Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

Q: The test examines more than 2 million spots in a person’s genetic code, seeking variants that individually nudge a person’s obesity risk up by a tiny amount. The researchers drew on previously published data about those variants to create a risk score. A high score didn’t guarantee obesity, nor a low score rule it out. But middle-aged people with scores in the top 10 percent were 25 times as likely to be severely obese as those in the bottom 10 percent, scientists reported in a paper released Thursday by the journal Cell. Those two groups were separated by an average weight difference of about 29 pounds (13 kilograms), researchers said. Analysis showed the genetic propensity to obesity began having an effect on weight around age 3. Up to about age 8, “you might be able to make a difference in the kids who are born susceptible to obesity,” said one author of the study, Dr. Sekar Kathiresan of Massachusetts General Hospital in Boston and the Broad Institute of MIT and Harvard. But it will take further research to see whether intervening would work, Kathiresan said. The results for middle age came from a study of about 288,000 people. Overall, the risk-score research included data from more than 300,000 people at various ages. Severe obesity was defined as a body mass index of 40 or more. Results show genetic inheritance “plays a large role in how heavy one gets,” Kathiresan said. The risk score probably takes about half of a person’s genetic propensity into account, he said, and it shows similar accuracy in predicting ordinary obesity, defined as a BMI of 30 or more. Even if one inherits a propensity for obesity, he said, “you still have control over your fate. You’re not fated to be obese, but it’s very clear those individuals who’ve inherited susceptibility have to work that much harder to keep the weight off.” Among study participants with the highest scores, he noted, 17 percent were of normal weight. Other analyses show that people who remain lean despite an inherited propensity for obesity tend to eat better and have more physical activity than others with a high score who got fat. “So you can do something about it,” he said. Ruth Loos, a professor of environmental medicine and public health who did not participate in the study, said the risk score explains more of people’s genetic tendency than previous studies did. But she doubted it would be useful in a doctor’s office. It is “never going to be a good predictor,” said Loos, of the Icahn School of Medicine at Mt. Sinai in New York. She noted that in one test of the score’s predictive power, only 58 of the 371 subjects scoring in the top 10 percent ended up severely obese. And many other severely obese people didn’t score in the top 10 percent, she said. Simply asking about family history of obesity would probably work better, she said. The large role of lifestyle in obesity means a purely gene-based predictor will never be perfect, she said. Kathiresan, a cardiologist, said the risk score is best seen as a risk indicator, like high cholesterol. Most people with high cholesterol don’t get heart attacks, he said, but they do run a higher risk than others. Jason Boardman of the University of Colorado Boulder said genetic variants might affect body size indirectly, through an impact on lifestyles or other social and behavioral traits. Other research suggests the effect of genes on size depends on what kind of social and physical environment a person lives in, including such factors as access to unhealthy foods, he said in an email. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

A: Study: Genetic test predicts middle-aged obesity risk.
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Q: This is a tricky one. The story does not explicitly address cost, except to call text messaging “a scalable and affordable approach.” For many (or most) patients, the cost of receiving four text messages a week would likely be negligible — covered by an individual’s phone plan or by nominal text rates. However, not everyone owns a mobile phone, a fact that makes access (and cost) a more significant issue. However, the story does deliver on this point. The story discusses both the number of U.S. adults who own mobile phones (90 percent) and the fact that text messages are more accessible than other forms of mobile health communication (such as apps, which require patients to own smartphones or other smart devices). So, while we’d prefer a more in-depth discussion here, we’ll award a Satisfactory rating for the story’s nod in this direction. The story addresses the range of benefits reported in the study, such as reduced cholesterol and blood pressure, but doesn’t quantify that information or offer readers any context. For example, while the story says “patients who had received the text messages had reduced their cholesterol,” the JAMA paper reports that patients who received the text messages had a “mean difference [of] −5 mg/dL” in “LDL-C.” In other words, the information in the paper, while quantified, probably isn’t very useful to many readers outside the health industry. Is “a mean difference of −5 mg/dL in LDL-C” good? Bad? Irrelevant? This is where reporters have an opportunity to shine. If a news story can take those numbers and translate them into language that is accessible to non-experts, it provides a very real service. It would have been great to see that here. As long as people aren’t driving and checking their cell phones, there don’t appear to be any harms associated with receiving well-meaning text messages four times a week, so we’ll mark this one “not applicable.” This is a strong suit. The story not only offers a concise, but good, summary of the study — but it also goes out of its way to address the study’s limitations. For example, the study notes that the study “can’t tell us whether text messaging could eventually lead to fewer subsequent heart attacks among the patients receiving those messages or whether the positive health outcomes would continue past the six-month study window.” Good points, and we’re glad the story includes them. No disease mongering here. The story includes input from an outside expert who was not involved with the research. The story clearly meets our bar here, although it would have been stronger if it had reached out to at least one more independent source — preferably one who hadn’t written an editorial that ran in conjunction with the paper in JAMA. Yes, the editorial was independent and provides some insightful commentary. But it also means we already knew where this source stood on the issue. Finding another reputable expert, who hadn’t already weighed in publicly on the work, would have been great. The focus of the story is not so much on how the text message intervention directly reduced heart disease risk, but on the extent to which it resulted in patients taking steps to reduce their own risk — such as by exercising more, smoking less, making dietary changes, or taking prescription drugs on a regular basis. The story does discuss other “mobile health interventions,” such as smartphone apps — but notes that there don’t appear to be many mobile health projects that rely simply on text messages. The story also looks at how the text messages helped patients pursue lifestyle changes — like exercising more and smoking less — that reduced their risk. It was fairly clear from the story that this was a clinical trial, and that this particular service doesn’t seem to be available to offer customized, encouraging text messages for heart disease patients. From the start, the story frames this research in the context of the much larger “mobile health” field. For example, the story notes that “While there are more than 100,000 health-related apps on the market, the evidence to date is lacking as to whether many of those apps are safe or effective.” Since the story includes quotes from an interview, we can be fairly certain it went beyond the related JAMA news release.

A: Text Reminders Help People Lower Cholesterol, Blood Pressure
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Q: We’ll give this story a Satisfactory rating in this category since it does mention the $1,000 cost of a colonoscopy and that one of the two at-home screening tests costs about $25. But readers would benefit more by knowing the average costs of the two alternatives, rather than just the cost of one. This story focuses on the available methods of colorectal screening, comparing them based on available data, and points out that the two at-home screening kits are comparably effective to the two invasive procedures: sigmoidoscopy and colonoscopy. One of the at-home tests — the FIT, or fecal immunochemical test — when used, is estimated to prevent 20-23 deaths per thousand people screened, while estimates among those using colonoscopy suggest 22-24 deaths are prevented per thousand people screened. The story is clear in saying that there has been no head-to-head comparative study pitting the techniques against each other. The story gets a Satisfactory rating here since it does mention that with colonoscopy, there’s “a small but real risk of harm, such as a perforation” from the screening test. But, as with all screening methods, there is the possibility of false positives or false negatives with the at-home tests which could produce either false confidence or needless worry, not insignificant issues. We would have liked the story even better had it mentioned these factors. The story is quite open with the fact that comparative data assessing the various screening methods against each other are not available, but it strengthens its offerings by citing recommendations from both the US Preventive Services Task Force and the Canadian Task Force on Preventive Health Care. The recommendations of these independent groups are based on a rigorous evaluation of the highest-quality evidence available. Colon cancer is the second-leading form of cancer-related death in the country; the story does not disease monger. The story quotes three independent sources for information and the recommendations of agencies from two different governments. There is no suggestion that in a story offering a selection of screening techniques, with no one preferred above another, that there is any issue with conflicts of interest. Since this story is totally about the available alternatives for colorectal cancer screening, it easily gets a Satisfactory rating. Both colonoscopy and sigmoidoscopy have been available for years and the at-home screening tests mentioned in the story are said to be available through a patient’s doctor’s office. These details establish the methods’ availability. It also quotes one source as recommending against the use of over-the-counter home screening tests for this disease. The story notes that what’s novel here is that the U.S. Preventive Task Force recently finalized their guidelines on colon cancer screening. There is no indication that this story relied on a news release.

A:
You Could Skip Your Colonoscopy If You’re Willing To Collect Your Poop
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