Check the facts to get the truth

Can the ability to do 40 push-ups protect you from heart attack?A few weeks ago I heard a friend mention an article we had both seen, which spoke a hopeful message for general health: the ability to do 40 or more press-ups gives a good deal of protection against heart attacks.

That is some accessible truth they are positing! It resonated with me because I have recently shifted from chin-ups to press-ups, and had recently hit the alleged sweet spot a few days prior.

My immediate reaction was to feel cocky, secure in my existence and chuffed at how easy it was to get a health guarantee. After all, it's a scientific study isn't it? I mean, with the "scientific study" sticker attached, all you need to do is read the headline surely? Okay, hang on. I access my five star general junior woodchuck level scepticism badge, and remember that the newspaper is not a medical journal, and we have had a recent onslaught of pseudo science factoid stories in the mainstream media (MSM). Why it was only a mere six months ago this very writer was lamenting the media and sciences relationship.

Who can forget the EAT guidelines, financed and pushed by vegan billionaires demanding that we eat 14 grams of meat, and one and a bit egg a day? Not so much science, but activism and alarmism masquerading as science. If you were to look you may find that Zoe Harcombe PhD performs an elaborate nutritional analysis of the imposed, er proposed diet and finds it nutritionally deficient. Christopher Snowden writes a good evaluation of EAT in his blog: Velvet Glove, Iron Fist. "EAT is a campaign group run by a Norwegian billionaire couple who fly around the world in a private jet telling people to eat less meat to save the planet. (Irony?) They state their preferred option bluntly: 'restrict choice' or, better still, 'eliminate choice'.
This has not been reported in the main stream as often as the buzz over saving the planet through eating. Most New Zealanders might find that alarming, and recent purchasers of barbecues may start to tremble.

My point, however subtle, is that if we fail to question the news, we are destined to lose our sanity and the truth is out there. Just not at your fingertips.

So surely the press-up message is pure? It's from Harvard right? It's in the JAMA journal?
You can get a sweet 96 per cent discount on your risk of heart attack if you can smash out 40 reps, compared to your weakling peers who can only do 10? Sign me up!
You would think that this effect was going to be applicable across all ages right? It's presented like a magic spell, a life hack, but wait, there's more. Tom Naughton, documentary maker, has done a workover on the data and conclusions, and he points out for the lay reader a few caveats that aren't reported clearly, or perhaps at all:
1. The researchers didn't control for smoking. That's a relevant heart risk factor, but they seem to have ignored that little variable. Wouldn't it seem important that the group that could do the 40 press-ups had 6.7 per cent smokers, while the group who could only do 10 had 23 per cent of smokers?
2. The ages of the high scorers aren't spread across the range. In other words, the ones who can get 40 press-ups were on average 35 years of age. The age of the low scorers — 10 or less press-ups — was 48. So no conclusion drawn about how as you get older your muscles lose muscle fibres, or sarcopenia. As you would expect the guys who do less are on average the older guys. The inference made in this study is that lower press-up reps are higher risk of heart attack, but isn't that obvious? Aren't the 48-year-olds going to be statistically more likely to have a heart attack than the 35-year-olds achieving higher reps?

Correlation studies have been known to be rather useless at times. As you can see above, the case for press-ups and heart health based on a prescribed repetition prescription looks more tenuous.
An extreme example is this study that shows a strong correlation between margarine consumption per capita in the US, and divorce rates in the state of Maine (US). You'd be within your rights to argue this as a strong causation of divorce, and as we know margarine is a little faux, but a correlation of 0.992558 is hard to ignore. (The r value closest to +1 is a very strong indication two variables are related).
Naughton concludes in a succinct way what the article is actually saying: "younger men who smoke less are less likely to develop heart disease during the next 10 years". The 96 per cent reduction in heart attacks is proposed even though in the group who could do 40 reps, the data failed to reach statistical significance.

You may ask why is it then wrong to promote press ups with questionable data? Surely it's great to be doing them?
It seems that it's like misleading your kids to get them to do their chores. It makes us suckers to a headline. We fall for every headline because it's in the media. It must be virtuous? But how much of what is presented to us in the name of science is activism dressed up as truth?
I as a scientist don't want to be sucked in by a lack of journalism.

It is easy for science to be trumped by the media. The intention of the researchers is fair, but the data is being presented in a misleading fashion. Dig deeper and you may uncover the truth. Press ups are a cheap great exercise. Consult with a health professional to get the green light. If you have serious heart or health issues, first speak with your doctor. They are a fantastic drill for good health.

Greg Bell is a physiotherapist practising at Bell Physiotherapy. www.bellphysio.co.nz