which technologies are good or bad. Rather, simply use technology to augment human social interaction.

Kent Bottles wrote a piece titled “Check Lists and Decision Trees” that mulled whether structures like a decision tree can help people negotiate the huge information dumps that come with data-driven medicine. Besides the flattering proximity to Atul Gawande’s book, Bottles was generous in grasping the fact that I’m not claiming a decision-tree paradigm depends solely on rational decision making (which is inevitably unrealistic) but that I’m trying to find a way to bring our rational capacity together with our emotional needs – and therein lies better healthcare.

Brian Ahier wrote a terrific post on O’Reilly Radar, largely about the book. Riffing off one of my set phrases – it’s data, not drugs – Brian – who’s not only a health IT expert and blogger but also a member of his city council – nailed the promise and riddle of turning to a data-intensive model for healthcare. As he puts it, “Putting the patient at the center of healthcare and creating a strategy to process all of health data available today is a great start towards meaningful healthcare reform.” I was especially glad that Brian recognized the flexibility of my three principles for patient-centric health: Early is better than late; Let data do the work; and Openness is a powerful thing.

And Susannah Fox of the Pew Center lobbed a characteristically provocative take recently on e-patients.net. Her take: that the book could be retitled What to Expect When Your Expecting a Long Life. (Fine with me; those What to Expect books are huge!). In addition to the flattering notion that the Decision Tree compelled Susannah – a longtime health expert – to rethink her own health decisions, she astutely recognizes that I’m not just calling for self-tracking gadgets and gizmos – I’m really arguing that we should use whatever tools we have, including messaging from the FDA and other official bodies – to make health information clearer and more personalized.

It’s very heartening to me that three people who constitute experts in the field all seem to think the book is in tune with their own knowledge – that the notes are right, and that the composition is in the right key. My hope, of course, is that the book will also find a larger, less-expert audience, but my hunch is that unless I convince the experts, the lay audience won’t be there. If these three are any indication, I’m on the right track.

Lastly, I want to address some Twitter kibbitzing that these ideas are simplistic, naive, or somehow dangerous. I take some assurance that so far, this chatter comes from people who haven’t read the book – because the book itself goes to great lengths to explore both the promise as well as the perils and challenges of engaging in patient-centric healthcare (challenging both for the patient and the system). There is ample evidence presented in the book; the bibliography alone runs to 15 pages. Of course, I’ll answer this head-on when I have the chance. But broadly, I’ll offer this:

There is hope in the book, yes; there is a simplicity to the idea, indeed – but naive or simplistic it is not.

Japan’s population is about to tank, and with it, will fall the world’s second largest economy. In roughly 100 years, the country’s population will decrease from 127 million to 44 million. The outlook is bleak, as birth rates are at an all-time low, and the country maintains the highest proportion of senior citizens in the world. By 2050, the Japanese workforce could decrease by as much as 70%. An entertaining segment on Current TV explored both the cause of, and a possible solution to, Japan’s population catastrophe.

Japanese couples are not having babies. As more and more Japanese women and men prioritized their career ambitions over starting families, the national birth rates plummeted. Inadequate child care and employer discrimination of working mothers further discouraged working couples from having children. Swallowed up in the “work hard, play hard” pace of big cities like Tokyo (not to mention all the pretty faces at the local Host/Hostess Clubs), the Japanese 30-somethings claim they’re now too set in their ways to consider having kids.

So if they’re aren’t enough children to run Japan’s future economy, what about letting more people into the country? Could allowing more immigrants to enter Japan boost the country’s future population and workforce? Not likely, if current trends hold true, as less than 2% of Japan’s population was born outside of the country.  For those that make it through the immigration process, life is far from charmed. In Japan, immigrants are often viewed as second-class citizens — they lack basic civil rights, cannot vote, and are mostly tasked with menial manual labor jobs.

So what’s left? Children are out — the Japanese aren’t even having sex, let alone children (the average number of sexual encounters per person in Japan is half the number in the US.). Foreign workers don’t seem to be a solution either; in fact, immigration reform in Japan might be a tougher battle than health care reform in the United States! Japan’s best guess: robots. Seriously, robots? Why not just throw jet-packs, flying cars, and tele-porters into the solution while we’re at it? But it turns out, the Japanese may be on the right track. Japanese scientists have created new human-like robots that not only express emotion, but recognize it as well. Visionaries see the vast potential of these robots — from primary caregiver roles where they help out with grandma’s housework, to running the front desk at the DMV.

One Japanese scientist even created a robot in his own likeness. He figures this way, he can exist in multiple places at once. Gone will be the days when his wife complains of him spending too much time in the lab. Now he can send his robot to substitute for him at…err…home, so he can continue his important lab work uninterrupted. Seriously. Watch the video…

In a recent post, I talked about the dangers of celebrities promoting pseudoscience.  Well, maybe the celebrities have redeemed themselves.  GQ featured a pictorial of scientists kicking it with rock stars such as Joe Perry and Sheryl Crow, aimed to raise public awareness of important medical and scientific research.

Not since will.i.am of the Black Eyed Peas appeared via hologram (seriously) to talk to CNN’s Anderson Cooper during the 2008 Presidential Election, has the rock & roll establishment nerded-out so much.  But I applaud this effort to break down the stereotypes of scientists.  Despite common misconceptions, we too have a sense of humor and can have fun.  Enjoy.

Two recent blogosphere topics revolve around celebrities handing out scientific advice.  I want to be clear in this post, I’m a huge fan of citizen science, where the public invokes the scientific method to run their own series of experiments, and answer scientific questions for themselves.  After all, science is not meant to be stuffed away in a lab, only attempted by rubber-gloved scientists in white lab coats.  Science needs to live and breathe on our streets, in our schools, and in our backyards.  But it bothers me when celebrities start dishing out anecdotal advice as “science-based”, when it’s simply based on isolated personal experiences.  Such advice is not citizen science, but rather a ploy to gain media attention, boost ratings, or sell products and books.  I want to highlight two excellent articles I came across — one that discusses the science that debunked the autism-vaccine controversy, the other on the danger of Oprah’s health advice.

First, let’s talk about an excellent review featured in PLoS Biology that exposes the pseudoscience behind the autism-vaccine controversy.  To summarize, people began to fear childhood vaccines, such as the measles, mumps, rubella (MMR) vaccine, which contained a certain preservative called thimerosal that contains ethyl mercury (49.6% by weight).  This type of mercury sounded similar enough to methyl mercury, a chemical that is present in certain seafood, which causes neurological developmental disorders in children when mothers consume large amounts of mercury-tainted foods during pregnancy.  Although a single letter “M” separates ethyl- from methyl-mercury in spelling, they are distinctly different in chemical composition.  Before science had weighed-in on whether ethyl-mercury was in fact dangerous, fear-mongers demanded companies to remove the thimerosal from child vaccines.  Government health agencies complied, removing the preservative from all vaccines in 2001.  Since then, science has determined that the ethyl-mercury in thimerosal does not accumulate in the body in the same was as the methyl-mercury that’s in certain seafood, and therefore will not cause the same harmful neurological effects.  From the government health agencies’ perspective, they were simply making a safe vaccine safer by preemptively removing thimerosal.  Instead, certain groups used this motion to falsely conclude that the government must have known thimerosal was dangerous.

The PLoS review article says that 25% of people actually believe there is a link between autism and vaccines, despite the scientific and medical experts telling us otherwise.  That statistic is poised to worsen now that celebrities have jumped on the bandwagon.  Jenny McCarthy, has become the poster-child for vaccine-autism controversy as she tells her powerful narrative of her son’s struggle with the disease, and his “recovery” through homeopathic treatment.  She’s appeared extensively on cable news shows where she has made ridiculous statements such as “parents’ anecdotal information is science-based information”.  Sorry, Jenny, but that’s simply not true.  Another celebrity, Robert F. Kennedy, Jr., published his investigation on what he called a government conspiracy to cover up the links between autism and vaccines in the, ahem…illustrious and rigorous scientific journal, Rolling Stone.  As a result of this type of propaganda, infectious diseases once thought to be eliminated from the developed world are reemerging because some parents are not having their children vaccinated.

Next, I want to point out a Newsweek feature that criticized the health advice the infallible Oprah Winfrey is promoting within her media empire.  Don’t get me wrong, I know Oprah has done a lot of good for many people, but she has to be held accountable for the health advice she hands out, especially when that advice drastically differs from common medical practice.  For instance, the Newsweek article mentions an interview Oprah conducted with actress Susanne Somers, who advocates using non-FDA approved, synthesized hormone replacement products aimed at post-menopausal women to reverse the process of aging.  Common medical practice suggests that hormone replacement therapy be used in small doses, for a short period of time, to relieve the symptoms of menopause ONLY in very extreme cases.  Hormone therapy can increase a woman’s chance of developing cardiovascular disease (heart attack or stroke) and cancer.  During the show, Oprah had medical experts on-site, but since they were in the audience, and had to raise their hands to interject in the dialog.  When a physician expressed concerns over Susanne Somers’ promotion of hormone supplements, Oprah came to Somers’ defense.  Apparently, Oprah takes the word of an actress over physicians in the audience.

The best advice I ever received in graduate school was, “Don’t believe everything you read”.  This pearl of wisdom was directed at scientific literature, as one of the most powerful skills a scientist learns is the ability to distinguish between good studies and not-so-good studies.  I suggest a revised mantra for the times — “(Please, Please, Please) Don’t believe everything celebrities say”.  Check out the links to the full articles I covered here.  You’d be severely short-changed if you only relied on my 5-cent summaries.

Since the 1980′s, American soft drinks have been sweetened with high fructose corn syrup (HFCS), and it’s rapidly becoming the sweetener of choice in most processed foods.  Critics are quick to point a finger at this enigmatic sugar as the root of all evil, claiming its empty calories are contributing to the obesity epidemic, and the numerous chemical processes needed to make it are simply “unnatural”.  These accusations didn’t sit well with “King Corn”, and The Corn Refiners Association fired back with a series of TV commercials stating that HFCS was in fact natural, and completely safe in moderation.  Government officials have been talking out of both sides of their mouths on the issue, first allowing HFCS to be called natural, then recently proposing it be taxed, thereby equating it to other unhealthy items, such as cigarettes.  With all this conflicting information, what should the public think?  Should we avoid HFCS at all costs?  How does HFCS compare to other sugar sweeteners?

Let’s start with the science.  I recently came across two blog posts (links below), which centered on a study in the Journal of Clinical Investigation that compared the health effects of consuming different dietary sugars — one experimental group’s sugar of choice was glucose, the other group’s was fructose.  The study boosted the subject’s sugar consumption to 25% of their total daily calories by adding fructose or glucose to unsweetened Kool-Aid.  The results showed that both groups put on weight, which is not surprising given the sheer volume of sugar consumed.  However, the group with the fructose-based diet had higher visceral fat, triglycerides, plasma LDL and oxidized-LDL levels, plasma glucose level, as well as signs of increased insulin resistance, compared to those in the glucose group, all of which are signs of deteriorating health.

There were some shortcomings of the study, which were pointed out nicely in the blog posts: 1.) it was a small study (n=32), 2.) its only participants were obese people (i.e. will the results hold true for normal weight people?), 3.) subjects consumed much more sugar than the average American (mean=15.8% of total calories), and 4.) fructose is more than 2x sweeter than glucose, so in theory, you’d need less fructose calories to obtain the same level of sweetness.  Despite the study’s limitations, similar results have been shown in primates, which further substantiate the main finding — fructose-based sweeteners cause secondary health problems.

So what do these results mean to us? First, it seems the sweetener used in this study was either 100% glucose or fructose.  We typically don’t use such pure sugars, as we primarily satisfy our sweet tooth with either table sugar or the high fructose corn syrup that’s hidden in the ingredient list of processed foods.  What exactly is the difference between these two sugars, and how does using them affect our health?  HFCS is a 55/45 mixture of fructose and glucose, respectively. The Journal of Clinical Investigation study claimed that HFCS may be just as bad for you as pure fructose, as the results of a short-term experiment showed comparable negative health effects between subjects that consumed either of these sugars. Table sugar (sucrose), on the other hand, is a 50/50 mixture of glucose and fructose, which is surprisingly similar in composition to HFCS.  The primate study I cited earlier reported that diets high in both HFCS and sucrose increased triglyceride levels.  So it seems possible that added fructose, regardless of the source or relative concentration, may be detrimental to our health.

So if fructose causes a barrage of negative health effects, does that mean eating an apple is bad for you?  After all, fructose is the main sugar in fruits.  Michael Pollan address this question best in his book “In Defense of Food” (which I just finished reading, and I hope to get a review posted here soon).  Pollan states that, opposed to the fructose in the Kool-Aid given to the study participants, the fructose in an apple is not an isolated monosaccharide — it exists in a complex micro-environment where it is surrounded by lots of fiber, which prevent the fructose from causing a sugar spike, and allow it to be metabolized slowly.  Simply put: with food, context is everything.  Mother Nature made fruits sweet for a reason — they are good for us, and contain vital nutrients.  But perhaps fructose was never meant to be isolated in a lab and poured into soft drinks, as the results I’ve discussed show that processed fructose is rapidly metabolized, and leads to negative health.

While more stringent scientific studies need to be conducted to investigate the effects of HFCS on a diverse population, I think it’s safe to say that regardless of the source, the 39 grams of sugar in the average soft drink isn’t helping the obesity problem in the United States.

Sources:
Some Sugars Worse Than Others?  The Bittersweet Fructose/Glucose Debate

Dark Sugar: The Rise and Fall of High Fructose Corn Syrup