In a 1939 radio address, President Franklin Roosevelt said, "Repetition does not transform a lie into a truth."
In these days of the Internet, this statement carries more substance than ever before. The World Wide Web lends itself easily to repetition. Just cut and paste.
When an error is put into an authoritative context, it can appear to have as much validity as a fact. The original source of the error can correct it, but once an error is loose on the Web, it can be impossible to pull it back.
Late last year we found a dangerous example of this "error multiplication" in an infant nutrition recommendation. On Oct. 15, a Friday afternoon, we were reading an article titled "Pediatricians Issue New Iron Guidelines." The article was about the reputable MedlinePlus website. The guidelines had been released by the American Academy of Pediatrics on Oct. 5.
Infant brain development can be severely impaired by poor iron status, so we considered this to be important and timely information. As we read the new guidelines, we hit a sentence that stopped us in our tracks. It stated that babies 6 months to a year of age need "11 mg/kg of iron a day." This level of iron intake is toxic for an infant!
Following the recommendation, the typical 22-pound infant would be given 110 milligrams of iron per day. This would put the iron intake at almost three times the Institute of Medicine’s "Tolerable Upper Intake Level" for iron intake by an infant of this age range.
According to the National Institutes of Health Office of Dietary Supplements, a single dose of 200 mg of iron can kill a 22-pound child. Consequently, 110 mg of iron per day for multiple days has the potential to kill a child, too.
We immediately went to the Pediatrics journal article that the MedlinePlus article cited and found that it recommended 11 mg of iron a day, not per kilogram. The thought of some well-intentioned parent following the erroneous recommendation was sobering. A bit of Web searching demonstrated that this error was on many other websites, including WomensHealth.gov and many news sites. It was even showing up on motherhood blogs, etc.
It initially appeared that the source of the error was HealthDay, a reliable news service for health-related topics. Contacting someone at HealthDay on a weekend was not working, so we continued on to the American Academy of Pediatrics website and found a press release that contained the error. So, Health Day had gotten the error from "the horse’s mouth"!
The error from the original sources had been on the Web for only about 12 days before it was corrected. Last week, however, we checked to see how many websites still have the error and were disappointed to find more than 25 that still have the incorrect and dangerous information. These websites included U.S. News & World Report, MedicineNet, Wellsphere, Health.com, HONnews, WrongDiagnosis, Doctor NDTV, NorthBay HealthCare, Bermuda Hospitals Board, University of Mississippi Health Care, Baby Center, Moms Like Me, Sixty Second Parent, etc.
Pandora’s box has been opened!
Joannie Dobbs, Ph.D., C.N.S., and Alan Titchenal, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dobbs also works with University Health Services.