Discovery Thursday: HealthNews Reviews

I found another gold nugget today by searching the ResourceShelf archives:

HealthNews Reviews

HealthNewsReview.org reviews news stories that make a therapeutic claim about:
• Specific treatments
• Procedures
• Investigational drugs or devices
• Vitamins or nutritional supplements
• Diagnostic and screening tests

A multi-disciplinary team of reviewers from journalism, medicine, health services research and public health assesses the quality of the stories using a standardized rating system. Stories are graded and critiques are published on this website.

This website is modeled, in large part, upon the pioneering effort begun by an Australian team that launched the Media Doctor Australia website in 2004. We are grateful to David Henry and the Media Doctor team for sharing their ideas and perspectives with us. The Australian effort has also been the inspiration for a Media Doctor Canada site, whose publisher, Alan Cassels, has been very helpful in guiding us.

You can either begin browsing and reading the site from the home page or search for  reviews by rating, keyword, news organization or date.

Perhaps you recently read or heard about this Wall Street Journal article on the fat versus carb debate and wondered if it was reporting the research accurately, completely and with balance. Here's an excerpt from the HealthNewsReviews' evalution of the article:

Does the Story

[Criterion #4]Evaluate the quality of evidence? - SATISFACTORY
This article receives high marks for accurate presentation of medical evidence.   This article devoted enough space to adequately cover the study methodology, e.g. the study setting, participant characteristics, calories and composition of each of the three diets, etc., which is not always provided in the such stories.  This article did a thorough job in presenting detailed results of the three diets for several outcomes in addition to weight loss: blood lipid profiles (LDL "bad cholesterol", HDL "good cholesterol", triglycerides), blood sugar levels, and adherence to the diets.

[Criterion #9]Use independent sources and identify conflicts of interest? - SATISFACTORY
This study accurately summarized the results of the New England Journal of Medicine article on weight loss with three popular diets.  This article provided a good balance of commentary by independent experts representing alternative opinions and interpretation of the results.

You can read this complete review here.

Because HealthNews Reviews monitors only major US media news stories, if you live and/or practice in Australia or Canada, you probably also will want to check out Media Doctor Australia and Media Doctor Canada.

Addendum (09 August): Sophie, who writes the healthy, sustainable, tasty and lovely-to-look-at Mostly Eating has provided this useful link for UK readers: Behind the Headlines.

Thank you, Sophie.

Research article: undernutrition & stroke outcome

Citation: Davis JP, Wong AA, Schluter PJ, Henderson RD, O'Sullivan JD, Read SJ. Impact of premorbid undernutrition on outcome in stroke patients. Stroke 2004;35:1930-1934.

Last week I was looking for information on nutrition risk screening in stroke patients -- specifically, evidence to support including a screening tool in our new acute stroke pathway. (Of course you can guess my bias.)  Google Scholar led me to David et al's article that reports on the prevalence and impact of malnutrition in a cohort of stroke patients. Here's the abstract:

Background and Purpose — To assess the prevalence of premorbid undernutrition and its impact on outcomes 1 month after stroke.

Methods — The study recruited from consecutive stroke admissions during a 10-month period. Premorbid nutritional status (using the subjective global assessment [SGA]), premorbid functioning (modified Rankin scale [MRS]), and stroke severity (National Institutes of Health Stroke Scale [NIHSS] score) were assessed at admission. The associations between premorbid nutritional status, poor outcome (defined as MRS 3), and mortality were examined before and after adjustment for confounding variables, including age, gender, stroke risk factors, stroke severity, and admission serum albumin.

Results— Thirty of 185 patients were assessed as having undernutrition at admission. Significant unadjusted associations were observed between undernutrition and poor outcome (odds ratio [OR], 3.4; 95% CI, 1.3 to 8.7; P=0.01), and mortality (OR, 3.1, 95% CI, 1.3 to 7.7; P =0.02) at 1 month. NIHSS, age, and premorbid MRS were also significantly associated with poor outcomes. After adjustment for these factors, the effect size of associations remained important but not significant (poor outcome: OR, 2.4; 95% CI, 0.7 to 9.0, P=0.18; mortality: OR, 3.2; 95% CI, 1.0 to 10.4, P=0.05).

Conclusions— Premorbid undernutrition, as assessed using the SGA, appears to be an independent predictor of poor stroke outcome. Stroke prevention strategies should target undernutrition in the population at risk for stroke to improve outcomes.

I extracted from the authors' thorough discussion this 4-item "take-home" message:

(1) The study found a significant crude association among premorbid nutritional status and mortality and poor outcome at one month. (2) After adjustment for factors such as age, premorbid dependence, and stroke, the associations were not statistically significant.  (3) This study measured premorbid undernutrition, which was the only modifiable risk factor to show an important effect on morbidity and mortality that approached statistical significance. (4)  "In keeping with previous studies, we also found older people, especially those with impaired functional capacity, and those living in aged care facilities to be more susceptible to undernutrition. These groups in particular need to be targeted by nutrition improvement strategies to limit the impact undernutrition has on stroke outcomes."

You can read the full text of the article here. If you aren't able to access it, please contact me.

Applied Physiology, Nutrition, and Metabolism

Yesterday I found gold; today, a gem: an online peer-reviewed nutrition journal that Canadian readers can access free of charge through the Depository Services Program. 

"This bimonthly journal has a 30-year history of publishing, first as the Canadian Journal of Sport Sciences, and later as the Canadian Journal of Applied Physiology.  It publishes original research articles, reviews, and commentaries, focussing on the application of physiology, nutrition, and metabolism to the study of human health, physical activity, and fitness.


The published research, reviews, and symposia will be of interest to exercise physiologists, physical fitness and exercise rehabilitation specialists, public health and health care professionals, as well as basic and applied physiologists, nutritionists, and biochemists."