March 20, 2014 | 1
The Press Release That Started it All
In February, the Centers for Disease Control and Prevention (CDC) published a study in the Journal of the American Medical Association on obesity prevalence that concluded: “Overall, there have been no significant changes in obesity prevalence in youth or adults between 2003-2004 and 2011- 2012.”
Some of the subgroups within the study sample did show statistically significant changes. Women aged 60 and older had a significant increase in obesity (31.5% to 38.1%), and children aged 2- to 5- years saw a decrease in obesity (13.9% to 8.4%). In discussing these results, the study authors urged that “these findings be interpreted with caution.”
In a probably well-meaning but perhaps misguided move, someone in the CDC press office abandoned the caution the study authors encouraged, and the subsequent press release headline announced, “New CDC data show encouraging development in obesity rates among 2- to 5- year olds.” In the lead paragraph, the author of the press release did some rounding to come up with a decline of 43% (it was actually 39.5%).
The media ran with it. The Washington Post, Fox News, and USA Today all included the 43% figure in their headlines, and the New York Times added a bit of a flourish: “Obesity Rate for Young Children Plummets 43% in a Decade” (emphasis mine). An exception to the excitement came from a Forbes article by epidemiologist Geoffrey Kabat, who did a fair job of describing the discrepancy between the report’s findings and its accompanying press release.
Looking past the overzealous headlines, most of the reporting did include caveats from the CDC study authors and other experts, pointing to possible data fluctuations, the smaller size of the subsample, and the ever-present call for additional research. However, the general consensus seemed to be cautious optimism about the findings. And there’s good reason to be optimistic.
While even a 39% decrease in obesity among young children may be higher than expected, there are indications that some of the public health efforts at reversing obesity may finally be paying off. The fact that obesity rates are no longer going up after a multi-decade increase should be good news in itself. Especially promising are changes in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides healthy foods and nutrition education for low-income women who are either pregnant or caring for young children. In 2009 the USDA implemented improvements to the WIC packages, increasing whole grains, fruits and vegetables, and also substituting whole milk for low-fat. In the following years, a number of studies examined how these changes have affected the diets of women and young children in the WIC program. The results have been promising. Indeed, the WIC changes were repeatedly cited by experts as a possible explanation for the drop in childhood obesity seen in the February CDC report.
Reuters Revisits the Issue
But that’s not what one would conclude after reading a recent Reuters story that zeroed-in on that 43% number. Reporter Sharon Begley pointed to the same discrepancy that Forbes contributor Geoffrey Kabat thoroughly described back in February. Begley, like Kabat, also took issue with the way the finding was reported by the media, even speaking with Kabat, an epidemiologist, as an expert source for her story.
But Begley took it quite a bit further.
Yes, the magnitude of the decline in obesity among preschoolers may have been exaggerated by both the CDC press release as well as the media coverage of the report. But there does appear to be a decline underway, and there’s pretty good evidence that changes in the WIC program are contributing to that decline.
However, based on Begley’s reporting, readers could easily conclude that there has been no change at all, and Begley went as far as to say that obesity rates may even be increasing. Begley made a number of questionable interpretations of the science on this subject, repeatedly implying that the WIC program is not having a positive impact on children.
Begley wrote: “A study of preschoolers in the federal WIC program . . . found virtually no change in obesity rates.” This is interesting, because the studies that Begley was referring to actually did find reductions in obesity rates. To be sure, these changes were not of the magnitude reported in the February CDC report (Begley briefly touched on this), but the overall trend does indicate a positive change.
Begley reported that there are “scant signs of behavioral change.” She pointed to another study that looked at the effectiveness of counseling classes in the WIC program meant to encourage healthy eating and physical activity. Television watching and consumption of sweet and salty snacks actually rose, Begley wrote, while fruit and vegetable consumption fell.
“Their findings were discouraging.” wrote Begley.
I spoke with Shannon Whaley, lead author of that study, and Director of Research and Evaluation at the Public Health Enterprises Foundation.
“Our findings have been encouraging.” she said.
In fact, in that particular study, compared to a control group, participants who received classes and counseling had lower rates of television watching and consumption of unhealthy snacks, and higher fruit and vegetable consumption.
“That study was misquoted almost completely,” Whaley said in response to the Reuters story. She also said that that particular study looked at data collected before the changes in the WIC packages took place. “There’s so much more work that is much more recent and more relevant to the findings of the CDC report,” she said. Indeed, Whaley said that after their interview she sent Begley a number of studies showing positive health trends among participants in the WIC program.
“My point to her was that overall, [the CDC report] is great news,” Whaley said. “We have multiple sources saying we have a reduction in childhood obesity. In this case, it’s a question of magnitude. I feel like I was misquoted as sounding like I doubted their [the CDC’s] science. Our data shows similar trends.”
Whaley said that a finding like the 39% decline could be useful. In an email she wrote: “To be clear, I have great enthusiasm for the many studies documenting downward trends in obesity rates of preschool-aged children. The discrepancies from study to study in the reported magnitude of these trends provides a rich opportunity to examine and isolate the potential factors contributing to the changes. Identifying these factors will be key to ongoing obesity reductions across the population.”
Cynthia Ogden, PhD, lead author of the CDC study stood by the results: “There is some degree of hope in those numbers,” she said in a phone interview. “I’ve been looking at these for a while, and this is the first time we’ve seen a significant decrease in this subgroup. I’m looking forward to seeing what the new data from 2013-2014 show, to see if this trend continues.”
To be fair, it is possible that Begley’s sources were meant only to support the idea that the 43% number was high. But really, that’s the only real story here, and it had already been done, back in February, by Geoffrey Kabat. So what more was there to add? Her selective use and misinterpretation of the WIC studies, her misrepresentation of Whaley’s response to the CDC findings, and the general tone of the article, all leave readers with an idea that the CDC researchers were trying to pull a fast one on us, and that WIC interventions aren’t effectively reducing obesity among young children.
In addition, by including the not-entirely-relevant fact that First Lady Michelle Obama commented on the 43% finding, the story took on a political undercurrent that opened the door for such commentaries as this one from the Weekly Standard that received 1.4k Facebook likes: “Experts: Michelle Obama Cited Bogus Study Showing Drastic Drop in Childhood Obesity.” Also this doozy from the Washington Examiner: “Michelle Obama’s ‘Let’s Move’ Initiative May Have Increased Obesity Rates.” Obviously it doesn’t take much to get uber-partisan publications like these to pounce, but the Reuters story provided easy fuel for the fire. It was also picked up by The Huffington Post, Fox News, Mother Jones, and Parents.com.
A Tired Game of Telephone
Between the CDC press release, the media coverage of that release, the First Lady’s Comment, the Reuters story, then the punditry and reporting on the Reuters story, somehow we went from a straightforward report about obesity prevalence, to “Michelle Obama is making kids fat.” Hopefully, this kerfuffle ends here, no harm done. But after this episode, I’ll certainly be paying attention the next time WIC or CDC funding comes up on the Senate floor.
Begley’s other sources, Dr. Lee Kaplan and Geoffrey Kabat did not immediately respond to requests for comments.