4 ms·

Okay: 1. I hope everyone realises that reading one abstract online does not constitute medical advice, or even the true state of scientific knowledge on the fi

by frossie 17y ago

Okay: 1. I hope everyone realises that reading one abstract online does not constitute medical advice, or even the true state of scientific knowledge on the field. 2. If regardless you do intend to base your life decisions based on something you read on-line, I direct you to the publications of the Cochrane Collaboration - the gold standard in meta-analyses and as close as you can get to the final word on the current state of the publication field. In this particular case, the relevant Cochrane reports seem [I am not a doctor nor do I play one on HN] to say two things: 1. Dietary changes do affect your cardiovascular risk 2. But they have to be maintained for long periods (> 2 years) and the vast majority of people are not compliant so in practice they are ineffective. http://www.cochrane.org/reviews/en/ab002137.html http://www.cochrane.org/reviews/en/ab002137.html http://www.cochrane.org/reviews/en/ab002128.html http://www.cochrane.org/reviews/en/ab002128.html etc.

gregwebs 17y ago
Cochrane is good, but not infallible. If you read farther down in your first link: There was no significant effect on total mortality. Do you care if you have reduced your risk of CVD death, if risk of other deaths increase? The second review is pretty much worthless for the point at hand as it is just determining if dietary advice affects risk factors (and the main benefit found- total LDL reduction- is not a good risk factor anyways).
- frossie 17y ago
  Do you care if you have reduced your risk of CVD death, if risk of other deaths increase? I might if I have a family history of heart disease. I might if I have confounding factors for CVD (like being on oral contraceptives). The point is, this is why people have doctors who went to medical school. Dr Google doesn't know about your particular situation. Moreover, if I may channel badscience.net for a minute, I think the whole "science says don't eat butter! science says butter is okay!" ping pong reporting undermines public understanding of the scientific process. While this complaint is usually addressed at traditional media, we are in fact being complicit by submitting/upvoting these kind of stories, since we are essentially meta-publishing them. I do actually agree with you about the fact that total mortality is the most appropriate indicator for people to take to heart, and I do agree that there is a lot of evidence that points to the fact that cholesterol levels are not as correlated with mortality as people who sell you statins will have you think. But that is beside my point.
  - gregwebs 17y ago
    I am glad we are very like-minded, but I will continue to focus on the few differences: The point is, this is why people have doctors who went to medical school. The average doctor knows very little about nutrition and exercise. They are lucky to spend a week's worth of time on it in medical school and generally just repeat what they have been told on the subject. Following your doctor's advice on these issues is a sure way to ruin your health.
    - frossie 17y ago
      Following your doctor's advice on these issues is a sure way to ruin your health. I actually don't agree with that. While I am willing to believe that the average doctor's understanding of nutrition is incomplete, I doubt the average punter's is any better. Most people I personally know that "self-medicate" with advice they found on the Internet or read from some popular pseudo-science book seem to be engaging in magical thinking, and/or doing a great job ruining their own health by themselves. Perhaps you run with a more informed crowd.
      - gregwebs 17y ago
        I agree that this is a big problem. However, there aren't just 2 alternatives: your doctor's pseudo science or somebody else. Another alternative is to not listen to any advice at all and just eat what you want. America might actually be much healthier today if the government (including through doctors) never started pushing their nutritional advice on us. I do agree that taking responsibility for your own health is a difficult, time consuming task that may be highly wasted if one can't distinguish between valid and invalid information. I wish I could figure out a way to help people with this process. If I show someone scientifically dense information their eyes glaze over.

by frossie 17y ago

gregwebs 17y ago

Cochrane is good, but not infallible. If you read farther down in your first link: There was no significant effect on total mortality. Do you care if you have reduced your risk of CVD death, if risk of other deaths increase? The second review is pretty much worthless for the point at hand as it is just determining if dietary advice affects risk factors (and the main benefit found- total LDL reduction- is not a good risk factor anyways).

frossie 17y ago
Do you care if you have reduced your risk of CVD death, if risk of other deaths increase? I might if I have a family history of heart disease. I might if I have confounding factors for CVD (like being on oral contraceptives). The point is, this is why people have doctors who went to medical school. Dr Google doesn't know about your particular situation. Moreover, if I may channel badscience.net for a minute, I think the whole "science says don't eat butter! science says butter is okay!" ping pong reporting undermines public understanding of the scientific process. While this complaint is usually addressed at traditional media, we are in fact being complicit by submitting/upvoting these kind of stories, since we are essentially meta-publishing them. I do actually agree with you about the fact that total mortality is the most appropriate indicator for people to take to heart, and I do agree that there is a lot of evidence that points to the fact that cholesterol levels are not as correlated with mortality as people who sell you statins will have you think. But that is beside my point.
- gregwebs 17y ago
  I am glad we are very like-minded, but I will continue to focus on the few differences: The point is, this is why people have doctors who went to medical school. The average doctor knows very little about nutrition and exercise. They are lucky to spend a week's worth of time on it in medical school and generally just repeat what they have been told on the subject. Following your doctor's advice on these issues is a sure way to ruin your health.
  - frossie 17y ago
    Following your doctor's advice on these issues is a sure way to ruin your health. I actually don't agree with that. While I am willing to believe that the average doctor's understanding of nutrition is incomplete, I doubt the average punter's is any better. Most people I personally know that "self-medicate" with advice they found on the Internet or read from some popular pseudo-science book seem to be engaging in magical thinking, and/or doing a great job ruining their own health by themselves. Perhaps you run with a more informed crowd.
    - gregwebs 17y ago
      I agree that this is a big problem. However, there aren't just 2 alternatives: your doctor's pseudo science or somebody else. Another alternative is to not listen to any advice at all and just eat what you want. America might actually be much healthier today if the government (including through doctors) never started pushing their nutritional advice on us. I do agree that taking responsibility for your own health is a difficult, time consuming task that may be highly wasted if one can't distinguish between valid and invalid information. I wish I could figure out a way to help people with this process. If I show someone scientifically dense information their eyes glaze over.