Reading Science Headlines? Look for the Underlying Causes

Sam Westreich, PhD

How smart science readers can look beyond the initial correlation

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I hope she's reading the latest science news. It's important to stay up to date.Victoria_Art/Pixabay

There’s a challenge that comes with reading scientific news articles; I like to see it as a hidden strategy. The headline and the article will often discuss the direct discovery, but the interpretation and underlying true cause is often left up to the reader.

For example, here’s a recent headline: “Erectile dysfunction predicts mortality in middle-aged and older men independent of their sex steroid status.

The article looks at a group of men who participated in a series of aging studies. The authors noted that men who had erectile dysfunction, lower libido, and/or reduced morning erections were more likely to die, even though they had similar free testosterone levels compared to the men who didn’t report these issues.

At first read, this looks like a promising method to check for people at a higher risk of early death. This could be an effective screening method to better select for high-risk individuals!

…But before we start referring every man with ED to get a full health checkup, let’s dig a little deeper.

Primary reasons for erectile dysfunction

The penis is complex, but we can model it fairly simply — it’s a balloon that can fill with blood. Therefore, erectile dysfunction (ED) is often caused by a number of broader conditions that can limit blood flow.

ED is complex, because male arousal is a combination of physical and psychological factors. Issues with erections can arise from either a physical issue, a mental issue, or the combination of the two (high blood pressure leading to increased anxiety about getting and maintaining an erection).

Common causes of ED can include:

  • Diabetes, specifically type II diabetes.
  • Atherosclerosis.
  • Heart disease.
  • Obesity.
  • High blood pressure.
  • Metabolic syndromes, often stemming from increased fat and cholesterol levels.
  • Depression, often from the prescribed antidepressants.

People with these conditions tend to be prone to developing ED, and will often show it earlier, by 10–15 years, versus someone who does not have diabetes or high blood pressure.

And these folks tend to die earlier. Can you see why?

Here’s a hint: it’s not because of their inability to maintain an erection.

Many complex outcomes, arising from a few core issues

I believe that these sort of scientific headlines highlight a challenge of science research: we’ve already uncovered the main strategies to living at least past the median lifespan, heading towards the maximum.

Putting it simply:

  1. Consume a healthy diet, minimizing the levels of unhealthy compounds (processed carbs, sugars, nutrient-poor food).
  2. Exercise regularly, with the goal of maintaining a healthy heart and a healthy bodyweight.
  3. Socialize to keep up mental health.

That’s pretty much it. There are genetic factors that will make these goals harder or easier for some people, but the majority of later-life diseases and syndromes arise from carrying too much weight, putting too much stress on our heart and circulatory system, and hormone imbalances (like insulin resistance).

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Pictured: the likely core cause for erectile dysfunction.Photo by Towfiqu barbhuiya/Unsplash

Do doctors need to do a better job of targeting core causes?

Unfortunately, this philosophy doesn’t always align with our current medical system. The focus is often placed on treating the specific disease, alleviating the symptoms, rather than necessarily targeting the core cause for a long-term cure.

Some of this onus is also placed on us, the patients. Consider if someone who is overweight and has type II diabetes goes into the doctor, complaining about challenges getting and maintaining an erection (ED).

The long-term solution is for the person to lose weight and work to manage their diabetes as best as possible.

The short-term solution is a Viagra prescription.

If the short-term solution (a prescription for medication) solves the ED issue, why should we focus on the longer-term solution? Issue’s solved, no need to worry about it further!

The problem is, as articles like the scientific paper linked above demonstrate, these core conditions are predictors of other breakdowns, coming further down the line. Erectile dysfunction doesn’t cause early death; ED indicates that there are deeper issues at play, that are undermining our health behind the scenes and resulting in earlier death.

Even those base steps, like exercise and healthy diet, have requirements of their own. If someone is working long hours and is unable to afford fresh food, or if they live in a “food desert” where it’s tough to even find stores selling healthy options, or if they do not have leisure time to focus on exercise due to the amount of work needed to survive… how are they supposed to maintain health?

Someone who is low-income and working multiple jobs may hear from the doctor that they need to exercise, eat healthier, and lose weight (assuming that they can even afford a visit to a doctor at all), but that advice is worthless if the person can’t afford to follow up on it.

Imagine if we wanted to implement wide-scale health reforms on our nation. Immediate thoughts might go to targeting direct diseases (investing more money into research for ED), but that’s just treating a symptom.

If we want to add more years of healthy life onto our entire population, we need to make better food and fitness options available — which means ensuring that everyone has the resources and access to obtain those options.

Next time you read a science news article, dig for the core causes

Most of the symptoms that we see for various diseases are acting as a canary in the coal mine, sending up an alert that there is a deeper issue at play. ED is a great example of this; the blood vessels that feed the penis are smaller than other arteries, and will be clogged/blocked before others. If the penis topples, it’s a warning that other, larger, more vital arteries are likely also in trouble.

We can still see the value in these specific conditions as indicators, but our treatment should not focus on fixing the indicator. If the canary passes out in the coal mine, the solution is not to give the canary its own tank of oxygen; it’s to evacuate the entire mine.

Similarly, when we see these correlations, it should warn us that we need to address the root cause of the problem. If someone has ED, they are at a higher risk of early death, due to underlying factors that both cause ED, and will eventually cause death.

Consider these other examples:

  • When a food is touted as a “superfood”, is it compounds in that food itself? Or is it replacing unhealthier items in that person’s diet?
  • When a specific activity is a “health hack”, is it that activity in particular, or just increased physical activity overall versus a sedentary lifestyle?
  • If a certain job is linked with increased death rates, is it the actual job itself, or the restrictions that it imposes? Do low-paid service workers die earlier because of the job itself, or because it denies them access to a healthy diet and leisure time to exercise?

The media knows that we’ve all heard it before; the best way for a population to have long lives is to ensure everyone has a healthy diet and adequate exercise (which also requires that everyone has the resources and financial stability to obtain those items). When we go to a doctor, we’re tired of the doctor pointing out that we’re overweight, not eating well, not exercising enough.

Better connections and correlations, like the link between ED and early death, can help alert us to when larger problems are in danger of boiling over. But we shouldn’t take them as an indication that fixing the smaller effect will correct for the larger imbalanced system.

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A microbiome scientist working at a tech startup in Silicon Valley, Sam Westreich provides insights into science and technology, exploring the strangest areas of biology, science, and biotechnology.

Mountain View, CA
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