6 ms·

The beauty is there is always plausible deniability. But take diabetes (I'm speaking type 2 here, to be ckear) as an example: we know there are safe dietary int

The beauty is there is always plausible deniability. But take diabetes (I'm speaking type 2 here, to be ckear) as an example: we know there are safe dietary interventions that result in controlled blood sugars and significant reductions in medication use. These diets have study after study showing their safety. Yet, when a person is diagnosed as diabetic, they are told to eat a diet opposite of what the studies show will manage their diabetes, all while being given a prescription to take more meds. Dietitians are openly hostile to a diet that literally saves people's limbs. If you look at how the sponsorship model works in these orgs, companies are essentially buying the ability to provide continuing education. And while I don't necessarily believe the sponsors are out-right lying, I do think they are presenting a very one-sided view. There is a further problem that we saw as soon as the USDA published its food guide (a document that hasn't changed substantially in 30 years): the government now had a baseline of what research should try to prove. If your hypothesis didn't follow the orthodoxy, you lose your funding and perhaps your job. Diabetes is a complex illness. We don't know the actual cause, and we don't know what actually will cure it, but today's pharmacological path sells lots of drugs and results in lots of neuropathy, amputations, heart disease and dementia. Hardly what I would call managing. It's not a given that a strong focus on diet would change anything, but it might. It's worth a try. I fully admit to being biased. It is not only possible, but likely, that I overstated my case on TLAs caring more for themselves. Certainly, tuberculosis organizations did wonderful things. It does make me wonder if we passed a point somewhere where corporate interests in profits at any expense overshadowed the health of people. I don't like that hypothesis (I don't believe people, in general, are that selfish), so I am actively looking for alternatives. Understanding the cause helps us solve the problem.

dalke 12y ago
The ugly is there's always the possibility of falsely accusing people. Is there any way for the ADA to show itself unaffected other than getting rid of sponsorship, and of it does, would the result be worse for those with diabetes? I find it easier to believe that a diabetes researcher whose parents have diabetes is less likely to be concerned about the profit/loss statement of a sponsoring company and more concerned about the parents. I also find it harder than you to believe there is consistent capture across all research organizations in the world. I agree that the USDA food guide is incorrectly and unduly influenced by money and politics. But that's not the only food guide in the world and the US isn't the only research system. Other countries also have different economic goals that the US system. If a country has a single-payer national health care, and fund health research, then it's more likely to fund research in ways to reduce its health care payments. While I agree that pharma money can and does buy influence, especially when things are ambiguous, I think that big inconsistencies across different health care and research systems is hard to pull off. I also think orthodoxy is hard to enforce in the way you suggest, especially since there's a long practice of unorthodox publications becoming part of the new orthodoxy, even to the point of winning the Nobel Prize. Regarding diet, the diabetes literature is vast and I know very little of it. I know that those with diabetes are told to stop eating as much sugar. I'm surprised to hear that the opposite - eating more sugar - is the better diet. It's more likely that I don't understand your point. In a cursory review (I read care.diabetesjournals.org/content/34/1/14.full ) it seems that: > Observational studies have also shown that diets rich in vegetables and low in red meat and whole-fat dairy products are associated with a decreased risk of diabetes, whereas dietary patterns rich in red meats, processed foods, refined grains, and sweets increase diabetes risk > Recently, a clinical trial showed that, compared with a low-fat diet, a MedDiet allowed better glycemic control and delayed the need for antidiabetes drug treatment in patients with newly diagnosed diabetes (11). However, the role of the MedDiet in the prevention of diabetes has not been tested in a clinical trial. Which safe dietary interventions studies are you talking about? How are they different from, say, the CDC recommendations?
- SoftwareMaven 12y ago
  I would bet most researchers have good intentions. However, it is very difficult to see things that your own salary requires you not to see. If your paycheck depends on researching how drugs impact diabetes, it doesn't matter how much you believe in diet as a method of control, your research will reflect drugs. When the USDA bought into the low fat dogma in the early 80s, suddenly all research dollars went to people who would perform studies showing how bad fat was. People who disagreed were black-balled. On the topic of other countries, it is interesting. France has largely kept its traditional diet (which is incredibly high in saturated fat), but almost all of the English speaking world has followed the US into a high-sugar, low-fat, grain-based, heart-unhealthy diet, whether grain is a primary agricultural product of that country or not. In the end, I don't think it is all about money. Some of it is pure obtuseness. A recent 125 page report detailed the effects of salt consumption on health risk. It showed a significant increase in risk as salt consumption dropped below 2300mg/day. The Institute of Medicine has changed its recommendation as a result, but the AHA has decided 1500mg is still the right target for everybody. This is not a result of a financial agreement; instead, it seems to be more a result of an unwillingness to admit they were wrong. That's a powerful pull, because once there is a crack in the exterior, the whole wall may crumble. In the end, I could be wrong. I'm making deductions based on appearances and behaviors coupled with the massive funds (millions and millions of dollars) being funneled into these organizations. I'm sure the researchers sitting in the labs are doing the best they can within a set of constraints dictated by the funding organizations. On the diabetesjournals.org article, my comment would be two-fold: First, observational studies are shit. You cannot make conclusions from them the vast majority of the time. It was smoking that brought those studies into vogue, where relative risks were in the range of 2000% to 10000% (compare that to 25% in diet studies) and absolute risks were in 20-40% (compare that to maybe 1.5% in a "highly successful" diet study). Second, I'll leave this[1] reference. Dr. Richarch Feinman came to nutrition after teaching biochemistry in medical school. The biochemistry was so abundantly clear that he was shocked when he found out the orthodox position in nutrition is almost diametrically opposed to the biochemistry. Diabetes is a disease of carbohydrate intolerance, recommending 6-11 servings of carbohydrates a day is silly. Now, what is missing is the causal link between over-consumption of carbohydrates and diabetes. My own hypothesis is that there are a few components: a genetic component that defines maximum tolerance and a dietary component influenced by certain foods that tend to put the body into an inflammatory state. If one is healthy, I think one can eat just about any real food diet and remain healthy, whether paleo, low carb, Mediterranean or ovo-lacto vegetarian (vegan requires supplementation, so I can't include it in the list). If, on the other hand, one has a damaged body from eating too many not-quite-food products, the equation shifts and looks much more like what treating Type 2 diabetes looks like. 1. http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/f...

dalke 12y ago

The ugly is there's always the possibility of falsely accusing people. Is there any way for the ADA to show itself unaffected other than getting rid of sponsorship, and of it does, would the result be worse for those with diabetes? I find it easier to believe that a diabetes researcher whose parents have diabetes is less likely to be concerned about the profit/loss statement of a sponsoring company and more concerned about the parents. I also find it harder than you to believe there is consistent capture across all research organizations in the world. I agree that the USDA food guide is incorrectly and unduly influenced by money and politics. But that's not the only food guide in the world and the US isn't the only research system. Other countries also have different economic goals that the US system. If a country has a single-payer national health care, and fund health research, then it's more likely to fund research in ways to reduce its health care payments. While I agree that pharma money can and does buy influence, especially when things are ambiguous, I think that big inconsistencies across different health care and research systems is hard to pull off. I also think orthodoxy is hard to enforce in the way you suggest, especially since there's a long practice of unorthodox publications becoming part of the new orthodoxy, even to the point of winning the Nobel Prize. Regarding diet, the diabetes literature is vast and I know very little of it. I know that those with diabetes are told to stop eating as much sugar. I'm surprised to hear that the opposite - eating more sugar - is the better diet. It's more likely that I don't understand your point. In a cursory review (I read care.diabetesjournals.org/content/34/1/14.full ) it seems that: > Observational studies have also shown that diets rich in vegetables and low in red meat and whole-fat dairy products are associated with a decreased risk of diabetes, whereas dietary patterns rich in red meats, processed foods, refined grains, and sweets increase diabetes risk > Recently, a clinical trial showed that, compared with a low-fat diet, a MedDiet allowed better glycemic control and delayed the need for antidiabetes drug treatment in patients with newly diagnosed diabetes (11). However, the role of the MedDiet in the prevention of diabetes has not been tested in a clinical trial. Which safe dietary interventions studies are you talking about? How are they different from, say, the CDC recommendations?

SoftwareMaven 12y ago
I would bet most researchers have good intentions. However, it is very difficult to see things that your own salary requires you not to see. If your paycheck depends on researching how drugs impact diabetes, it doesn't matter how much you believe in diet as a method of control, your research will reflect drugs. When the USDA bought into the low fat dogma in the early 80s, suddenly all research dollars went to people who would perform studies showing how bad fat was. People who disagreed were black-balled. On the topic of other countries, it is interesting. France has largely kept its traditional diet (which is incredibly high in saturated fat), but almost all of the English speaking world has followed the US into a high-sugar, low-fat, grain-based, heart-unhealthy diet, whether grain is a primary agricultural product of that country or not. In the end, I don't think it is all about money. Some of it is pure obtuseness. A recent 125 page report detailed the effects of salt consumption on health risk. It showed a significant increase in risk as salt consumption dropped below 2300mg/day. The Institute of Medicine has changed its recommendation as a result, but the AHA has decided 1500mg is still the right target for everybody. This is not a result of a financial agreement; instead, it seems to be more a result of an unwillingness to admit they were wrong. That's a powerful pull, because once there is a crack in the exterior, the whole wall may crumble. In the end, I could be wrong. I'm making deductions based on appearances and behaviors coupled with the massive funds (millions and millions of dollars) being funneled into these organizations. I'm sure the researchers sitting in the labs are doing the best they can within a set of constraints dictated by the funding organizations. On the diabetesjournals.org article, my comment would be two-fold: First, observational studies are shit. You cannot make conclusions from them the vast majority of the time. It was smoking that brought those studies into vogue, where relative risks were in the range of 2000% to 10000% (compare that to 25% in diet studies) and absolute risks were in 20-40% (compare that to maybe 1.5% in a "highly successful" diet study). Second, I'll leave this[1] reference. Dr. Richarch Feinman came to nutrition after teaching biochemistry in medical school. The biochemistry was so abundantly clear that he was shocked when he found out the orthodox position in nutrition is almost diametrically opposed to the biochemistry. Diabetes is a disease of carbohydrate intolerance, recommending 6-11 servings of carbohydrates a day is silly. Now, what is missing is the causal link between over-consumption of carbohydrates and diabetes. My own hypothesis is that there are a few components: a genetic component that defines maximum tolerance and a dietary component influenced by certain foods that tend to put the body into an inflammatory state. If one is healthy, I think one can eat just about any real food diet and remain healthy, whether paleo, low carb, Mediterranean or ovo-lacto vegetarian (vegan requires supplementation, so I can't include it in the list). If, on the other hand, one has a damaged body from eating too many not-quite-food products, the equation shifts and looks much more like what treating Type 2 diabetes looks like. 1. http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/f...