Research Bias: Be Careful Where You Place Your Trust

Industry funding is a major impediment to unbiased results when it comes to testing new methodologies and pharmaceutical drug interventions, as analyses have shown that industry-sponsored trials report positive outcomes significantly more often than trials financially backed by the government, nonprofits, or nonfederal organizations.1 In a publication, bias known as the “file drawer” phenomenon, negative and null trials, or results that are unfavorable to drugs are more likely to be suppressed.2 There is also widespread rigging of data—deliberate manipulation of outcomes and use of statistical sleight-of-hand—wherein the outcomes of trials are being corrupted by commercial interests.3 And then there is the issue of industry bribery of journal editors. One retrospective observational study revealed that 50.6 percent of journal editors accept payments from industry sources, with an average payment of $28,136 and some payments approaching half a million dollars, meaning that the editors of the most influential journals in the world, who steer the scientific dialogue, are effectively on the take.4 In addition, a 2007 national survey published in the New England Journal of Medicine found that 94 percent of physicians had ties to the pharmaceutical industry, with physicians receiving free meals, reimbursement for medical education or professional meetings, consulting, lecturing, and enrolling patients in clinical trials.5

1. Florence T. Bourgeois, Srinivas Murthy, and Kenneth D. Mandl, “Outcome Reporting among Drug Trials Registered in ClinicalTrials.gov,” Annals of Internal Medicine 153, no. 3 (2010): 158–66, https://doi.org/10.7326/0003-4819-153-3-201008030-00006.

2. Erick H. Turner et al., “Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy,” New England Journal of Medicine 358, no. 3 (2008): 252–60, https://doi.org/10.1056/NEJMsa065779.

3. John P. A. Ioannidis, “Why Most Published Research Findings Are False,” PLoS Medicine 2, no. 8 (2005): e124, https://doi.org/10.1371/journal.pmed.0020124; and Alex Hern and Pamela Duncan, “Predatory Publishers: The Journals That Churn Out Fake Science,” The Guardian, August 10, 2018, www.theguardian.com/technology/2018/aug/10/predatory-publishers-the-journals-who-churn-out-fake-science.

4. Jessica J. Liu et al., “Payments by US Pharmaceutical and Medical Device Manufacturers to US Medical Journal Editors: Retrospective Observational Study,” BMJ 359 (October 26, 2017): j4619, https://doi.org/10.1136/bmj.j4619.

5. Eric G. Campbell et al., “A National Survey of Physician-Industry Relationships,” New England Journal of Medicine 356, no. 17 (2007):1742–50, https://doi.org/10.1056/NEJMsa064508.)

The Promise of (Omega-3) DHA

From heart disease to joint pain, the conditions shown to benefit from increased omega-3 fatty acid intake are diverse. The cardioprotective and anti-inflammatory benefits of omega-3s are well established in scientific literature. The heavy skewing of polyunsaturated fats toward omega-6 in relation to omega-3 in the modern Western diet is a contributing factor that exacerbates many chronic conditions regularly seen in clinical practice. With docosahexaenoic acid (DHA) serving as a structural component of cell membranes—particularly in the brain—and also recognized as a precursor to inflammation-resolving molecules, sufficient intake of DHA via marine foods or supplements can have far-ranging effects. Obvious and well-documented benefits from DHA are conditions involving inflammation, chronic pain, and ocular health. However, recent research is bringing to light new potential for this fatty acid.

A promising study in rats demonstrated that DHA may minimize neuronal damage due to traumatic brain injury (TBI). Researchers gave test animals DHA doses equivalent to 3, 12, and 40mg/kg for 30 days before inducing TBI. They observed that DHA at the highest dose resulted in positive changes to all markers of axonal and cellular injury studied. Lower doses had more selective effects on individual markers, but were still beneficial. The same researchers had also shown that omega-3 supplements can be helpful for repair following a TBI, but the former study is one of the first to suggest that DHA might actually have prophylactic effects when serum levels are replete prior to injury. Considering how devastating the physical, emotional, and financial effects of TBI can be for the military’s ‘wounded warriors’ and their families, researchers have suggested the Department of Defense prioritize research into regular supplementation with omega-3 fatty acids to establish a protective baseline for those at greatest risk for TBI. The same beneficial effects could also be expected to carry over to others at risk for head injuries, such as young athletes engaged in contact sports.

Another expanding role for DHA is in sleep quality. In a study from Oxford University, children ages 7-9 who were given a 600mg DHA supplement (from algae) for 16 weeks slept close to one hour longer than children taking a placebo. They also had fewer episodes of waking during the night, which could positively impact learning and academic performance. The authors suggest this could be because omega-3 status—especially DHA—seems to influence melatonin production and pineal gland function.   

DHA repletion has also been shown to benefit learning and behavior in children. This makes sense, given DHA’s key role in the physical structure of the brain, but in light of the newer research, perhaps it’s also the result of improved sleep quality. Although the study subjects were children, most adults are only too aware that insufficient sleep makes it difficult to focus and retain new information.  Children given 600mg DHA/day showed improvement in reading ability as measured on standardized tests, and improvement in behavior (attention, impulsivity, opposition, hyperactivity) as rated by parents.