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Preview: Comments on Whole Health Source: Modern Diet-Health Epidemiology: a Self-Fulfilling...

Comments on Whole Health Source: Modern Diet-Health Epidemiology: a Self-Fulfilling Prophecy? Part I





Updated: 2018-04-25T03:20:05.467-07:00

 



Dan, The fact that you read this blog places your...

2009-04-28T22:07:00.000-07:00

Dan,

The fact that you read this blog places your outside of the category of guys who don't shave and don't care about their health.

But coarse hairs-- you'd better watch out!



Oops. I'm short, shave infrequently, unmarried, a...

2009-04-27T20:49:00.000-07:00

Oops. I'm short, shave infrequently, unmarried, and...well you get the idea. I also have course hairs growing out of my ears (associated with heart disease in a study from long ago). I don't want to shave--can I pluck my ears, or shave some mice instead?



Sushil, I agree -- that's why I suggested Crocs. ...

2009-04-10T14:29:00.000-07:00

Sushil, I agree -- that's why I suggested Crocs. :)



Put a loose shoe on one foot and a tight one on th...

2009-04-10T14:26:00.000-07:00

Put a loose shoe on one foot and a tight one on the other.



"Good point, it might be good to test different ty...

2009-04-10T08:47:00.000-07:00

"Good point, it might be good to test different types of shoes too, like high heels."

I say we put mice in tiny Crocs.



Jenny,I did see your post. Yet another reason to ...

2009-04-09T20:30:00.000-07:00

Jenny,

I did see your post. Yet another reason to wonder what exactly they were measuring.

Homertobias,

Yes, intervention trials are terribly expensive. I don't think that justifies using observational data to form public health advice though, unless it's a massive link like the one between smoking and lung cancer. The DART trial was published in 1989 in the Lancet. I had to photocopy it at my library to get a copy.

Chris,

Good points. I revised the post to add a couple of the things you mentioned.

Aaron,

I appreciate the encouragement.

Bogartg1.

Yes there are a million different views on diet and health. That's why it's important to stay grounded and keep in mind what healthy traditional cultures were doing. That's the only proven model.

Phantamere,

Good point, it might be good to test different types of shoes too, like high heels.



The MD says "Budgets are tight. Could we try milli...

2009-04-09T14:27:00.000-07:00

The MD says "Budgets are tight. Could we try millipedes"? (-:



:-) @ phanamere!Great post as usual, Stephan!

2009-04-09T13:05:00.000-07:00

:-) @ phanamere!

Great post as usual, Stephan!



I would like to suggest that each mouse could pote...

2009-04-09T08:03:00.000-07:00

I would like to suggest that each mouse could potentially serve as its own control, wearing two tight shoes and two loose shoes apiece - thus reducing the effect of inter-subject biological variability. The pattern of loose-tight shoe assignment for each mouse should ideally be randomized to control for any possible "lateral" or "symmetry" effect on bunion formation. Compliance may well be an issue with the mice so their level of adherence to the shoe-wearing protocol must be rigorously documented and included as an independent variable during analysis. That said, we should all guard against an overly mousopomorphic view of this (and other) health issues which may be due to increasing pressure from the mouse lobby to leverage NIH resources in its own interest.



Thank you for another enlightening post. It is no...

2009-04-08T21:10:00.000-07:00

Thank you for another enlightening post. It is no wonder that the conventional wisdom about maintaining optimum health is often wrong and has people like Dr Eades and Jenny (above) so frustrated. It is not surprising that there is so much diversity of thought and interpretation about health matters among even the most critical thinkers such as yourself, Jenny, Dr Eades, Dr William Davis etc.

I'm feeling for those mice having to wear two pair of tight shoes!



My statistics classes were pretty good, I have to ...

2009-04-08T17:53:00.000-07:00

My statistics classes were pretty good, I have to say (enviro biology). However, the stats classes at the neighboring university (with 10 times the tuition rate) sucked and that's putting it mildly. All the epidemiology students came over and took stats at our university. Jenny, I have some bio students going into nutrition and what is worse than not having to take stats is that they don't have to take biochem!!! Can you believe it!?

Controlled trials are best but sometimes observational studies are all we have. Especially in the environmental sciences where controlling for variables in experimental designs in the field can be almost impossible. I guess what I'm trying to say, Jenny, is that IMO the worst thing about that meat paper (I checked out their methods) was that they failed to correct for some very relevant variables. The stat methods weren't all that bad, I didn't think. The fact that they corrected for all kinds of other dietary factors except for types of carbohydrate intake is so telling. Most Americans get their feedlot meat served to them on a big fat white bun with trans fat fries and an HFCS coke... (but I think you mentioned this, too). This was apparently lost on them. I guess everyone knows that bread and HFCS are harmless! Pathetic.



Wonderful post. Thank you.

2009-04-08T14:15:00.000-07:00

Wonderful post. Thank you.



Stephan,I'm going to assign this post to my learni...

2009-04-08T08:50:00.000-07:00

Stephan,

I'm going to assign this post to my learning lab class (we're doing a behavioral study with rats). Next week's class is the first in which we will cover scientific writing, and this post is a fantastic example of superb writing. You tell a story. Stephan, you are a remarkable story teller and that's what is wrong with most bad writing, even in science. The authors forgot that what they are doing is telling a story, spinning a yarn, parlaying a narrative. Your posts are consistently well written. I hope you continue on in your profession and continue to publish peer-reviewed papers with the same high quality writing as you use in your blog.

Bravo!

PS. For an excellent piece on scientific writing (though it applies to all writing) is Gopin and Swan's "The Science of Scientific Writing". You can Google it.



Stephan,I look forward to your next post!I think y...

2009-04-08T08:18:00.000-07:00

Stephan,

I look forward to your next post!

I think you could make an addition couple of points here. If A is correlated with B, there are three possibilities: A causes B, B causes A, or a third factor C causes each, assuming the association is real.

The bunions could cause the wearing of tight shoes if people with bunions find that loose shoes are more likely to slip and slide against the bunions and thereby irritate them.

Infrequent shaving absolutely could cause heart attack or stroke if it intermediately causes the other social variables. Do people who are not married shave less because they are not married, or are they not married because they shave less frequently and it is more difficult to find a mate?

This complicates adjustment. If the real cause was shaving and they adjust for donut intake, they eliminate the correlation with shaving when it was the causal factor. Adjustments can turn true data into false data or false data into true data, depending on whether your hypothesis underlying the adjustment is correct. But while you are adjusting, it's still just a hypothesis!

Another complication is the level of statistical significance. If the level is set at 0.05, then one out of twenty correlations will be false. Moreover, if you do multiple comparisons in one study, you need to adjust the p level downward. So if you do ten comparisons in one study then your p level must be 0.005 in order for one out of twenty findings to be false. This is getting complicated here because it depends on what procedure you use, but many researchers get away with using less rigorous tests and failing to adjust the significance level for multiple comparisons because it will make their data non-significant. So we have the additional problem that many of the correlations are not real correlations. Only out of the true correlations do we face the issue of causation, and of course epidemiological evidence cannot address causation!

I look forward to your next post as I said!

Chris



The biggest problem with The "Gold Standard" rando...

2009-04-08T07:31:00.000-07:00

The biggest problem with The "Gold Standard" randomized placebo controlled trials is that they are soooo expensive to conduct. And then there are always confounding variables, drop out rates,etc. The number you need to enroll and the time you need to follow them in order to find a valid difference between two groups is often very large. Still they are the best we've got.

Stephan, help me. I can't find your DART trial. Pubmed just gets bogged down in a DART trial involving HIV in Africa. The closest I could find was tne Iowa Woman's Heart Study which showed an increase in mortality and CV disease in women who ate refined grains as compared to women who ate whole grains.



Unfortunately, there was no critical thinking taug...

2009-04-08T07:05:00.000-07:00

Unfortunately, there was no critical thinking taught in my education program nor dietetic internship. I had to learn it myself (thank you Gary Taubes and Dr Eades). The funny thing is, I do remember my teachers using this "other variable" technique to discount any study that was favorable to a low carb diet.



Stephan,I'm assuming you saw my Blog post based on...

2009-04-08T04:49:00.000-07:00

Stephan,

I'm assuming you saw my Blog post based on the full text of the "Red meat kills" study which pointed out that the same study "proved" with the same logic used to create the "red meat kills" headline, that eating red meat makes men die in accidents.

When, exactly, did they stop requiring statistics classes when granting M.D.s and Ph.D.s in nutrition? It must have been a while ago, given the studies that have passed peer review lately.
--Jenny Ruhl