MMI Critical Thinking - Aspartame Question / Answer

[shirazis]

Hi All

 

I have been following this site for some time and wanted to thank everyone on who contributes as it is a very good resource.

 

I have an MMI interview in the UK tomorrow and was wondering if you guys would be kind enough to critique the below response for me?

 

Many thanks in advance.

 

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Aspartame (Critical Thinking)

A message that recently appeared on the Web warned readers of the dangers of aspartame (artificial sweetener – Nutrasweet, Equal) as a cause of an epidemic of multiple sclerosis (a progressive chronic disease of the nervous system) and systemic lupus (a multisystem auto-immune disease). The biological explanation provided was that, at body temperature, aspartame releases wood alcohol (methanol), which turns into formic acid, which 'is in the same class of drugs as cyanide and arsenic.' Formic acid, they argued, causes metabolic acidosis. Clinically, aspartame poisoning was argued to be a cause of joint pain, numbness, cramps, vertigo, headaches, depression, anxiety, slurred speech and blurred vision. The authors claimed that aspartame remains on the market because the food and drug industries have powerful lobbies in Congress. They quoted Dr Rhonda Blaylock, who said, 'The ingredients stimulate the neurons of the brain to death, causing brain damage of varying degrees.'

 

Critique this message, in terms of the strength of the arguments presented and their logical consistency. Your critique might include an indication of the issues that you would like to delve into further before assessing the validity of these claims.

 

 

I would like to discuss:

 

• The source of the article and the credibility of the source

• the credibility of the research

• the credibility of the author / quoted expert

• the assumptions made in the text

• the reasons and the conclusions given

• claims supporting the statements

• the logical consistency of the arguments made in general

• Overall evaluation of the text

 

Firstly the article states that the source of the material is the “web”, however it does not clarify where exactly on the web. For example, could this be a summary of a research article from the Journal of Biochemistry, the BMJ? Alternatively, could it come from popular media such as the Sun or Daily Mail, or even from a blogger or an internet forum. In order to assess the credibility of the source, the references must be stated in the text.

 

Secondly, it is implied that there has been research carried out due to the statement “the authors claimed…” however, there is no reference to the research. It is also unclear whether the research was a clinical trial, and if so of what type. For example, to assess the robustness of the research, you could assess if one of the following where used:

 

• Observational trial

• Randomised control trial

• Was it peer reviewed?

• Was it a single paper or a meta-analysis?

• Where human participants used?

• The text states that one of the diseases is progressive and chronic. Was the trial longitudinal to take into account the long term nature of the disease and follow its effects?

 

Thirdly, the author’s names have not been explicitly referenced, however the name of an expert has been provided. The reader is left to consider whether the expert is one of the authors. The expert’s credentials and reputation have not been stated. We do not know in what field she is a doctor of, it could be philosophy. The text has also not declared any vested or conflicting interests of the expert, the authors, and the person who wrote the text.

 

Assumptions - The assumptions made include the fact that because formic acid is in the same class as cyanide and arsenic, it must be toxic. We are not given the class of chemicals. Another assumption is that metabolic acidosis causes the side effects/conditions listed.

 

Reasons – The reasons given in the article are weak. There is no explanation provided as to how formic acid causes metabolic acidosis, whether this happens in vitro, whether the amount of substance produced is sufficient to cause metabolic acidosis, and whether metabolic acidosis is toxic to humans.

 

There is no evidence or any claims to support the statement that food and drug companies have powerful lobbies in congress, and that they have lobbied to keep aspartame on the market.

 

There is no evidence to support that the ingredients listed cause neuronal cell death, and an assumption is made that the ingredients referred to are formic acid. The text also refers to a plural (ingredient(s) ) rather than single, but does not there is only reference to one ingredient earlier on in the article which is stated causes the illness.

 

Further the symptoms stated are very vague and generic, and therefore, you would expect detailed research findings explaining the mechanisms by which the symptoms are created in order to link the symptoms to the metabolic acidosis caused by the formic acid.

 

Overall, the text is poorly written and makes wild claims without them being substantiated. There are also a number of assumptions. The reasons are not supported by evidence, and there is no reference to any clinical trial. If the audience was the scientific community, then the text would be disregarded. However, if the audience was the general public and the article appeared in popular media such as the Daily Mail, then I would say the article is irresponsible as it may create panic among the public, which could lead to a number of scared patients that need to be re-assured by the medical community such as their GPs.

[marcel]

Although i have seen this question before, thanks for sharing it - i think a lot of people will benefit from your contribution.

 

Would you or anyone else have other good examples of MMI critical thinking questions??

[alxdude]

You have some great points and a robust argument. If you did that in 8 minutes without seeing the question beforehand I'm impressed.

 

I might have touched on the "Your critique might include an indication of the issues that you would like to delve into further before assessing the validity of these claims" aspect of the prompt.

 

Your style is also a bit hostile and perhaps you may have jumped to conclusions a bit more quickly than I would have. I might have been a bit more cautious and tentative with my own answer (sort of like I am in this paragraph).

[shirazis]

Hiya guys, thanks for the feedback. It's very much appreciated. Unfortunately it was untimed, I think about 13 mins. But writing it out does take longer than speaking it.

 

I had seen the document the question comes from but never before read this specific question

 

Alxdude - just wonder how you would provide an indication of the issues that you would like to delve into before going into details because I thought that I would just provide the bullet list of the area I'd discuss. Be keen to hear if you think there is a better way of doing this, or if you feel it did not address the point.

 

As for my direct approach , I've developed a thick skin from work, so maybe I need to try to come across less harsh but not sure how I'm going to change that now. Maybe I'll just be really softly softly inthe acting / role play station.

 

Did a mock interview yesterday and recorded my self. Not feeling confident as my head is ALL OVER THE SHOP and I can't formulate my thoughts at all. ARGHH!

[future_doc]

Although i have seen this question before, thanks for sharing it - i think a lot of people will benefit from your contribution.

 

Would you or anyone else have other good examples of MMI critical thinking questions??

 

See my Sticky on this forum.

[alxdude]

Alxdude - just wonder how you would provide an indication of the issues that you would like to delve into before going into details because I thought that I would just provide the bullet list of the area I'd discuss. Be keen to hear if you think there is a better way of doing this, or if you feel it did not address the point.

 

Personally I'd want to integrate it directly into my argument. For example, "The message uses 'the web' as a source linking aspartame to multiple sclerosis and lupus, which immediately makes me skeptical about these links because the web can be very unreliable. However, I would want to review the medical literature on these links between aspartame and disease before dismissing them."

 

I hope this helps!

 

my head is ALL OVER THE SHOP

 

I know what you mean mate, when you're in that 8 minute window it gets hard to focus. I actually did this exact prompt in 8 minutes several months ago over instant messenger and found it so I'll share what I actually ended writing.

 

The thing that jumps out at me first is the claim that formic acid is the mechanism for the epidemic they are suggesting.

If this is true, then a single fruit is many times more harmful than a typical single dose of aspartame.

Much more convincing would be a link between aspartame itself and the symptoms they suggest, rather than a description of symptoms caused by metabolic acidosis, which they do not convincingly show is caused by the small amount of formic acid produced by the metabolism of aspartame.

They also say that aspartame is still on the market because the food and drug industry lobbies congress.

This does not indicate that aspartame is bad. Furthermore, large amounts of independent research have been paid by for the government that have failed to find a link between aspartame and disease. The government seems to me to be capable of ensuring the safety of citizens in spite of the lobbyists.

Finally, I would want to know the context of Baylock's comments and what the authors means when they write "clinical" before making further judgements on the article.

For example, using 30 or 40 servings may indeed be dangerous, but that does not mean that 1 or 2 servings pose any threat at all.

 

So yeah I guess I totally didn't follow my own advice in those 8 minutes lol and I definitely wasn't able to come up with as much content as you