Sponsored content on health sites can mislead patients

Occasionally, my vocation of treating obesity and my avocation of health care social media intersect.

This is one of those moments. This is the story of a health care social media betrayal in which obese children and e-patients are the victims. Nobody died, except medical ethics, good judgment, and trust in doctors. This is WebMD’s Health Care Social Media Disaster.

Recently, WebMD published the following “advertorial” from Kellogg’s: ”Mums, kids & breakfast: The truth about sugar with a brief disclaimer, “This content is from our sponsor. The sponsor has sole editorial control.”

Myth #1 :Sugar is always responsible for tooth decay

The truth: Breakfast cereals eaten with milk, even pre-sweetened varieties, do not increase the risk of tooth decay.

Myth #2 : Sugar is bad for you

The truth: A panel of world health experts recently reviewed the scientific evidence and concluded that a high sugar intake is not related to the development of heart disease, diabetes, high blood pressure or cancer.

Myth #3: Some sugars are more nutritious than others

The truth: All sugars provide approximately 4 calories per gram. And despite popular belief, no type of sugar is more nutritious than any other.

Myth #4: Children should eat a lot less sugar than adults

The truth: Children do have different needs to adults, so they have different Guideline Daily Amounts (GDAs) for sugar. But not as different as you might think.

Because they are active and growing, children are not vastly different to the “average person” used on the front of the pack. In fact, for sugar, it is very similar indeed.

GDA for sugar: Average person – 90g; Children – 85g

Advertisers can claim pretty much anything as long as they can manipulate data. No surprise Big Food is fighting back on the attack on the nutrient value of processed food. The problem is not the advertisers. The problem is WebMD and the trust we want e-patients to have on the internet.

The main tenet of health care social media is to advise e-patients, also known as empowered patients, to seek out reliable and credible medical information, most often on major medical websites, including WebMD. We “soc med” docs are working hard to direct the 88% of patients getting healthcare information off the internet* to these sites. Our good faith and theirs. When a major medical site allows this level of misinformation in advertising, the average person is at serious risk.

Here are the tweets ….

@Appetite4Profit What happens when a medical site sells out to Big Food? Kellogg & WebMD report sugar’s good for you!

@AplusPaz Cigarettes are good for kids too, the nicotine kills bacteria within their stomach.

@MagWrites I guess that now really makes them cereal killers

@YoniFreedhoff Kellogg’s states 360 calories of sugar daily = good 4 kids. That’s 20-30% daily cals!

Obesity expert Dr. Yoni Freedhoff pondered the judgment of advertising authority in his blog, Weighty Matters, “I wonder who the WebMD genius was who decided giving sponsors sole editorial control over content was a good idea?”

I’m figuring it was the person who ate the sugared breakfast cereal, and was cognitively impaired for the rest of the day.

Sara Stein is an obesity specialist at Stein Wellness Center and can be reached on Twitter and Facebook.

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  • http://www.facebook.com/obesityppm.hflannery Heather Tollerson Flannery

    Thank you for the excellent and timely article. The choice WebMD made in this instance is irresponsible and indefensible.  Clearly it is within their legal rights to make such a choice, but ethics and legality do not always overlap.Unethical actions such as these fuel our hyper-regulatory political climate. I’m a proud capitalist; and like most, that means that contrary to common belief, I do not compromise my principles to make a buck. Actions such as WebMD’s negatively impact all for-profit health services companies — not only by increasing the difficulty of winning the public’s trust, but also by contributing to our growing downstream regulatory burden.  Like the majority of business people, I focus on building and delivering value to my customers within the bounds of my integrity: the true source of long term prosperity and abundance.  In cases such as these, the few do irreparable harm to the many.  One unfortunate point is that Kelloggs can only make such claims (without the FTC shutting them down) because they are parroting the dietary guidance provided by our public health authorities.  Unless we can create a consensus about what defines an healthy human diet under distinct, relevant scenarios, we can expect advertisers with sugary products persist in making “health” claims.  Clearly, with childhood and adult obesity rampant in the developed and developing world, a moderate to high sugar intake is not a valid recommendation; it’s a crying shame we can’t rely upon the private sector to recognize that and serve as a rational backstop.  

    • http://twitter.com/sarasteinmd Sara Stein MD

      Thanks Heather – pass it forward. You do great work! Best, Sara

      • http://www.facebook.com/obesityppm.hflannery Heather Tollerson Flannery

        Thanks Dr. Stein!  Means a lot.  :)

  • Anonymous

    You accurately figure out the problem here: sponsors should never have sole editorial control over content on a health-related website designed to educate patients. As crazy it may sound, curating your content (ads ARE content) is what even a small time blogger would do for their readers. Why wouldn’t WebMD do the same? It simply makes no sense why they are allowing this nonsense on their site.

    • http://lindaeaves.com Linda Eaves

      dialdoctors - Curating content especially ads does not sound crazy at all. The site creator / CEO needs to plan their editorial calendar (including advertisers) making sure the message is congruent for what they want to convey to their readership. Anything else is confusing and causes people to wonder if they should continue to listen to the site message.

  • Anonymous

    Kind of not surprised … processed food in general and large companies like K depend upon are societies adiction  to sweets (sugar, HFCS, etc.), sodium, and certain fats (keebler cookies, pop tarts, etc.) They’ve justified there products in the context of ‘a balanced diet’ … only incentive to change is when people stop buying there products.  Capitalism (like democracy) does work … it just works a lot better when you have a well informed, educated, and responsible citizenry.

  • http://twitter.com/sarasteinmd Sara Stein MD

    Here’s the link to the advertorial http://www.webmd.boots.com/mums-kids-breakfast/sugar-myths
    sorry the link didnt translate –
    appreciate all the comments – I was truly shocked! I expected some attempt to maintain at least the appearance of accurate health information even in advertising!
    Amazing.
    thx, Sara

  • Anonymous

    I thought that we got beyond the sugar nonsense decades ago. How can one differentiate your silly views on sugar from the disastrous ant-vaccine rants of recent years?

    • http://twitter.com/sarasteinmd Sara Stein MD

      @bill10526:disqus – Not MY silly views – this is sponsored WEBMD.com material by Kellogg’s. Dont shoot the messenger, dude. And yes I totally agree, I thought we got past the sugar nonsense and would have expected WebMD to kill that content.
      Best, Sara

  • Anonymous

    Social media are popular because they serve as a platform for a patient to interact with another patient.  It was never meant to replace the uniqueness of a doctor/patient interaction nor to alleviate the fear of medical malpractice suits due to medical mistakes.  The abuse of social media stems from the fact that speed and image of conveying information are the driving forces of our culture.  There is nothing more dangerous than the half- truth compared to a bold lie.  In the examples given by Dr. Stein with respect to the myths surrounding the effects of sugar, the reader can identify that myth number one confuses the terms relation and correlation.  If it is the second, where are the associated statistical terms?  In myth number two, there is no mention of the recognizable side effects of insulin recoil.  In myth number three, where is a comparison between the effects of processed sugar versus sugars contained in fruits and vegetables?  In myth number four, where is the comparison data that indicate differences in the metabolism between adults and children?  We are all aware that sugar can make a bitter pill taste sweeter.  We just don’t want to see this on our web- site for M.D.s to promote their wellness center like Dr. Steins.

    • http://twitter.com/sarasteinmd Sara Stein MD

      @katarinahurd:disqus Just as an FYI, that is where I work, I’m in private practice, and
      KevinMD wrote the tagline from the information I provided. If you write a
      blog piece, they will do the same.

      Again, here is the link to advertorial by Kelloggs http://www.webmd.boots.com/mums-kids-breakfast/sugar-myths

      Best, Sara