First Opinion is STAT’s platform for attention-grabbing, illuminating, and provocative articles in regards to the life sciences writ giant, written by biotech insiders, well being care employees, researchers, and others.
To encourage strong, good-faith dialogue about points raised in First Opinion essays, STAT publishes chosen Letters to the Editor obtained in response to them. You may submit a Letter to the Editor right here, or discover the submission kind on the finish of any First Opinion essay.
The story
“Are blue zones actual? Answering that query is more durable than ever,” by Shelley Wooden and Eric J. Topol
The response
I’ve spent the previous 20 years writing for Nationwide Geographic, throughout which era I’ve written 4 main articles about blue zones, the world’s statistically longest-lived scorching spots. I broke the story saying their discovery, defined the strategies used to validate them and recommended the teachings the remainder of us may be taught from them. At Nationwide Geographic the very fact checkers occupy nook workplaces; editors drive journalistic integrity.
Essentially the most stunning factor about STAT’s current article questioning the validity of blue zones wasn’t that it featured critics. Scientific criticism is crucial. Any severe concept that has attracted world consideration needs to be scrutinized, challenged, and examined.
What stunned me was what the article not noted. Readers had been introduced with a prolonged retelling of a sole critic who argues that blue zones are constructed on flawed demographic assumptions, questionable age validation, and statistical anomalies.
But nowhere within the article had been readers knowledgeable that the majority of those self same criticisms had been instantly addressed and disproven in a peer-reviewed paper revealed in The Gerontologist, one of many main journals in getting older analysis. Whether or not one agrees with that response is irrelevant. The purpose is that it exists. When overlaying a supposed scientific controversy, it’s arduous to justify giving a lot house to 1 aspect whereas leaving out a significant peer‑reviewed response that challenges whether or not there’s an actual dispute in any respect.
This omission will not be a minor element. It basically alters how readers perceive the state of the proof. The article leaves the impression that blue zones researchers have been confronted with devastating new criticisms to which there was little significant response. That’s merely not true. There are over a dozen peer reviewed articles by profession demographers documenting the validity of blue zones; the STAT article solely presents the arguments from a lone critic who repeatedly fails peer evaluation.
Extra importantly, the article repeatedly conflates two very totally different topics: blue zones analysis and Blue Zones Venture. The excellence issues as a result of one is a scientific inquiry into locations the place individuals have traditionally lived exceptionally lengthy lives, whereas the opposite is a group well-being initiative designed to enhance well being outcomes in trendy cities. The article spends appreciable time questioning the primary whereas implying doubts in regards to the second. However these are completely separate questions.
What has at all times struck me as odd in regards to the current assault on blue zones is 1) they compile deceptive straw man arguments whereas conveniently omitting the very fact profession demographers spent years painstakingly verifying ages, and a couple of) the zeal with which the gullible well-liked media parrot the identical deceptive claims.
The authors of the STAT article appear to have fallen prey to the identical clickbait.
Readers weren’t advised {that a} peer-reviewed response to the criticism exists. They weren’t advised that this isn’t an lively scientific debate a lot as one being introduced that manner. They usually got little details about the tangible, systems-level enhancements in individuals’s lives that Blue Zones Venture has produced in communities the place it’s been put into observe.
The result’s a narrative that asks whether or not blue zones are actual whereas largely overlooking the proof that issues most. For me, a very powerful query is how we are able to apply what we be taught from the world’s healthiest populations to drive system‑degree adjustments that assist individuals stay higher, more healthy lives.
The unique blue zones work started with a easy statement: Sure populations appeared to provide unusually excessive concentrations of wholesome older individuals. Working alongside revered demographers, epidemiologists, and researchers, we sought to know what components may contribute to that phenomenon. In all of the blue zones, our central observations stay remarkably constant: Individuals are likely to stay longer after they transfer naturally all through the day, keep robust social connections, keep away from smoking, eat principally complete meals, and have a way of objective. Their secret? They stay in environments that make these wholesome selections simple or unavoidable. These ideas are supported by many years of public well being and epidemiological analysis that extends far past any single longevity scorching spot.
But the bigger omission within the STAT article issues outcomes. If writers wish to consider Blue Zones Venture, then the related query will not be whether or not teachers proceed to debate demographic information in Okinawa or Sardinia. The related query is whether or not communities that implement Blue Zones ideas turn into more healthy.
That query has really been studied.
For years, Gallup measured well-being in communities the place Blue Zones Venture was carried out. In Fort Price, Texas, Gallup documented substantial enhancements in inhabitants well-being, wholesome behaviors, and high quality of life. Throughout a interval when many American communities struggled to maneuver these indicators in a optimistic course, Fort Price grew to become one of many strongest examples of large-scale enchancment. Related beneficial properties had been recorded in California’s Seashore Cities, the place residents constantly reported ranges of well-being that exceeded nationwide averages and the place long-term enhancements had been noticed throughout a number of well being and quality-of-life measures.
These findings aren’t promotional slogans. They’re population-level measurements collected over years. They characterize the kind of proof public well being specialists routinely search when evaluating whether or not an intervention is working.
But readers of the STAT article be taught nearly nothing about these outcomes.
As a substitute, they’re inspired to view blue zones primarily by way of the lens of a sloppy critique that has already been discredited.
Additionally it is essential to right one other frequent false impression. Cities don’t pay Blue Zones Venture for certification. Communities interact Blue Zones Venture as a result of they want help in bettering the social and environmental circumstances that form well being — the insurance policies, faculties, workplaces, meals environments, social networks, and constructed environments that decide how simple or arduous it’s to stay properly in a given ZIP code. The target will not be branding. The target is measurable enchancment in inhabitants well being and well-being by comprehensively making the wholesome alternative the straightforward alternative. We’re proud that the Blue Zones group mannequin stands as one of the crucial significant improvements in inhabitants well being.
That’s the work Blue Zones has at all times been about. And that’s the query readers should see examined with the identical rigor utilized to the controversy.
— Dan Buettner
The response
My nation of origin will be thought of what is named a Blue Zone. There have been and nonetheless are members of the inhabitants who lived to their 90s and past. I’ve had kinfolk on this class, however sadly it appears the following technology is not going to. Centenarians had been visited by an official of presidency, and this occasion was revealed within the information, so information of those milestones exist and that is nonetheless ongoing.
The menace to this lifestyle is motion of individuals to and from these locations. Some could name it progress. As a toddler, in my previous nation there have been fewer than 20,000 vehicles, now it has elevated to 180,000. Processed meals has elevated, however recent meals continues to be ample. Martinique was talked about within the article, however please observe, the broader Caribbean together with Barbados have lived like this for a few years however could not sooner or later.
— Loretta Cuffley
The response
Leaving apart the controversy as as to if these explicit locales qualify, why would one not count on inhabitants isolates exhibiting elevated or decreased getting older merely on account of genetic variance alone? Such scorching spots of associated people with a selected haplotype could correlate with wholesome life or could not, as proven by centenarians who used alcohol or had been sedentary for a lot of their lives. The conclusion that way of life is answerable for an as but unreplicated discovering appears untimely.
— Victor Reus, M.D., UCSF College of Drugs
The story
“Ending animal testing might set again xenotransplantation simply as the sphere is poised for a breakthrough,” by Joshua Mezrich
The response
The highway map for phasing out animal experimentation is grounded in two interrelated concerns: the ethical recognition of animal struggling and the rising proof that animal fashions are sometimes unreliable predictors of human biology. Collectively, these moral and epistemic critiques underpin present efforts to scale back and finally change animal use in science. Xenotransplantation disrupts this trajectory.
As Mezrich notes, constraints on animal-based analysis could hinder xenotransplantation. Nonetheless, the sphere is structurally depending on in depth animal use throughout its complete translational pipeline. Rodents are used to check immune rejection, inflammatory pathways, coagulation incompatibilities, and graft survival. Gene-edited pigs are generated by way of genome engineering and somatic cell nuclear switch, requiring oocyte donor animals, surrogate sows, and extra populations to ascertain and keep breeding traces. Massive pathogen-free herds are sustained for selective breeding and organ manufacturing. Earlier than scientific utility, non-human primates similar to baboons and macaques function recipients in preclinical transplantation research to evaluate graft perform and long-term survival.
Throughout these phases, animals perform concurrently as experimental fashions, reproductive sources, breeding populations, and organ sources. If translated into scientific observe, this technique extends past analysis and turns into embedded in well being care supply, the place animal our bodies are repeatedly produced and consumed as therapeutic infrastructure.
Past animal ethics, xenotransplantation raises questions of distributive and scientific justice. It’s unclear which sufferers will obtain animal-derived organs and which is able to obtain human organs. If human organs stay clinically preferable, xenotransplantation could generate stratified entry to transplantation. Issues concerning zoonotic danger may additionally require long-term surveillance, monitoring, and behavioral constraints for recipients of animal organs.
The coverage dedication to scale back and change animal experimentation displays a longtime moral and scientific course by which animal use shouldn’t represent the default framework of biomedical analysis. Xenotransplantation departs from this trajectory by reestablishing animal use as a central and everlasting part of medication. It institutionalizes a system by which animals are intentionally engineered, bred, confined, and killed as renewable organic sources for human therapeutic ends.
This transformation represents a substantive reconfiguration of the human–animal relationship in medication and sits in rigidity with up to date science coverage aims. Though citizen interviews, focus teams, and deliberative research on xenotransplantation are restricted and never systematically up to date, they constantly report ethical resistance to animal instrumentalization, alongside issues about genetic modification, intensive breeding, killing, and precautionary dangers. Xenotransplantation subsequently stays ethically contested and lacks secure social consensus, warranting express democratic deliberation moderately than implicit normalization.
— Arianna Ferrari, Middle for Innovation Programs and Coverage, Austrian Institute of Expertise
The story
“We revealed in Nature Drugs in 2025 without cost. In 2026, it price us $12,850,” by Elizabeth Selvin
The response
June 11’s First Opinion by Elizabeth Selvin represents frequent misunderstandings of the economics of scientific publishing right now. We wish to make clear some factors to additional the dialog.
False: Not paying an article-processing cost (APC) to be revealed means being revealed with out one was “free.”
Reality: There’s a price both manner, and hybrid (subscription + free articles) journals like Nature Drugs want to separate the distinction.
False: The writer is accountable for the “new” price.
Reality: NIH introduced in April 2025 that the coverage can be efficient July 31, 2025. The paper in query was submitted Aug. 7, 2025.
False: The price was unavoidable.
Reality: If the price of open-access charges is a monetary hardship, there’s a world shopping center at your fingertips. Citations and press protection for a paper in Nature Drugs pay dividends in educational credibility and additional funding alternatives. Everybody is aware of that.
False: Paying $13,000 is an excessive amount of.
Reality: The return on funding on a publication payment that may be a proportion of an R01 grant is relative.
False: PubMed Central sans embargo is the way in which to go.
Reality: Congress allocates tax {dollars} for analysis grants. Experiences of this analysis could flip into scientific papers. Publishers independently assess these stories and take monetary dangers for his or her authors. PubMed Central is a secondary U.S. taxpayer-funded platform created to help “public entry” compliance. Like several tech platform, it’s costly to run and keep. It hosts content material from authors and publishers throughout the globe whereas U.S. taxpayers foot the invoice. Some estimates counsel that the price range to run it has quadrupled in recent times. Like the whole lot else, it’s topic to political crosswinds.
We perceive Selvin’s standpoint. Blaming impartial industrial publishers for attempting to run their companies whereas an untrustworthy U.S. authorities adjustments insurance policies on a whim, nonetheless, is simply the tip of a messy iceberg that op-eds like hers make messier. Evaluating the “prices” of publishing in Nature Drugs to what she has gleaned from her time as a part-time editor for an American Diabetes Affiliation journal is evaluating apples and oranges. It’s of no assist to her fellow U.S. scientific colleagues who’re getting squeezed.
— Kent Anderson and Pleasure Moore, co-authors, “How the Web Disrupted Science” (Globe Pequot, August 2026)
The response
Selvin is true that publicly funded analysis needs to be broadly accessible to help data and discovery, a purpose Springer Nature shares. Nonetheless, the piece misses essential distinctions, notably round article processing costs (APCs). Publishing is each useful resource intensive and excessive worth. Below a subscription mannequin, establishments and libraries that subscribe to journals cowl the price. Publishing open entry with out embargo intervals — which NIH coverage requires — shifts these prices to APCs, that are usually coated by analysis funds. Our APCs are clear and replicate the prices related to publishing high-quality trusted analysis. APCs help editorial analysis, impartial evaluation, formatting, and distribution, and guarantee steady entry to publications. In addition they enable for funding in analysis integrity infrastructure, together with superior detection of fraudulent submissions — important to making sure revealed science will be trusted.
Springer Nature’s common APC is $2,500. For top-impact, selective journals like these within the Nature portfolio, prices are increased as a result of time, experience, and funding required. These journals obtain a really excessive variety of submissions, which means specialist groups assess many extra papers than are finally revealed, leading to increased prices per article. Our authors retain copyright of their work. We’re granted a license to publish by the writer so we are able to guarantee their work reaches the widest variety of individuals and has the best affect. Licensing phrases assist shield authors’ work from reuse in methods that aren’t clear or aligned with their intentions. Entry to trusted analysis is central to scientific and societal progress. We’re dedicated to partnering with researchers and the federal authorities to help this shared purpose.
— Anna Troise, Springer Nature
The story
“Dr. Glaucomflecken desires to make a stink,” by Torie Bosch
The response
I simply wish to thanks for airing this story. Unchecked capitalism is making all of us poorer in precise wealth and likewise in companies and protections that matter (except we’re within the 0.1%). Let’s hyperlink corruption, “lawful” or illegal, with a poorer final result for all of us as a result of that’s the reality. I’m so unhappy that docs are pressured or coerced by cash to take jobs in unbridled capitalistic ventures that suck cash from us all. I’m even sadder that younger docs assume that is how it is going to be. I’m a psychiatrist in non-public observe for a number of many years save for a five-year stint at an aspiring startup. I advised myself I might work there as a result of it’s a “good model” of what’s coming anyway. Sadly, it in all probability is a greater model. However any observe having non-medical stakeholders can’t additionally care about sufferers and docs greater than giving that concern lip service. It’s like that previous saying: You may have two out of three, however you possibly can’t have all three. One instance: A affected person was charged a no-show payment despite the fact that her “excuse” was “I used to be sitting with my husband who died the day of my appointment.” If I didn’t see it with my very own eyes I wouldn’t have believed it. Please, please, please allow us to as physicians push again on large enterprise which is making us all poorer. Younger individuals: Don’t assume it must be this fashion.
— Jody Whitehouse
The story
“AI docs needs to be licensed. Right here’s a framework to try this,” by Alon Bergman
The response
Alon Bergman’s considerate essay highlights the urgency of constructing a coherent federal framework for autonomous scientific AI. But the Utah pilot and the broader nationwide debate reveal a deeper governance hole that precedes questions of licensure or competency testing. Earlier than we are able to responsibly license an “AI physician,” we should first regulate what an AI system is allowed to be perceived as.
Latest occasions in Pennsylvania underscore this level. There, a client chatbot allegedly adopted the id of a licensed psychiatrist and supplied remedy‑fashion steerage underneath a fabricated license quantity. In Utah, the state’s regulatory sandbox approved an autonomous system to resume prescriptions for almost 200 medicines, with plans to part out doctor evaluation. These two instances seem totally different — one is misrepresentation, the opposite delegation — however they expose the identical lacking pillar: We lack a normal for the way AI techniques could current themselves, what authority sufferers are led to attribute to them, and who’s accountable as soon as a affected person depends on that interplay.
This hole issues as a result of AI‑mediated medical recommendation turns into unsafe lengthy earlier than we consider the accuracy of the recommendation itself. With out clear guidelines for id, accountability, knowledgeable consent, and actual‑world monitoring, sufferers could moderately assume that an AI system is licensed, supervised, or federally validated when none of these circumstances are true.
The result’s a distortion of belief that neither state‑degree experimentation nor federal gadget regulation is at the moment geared up to deal with. Bergman is true that the FDA’s static gadget framework can not hold tempo with adaptive fashions, and {that a} nationwide competency normal is required. However competency alone is inadequate. A licensing pathway have to be paired with guardrails that outline how AI techniques talk their function, how accountability is shared between builders and deploying establishments, and the way sufferers are knowledgeable in plain language, when an autonomous system is performing instead of a clinician.
With out these protections, even a extremely succesful mannequin dangers being deployed in ways in which outstrip public understanding and erode belief. The promise of AI in addressing workforce shortages is actual, notably for routine, decrease‑danger duties. However secure integration requires greater than demonstrating that AI can carry out at or above the median USMLE rating. It requires a governance construction that ensures sufferers perceive who’s caring for them, what these softwares can do, what the system is permitted to do, and who stands behind its choices. Till that basis is in place, the central query will not be merely whether or not AI is competent, however what the AI leads the affected person to consider and who’s answerable for that perception.
— Ediriweera Desapriya, Division of Pediatrics, College of Drugs, College of British Columbia
The story
“Tributes to Craig Venter and the genomics race are lacking one thing essential,” by Zachary Utz
The response
I beloved the message and the steadiness of this text. It by no means diminishes Venter’s creativity and affect whereas acknowledging that lots of of scientists, many NIH funded, but additionally from the U.Okay., Japan, France, and many others., had been vital. In addition they generated not simply sequence knowledge however shared know-how, bodily reagents, and genetic maps that constructed a scaffold onto which sequence knowledge from many sources might be overlaid. Including within the many non-U.S. contributors going again to not less than the Seventies may much more absolutely full the image.
— Jeff Murray, College of Iowa
