Saturday, December 7, 2013

Science, Diet, Health, Cognitive Dissonance, Opinion and Humility

Dr. Mike Eades of is blogging again and that's good for me, I have learned quite a lot over the years from his blog.  If he's overly contemptuous from time to time, he's also very skilled at teaching the scientific method as applied to health and diet.  There were a couple of posts that completely changed how I see human metabolism.  Thanks Mike!

In this post, he discusses the challenges in the business of helping people sort out dietary right from dietary wrong.  The title - Eat Less Move More and Die Anyway - points to the oft cited formula for how to change the world's predicted health care disaster (if everyone is sick, you can't pay for all the necessary meds and care).  The benefit of this simple approach is it is not intimidating - you might think "anyone can do this, even me."  The downside - the science that is available indicates that moving more and eating less does not help you dodge those nasty terminal endpoints of life that we would like avoid so that we can live long enough to die in our beds (as we used to say when I was a Patrolman trying not to get killed in the line of duty).  At the link above he details a 9 year study which proved fairly convincingly that a low fat, low calorie intervention with moderate exercise was not effective at combatting the diseases of civilization.

Not that you would have heard about that 9 year study, because if they mentioned that, they'd have to start saying things like "we never really knew whether low fat, low cal was good for you or not, but we were sure hoping it would be.  Sorry about all your dead relatives and all those meds you are taking to help with hypertension, gout, and diabetes."  As to that point, one might be concerned that government health care authorities made recommendations that may be killing us, and may be making us sick and at the same time enormous consumers of the medications that sick people get in this country, AND that those recommendations were not proven by science.  The implications are immense, but that's another discussion.

Nor were you likely to have heard about these studies, which could have changed the debate all by themselves (these quotes are also from Mike Eades' blog):

"A couple of years ago, Ron Krauss, as mainstream a researcher as you could find and holder of all sorts of academic credentials, started thinking that maybe saturated fat wasn’t the demon everyone thought it was. He dug up all the studies he could find looking at whether or not saturated fat actually did cause heart disease. He put all these studies together in a meta-analysis, and got it published in the prestigious American Journal of Clinical Nutrition (AJCN). The article, titled Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease, came to the following conclusion:
there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.
"And, as if to rub salt in the wounds of the lipid hypothesis folks, Krauss published another paper in the same issue of the same journal looking at a nutrient that often replaces saturated fat.
"This second paper, titled Saturated fat, carbohydrate, and cardiovascular disease, concluded
there are few epidemiologic or clinical trial data to support a benefit of replacing saturated fat with carbohydrate. Furthermore, particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity.
The point Mike Eades is grinding on is the abuse of the mantle of science by the combination of the "gurus" and the science journalists, who should know better than to simply babble on about the results of studies that, almost always, can't show cause and effect, but are treated as if they do.

You can see the resulting cognitive dissonance here, where Forbes reviews the book Grain Brain:
Some in the nutrition and medical communities take issue with Perlmutter’s premise and prescription. Several critics, while not questioning the neurological risks of a high-carb diet, have pointed out that readers may interpret his book as a green light to load up on meat and dairy instead, a choice that has its own well-documented cardiovascular heart risks.
“Perlmutter uses bits and pieces of the effects of diet on cognitive outcomes — that obese people have a higher risk of cognitive impairment, for example — to construct an ultimately misleading picture of what people should eat for optimal cognitive and overall health,” St. Catherine University professor emerita Julie Miller Jones, Ph. D., told the website FoodNavigator-USA.
If it is so dangerous to load up on a meat and dairy based diet, which of course is not what low carbers typically advocate, why can't they show one single intervention study in which people eat that way have poor mortality results?  Answer - because when people are put on a diet like that they don't get sick.  The thing that's not there can be ignored by those who still believe what has never been true.

Science is supposed to be about conflict, because the scientific method is fundamentally about the human condition.  Humans are not good at doing truth.  Humans are subject to all kinds of bias.  Being a scientist does not cure one from being human.  Thus, the first response to all scientific efforts should be to think "that's BS, how could they prove that?"  Perversely, we consult scientists and ask them their opinions as if that's the same as the scientific method.  Things that scientists say are judged authoritative.  This leads to the "You are an idiot and I'm a genius" argument that is all over the web, in which a person grades their own homework and tells the world how they know the science like no other.  It is certainly tough to get a blog audience by saying, "gee, we don't really know, but this is what I think".  When science is conclusive - drop an apple, it falls, debate about gravity over - we don't have much to fight over.  The presence of web-fighting about something is evidence of weak science.

Because the science of diet and health is so immature, humility will serve one well.  Rather than pretending to know what isn't known, I think it's more useful to focus on what works - for yourself, for your clients, while continuing the search for truth.  Human nature gets in the way of this approach, ego demands we proclaim our intellectual victories and pummel the ignorant authorities proved wrong daily, but that's the struggle of being human.  As it seems to be for Mike Eades, it is hard for me not to feel contemptuous and angry about folks who should know better, who hold positions of authority in government and as industry leaders, who say "this is true" when, based on the scientific method they claim supports them, "this may or may not be true."

What I think, and what has worked for me, is that excess blood sugar is the worst thing one can do to oneself if the goal is to avoid early decline, physical and mental degeneration, and the diseases of civilization.  The best way to regulate blood sugar is to avoid destroying your body's ability to regulate it for you.  The body has an ancient mechanism that works well when not bombarded by too much of the agricultural monsters we produce for ourselves today (primarily sugar and wheat, with industrial seed oils playing a role via enhanced inflammation). You will die one day, I will die one day, the point is what do you get to make of the days you have before that terminal end point?  The sick have fewer choices, and the sick take choices away from the ones that they love.  Striving for thriving health is the shizzle, I think, if shizzle still means what it did the first time I heard that ten years ago.  My conjecture may not work for everyone.  My conjecture has quite a bit of supporting evidence in the scientific literature but is far from proved true (although may be able to do something about that before I reach my terminal end point).

You can test this conjecture on yourself with ease.  If you restrict carbs with a well formulated high fat, moderate protein diet, does your blood sugar regulation improve?  Do you have less hunger?  Can you start to win the battles with your food obsessions?  Does real food begin to taste better?  Do your aches and pains feel less achy?  Are you sleeping more soundly?  Is your belly getting smaller?  Has the government stopped recommending foods that used to make you fat, lazy and sick?  (Just kidding on that last part, that's not going to happen anytime soon because they haven't exhausted their ability to try to prove what they said was proven 40 years ago).

So don't take some blogger's word for it, or some person's word for it who has a PHD after their name.  Do the experiment on yourself, the results can be (if the experiment is done correctly) more significant than a lifetime of expensive science performed by folks who you never met.

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