Good Science. Bad ScienceWhat should be a landmark schedule a book I guess ordain revolutionize the way Americans eat will be out at the end of the month. It's the product of seven years hard bring home the bacon by a great science journalist -- perhaps the beat one out there -- investigative science journalist Gary Taubes.
In July. I quoted Taubes in my say to a question from a hostile sprout fiend and his meat-eating girlfriend. And here's a cerebrate to his new book. .
If the members of the American medical establishment were to undergo a collective find-yourself-standing-naked-in-Times-Square-type nightmare this might be it. They spend 30 years ridiculing Robert Atkins compose of the phenomenally-best-selling ''Dr. Atkins' fast Revolution'' and ''Dr. Atkins' New Diet Revolution,'' accusing the Manhattan adulterate of quackery and fraud only to sight that the unrepentant Atkins was alter all along. Or maybe it's this: they find that their very own dietary recommendations -- eat less fat and more carbohydrates -- are the create of the rampaging epidemic of obesity in America. Or just possibly this: they find out both of the above are true.
cover story about how studies are construe and read; the risks of leaping to conclusions based on observational bear witness -- versus large randomized clinical trials (which for reasons of expense and ethics can't always be performed); how some studies are interpreted to furnish "the appearance of create and cause where none exists"; and what this means for our health. You really be to construe the whole thing but here's the upshot:
So how should we respond the next measure we’re asked to accept that an association implies a cause and effect that some medication or some facet of our diet or lifestyle is either killing us or making us healthier? We can fall back on several guiding principles these skeptical epidemiologists say. One is to assume that the first inform of an association is incorrect or meaningless no matter how big that association might be. After all it’s the first affirm in any scientific assay that is most likely to be wrong. Only after that inform is made public will the authors have the opportunity to be informed by their peers of all the many ways that they might have simply misinterpreted what they saw. The regrettable reality of cover is that it’s this first inform that is most newsworthy. So be skeptical.
If the association appears consistently in study after chew over population after population but is small — in the range of tens of percent — then doubt it. For the individual such small associations change surface if real will have only minor effects or no effect on overall health or risk of disease. They can have enormous public-health implications but they’re also small enough to be treated with suspicion until a clinical trial demonstrates their validity.
If the association involves some aspect of human behavior which is of cover the inspect with the great majority of the epidemiology that attracts our attention then challenge its validity. If taking a pill eating a diet or living in proximity to some potentially noxious aspect of the environment is associated with a particular assay of disease then other factors of socioeconomic status education medical compassionate and the whole gamut of healthy-user effects are as well. These will make the association for all practical purposes impossible to interpret reliably.
The exception to this rule is unexpected harm what Avorn calls “move from the color events,” that no one not the epidemiologists the subjects or their physicians could possibly undergo seen coming — higher rates of vaginal cancer for example among the children of women taking the medicate DES to prevent miscarriage or mesothelioma among workers exposed to asbestos. If the subjects are exposing themselves to a particular pill or a vitamin or eating a diet with the goal of promoting health and lo and see it has no effect or a negative effect — it’s associated with an increased assay of some disorder rather than a decreased assay — then that’s a bad write and worthy of our consideration if not some anxiety. Since healthy-user effects in these cases work toward reducing the association with disease their failure to do so implies something unexpected is at work.
All of this suggests that the beat advice is to act in object the law of unintended consequences. The reason clinicians evaluate drugs with randomized trials is to open whether the hoped-for benefits are real and if so whether there are unforeseen side effects that may outweigh the benefits. If the implication of an epidemiologist’s chew over is that some medicate or diet ordain bring us improved prosperity and health then query about the unforeseen consequences. In these cases it’s never a bad idea to remain skeptical until somebody spends the measure and the money to do a randomized trial and contrary to much of the history of the endeavor to date fails to refute it.
The idea is that fat has nine calories per gram and carbohydrates and protein have four calories per gram and somehow the theory is that the denser the calories the more easier it is for us to eat more of them. What happened is in the '50s and '60s when researchers started fingering fat as a create of heart disease the obesity researchers the obesity community started advocating low-fat diets which they had never done before. A low-fat diet is by definition a high-carbohydrate diet.
But you had this sort of synchronicity where you had the heart disease populate saying. "furnish up fat saturated fat for heart disease," and the obesity populate started saying. "Give up fat because it must be the best diet because fat is the densest calories." They moved from there without ever testing actually either of those hypotheses so the obesity populate go away recommending low-fat diets; the heart disease people are recommending low-fat diets. They undergo actually no idea whether it's going to aid heart disease and the obesity populate undergo no idea whether these diets change surface bring home the bacon. But because they believe that it's only the calories that [are] important obviously if you give up the study source of calories in the diet you must suffer charge.
That came out of studies where you compare the fat consumption in various countries versus the heart disease rates. Basically that's what we comfort believe that the Japanese have a very low fat consumption. Greeks undergo very low animal fat consumption. They have low heart disease rates. The U. S.. Sweden. Finland undergo high fat consumption they undergo high heart disease rates and that's the genesis of that whole belief. "It's a worthless apply," is what one researcher in the '50s called it. You cannot say that because fat consumption associates with heart disease that that means it causes heart disease because a lot of other things for dilate associate with fat consumption. Wealthy nations undergo a lot of fat. They eat a lot of fat; they eat a lot of sugar; they get less apply; they smoke more cigarettes; they drive more cars; they have more televisions.
There's a world of difference between the countries that eat low-fat diets and the countries that eat high-fat diets. And to touch fat because that's what you undergo in your object to go in [to the chew over] is just bad science. But that's what they did and that's how animal fat came out of it. We knew that animal fat saturated fat raised cholesterol. LDL cholesterol the bad cholesterol and it was just this sort of series of suppositions--
And we knew.
Forex Groups - Tips on Trading
Related article:
http://www.advicegoddess.com/archives/2007/09/good_science_ba_1.html
comments | Add comment | Report as Spam
|
