Fake Studies, The Case Of Almonds

Almonds are not a superfood.

Fake studies are out of hand. I’ll be reading a study, going along with its findings, when something starts to feel a little off. I dig deeper and realize I’ve been hoodwinked by a company trying to peddle their product. This is happening with studies published in the most prestigious journals (to which my example testifies). It didn’t used to be like this. Science was and is supposed to be about testing a hypothesis, getting to the truth, finding ways to help humanity. It’s not supposed to be about selling. These fake studies look like science, but they’re really advertisements in science clothing.

This study, which purportedly found benefits to eating almonds, was paid for by the Almond Board of California:

Almond Consumption during Energy Restriction Lowers Truncal Fat and Blood Pressure in Compliant Overweight or Obese Adults, The Journal of Nutrition, December 2016.

Give-aways to this being more about selling a product than about science:

1. The study is not behind a pay wall. How can you advertise, how can you reach the most people, if no one can see your advertisement?

2. The word “compliant” in the title. When you test an intervention, you measure its impact on the whole treatment group. You don’t pick out special “compliant” people in the group who are more likely to show the particular effect you’re looking for.

3. Expecting people to eat 15% of their calories as almonds, while on a diet, is not practical. It’s not me saying that, it’s the authors:

“The findings from the ITT* analysis reflect the practical implications of almond consumption during energy restriction, whereas the complier analysis reflects more closely the efficacy of the almond intervention when individuals are compliant with almond consumption during energy restriction.”

*ITT: Intention-to-treat (ITT) analysis. ITT is all participants who received the almond intervention, compliant or not. As you’ll see in No. 4 below, the ITT analysis, the PRACTICAL analysis, didn’t do anything.

People lose their desire to eat 1/4 to 1/3 of a cup of almonds every single day:

“In our study, almond palatability ratings decreased considerably over time.”

4. The ITT group (which did receive almonds and which included compliant individuals) did not experience benefits in truncal fat, total fat, blood pressure, or visceral adipose tissue (VAT: fat around the organs). It says it right there in the abstract and throughout the study. To get positive effect from almonds, according to this study, you HAVE to be on a diet, be restricting energy intake, and you HAVE to be eating 15% of your calories as almonds (1/4 to 1/3 of a cup) EVERY DAY. People walk away from this study thinking if they eat a few almonds here and there, without also being on an energy-restricting diet, they will experience these benefits. That is not what this study found. Their title is misleading. Purposefully?

5. They went fishing. That means they choose to test a lot of variables: weight, body composition, VAT, resting BP, waist circumference, sagittal abdominal diameter (SAD), serum lipids (LDL, HDL, total cholesterol, triglycerides), insulin, glucose, 24-h ambulatory BP, and 24-h free-living appetite. The more variables you test, the more likely you are to find something that was changed, something worthy of publishing a study and getting people to eat almonds.

6. Nowhere do they mention the cost to the average person of adopting this intervention. A quarter to a third of a cup of whole salted, roasted almonds a day is not cheap. In this study, those 15% of calories were paid for by the investigators. I do not see that the non-almond group were compensated for the cost of 15% of their calories. Do you know why none of this was mentioned? Because it’s an advertisement.

7. You know what else wasn’t mentioned? Any negative effects of eating all those almonds. Almonds are very high in omega-6 fatty acid. One ounce of almonds has 3573 mg of omega-6 and zero mg of omega 3. A healthy ratio of n-6:n-3 is 4:1, not 3573:1. That would throw someone’s omega-6/omega-3 ratio way over to the omega-6 side, which has been shown to be pro-inflammatory. No mention. An advertisement.

Do you think this study would have been published if it found eating almonds was detrimental? The Almond Board of California would have locked it in a filing cabinet. That’s called publication bias.

Fake studies such as this are how foods work their way onto “superfood” lists. Nuts are not superfoods. They are a great addition to a diet, but to think they will counteract the negative effects of a bad diet is naive. No one food can do that.

7 thoughts on “Fake Studies, The Case Of Almonds

  1. Melinda

    Oh wow, didn’t know that about Omega 6. I remember you writing years ago on your other blog about the untrustworthy character of academic science and medical journal articles. Something like this, though when I googled for it, I found there actually are a number of editorials about such “fake studies” now. Just goes with “fake news” in general, I guess. https://ethicalnag.org/2009/11/09/nejm-editor/

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    1. Bix Post author

      This was my old post, from May 2009, 6 months before hers:

      Corrupted Research

      Former editor-in-chief of The New England Journal of Medicine, Dr. Marcia Angell

      “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”

      It’s gotten worse. And you know what? It’s working. Fake studies sell.

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    2. Bix Post author

      It’s discouraging when the media publish an article claiming “New Study Finds Eating Almonds Burns Fat, Lowers Blood Pressure” then cites this study. There’s no accountability … not from the study’s authors, not from journalists, not from the study’s sponsor (ha).

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    3. Bix Post author

      In President Obama’s farewell speech, he advised us to guard against cynicism. I’m working on that.

      There was another phrase Obama used in that speech that stood out for me, “jealous anxiety”. It’s a phrase that George Washington used in his own farewell address:

      In his own farewell address, George Washington wrote that self-government is the underpinning of our safety, prosperity, and liberty, but “from different causes and from different quarters much pains will be taken … to weaken in your minds the conviction of this truth.” And so we have to preserve this truth with “jealous anxiety;” that we should reject “the first dawning of every attempt to alienate any portion of our country from the rest or to enfeeble the sacred ties” that make us one.

      And Obama repeated:

      It falls to each of us to be those those anxious, jealous guardians of our democracy; to embrace the joyous task we’ve been given to continually try to improve this great nation of ours. Because for all our outward differences, we, in fact, all share the same proud title, the most important office in a democracy: Citizen.

      There is a sense of solidarity and hope in these words, both from Washington and from Obama. I find it comforting in the present political climate.

      The quotations are from Obama’s Farewell Address. Here’s the transcript.

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  2. Marj

    Just more to realize we’re living in a world where nothing seems to be as presented. It is so tiring (to put it mildly) and demoralizing in the extreme. Thank you for the comments by Presidents Obama and George Washington. I, too, was astounded at reading that Omega 3 and 6 in almonds were at those levels. Thank you for that. I’ve never looked them up since it was “just understood” that almonds were a great thing to eat every day. And I’ve been concerned about my low level of Omega 3s.

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    1. Bix Post author

      I hope I don’t sound anti-nut. I like almonds. That’s what drew me to the study. But eating 15% of your calories as almonds to lower your blood pressure was a bit of a stretch! There are better ways…

      By the way, on a positive note … I saw that they dry roasted raw almonds at about 265 degrees for 50 minutes. I had to try it! I soaked some in tamari and salt and roasted them at 270 for about 30 minutes. A bit overdone but not a bad way to cook them.

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