Today’s NY Times op ed from pathologist Bemmet Omalu “Don’t Let Kids Play Football”, compares the sport to public health menaces including tobacco smoke, asbestos and fetal alcohol exposure. The stance he takes is far more extreme than even the American Academy of Pediatrics’ position on tackle football among youth, which reviewed the evidence and determined that the decision is an individual one: “players must decide whether the benefits of playing outweigh the risks of possible injury”.
Dr. Omalu states in his op ed: “If that child continues to play over many seasons, these cellular injuries accumulate to cause irreversible brain damage, which we know now by the name Chronic Traumatic Encephalopathy, or C.T.E., a disease that I first diagnosed in 2002.” Moving beyond anecdote to research, a recent and well-done review of the literature on CTE, concludes that “there are more questions than answers about all aspects of the CTE concept, from biomechanical substrates to molecular pathogenesis to the existence of CTE as a distinct entity.” Two other articles–here and here–by leading researchers in this area also found no association between football and CTE among retired football players. Among the researchers investigating the association between concussion and outcomes in children are my two University of Colorado School of Medicine Department of Pediatrics colleagues Michael Kirkwood and Joe Grubenhoff; check out their research here.
A third colleague–Dawn Comstock–had her head injury epidemiology work featured in a different NY Times op ed piece.
Returning to anecdote, working in an emergency department in a children’s hospital, I treat plenty of sports-related concussions; however, the morbidity I treat among sedentary and overweight children is far more common. A recent article in the New England Journal of Medicine found that, among children starting 8th grade, 20.8% were obese and an additional 17.0% were overweight. Although these children have physical exercise options other than football, for those who love most of all to play football, it is hard to know whether following the New York Time’s op ed’s admonition is a correct balance of risks and benefits.
The Coca-Cola Company is retreating from the research program it has funded in an effort to distract consumers from the role of sugary soft drinks in obesity and associated morbidity and mortality. Emails released by the Associated Press show some of the role Coca-Cola took in shaping the Global Energy Research Network’s research agenda. Last month my academic setting, the University of Colorado, returned a $1 million gift it had received from Coca-Cola as seed money to establish this network.
In an email Coca-Cola voiced its goals that the group would “quickly establish itself as the place the media goes to for comment on any obesity issue.” Instrumental in unveiling the facts in this case, the New York Times noted that such an arrangment “would have put a scientific veneer on what amounted to a marketing campaign by the company with the help of academic scientists.”
Although a scientific review in PLOS Medicine has showed that industry-funding biases the findings in studies of sugary beverages and obesity, not all industry-funded research is suspect. Funding for scientific research can come from a variety of sources including industry and government, and governmental funding of healthcare research is a shrinking resource. As noted by the International Food Information Council Foundation: “What makes a given study trustworthy is not the funding mechanism but the scientific process; adherence to valid and reliable procedures in designing, executing, and analyzing the research, and the peer review mechanism”.
Prior efforts to raise awareness of the link between sugary drinks and poor health include a PSA created by the Center for Science In The Public Interest that flips the popular image of Coca-Cola’s cola guzzling polar bear with a cast of “Real Bears” who go through a series of serious health issues thanks to their sugary drink habit.
One of the pioneers of the idea that sugar–and especially sugary drinks–are culprits in the obesity epidemic is the University of California at San Francisco’s Dr. Robert Lustig, who made in Sugar: The Bitter Truth, a 2009 UCTV video that sparked a national dialogue. In a follow-up series, The Skinny on Obesity, Dr. Lustig and two of his UCSF colleagues tease out the science behind his sugar-obesity claim and the threat it poses to public health.
Another great post on the science behind the obesity epidemic is here on the Best Friends for Life blog.