Thursday, 26 May 2011

Flat earth 2

Science journalist, Gary Taubes, has roundly challenged the lipid hypothesis. He is also critical of people in the field of medicine and was shocked to find how little rigorous debate of ideas seemed to take place compared to physics and chemistry.

Here he discusses the 'calories in calories out' view of weight loss and the central mechanism for regulating weight: insulin:

Gary Taubes, nicknamed 'Mr Meat' by his wife, recently revealed his lipid panel scores to demonstrate what a high fat, low carb diet has done for him. The results are excellent despite dire predictions by his critics.

One challenge to Taubes comes from Stephan Guyenet, a student of the neurobiology of fat regulation, who disagrees with the idea that carbohydrate causes obesity by elevating insulin, thereby causing increased fat storage in fat cells. His article is a clear analysis of the pros and cons of the idea, but recommends further research.

Former engineer, Dr Richard Bernstein, reversed the major symptoms caused by his diabetes through dietary changes designed to regulate insulin to normal levels. He wanted to publish his findings in medical journals but was dismissed. He retrained as a doctor so that he could treat other people whose symptoms worsened when they followed official guidelines.

Cardio thoracic surgeon Dr Steven Gundry subscribed to conventional wisdom about diet until he met a patient who had lost weight and reversed blockages in blood vessels of the heart using supplements.

He reflected on these results and developed his own diet. Here he talks about his education, career, research and how this contributed to his diet (clearly it worked for Dr Gundry):

Heart specialist, Dr William Davis, reduces coronary plaque in patients by making changes in diet and lifestyle. He recommends certain supplements and encourages people to eliminate wheat from their diet. Some of his patients have achieved spectacular results.

There are some key differences in all of these people's views about heart disease, health and diet, but they all agree on the need to reduce refined carbohydrates to normalise insulin.

What prevents health associations and governments from changing their guidance on heart health and diet?

In the United States elected representatives from each state come under pressure from special interest groups if their livelihood is threatened. Economies of some states are dependent on profits from agriculture based around wheat and maize, for example. A sudden change of opinion by government officials would jeopardize the fragile state of agriculture in a global economy.

The US government is also subject to pressure from lobbyists on behalf of corporations. One group that has benefited from government policy on health and diet is the pharmaceutical industry. Blood pressure medication, insulin injections and statins are enormous profit generators, so a move to reduce the need for medical intervention would damage their prospects.

If the government recommends reducing fat, then other macronutrients replace it, such as carbohydrates, including sugar. Sugar makes some foods more palatable and it also masks salt. None of this is beneficial to human health in the long term.

The food industry has also made substantial changes to fall in line with government regulation reducing saturated fat and substituting trans fats (now found to be much more damaging to human health). Sugar has been replaced by high fructose corn syrup, benefitting maize farmers and reducing the price of many goods. Carbonated soft drinks, crisps and other snack foods now occupy aisles of space in supermarkets but no substantial link has been made between empty sugars and carbs ('cafeteria diet') and the development of diabetes, obesity and heart disease by government officials. It would be a quick way to lose the next election in the US.

What keeps a dominant and erroneous paradigm in place? Money and power.

Ah but scientists wouldn't accept ideas without any evidence to substantiate them, would they?

How does medical science progress?

Research drives the field forward. Much of it is undertaken by or on behalf of pharmaceutical companies to develop products to solve particular medical problems and make a profit. Low cost solutions that are cheap for the consumer do not benefit drug companies. Other research requires public funding and that is often controlled by government and its policies.

In the UK, recent legislation bans the use of certain complementary medicines unless they are registered and have undergone rigorous and expensive testing. This is out of the reach of most practitioners and retailers, for whom the income generated from this area cannot cover the required outlay for registration. The precautionary principle is useful when applied to protect the safety of patients and clients. Unfortunately some of the products may be beneficial and not harmful, but they cannot now be used.

If government has opted for a particular paradigm, which research are they likely to fund, work that contradicts or supports it?

Dr Malcolm Kendrick and others describe medical opinion before and after Ancel Keys' 7 nations study and tell us that colleagues were sceptical or downright dismissive of the lipid hypothesis. However when funding and jobs depend on complying with government decisions, then most people tend to toe the line.

If the research isn't done or findings are not deemed sufficiently rigorous for publication, then ideas that may help the development of medical knowledge are not circulated or accepted. Dr Richard Bernstein was dismissed as merely touting anecdotal evidence and lacking the medical credentials to be taken seriously. The people who developed the idea of helicobacter pylori as a precursor to duodenal and gastic ulcers were caught in a similar bind and published in the popular press as a way to disseminate their hypothesis.

In the West we criticise Russia and China for their draconian response to dissidents. We would never send people to Siberia or imprison them for winning an award.

We overlook the simple, cost effective ways that we use to control people and keep them in line or 'on message'. Hit them in the pocket or keep them out of the loop. Cutting off money for research, sacking people from their jobs or banning them from a discussion group on the internet are some of the ways to maintain the status quo.

In the UK the NHS practises evidence based medicine. All evidence is equal, though it now seems that some evidence is more equal than others.

Here's an alternative proposal from a medical student who encourages people to use their own functioning brains.

Sometime it may be confirmation bias that determines what scientists see or toss in the waste bin, as explained here.

If you've visited this post from another site, you might like to read Part 3 here.

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