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: Most people know roughly what a bottle of vitamin D supplements might cost them, so the lack of information on cost is not a significant gap. We appreciate that the story provided data showing the large and growing amount our society is spending on vitamin D supplements ($430 million in 2009), with apparently little health benefit to show for it. The story was mostly concerned with discussing the lack of benefit from taking extra vitamin D and calcium. And in this area it excels. While the story does lack precision when it suggests that adolescent girls should be getting more calcium (it never specifies how much they are getting now, how much more they’d need to meet the recommendations, or what benefits they might expect from this increased intake), it would be difficult for a journalist to come up with any sort of quantifiable benefit or harm estimate from the IOM report. The story captured the overall gist of the problem, which is that the evidence base is complex and still inadequate. The story notes that, contrary to the claims of many advocates for increased supplemental vitamin D, there is evidence that high levels of vitamin D may have adverse effects, such as increased risk for fractures and an increase in the overall death rate. The story also explained that too much calcium has been linked to increased risk of kidney stones and, more tentatively, heart disease. The story did a good job of describing how the expert committee conducted its review and what evidence they found. Importantly, it noted that  claims of benefit from extra vitamin D are based on observational studies that most scientists agree “cannot determine cause and effect.” We also like that the story solicited opinions from a variety of experts with no obvious stake in the controversy. This produced a number of quotes that emphasized the need for restraint when interpreting the research on vitamin D. Examples: “I think this report will make people more cautious” and “The onus is on the people who propose extra calcium and vitamin D to show it is safe before they push it on people.” Although we agree with the story’s skeptical overall message, we think it may have slammed the door just a bit too hard on the possibility of benefit from supplemental vitamin D. While claims of benefit may not be supported by the currently available evidence, they have not been conclusively disproved in randomized controlled studies, either. In fact, research is now underway to determine whether the benefits found in observational studies of vitamin D can be replicated in more rigorously designed trials. The story probably should have mentioned this research, and left the door to potential benefits open just a crack. No disease-mongering here. The diversity of independent voices included in this story is a real strength. Although it solicits the obligatory comment from a supplement industry spokesman, it didn’t go out of its way to find any of the more widely known vitamin D experts, some of whom have been issuing recommendations that are untenable based on current evidence. The enthusiasm of some of these researchers might be explained by their significant career and financial interests in promoting vitamin D. Not applicable for this story. The approaches discussed are not new, and there’s not really any alternative to getting adequate amounts of these essential nutrients. The availability of vitamin D from diet, sunlight and supplements is clear from the story. The novelty of vitamin D and calcium is not really in question, so we’ll call this not applicable. This story was not based on a news release.

A: Report Questions Need for 2 Diet Supplements
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Q: There’s no discussion of cost, even to mention that statins are relatively inexpensive these days and are mostly generically available. To its credit, the article does mention the cost of a calcium scan. We learn that “anywhere from 50 to 200 healthy people need to take a statin daily to prevent a single heart attack for five years.” That’s helpful information. It also notes that the observed benefit is less for older patients. The story could have added that even those numbers might disputed by some experts who perceive no meaningful benefit. For example, one review found being on a statin does not help people with low risk for heart disease live longer. The story does a service by highlighting the harms of statins. It explains: “The most common side effect of these drugs is muscle pain, which usually goes away if patients stop taking the medicines. People taking statins are also at a higher risk of developing diabetes, which is harder to reverse.” It also mentions the potential for overtreatment with the use of coronary calcium scans. However, we wish it had included absolute numbers. The story says harms are “uncommon,” but provides no data to back that up. Rates of adverse effects with statins have been measured at 1 to 10%, which makes them “common” in the definition of the European Medicines Agency. Also noteworthy is that some contend that adverse effects of statins have not been reliably reported. The story doesn’t explain the quality of the study, or of studies on which current guidelines are based. We don’t explicitly learn that this is a modelling study. In other words, this study consisted mostly of reinterpretations of math, not re-evaluations of real-life patients. The researchers said they were unable to obtain enough data on all possible harms and age-specific data on some harm outcomes, “so the risk thresholds we determined may still be too low.” There is no disease-mongering here. This story includes sources that weren’t involved in the study. The study’s authors reported no conflicts of interest. The story could have acknowledged the influence of pharmaceutical companies in creating guidelines for statin use. The alternative of not taking a statin was the key message here, and that’s laudable. However, we have a couple of concerns. First, we learn that “some statins were more effective than others, with atorvastatin (the generic name for Lipitor) being the best of the bunch.”  However, the story doesn’t explain on what basis some statins are “more effective.” In fact, some statins may be more effective at lower cholesterol, but the study found that no statin rises above others when it comes to the outcomes that counts most to patients — reducing cardiovascular deaths. Also, the story doesn’t mention lifestyle interventions — diet and exercise. The story makes it clear that statins are widely prescribed. The story states this an attempt to better weigh the benefits and harms of statin use. There was a good range of interviewees with no reliance on a news release

A: Before Starting A Statin, Talk It Over With Your Doctor
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Q: The Southeast Asian nation had been the most populous country in the world to say it had no cases, despite sharing a long and porous border with China, where the virus originated in the city of Wuhan. The health ministry said a 36-year-old traveling from the United States and 26-year-old returning from Britain, both Myanmar nationals, had tested positive. “Investigation is ongoing on history of people who have been in contact with these two patients,” it said in a statement late on Monday. The news of the confirmed cases sparked panic buying in the commercial capital of Yangon, with shoppers packing major supermarkets. Myanmar last week closed land borders and banned mass gatherings, including for the upcoming Buddhist New Year. Cinemas have been closed, though bars and restaurants remain open. Government spokesman Zaw Htay told a news conference earlier this month that the “lifestyle and diet of Myanmar citizens” had protected the country against the virus, while others credited the country’s Buddhist religion. Some doctors say they fear a major outbreak though in a country with a health system ranked among the world’s worst after decades of neglect under military rule. Many services are run by volunteers and aid groups. Two doctors told Reuters a likely explanation for the lack of cases in Myanmar was limited testing. Myanmar had carried out around 300 tests as of Monday evening, in a population of 51 million, according to health ministry spokeswoman Khin Khin Gyi. “WHO has said, ‘test, test, test,” she said. “But who should we test? It has said specifically that we should test the suspected cases... We don’t test random people.”  Until recently, each test had to be approved by a central committee based in the capital of Naypyitaw, she said. Thousands of migrant workers have returned to villages across the country in recent days from Thailand, which has confirmed hundreds of cases, raising fears of further spread of the virus. “If these people have the virus, and it spreads widely, the situation will be very bad,” said Kyaw Ko Ko, a community worker from the city of Meiktila. “All we can do is sit and wait to collect all the dead bodies.”

A:
Myanmar reports first cases of coronavirus.
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