An Introduction to the Issues with Publication in Science and the Three Tier Publication System - a possible solution?

Scientists live in fear under the mantra ‘publish or perish’. This simple phrase has far reaching ramifications that many believe are harming both the reputation and integrity of science. The culture most scientists find themselves in is that their ‘value’ is measured by both the volume and ‘impact’ of their published work. Herein lie two problems. The first begins when researchers ask themselves, ‘how many papers can I get out of this?’ Most researchers, especially those in ‘un-sexy’ fields, are unlikely to ever get ‘high impact’ papers and so go for volume. At its worst, this can mean work is split up and spread thin. I’m sure many researchers are also familiar with trying to whip and fluff an otherwise stray dataset into a small paper. The second of our problems relates to ‘impact’ with high impact papers being used as an inappropriate proxy for good science. The allure of high impact journals such as Nature and Science can prove an all too tempting a carrot and has led to high profile fraud scandals but its effects can be more subtle. One major problem is the urge to overstate claims in a bid to make findings more attention grabbing and sensational. While the liberal use of bold language in abstracts and discussions may not bring about the downfall of science, it is symptomatic of an unhealthy culture where results are analysed with one eye on positive findings and the other firmly shut to anything that might mess up the ground-breaking paper. Instead of considered caution we have a culture of bold claims and superlatives.

    These issues, among others not discussed, have negative knock-on effects most notably on robustness and integrity – two words I feel make for a far more suitable mantra. Science is suffering from a well-documented reproducibility crisis as highlighted by one survey which found 70% of researchers have failed to replicate others results while half also failed to reproduce their own. In less anecdotal fashion, scientists from a biotech company tried to reproduce results from 53 ‘landmark’ papers in oncology, only succeeding in 6 (Begley and Ellis, 2012). There are a number of other such examples. While there are many reasons for low reproducibility, these findings are very worrying as they erode trust in the scientific process. They also have very tangible effects by, for example, contributing to rising cancer drug trial costs as a high proportion of pre-clinical results turn out to be no more than flashes of fools gold. The current system of publication and the evaluation of a scientists worth no doubt contributes to this worrying problem as papers are either rushed out with minimum requirements (insufficient replicates and inappropriate statistics), contain cherry picked data and are topped off with a not-so-healthy dollop of bluster and exaggeration.

    There have been no shortage of suggestions to remedy the current state of affairs but action has been lacking because the current system works just well enough and discoveries are still being made (and at least some are real!). But just well enough is not good enough as science is at risk of eroding away at its cornerstones: robustness and integrity. I’d also like to introduce another aspect of science which has long been in short supply: transparency. The current publishing system goes some way to promoting secrecy and rivalry which, while not always a bad thing, can be to the detriment of science. Collaborations have long been an integral part of science bringing together complementary teams to maximise productivity, spread ideas and even unite otherwise political enemies. To remedy the issues outlined here, many possible changes both big and small have been suggested but here I’d like to outline the skeleton of an admittedly radical alternative three tier system which could foster an all-round healthier, more connected scientific community.

    The first tier involves the publication of progress reports every few months much in the same way most (good!) scientists maintain a lab book basically including methods and data (with judicious use of censorship if appropriate). The second tier involves the publication of proto-papers every year or so when certain landmarks in a project are reached. These are intended to allow the easy digestion of results using good figures and also framed by introductions and discussions. Such proto-papers would not be traditionally peer reviewed but published in the way pre-print versions are now in repositories such as arXiv, bioRxiv, ChemRxiv and engrXiv. The final tier would be a more traditional peer reviewed publication. All three tiers would be linked using the magic of the internet under a project name and with all associated members linked to their contributions. The three tiers also allow interested readers to drill down into increasingly more detailed levels depending on their level of interest. Firstly, such a system would greatly increase transparency reducing the level of fraud, cherry picking of data and improper statistical analysis. The first tier could also greatly reduce redundancy as lab groups with overlapping interests might be encouraged to either collaborate more often or steer clear of too much overlap. The second tier of proto-papers allows the rapid dissemination of findings avoiding the frustrations of the peer review system in this regard. The proto-papers could also (again through the magic of the internet) be live documents with versions updated as new data rolls in as well as acting on suggestions and comments from peers. Such peer review-lite could be a powerful tool in increasing the robustness and integrity of research as interested readers might very well look into the first tier data and methods and spot inconsistencies or suggest improvements. The lack of any significant gap between data analysis and publication in proto-papers also means that people worried about being scooped need not as the time stamps of work are there for all to see and any ‘cheats’ can be quickly called out. What this should all mean is that the final published peer reviewed papers should both be fewer in number and higher in quality.

    A very important and intended side effect of all this is to alter the way we assess scientists. This system could be used to more accurately assess the contributions of individual researchers through their work output and ability to develop ideas and projects, all easily accessed at the click of a button. Potential employers would then have a tool to measure far more than just the number of papers a candidate has either sweated their way, or ‘networked’ their way, onto to. Of course this proposed system is far from perfect, but science is in need of a shake up or it risks becoming irrelevant through a loss of power in what it can achieve and, importantly, a loss of the general public’s trust. A dynamic and open system would also be greatly conducive to collaborations allowing the greater flow of ideas and knowledge, a science environment I know I want to be part of.

Can Coca-cola Stop the Tide?

There has been a growing consensus over the years that our ever increasing sugar intake is strongly linked to obesity, type II diabetes and heart disease. Sugar is everywhere being an almost ubiquitous component of processed foods (just check the ingredients of almost anything in your cupboard) and a major constituent of fizzy drinks, supposed ‘sports drinks’ (e.g. lucozade) and fruit juices. Standard coke contains a whopping 11% sugar which amounts to 35g in a single 330ml can which is already over the recommended daily allowances of the NHS (30g), the WHO (25g) and the American Heart Association (AHA) (37.5g). This all before you've consumed anything else that contains sugar or indeed is broken down into sugar like starch. Studies suggest that UK children and teenagers are on average consuming closer to 70g per day with adults only cutting down to around 55g. Those guidelines are even a little conservative (especially the AHA!) and many experts believe the guidelines could be slashed further and avoiding sugar completely is a perfectly reasonable approach.

    I don’t want to go much into the science behind why sugar is bad for you here, maybe in another post, but I’ll summarise two principal mechanisms by which it causes harm. First it's important to know that what we know of as table sugar is sucrose. This is the most common sugar in plants found in fruits, sugar cane and sugar beet and is a composite made up of equal parts glucose and fructose. Glucose is the primary energy source of our body and is also derived from breaking down complex carbohydrates such as starch as found in bread, pasta and other grains like rice. Too much glucose in our blood causes spikes in insulin. Insulins job is to mediate the uptake of glucose from our blood into tissues and to convert it into glycogen in the liver for storage. Abusing this system by flooding ourselves with sugar over years can lead to insulin resistance whereby insulin becomes less and less effective meaning you lose control of blood sugar levels leading to type II diabetes. The other dark side of our sugar addiction is the harmful effects of fructose. The thing with fructose is our bodies do not treat it like glucose. It can only be metabolised in the liver where it, for example, feeds into fat synthesis, is associated with what is known as metabolic syndrome and does not induce leptin production which tells our brains we have eaten. It is not particularly good stuff. Check out this website for more information.

     So given this little background, I wanted to talk a little about the ways some big players in the sugar world have been trying to hide these things from us. Diet and health are complex fields with so many external factors such as lifestyle and our genetic predispositions playing big roles. This complexity gives wriggle room for countless diet fads and questionable claims. Getting reliable data either supporting or rejecting various claims can often take a long time which also means a lot of money. The situation with sugar is in many ways similar to climate change where the science is complex and, while a consensus has emerged in both situations among experts, powerful vested interests exert their influences to muddle the debate by spreading doubt and confusion. You only need to look at the list of climate deniers and where their funding comes from to see how clear this conflict of interest is. Like oil, sugar is huge business and the big companies can flex their financial muscles to exert significant influence. For example, Coca-cola have been shown to have influenced research by funding work that seeks to blame lifestyle rather than diet. You can see from this paper an example of research biased by funding from the Coca-cola company and as such sugar is not discussed, only lifestyle and exercise. This is bad scientific practice and flies in the face of genuine unbiased research which should ideally be free from such blatant conflicts of interest. See this interesting article which gives some insight into the authors of the paper in which they defend their work. 

    Whether or not their work is good or bad science, this highlights the cynical approach by Coca-cola which funds anything that looks into alternate causes of obesity and diabetes besides sugar. The idea with this highly cynical approach is to say to people that lifestyle or other dietary factors (like fat) are to blame, not the sugar. Yes, people in general should exercise more and eat less in many parts of the world but exercise is not the main route to weight loss (diet is the key) and nor is simply eating less necessarily a solution – it’s what you eat less of. The different food types (e.g. sugar, fat and protein) are not equal and are not treated equally by our bodies and what has become clear is that it is in fact sugar, and in particular fructose, that is disproportionally to blame for obesity. The misdirection by vested interests has translated into the idea that all these ‘treats’ can be enjoyed as part of a healthy lifestyle. Think how often you see various big brands (like Coco-cola, McDonald's or Mars) sponsoring sports events which both serves to promote a brand image associated with active healthy lifestyles but this is also part of this multifaceted approach to distract from the real problem – diet. 

    The influence of the Coca-cola company is immense with millions spent on lobbying the American Government each year. Interestingly, this expenditure sky-rocketed in 2009 which was (not) coincidentally when the famous you-tube video, Sugar: The Bitter Truth, came out and more generally the spotlight was shifted to sugar and its harmful effects. Yes yes, we all know that companies lobby (and often more directly bribe) governments all round the world and it’s a largely accepted part of politics but the influence of Coca-cola also spread to charities. In 2010, the charity Save the Children were embarking on a sugar tax campaign in light of the fast emerging strong evidence that it was a leading cause of childhood obesity and health problems. This charity was then the beneficiary of multi-million dollar donations from Coca-cola and PepsiCo and low and behold, their campaigns shifted away from sugar tax and onto promoting healthy lifestyle and exercise (are you seeing a trend yet?)! Thankfully, however, the idea of a sugar tax has gained more traction in the intervening years and has come (or  will be very soon) into effect in many countries (South Africa, the UK, France, Denmark, Mexico (who have a huge sugar problem), Norway and the USA including others). The UK’s sugar tax, due to come in in 2018, is being fought tooth and nail by soft drinks companies who are now, rather than flat out denying the effects of sugar, are using the language of collective guilt (it’s not just the drinks fault, what about the chocolates!) and casting doubt on the effectiveness of a sugar tax in actually cutting obesity. Now these companies and pressure groups are not against this tax because it will hurt sales by increasing the cost of each drink although it might. A far more damaging side effect of this tax is the psychological effect a tax will have. Far more than simply being a financial disincentive, this tax legitimises the findings that sugar is generally bad for you. It is a major step to changing public opinion on sugar whereby the negative health effects will be more widely recognised as people think ‘well it’s being regulated, so it must be bad’. This is what the food and beverage companies are so afraid of happening and what will really harm sales.

    Even if the evidence behind an issue is confusing and not accessible for a non-expert (which most of us are), when a company with very clear vested/financial interests in one outcome or the other gets heavily involved to direct the argument, alarm bells should start ringing. For the same reason that the tobacco industry so blatantly denied, discredited and lied about the now obvious health impacts of smoking, the food and drink industries are throwing shadows across an important modern health issue that continues to wreck havoc on peoples health. Diabetes and obesity continue to rise with huge impacts on individuals lives as well as health services. Just like the bad effects of smoking became accepted, one day we will look back and think how naive we were about sugar. Just like tobacco is addictive, so too is sugar. Just like the tobacco industries were forced to pay out huge sums in lawsuits for lying about sending countless smokers to early graves following an undeniable body of evidence and shift in public opinion, so too will there be lawsuits against the food and beverages industry. However, just like the tobacco industry survived these ‘sticky’ patches, so too will Coca-cola, PepsiCo and the like as they are just too big to collapse and their delay tactics mean that public (i.e. consumer) opinion is slow to change allowing them time to adapt and probably tuck some money away for the rainy days to come. They cannot stop the tide, but they are doing a good job of slowing it.

    I’d recommend people to read up more on the effects of sugar and find the easiest way to cut it down in your diet. You don’t need it, we can get plenty of energy from other food sources, and too much is almost certainly doing you harm. Eating plenty of fibre with sugars and carbohydrates in general (including starch) helps moderate our bodies uptake of sugar reducing insulin spikes and reducing the chance of developing diabetes.

EXTRA READING: A longer but excellent article putting this subject into the wider context of our growing modern health epidemic relating to sugar. Crucially, it explains why obesity (and the related diabetes) is not an 'energy-balance disorder'.