As far as I can remember my mother has always told me to eat my vegetables, especially spinach. ‘It has a lot of iron,’ she said. ‘It will make you stronger.’
The power of spinach even dominated our popular culture. Kids grew up in awe of the pipe toting, spinach guzzling, righteous ‘Popeye the sailor man’ with bulging biceps. In an instant he would be pumped up to save his damsel in distress, with a dose of muscle in a can – you guessed it – Spinach!
This mystical belief in the power of spinach stems from a study done in 18711. Though the claim was disputed some 60 years later in the 1930s2, it took nearly a century for a conclusive verdict on spinach. In 19812, a publication in the British Medical Journal demonstrated that spinach is no more loaded with iron than, say cabbage.
Why is it that it took 100 years to dispel an error in the science of spinach? Why hasn’t this knowledge permeated the conscience of people? Why in 2019, do I see parents fretting over feeding a bowl of spinach to their toddlers?
There is more to it than just finding a justifiable reason to not eat spinach.
Studies that negate the accepted norm or present negative results, hardly ever gain the same traction as the original yet erroneous claims.
In 1998, Andrew Wakefield and colleagues published a paper linking the MMR vaccine with incidences of autism3. Despite 13 negative studies opposing the original claim and retraction of the original paper in 2010, in 2019 people still debate if they should have their children vaccinated. Four months into 2019 we have yet another measles outbreak in the United States of America.
Forget measles. Even something as innate as pain, eluded common acceptance when it came to new born babies. In the early 20th century it was a common belief that the immature nervous system of new born babies (neonates), makes them imperceptible to pain. This belief originates from studies in 1940’s that reported neonates did not withdraw their limbs when pricked with sharps pins, as an older child would.
The myth of neonate insensitivity to pain settled deep into the accepted medical practices without follow-up studies to substantiate the claims and theories. Most surgeries on neonates, as a consequence, were performed without aesthesia or even analgesics. Only muscle-relaxants or sometimes laughing gas were used.
This myth was dispelled in a ground-breaking article in 1985; albeit in a very specialized Journal of Pediatric Surgery4. This was followed by a reiteration by the same authors in 1987 in the more popular ‘The New England Journal of Medicine5.’ A week after its publication, The New York Times, took up the issue in their article ‘Infants’ Sense of Pain is Recognized, finally6.’ However, nearly three decades later in 2014, Linda Hatfield reported that ‘almost 80% of painful procedures were still performed without analgesia in neonates7.’
Even with convincing counter-facts it is nearly impossible to refute a study or a scientifically discredited myth after it passes the rigorous scrutiny of the peer-review process and is published in the annals of accepted facts.
First, the scientists who fail to replicate the original finding of a published work are doubted. Their experimental design and competence are questioned. Second, even if the integrity of their findings holds, the work is often published in an obscure journal with a meagre impact factor.
The finding negating the original study rarely reaches the masses as much as the original path-changing discovery published in top journals. Unless the original article is retracted, other scientists base their own future course on it and even cite it as support for their hypothesis in grant applications. The subdued voice of opposition gets lost in the deluge of thousands of papers published each year in the field.
We see many scientists reluctant to work on or publish negative results. The effort of going through a gruelling peer-review to publish a negative result is not outweighed by the benefits. Even the Journal of Negative Results in Biomedicine started in 2002, was discontinued in 2017. Much of the work that could prevent some other lab from wasting their time, energy and tax-payers’ (our) money never sees the light of the day.
One positive step in this direction is the emergence of pre-print websites such as BioRxiv.org or arxiv.org. These allow researchers to share their findings before they are published. This fosters open sharing of data, even negative data, that otherwise would not be released. However, since the articles are not peer-reviewed, it again comes down to credibility and acceptance of the results.
We need a change in the scientific community. The stigma associated with negative studies needs to be dispelled. When graduate students consistently fail to replicate a path-defining finding they should be encouraged and supported to complete the analysis and publish it.
Grant applications should demand a thorough search and critical analysis of all negative literature challenging the applicant’s hypothesis. It is not that negative studies do not exist. They just need to be dug out.
Progress depends not just on knowing what should be done, but also on what should definitely not be done! If one day I am diagnosed with an iron deficiency and my mother presents me with a bowl full of spinach, I should be able to respond with, ‘No spinach for me, thank you.’
References
- Wolff, ET von. Aschen-Analysen von Landwirtschaftlichen Producten Fabrik – Abfällen Und Wildwachsenden Pflanzen. Berlin: Wiegandt & Hempel, 1871
- Hamblin, T. J. “Fake.” Br Med J (Clin Res Ed) 283, no. 6307 (December 19, 1981): 1671–74. https://doi.org/10.1136/bmj.283.6307.1671.
- Wakefield, A. J., S. H. Murch, A. Anthony, J. Linnell, D. M. Casson, M. Malik, M. Berelowitz, et al. “RETRACTED: Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis, and Pervasive Developmental Disorder in Children.” The Lancet 351, no. 9103 (February 28, 1998): 637–41. https://doi.org/10.1016/S0140-6736(97)11096-0.
- Anand, K. J., M. J. Brown, R. C. Causon, N. D. Christofides, S. R. Bloom, and A. Aynsley-Green. “Can the Human Neonate Mount an Endocrine and Metabolic Response to Surgery?” Journal of Pediatric Surgery 20, no. 1 (February 1985): 41–48.
- Anand, K. J., and P. R. Hickey. “Pain and Its Effects in the Human Neonate and Fetus.” The New England Journal of Medicine 317, no. 21 (November 19, 1987): 1321–29. https://doi.org/10.1056/NEJM198711193172105.
- Boffey, Philip M. “Infants’ Sense of Pain Is Recognized, Finally.” The New York Times, November 24, 1987, sec. Science. https://www.nytimes.com/1987/11/24/science/infants-sense-of-pain-is-recognized-finally.html
- Hatfield, Linda A. “Neonatal Pain: What’s Age Got to Do with It?” Surgical Neurology International 5, no. Suppl 13 (November 13, 2014): S479–89. https://doi.org/10.4103/2152-7806.144630.
Author
Tanvi Butola did her doctoral work in Neuroscience at the Max Planck Institute for Biophysical Chemistry, Göttingen, Germany. After 7 years in Germany, she recently moved to New York City to continue her research on the mysteries of the brain. She currently explores the brain circuit which help us ‘learn from experience’. In her time as a research, she became aware of the disconnect between science and how it is communicated to the general masses. She actively participates in public outreach to make science more accessible to all and wields her pen in an effort to dispel scientific myths.
Editors
Arunima Singh, PhD and Roopsha Sengupta, PhD edited the article.
Arunima obtained her PhD from the University of Georgia, and is currently a postdoctoral researcher at the New York University. A computational structural biologist by training, she enjoys traveling, reading, and the process of mastering new cuisines in her spare time. Her motivation to move to New York was to be a part of this rich scientific, cultural, and social hub.
Roopsha did her PhD in the Institute of Molecular Pathology, Vienna and postdoctoral research at the University of Cambridge UK, specializing in the field of Epigenetics. Besides science and words, she enjoys spending time with children, doodling, and singing.
Artist
Ipsa provided the cover image. She is a post-doctoral fellow at Instem, Bangalore. She tries to communicate science through visual arts as a medium. Collecting graphic books, tree trash, and reading brain pickings is few of her favourites. Follow and purchase her artwork at Ipsawonders (Facebook, Twitter, and Instagram). She will be happy to hear praises and non-praises at ipsajain.31@gmail.com.
Other images in the blog courtesy Pixabay.
Blog design: Arunima Singh
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