16 ms·

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 de

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
My major point is that there are counter-examples, so the biases you point out are likely not the primary motivators for the organizations. I am not competent to judge the ongoing discussions on diet. Personally, I agree with your last paragraph. I did try to read the article but it depends on a large amount of background that I don't have. I note that Feinman references an observational study, so probably does not consider that methodology as shit as you do. I note also the declaration of interests section, where we learn that "Richard Feinman writes reviews for Fleishman-Hillard, whose client is the Corn Refiners Association and he has received grant support from the Veronica and Robert C. Atkins Foundation." The others work as consultants, are funded by, or in a consulting capacity for Atkins, for companies like Jenny Craig and McDonald's, for the pharmaceutical company Eli Lilly, and for a company which produces a low-carbohydrate meal replacement If the argument "If your paycheck depends on researching how drugs impact diabetes ..." has merit then surely the argument "If your paycheck depends on researching how refined corn oil and low carbs impact diabetes" also has merit. Why do you believe Feinman's work is any less biased by money than that of someone funded by the ADA? For some levity, this topic easily brings to mind Woody Allen's "Sleeper": "You mean there was no deep fat? No steak or cream pies or... hot fudge?" / "Those were thought to be unhealthy... precisely the opposite of what we now know to be true." As well as a scene in the 1951 film "The Day the Earth Stood still": when one doctor talks to the other: "[He] Says their medicine's much more advanced." / "He was very nice about it, but he made me feel like a third-class witch doctor." ... while handing the other doctor a cigarette. (This caused the audience to crack up when I saw it about 15 years ago.)
- SoftwareMaven 12y ago
  So epidemiological studies can answer whether something isn't bad, but they can't answer whether it is bad. If you think eating red meat it bad, and you watch a million people eat red meat or not, and there aren't adverse effects, it has given you pretty good evidence red meat isn't bad. However, if you see a difference in the red meat group, you still haven't shown red meat it bad. The problem is they get used incorrectly all the time, which is why I consider them nearly useless. I actually came to this more nuanced view after having conversations with Dr. Feinman about them. :) I think it's a completely valid question to ask why Feinman, Westman, et al, who all have financial ties to the their viewpoint, should be trusted. All scientists are financial vested in their results in some way, so you always have to be careful. (An aside: Dr. Feinman is an interesting case study, though: he was a biochemistry instructor at a medical school. He had no training in nutrition at all. Because of the biochemistry, he taught his students that fat is a great energy source and too many carbs are dangerous. At some point, he was told he wasn't allowed to teach that anymore, because it went against the nutrition orthodoxy (even though it followed the biochemistry), which was when he entered the nutrition arena.) Fortunately, we have better methods than check stubs to determine whether to accept something. I look at declarations as indicators of possible bias, but, in the end, a study is good or it is not good. It's unfortunate that it literally requires reading and understanding scientific studies if you want to figure this stuff out, because it is all so bogged down in politics and economics. It's even more unfortunate that many studies get a lot of press that fall squarely in the "not good" category. I've seen great studies come from researchers who set out to "prove" vegetarianism was the best diet. I've seen great studies from people paid by Atkins and by Ornish (a noted very low fat vegetarian proponent). Some of the worst studies I've seen have come out of Harvard, but even those aren't uniformly bad. The weird thing about nutrition is there is this huge disconnect between the science and the organization supposedly representing the science. The American Heart Association has studies that show saturated fat is not unhealthy, yet, as an organization, it continues its zeitgeist against it. The science is clear that sugar is absolutely horrible for diabetics, yet the ADA continues to tell diabetics it's fine to eat. Registered dietitians get continuing education credits from classes literally taught by McDonalds and CocaCola. I cannot say with complete confidence that it is because of their sponsors, but I do think, at a minimum, the influence of corporate sponsorship as a factor in resisting change is a reasonable hypothesis that fits the data better than any other hypothesis. So, is it possible that the ADA doesn't come out strongly for a low carb diet for Type 2 diabetics for a reason other than the fact they get most of their sponsorship money from companies that produce insulin and other diabetes drugs? Sure. A certain amount of it is inertia based on old, bad science, but I think the sponsorship money acts as a huge anchor, keeping that inertia in place.

dalke 12y ago

My major point is that there are counter-examples, so the biases you point out are likely not the primary motivators for the organizations. I am not competent to judge the ongoing discussions on diet. Personally, I agree with your last paragraph. I did try to read the article but it depends on a large amount of background that I don't have. I note that Feinman references an observational study, so probably does not consider that methodology as shit as you do. I note also the declaration of interests section, where we learn that "Richard Feinman writes reviews for Fleishman-Hillard, whose client is the Corn Refiners Association and he has received grant support from the Veronica and Robert C. Atkins Foundation." The others work as consultants, are funded by, or in a consulting capacity for Atkins, for companies like Jenny Craig and McDonald's, for the pharmaceutical company Eli Lilly, and for a company which produces a low-carbohydrate meal replacement If the argument "If your paycheck depends on researching how drugs impact diabetes ..." has merit then surely the argument "If your paycheck depends on researching how refined corn oil and low carbs impact diabetes" also has merit. Why do you believe Feinman's work is any less biased by money than that of someone funded by the ADA? For some levity, this topic easily brings to mind Woody Allen's "Sleeper": "You mean there was no deep fat? No steak or cream pies or... hot fudge?" / "Those were thought to be unhealthy... precisely the opposite of what we now know to be true." As well as a scene in the 1951 film "The Day the Earth Stood still": when one doctor talks to the other: "[He] Says their medicine's much more advanced." / "He was very nice about it, but he made me feel like a third-class witch doctor." ... while handing the other doctor a cigarette. (This caused the audience to crack up when I saw it about 15 years ago.)

SoftwareMaven 12y ago
So epidemiological studies can answer whether something isn't bad, but they can't answer whether it is bad. If you think eating red meat it bad, and you watch a million people eat red meat or not, and there aren't adverse effects, it has given you pretty good evidence red meat isn't bad. However, if you see a difference in the red meat group, you still haven't shown red meat it bad. The problem is they get used incorrectly all the time, which is why I consider them nearly useless. I actually came to this more nuanced view after having conversations with Dr. Feinman about them. :) I think it's a completely valid question to ask why Feinman, Westman, et al, who all have financial ties to the their viewpoint, should be trusted. All scientists are financial vested in their results in some way, so you always have to be careful. (An aside: Dr. Feinman is an interesting case study, though: he was a biochemistry instructor at a medical school. He had no training in nutrition at all. Because of the biochemistry, he taught his students that fat is a great energy source and too many carbs are dangerous. At some point, he was told he wasn't allowed to teach that anymore, because it went against the nutrition orthodoxy (even though it followed the biochemistry), which was when he entered the nutrition arena.) Fortunately, we have better methods than check stubs to determine whether to accept something. I look at declarations as indicators of possible bias, but, in the end, a study is good or it is not good. It's unfortunate that it literally requires reading and understanding scientific studies if you want to figure this stuff out, because it is all so bogged down in politics and economics. It's even more unfortunate that many studies get a lot of press that fall squarely in the "not good" category. I've seen great studies come from researchers who set out to "prove" vegetarianism was the best diet. I've seen great studies from people paid by Atkins and by Ornish (a noted very low fat vegetarian proponent). Some of the worst studies I've seen have come out of Harvard, but even those aren't uniformly bad. The weird thing about nutrition is there is this huge disconnect between the science and the organization supposedly representing the science. The American Heart Association has studies that show saturated fat is not unhealthy, yet, as an organization, it continues its zeitgeist against it. The science is clear that sugar is absolutely horrible for diabetics, yet the ADA continues to tell diabetics it's fine to eat. Registered dietitians get continuing education credits from classes literally taught by McDonalds and CocaCola. I cannot say with complete confidence that it is because of their sponsors, but I do think, at a minimum, the influence of corporate sponsorship as a factor in resisting change is a reasonable hypothesis that fits the data better than any other hypothesis. So, is it possible that the ADA doesn't come out strongly for a low carb diet for Type 2 diabetics for a reason other than the fact they get most of their sponsorship money from companies that produce insulin and other diabetes drugs? Sure. A certain amount of it is inertia based on old, bad science, but I think the sponsorship money acts as a huge anchor, keeping that inertia in place.