Commercial companies in the health and fitness indus- try often misuse ‘science’ in an attempt to gain credibility so that they can sell more products and make more money. A product supported by ‘science’ creates the im- pression that it is a worthy product. As laypeople are generally poorly educated on the role of science in health and fitness, they are often influenced by the many adverts that take advantage of this. For example, some companies market their products using terms such as ‘doctors agree …, experts have shown…’, or have adverts with pictures of learned-looking people wearing white lab coats next to their product. Other marketing mate- rial proudly claims that the product ‘...has been tested at a South African university’. While this statement may be true it lacks any sense with regard to supporting the efficacy of the product. One can do an experiment on the ergogenic effects of a piece of coal and honestly claim that it has been ‘tested’, even if it has absolutely no positive ergogenic effect. Prov- ing efficacy, validity, repeatability and potential side-effects of a product is another matter entirely. These are character- istics that have to be identified before legitimate claims can be made, and it may take several years of experimentation to accumulate the knowledge. Strategies for misusing ‘science’, such as those outlined above, are successful in South Africa largely because of the stance of the Advertising Standards Authority (ASA) which seems to prioritise legal matters over scientific facts and is too easily influenced by pseudo-science. 1 This has made ‘South Africa a great place for pedlars of snake-oils, slimming aids and unproved “therapies”’. 1 The first step in changing this paradigm is to educate the public on the role of science in developing knowledge. The scientific process begins with research that attempts to an- swer a question. In sports medicine the question is often identified by the coach, trainer or players. Sometimes physi- otherapists formulate a question and sometimes a doctor identifies a relevant question for which there is no immedi- ate answer. The point is that it does not matter where the question originates. A good research study is one that has a clearly identified question that is relevant. Ernest Rutherford, a pioneering nuclear physicist who won the Nobel Prize for his work has been quoted as saying ‘A theory that you can’t explain to a bartender is probably no damn good’ (quoted in Francis Collins, The Language of God, 2006:60). This same logic can be applied to simplifying questions around which research studies are designed. A clear, relevant question initiates a process of designing a study that attempts to answer the question. Factors such as type of subjects, adequate control, and sample size to make the data interpretable and representative have to be considered. Well-designed studies that consider these points have a high ‘believability’ factor and contribute towards pro- viding an answer to the question around which the study was designed. The process does not end there. After implement- ing the study plan the researchers still have to prepare the manuscript and subject it to peer review in an attempt to get it published. This is not an easy task. Most of the top inter- national journals have rejection rates of around 70%. In an analysis of research papers published in 6 leading basic sci- ence journals (approximately 25 000 papers), only 2% of the studies contained some information that had the potential to make a significant contribution to clinical application. 2 The rate of transfer of knowledge from research into practice is low. This can be illustrated in the acquisition of the practical knowledge on carbohydrate ingestion during exercise. In the last 30 years 1 103 studies have investigated carbohydrate ingestion and exercise (accessed from PubMed using the keywords ‘carbohydrate’, ‘ingestion’ and ‘exercise’). The col- lective knowledge from all these studies can be reduced to about 10 practical points. There are many other examples of routine practices in sports medicine which have evolved from systematic research. The following are thanked for reviewing manuscripts sub- mitted to the SAJSM during 2006. All these reviewers have made a significant contribution to the peer-review process which is the core to developing knowledge. This is the first of 4 issues of the SAJSM for 2007. I trust that you will enjoy reading it and that the papers published in this issue will contribute in some way to the promotion of sports medicine in an evidence-based way! Mike Lambert Editor-in-Chief 1. Welz M, ed. Fat chancers. Noseweek 2007; 89: 18-21. 2. Bishop DB, Burnett A, Farrow D, Gabbett, T, Newton, R. Sport science roundtable: Does sports-science research influence practice? International Journal of Physiology and Performance 2006; 1(2): 161-8. The misuse of science A topic which is receiving much publicity as I write is the banning of 5 skinny models from participating in the Madrid fashion week. Madrid’s regional govern- ment imposed the rules ‘to protect the models as well as teenagers who may develop anorexia as they try to copy underweight catwalk stars’. 1 They used a body mass index of 18 as their cut- off value. The ‘anti-thin’ move has been criticised in Paris and New York, two of the world’s leading fashion centres. However, in Italy the move was supported by the mayor who intimated that she would like to apply the same rulings when the fashion show moves to Milan. The motive for imposing the ban is noble, as the ‘skinny trend’ is not showing signs of abating. A recent report by the British Medical Association identifies a link between the images of ‘abnormally thin’ models that dominate television and magazines, and the increase in cases of anorexia nervosa and bulimia. 2 The incidence of anorexia is at an all-time high with predictions of 0 - 5% of all females having eating disorders. While eating disorders were previously usually regarded as a female syndrome, the situation is changing with a steady increase in the number of men being diagnosed with eating disorders. A recent estimate predicts that of the 60 000 people with eating disorders in the UK, 10% are male. 2 This trend can most likely be explained by the contemporary lean, hungry look of male stars. To get a snapshot view of changing body beautiful images of different eras one only has to compare the ‘hunks’ of the 1960’s movies (i.e. Sean Connery as James Bond) to modern day hunks to see how the masculine image has changed. Marilyn Monroe, with her curvy body shape in the 1950s would probably be regarded as too fat for a leading role 50 years later. While the organisers of the fashion shows should be complimented for taking a bold stand against their skinny, unhealthy-looking models, they can be criticised for the way in which they have gone about it. Using a body mass index of 18 as a cut-off value is inappropriate and may penalise some models who live normal healthy lives. Instead of this approach the organisers should establish a structure that evaluates the health status of the models including their eating, sleeping and substance abuse habits and make decisions accordingly. The information on how to do this is available; it just needs to be applied. This third issue of the journal for 2006 has 4 interesting papers. The first paper by Professor Mars and colleagues examines the cooling of skin, subcutaneous fat and muscle with an icepack, at rest and after short-duration exhaustive exercise. This study produced some interesting results with important clinical applications. The next paper by Ian Cook examines the accuracy of different types of pedometers. It is well known that people who use pedometers are encouraged to be more physically active, so therefore there is great value in making pedometers available to the general public. However, the enthusiasm to make and distribute pedometers has exceeded the concern about their accuracy. This study addresses this point with a comprehensive research design. The results make a valuable contribution to the literature. The third paper, by Dr McHardy and colleagues from Macquarie Injury Management Group, Macquarie University, Sydney, Australia, is a clinician’s perspective of the modern and classic golf swing. This paper is relevant to sports physicians, biokineticists and physiotherapists and provides a clear analysis of the different types of golf swing and their possible link to injury, particularly lower back pain. Finally the paper by Dr Draper and her colleagues describes the state of the fitness industry in South Africa. This comprehensive study gathered data from 442 facilities around the country. The data provide an important benchmark for the state of the industry and will make a significant contribution to the development of perceived weaknesses in the industry. Mike Lambert Editor-in-Chief 1. Milan fashionistas fear Spanish skinny model ban. news.yahoo.com/s/ nm/20060914/od_nm/italy_models_dc (accessed 18 September 2006) 2. The changing shape of the model. news.bbc.co.uk/1/hi/uk/769460.stm (ac- cessed 18 September 2006) Skinny fashion – a role for sports medicine? SAJSM voL 18 No. 3 2006 57 editoriAL pg57.indd 57 9/21/06 12:15:22 PM SAJSM voL 19 No. 1 2007 1 ediToriAL Aginsky K De Beer J De Milander L De Villiers R Dugas J Durandt J Gay J Gray A Havemann L Johnston R Keet J Kohler R Lambert V Manjra S McKune A Meurer B Micklesfield L Potter P Raine R Reid S Saunders C Smith C Smith J Stretch R Swart J Viljoen W Wright Z pg1.indd 1 4/4/07 9:52:46 AM