Archive for the “Bad Science” Category

It must be tough to be Dr. Dean Ornish these days. The man desperately wants to convince everyone to live on a low-fat vegetarian diet, and yet the Wisdom of Crowds effect is turning the tide in the opposite direction. People previously frightened into giving up eggs and red meat have gone paleo, improved their health, and announced as much to the crowd. Books like The Big Fat Surprise are shining a very bright light on the shoddy science that led to anti-animal-fat hysteria in the first place. Researchers are revisiting the science and declaring the low-fat diet a mistake.

This can’t sit well at all with Dr. Ornish, for whom the plant-based diet is clearly akin to a religion. In fact, I suspect that like many vegetarians and vegans, the thought process that formed his beliefs went something like this:

  • Eating animals is a sin.
  • Therefore, animal foods must harm your health – a punishment for committing sin.
  • Giving up animal foods must improve your health – a reward for no longer being a sinner.

Ornish has spent his career warning of the health hazards of animal foods. The emerging evidence – the reliable kind, anyway – keeps contradicting him, so now he’s like a walking, talking example of the people described in the terrific book Mistake Were Made (but not by me): having staked out a very public position, he can’t possibly change his mind without committing career suicide. He must cling to that position to the bitter end.

And so Ornish pops up now and then to bang the Animal Foods Kill! drum yet again … by pointing to a lousy observational study here and a mouse study there. You never hear him quoting clinical studies on humans (i.e., the studies that actually matter) because those don’t support his beliefs.

Ornish’s latest attempt to bang the drum came in the form of an essay in the New York Times, which several readers called to my attention. Let’s take a look.

Many people have been making the case that Americans have grown fat because they eat too much starch and sugar, and not enough meat, fat and eggs. Recently, the Dietary Guidelines Advisory Committee lifted recommendations that consumption of dietary cholesterol should be restricted, citing research that dietary cholesterol does not have a major effect on blood cholesterol levels. The predictable headlines followed: “Back to Eggs and Bacon?”

But, alas, bacon and egg yolks are not health foods.

And we know they’re not health foods because Dr. Ornish says so.

Although people have been told for decades to eat less meat and fat, Americans actually consumed 67 percent more added fat, 39 percent more sugar, and 41 percent more meat in 2000 than they had in 1950 and 24.5 percent more calories than they had in 1970, according to the Agriculture Department. Not surprisingly, we are fatter and unhealthier.

Notice how Ornish lumps added fat, sugar and meat together, attempting to paint them as members of the same murderous gang. It’s a bit like stating that the trio of Jeffrey Dahmer, Ted Bundy and Mother Teresa were responsible for more than 50 brutal murders. That’s technically true, but Mother Teresa’s share of the carnage was zero.

But what about that increase in added fat? Did we become fatter and unhealthier by consuming more butter and lard?

Dr. Mike Eades delved into Ornish’s creative uses of food-consumption statistics in a recent post. It’s worth reading the entire post, but here’s the bottom line:

The added fats are mostly vegetable oils – the exact type the vegetarian zealots insist are better for us than animal fats. Ornish reached way back to 1950 to grab figures on meat consumption so he could make a dramatic comparison with today and thus blame meat for obesity rates that began rising … wait for it … 30 years later. Let’s back up instead to 1970, when Americans were still lean on average and not suffering from record rates of diabetes.

Meat consumption rose by 13 percent from 1970 to 2005, but mainly because we eat a lot more chicken. During that same timespan, red meat consumption dropped by 22%, egg consumption dropped by 17%, and dairy consumption dropped a wee bit. Meanwhile, grain consumption increased by 45%.

Keep those figures in mind as we continue quoting Dr. Ornish.

The debate is not as simple as low-fat versus low-carb. Research shows that animal protein may significantly increase the risk of premature mortality from all causes, among them cardiovascular disease, cancer and Type 2 diabetes.

Dr. Ornish includes a link that goes to a study I already analyzed in this post. It’s another one of those number-crunching analyses of two lousy observational studies based on food questionnaires. Other analyses of the same parent studies (The Health Professionals Follow-up Study and the Nurses’ Health Study) have consistently shown that the participants who ate the most meat and eggs were also more likely to smoke, to drink, to be overweight, etc. In other words, we’re comparing adherers vs. non-adherers, not the effects of any one food.

But since Dr. Ornish apparently believes observational studies are rock-solid evidence, perhaps he can explain these results from a study of the Japanese elderly:

  • Nutrient intakes in 94 Japanese centenarians investigated between 1972 and 1973 showed a higher proportion of animal protein to total proteins than in contemporary average Japanese.
  • High intakes of milk and fats and oils had favorable effects on 10-year (1976-1986) survivorship in 422 urban residents aged 69-71.
  • The survivors revealed a longitudinal increase in intakes of animal foods such as eggs, milk, fish and meat over the 10 years.

I guess animal foods will kill you unless you’re Japanese, in which case they extend your life.

Back to Dr. Ornish:

Heavy consumption of saturated fat and trans fats may double the risk of developing Alzheimer’s disease.

Once again, notice how he lumps trans fats and saturated fats together. The vegetarian and vegan zealots do that all the time – well, at least now that they’ve admitted trans fats are bad. Back in the 1980s, The Guy From CSPI was pushing trans fats as a safe alternative to animal fats.  Point is, trans fats and saturated fats have very different effects on your health – which Dr. Ornish chooses to ignore.

A study published last March found a 75 percent increase in premature deaths from all causes, and a 400 percent increase in deaths from cancer and Type 2 diabetes, among heavy consumers of animal protein under the age of 65 — those who got 20 percent or more of their calories from animal protein.

Dr. Ornish forgot to mention a couple a couple of facts about that study:

  • It’s yet another observational study based on food questionnaires and is therefore nearly worthless.
  • Data from the same study showed that heavy consumers of animal proteins over the age of 65 had lower mortality and lower rates of heart disease and cancer, not higher.

So if this observational study actually tells us something about the health effects of animal protein (which it doesn’t), we’d have to conclude that meat will kill you until you turn 65, but after age 65 it will save your life.

Back to the good doctor:

Low-carb, high-animal-protein diets promote heart disease via mechanisms other than just their effects on cholesterol levels. Arterial blockages may be caused by animal-protein-induced elevations in free fatty acids and insulin levels and decreased production of endothelial progenitor cells (which help keep arteries clean). Egg yolks and red meat appear to significantly increase the risk of coronary heart disease and cancer due to increased production of trimethylamine N-oxide, or TMAO, a metabolite of meat and egg yolks linked to the clogging of arteries. (Egg whites have neither cholesterol nor TMAO.)

Ornish linked to a study to support that paragraph, so I checked it out. Here’s the abstract:

Mice that were fed a high-fat, high-protein, low-carbohydrate diet were found to have atherosclerosis that was not associated with traditional cardiovascular risk factors.

So I’m going to suggest you avoid (especially if you’re a mouse) the “Atkins Diet” version of laboratory rodent chow, which is a mix of corn starch, sugar, casein, and various fats including soybean oil, corn oil and Crisco.

Animal protein increases IGF-1, an insulin-like growth hormone, and chronic inflammation, an underlying factor in many chronic diseases. Also, red meat is high in Neu5Gc, a tumor-forming sugar that is linked to chronic inflammation and an increased risk of cancer. A plant-based diet may prolong life by blocking the mTOR protein, which is linked to aging.

To support those claims, Ornish referred to another mouse study and the observational study that showed a statistical link between meat and higher mortality up to age 65, but lower mortality after age 65. Since most of us will live to be 65 anyway, I think we can stop worrying about the meat.  Eat it now, and after celebrating your 65th birthday, start eating even more of it.

Are you recognizing the Ornish method of persuasion by now? He’s like the Wizard of Oz, blowing a lot of smoke and bellowing loudly, but really hoping you don’t look behind that curtain. A quick reference to a mouse study (which he doesn’t identify as a mouse study), a quick reference to an observational study (citing one result but skipping the result he doesn’t want you to see), a quick conflation of trans fats and animal fats, and VOILA! – you’ve almost got an argument against eating animal foods.

Ornish continues:

An optimal diet for preventing disease is a whole-foods, plant-based diet that is naturally low in animal protein, harmful fats and refined carbohydrates. What that means in practice is little or no red meat; mostly vegetables, fruits, whole grains, legumes and soy products in their natural forms; very few simple and refined carbohydrates such as sugar and white flour; and sufficient “good fats” such as fish oil or flax oil, seeds and nuts. A healthful diet should be low in “bad fats,” meaning trans fats, saturated fats and hydrogenated fats. Finally, we need more quality and less quantity.

Hmmm … let’s rewrite that paragraph to reflect the actual evidence:

An optimal diet for preventing disease is a whole-foods diet that is naturally low in harmful fats and refined carbohydrates. What that means in practice is meat, eggs, vegetables, fruits and nuts, but little or no whole grains or soy products; very few simple and refined carbohydrates such as sugar and white flour; and sufficient “good fats” such as fish oil, natural animal fats, seeds and nuts. A healthful diet should be low in “bad fats,” meaning trans fats, processed vegetable oils, seed oils, and hydrogenated fats. Aim for quality, and you’ll probably find the quantity takes care of itself.

I didn’t bother to read all the comments on Ornish’s article, but I did come across this one:

So far, 331 comments posted. About 88% either disagree or have a different view than the author. I suppose if you agree with him, then you may not comment. But it is obvious the author is not connecting to his audience. I suspect he is not much different than other vegans I have met: for him, diet is a religion and he cherry picks the science.

Sorry, Dr. Ornish, but the jig is up. People aren’t buying these weak arguments of yours anymore. You can keep bellowing away about the hazards of animal foods, but it’s the information age now and the crowd knows better – and the crowd is loud.

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A couple of news items landed in my inbox recently that aren’t directly related, but they’re both examples of the Vision of The Anointed at work.

I gave a brief summary of The Vision of The Anointed (as described by economist Thomas Sowell in a book by that name) in a speech I called Diet, Health and the Wisdom of Crowds.  If you haven’t seen it, here’s a recap of how The Anointed (who are nearly always members of the intellectual class) operate:

  • The Anointed identify a problem in society
  • The Anointed propose a Grand Plan to fix the problem
  • Because they are so supremely confident in their ideas, The Anointed don’t bother with proof or evidence that the Grand Plan will actually work
  • If possible, The Anointed will impose the Grand Plan on other people (for their own good, of course)
  • The Anointed assume anyone who opposes the Grand Plan is either evil or stupid
  • If the Grand Plan fails, The Anointed will never, ever, ever admit the Grand Plan was wrong

The first news item that reminded me of The Anointed was about an (ahem) study that pinpoints the reason we have an obesity problem in modern America.  Here are some quotes:

A new report puts some of the blame for Americans’ expanding waistlines on the growth of new Wal-Mart supercenters in the US.

Big box retailers, and Wal-Mart in particular, have made cheap, bulk-size junk foods more readily available, and Americans are eating more as a result, argues the report, which was published by the National Bureau of Economic Research.

“We live in an environment with increasingly cheap and readily available junk food,” Charles Courtemanche, an assistant professor of economics at Georgia State University and one of the report’s co-authors, told the Washington Post. “We buy in bulk. We tend to have more food around. It takes more and more discipline and self-control to not let that influence your weight.”

Well, there you have it.  People are fat because there’s more food around.  I remember asking my grandparents when I was a wee child, “Grandma, Grandpa … why aren’t you fat?”  And my grandpa plopped me on his knee and rubbed my head and said, “Well, we would be if we could.  But if you go look over there in the pantry, you’ll see we’re down to a few slices of bread and some carrots.  It happens all the time because there’s no Wal-Mart nearby and we can only afford to eat just as much as we should.”

The researchers found higher rates of obesity in areas dense with supercenters, which have a larger selection of food and also offer other services, such as auto repair. Just one additional supercenter per 100,000 residents increases average body mass index in the area by 0.24 units and the obesity rate by 2.3% points, they found.

Riiiight.  And since correlation proves causation, that means Wal-Mart is making people fat.  It couldn’t be, say, the fact that low-income people are more likely to be fat for all kinds of reasons, and that Wal-Mart super-centers are built where their most loyal customers live.

Notice how nobody who blames obesity on lower food prices can explain why the wealthiest Americans also have the lowest rates of obesity?  If it’s all about affordability, then wealthy people should be the fattest – they can eat whatever they want and as much as they want.  But no, it’s only if we’re talking about poor people that we blame affordability – and thus Wal-Mart.

“These estimates imply that the proliferation of Wal-Mart Supercenters explains 10.5% of the rise in obesity since the late 1980s,” researchers wrote.

Uh-huh.  And I’ll bet you all had no idea what to blame for obesity, then just stumbled across this data during a wide-open search for truth, then came to your astonishing conclusions.

Of course that’s not what happened.  These bozos with PhDs went looking for a reason to blame Wal-Mart and – ta-da! – they found it.  Intellectuals blaming Wal-Mart for the ills of society … now that is a shock.

In case you haven’t noticed, The Anointed are contemptuous of Wal-Mart and the people who shop there.  This article in the Atlantic, written by a Brit, describes the snobbery rather nicely:

As a young man I aspired to live and work in the US because I wanted to be part of a thriving classless society. Of course that was naive. America is not a classless society. I’m not talking about the 1% and the 99%, and I’m not talking about mainstream America and the underclass (shocking though that gulf is). I’m talking about elite disdain for a much larger segment of the country. It’s a cultural thing: American snobbery.

Many of my American friends have an irrationally intense loathing of Wal-Mart, as though delivering bargains to the masses isn’t quite proper.

In America elite and demotic cultures aren’t merging, they are moving farther apart. The elite is ever more confident of its cultural superiority, and the demos, being American, refuses to be condescended to. I don’t think it’s economic pressure that causes much of the country to cling bitterly to guns and their religion, as Obama put it so memorably. It’s a quintessentially American refusal to be looked down on.

[The elite] may use a self-conscious rhetoric of non-judgmentalism – words like ‘inappropriate’ and ‘challenging’, or phrases such as ‘people in need of support’ and ‘people with issues’ – but they have no inhibitions about instructing others about what food they should eat, how they should bring up their children, or what forms of behaviour are healthy.

Well said, my British friend.  You just described The Anointed.

Here are some similar thoughts from an essay in The National Review:

A few weeks ago, I was very much amused by the sight of anti-Wal-Mart protests in Manhattan — where there is no Wal-Mart, and where, if Bill de Blasio et al. have their way, there never will be. Why? Because we’re too enlightened to let our poor neighbors pay lower prices. The head-clutchingly expensive shops up on Fifth and Madison avenues? No protests.

Ironically, the anti-Wal-Mart crusaders want to make life worse for people who are literally counting pennies as they shop for necessities. Study after study has shown that Wal-Mart has meaningfully reduced prices: 3.1 percent overall, by one estimate — with a whopping 9.1 percent cut to the price of groceries. That comes to about $2,300 a year per household, savings that accrue overwhelmingly to people of modest incomes, not to celebrity activists and Ivy League social-justice crusaders.

And here’s a quote from Member of The Anointed Bill Maher explaining how Wal-Mart shoppers choose to vote:

Republicans need to stop saying Barack Obama is an elitist, or looks down on rural people, and just admit you don’t like him because of something he can’t help, something that’s a result of the way he was born. Admit it, you’re not voting for him because he’s smarter than you.

Uh, no, Bill, that’s not quite it.  It’s more along the lines of something Milton Friedman once said:  it’s not intelligent people who are the problem.  The problem is people who are so impressed with their own intelligence, they feel qualified to tell others how to live.

Barack Obama can’t help it if he’s a magna cum laude Harvard grad and you’re a Wal-Mart shopper who resurfaces driveways with your brother-in-law.

Ahh, Bill, so that’s the reason.  Wal-Mart shoppers resent smart people with Ivy League degrees.  Strangely, many of those Wal-Mart shoppers later voted for Mitt Romney, who earned both a law degree and an MBA from Harvard.

Brilliant argument.  Maher chides Republicans for saying Obama is an elitist who looks down on rural people, then makes it perfectly obvious that he, an Obama enthusiast, is an elitist who looks down on rural people.  (I’m pretty sure he didn’t mean Wal-Mart shopper as a compliment.)

Gee, Bill, I would think someone with your towering intellect would recognize how thoroughly you just undermined your own argument.   Of course The Anointed look down on rural people and Wal-Mart shoppers.  And despite what you and your fellow left-wing snots think, the rural Wal-Mart shoppers are smart enough to know it.

That sneering attitude towards “Wal-Mart shoppers” is the reason I can’t stand Bill Maher.  He’s a left-wing snot, and his live audience is full of left-wing snots who whoop and cheer at his snotty comments as a form of congratulating themselves for what they see as their superiority to people who shop at Wal-Mart and resurface driveways.

Even though I spent a chunk of my life as a comedian, I’ll be the first to say that if all the comedians disappeared, life would be less entertaining, but we’d be fine.  If all the magna cum laude graduates from Harvard Law School disappeared, we’d also be fine, if not better off.  But if all the people who know how to resurface driveways or otherwise build and repair stuff disappeared, we’d be screwed.

Anyway, you get the point.  The Anointed view Wal-Mart shoppers as idiots.  And since they’re idiots, the Wal-Mart shoppers are stuffing themselves and getting fat because – thanks to the low prices offered by the evil Wal-Mart – they can now afford to stuff themselves.  I mean, it’s not as if any of them have actually tried to lose weight or anything.

So The Anointed see all these stupid Wal-Mart shoppers getting fat, which means The Anointed must come up with a Grand Plan to fix the problem – and of course, as The Anointed, they aren’t expected to provide any evidence that the plan would work.

The plan that came out in the media recently was proposed in 2010 by none other than Jonathan Gruber.  If the name isn’t familiar, it should be.  Gruber was once called “the architect” of ObamaCare by Democrats … until he embarrassed himself and the party by getting himself caught on video telling the truth about what it took to pass ObamaCare:

Yup, “the architect” was justifying lying to the public about what ObamaCare would actually do.  The voters are stupid, ya see — one of the only two reasons anyone resists a Grand Plan proposed by The Anointed — so you have to lie to them to get a bill passed that’s really for their own good.

Gruber’s statements so perfectly captured the attitude of The Anointed, The Anointed in the Obama administration immediately tried to disown him.

Meanwhile, Bill Maher renewed his credentials as a member of The Anointed by agreeing with Gruber:

On Friday, Bill Maher, host of HBO’s Real Time, brought up Jonathan Gruber, the economist who was an advisor and main architect on Obamacare and got caught crediting the “stupidity” of Americans to get the bill passed. Maher joked they were “soulmates” and likened his fellow Americans to dogs, and didn’t understand why anything Gruber said about the average American’s stupidity was considered controversial.

Maher’s audience applauded wildly, as they always do for their hero.

By the way, the subtitle of Sowell’s book is Self-Congratulation as a Basis for Social Policy.  When Bill Maher agrees that you have to lie to the stupid voters to do what’s best for them and his audience of left-wing snots hoots and cheers in response, that’s a fine example of self-congratulation.  They were probably high-fiving each other for not being stupid voters … you know, the kind who shop at Wal-Mart and resurface driveways and don’t understand that we need The Anointed to make important decisions for us … such as what kind of health insurance we’ll be allowed to buy.

That’s the attitude.  Now here’s the kind of Grand Plan the attitude produces:

Jonathan Gruber, long credited as the architect of ObamaCare, once discussed the necessity of taxing fat people by body weight in order to fight obesity.

“Ultimately, what may be needed to address the obesity problem are direct taxes on body weight,” Gruber wrote in an essay for the National Institute for Health Care Management in April 2010, just months after helping design ObamaCare with the president in the Oval Office and during the period in which he was under contract as an Obama administration consultant.

If I’ve said it once, I’ve said it at least twice:  whenever The Anointed come up with a Grand Plan to fix a problem, it somehow always requires confiscating other people’s money or limiting their freedom to make their own decisions — or both, for a REALLY Grand Plan.

So there’s the mind of The Anointed at work:  people are fat because Wal-Mart has made food too cheap.  All those people who resurface driveways with their brother-in-law are overeating because they can afford to … and because they’re stupid and have no discipline.  But if The Anointed impose direct taxes on bodyweight, the stupid driveway resurfacers will say to themselves, “Well, heck, I can’t afford those taxes!  I’d better stop eating so much of this cheap Wal-Mart food and lose some weight.”

And then once again, The Anointed will have fixed society’s problems.  All hail The Anointed.

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As you know if you’re a regular reader, I’ve been yelling and screaming for years about the lousy science that convinced Americans heart disease is caused by eating too much fat and cholesterol.  From Ancel Keys on down, researchers jumped to conclusions based on weak associations.  Big muckety-mucks in our government bought into the lousy science, and the rest is history.

So it’s refreshing to learn that researchers are revisiting the whole “what causes heart disease?” issue and applying rigorous scientific thinking for a change.  Here are some quotes about an enlightening new study as reported in Medical Daily online:

Over the years, researchers have gathered several risk factors for heart disease ranging from not making a lot of money, to smoking, to stress. Now, a new study shows just how the use of Twitter can help dictate what populations are at risk of coronary heart disease: by identifying which users are tweeting about negative emotions like anger, stress, or fatigue.

A few of my blog readers and Twitter followers have complained that I don’t tweet often enough.  Well, now you know why.  I’ve suspected for a long time that tweeting causes heart disease, but I kept that suspicion to myself – meaning I didn’t tweet about it.

If you’re a health and history buff like I am, you know that heart disease in America plummeted during World War Two, then spiked after the war ended.  But you may not have connected that dot to the fact that the Defense Department restricted tweeting during the war.  I’m a pro-freedom type of guy, but I understand their reasons.  General Eisenhower couldn’t afford to have soldiers sending out tweets like:

The military didn’t prohibit tweeting entirely at first.  But soldiers pretty much gave up after seeing their tweets go into the world like this:

The final clampdown on tweeting came after the other side started engaging in what became known as Dirty Twitter Tricks.

So tweeting plummeted and, interestingly, so did heart disease.  After the war, tweeting skyrocketed and, again, so did heart disease.  So I think these researchers are on to something.

The study, led by Johannes Eichstaedt at the University of Pennsylvania (in collaboration with others) and published in the journal Psychological Science, found that a county’s tweets about negative emotions were associated with a higher risk of heart disease for that community, while tweets that were more positive were associated with a lower risk.

Okay, so it’s angry or negative tweets doing the damage here, not tweeting in general.  I stand corrected.  Nonetheless, I believe my observations about tweeting and heart disease both spiking in the years after World War Two are still relevant.

McCarthy died at age 48.  Let that be a warning to all you angry tweeters out there.

Here’s how the researchers made this discovery:

The researchers studied public tweets from 2009-2010, scattered across 1,300 counties. Language considered negative — such as the word “hate” or swear words — were associated with heart disease mortality, while more positive messages involving words like “friends” or “wonderful” were linked to a lower risk of heart disease mortality.

Just wanted to protect my heart a bit before moving on.

It wasn’t necessarily the people writing negative tweets who were dying of heart disease, however: rather, the tweets were indicative of a higher rate in certain communities.

Wait a minute … you mean this stuff doesn’t affect the person actually doing the tweeting?!

“The relationship between language and mortality is particularly surprising,” H. Andrew Schwartz, an author of the study, said, “since the people tweeting angry words and topics are in general not the ones dying of heart disease. But that means if many of your neighbors are angry, you are more likely to die of heart disease.”

Well, hell’s bells!  All these years, I’ve been operating on the theory that if you’re surrounded by angry neighbors, you’re more likely to die of a gunshot wound.  Now it turns out those neighbors sitting at their computers and sending angry tweets all day can give you heart disease.

I’m reminded of something Rocky Angelucci wrote in his book Don’t Die Early:  predicting your odds of suffering a heart attack based on your cholesterol score is like predicting your odds of a suffering a heart attack based on your zip code.  And here I thought he was making fun of cholesterol scores.  Turns out he was ahead of the curve on the neighbors give you heart disease theory.

Well, that’s it, then.  I’m going to start following my neighbors on Twitter.  If I see angry or negative tweets, I’ll respond with something like Knock it off, ass@#$%!! You’re raising my risk of a heart attack, dumb-@#$%!!

“Psychological states have long been thought to have an effect on coronary heart disease,” Margaret Kern, assistant professor at the University of Melbourne and an author of the study, said in the press release. “For example, hostility and depression have been linked with heart disease at the individual level through biological effects. But negative emotions can also trigger behavioral and social responses; you are also more likely to drink, eat poorly and be isolated from other people which can indirectly lead to heart disease.”

So let me follow the logic here … hostility and depression are linked to heart disease.  Check.  People who send angry tweets are more likely to be angry and depressed.  Check.  So in counties where lots of people are sending angry tweets, the rate of heart disease is higher, even though it’s not the tweeters who are having the heart attacks.  Check.  Add it all up, and you get the conclusion if many of your neighbors are angry, you are more likely to die of heart disease.

Well then, you’d better move out of that angry county as soon as possible.  Move to a county where people are nice and friendly – like ours, for example.  I remember visiting a bank to set up our accounts shortly after we moved here.  By the time the new-accounts manager and I were done, I knew her children’s names and the fact that her husband collects unusual knives.  She was so sweet, I felt a little guilty for not hugging her on the way out.  And as our local paper once pointed out, this county has the highest longevity in Tennessee – which prompted the writer to suggest the state should find a way to move more poor people here so their health would improve.

Of course, there’s another way to look at it:  positive people are more likely to be both financially successful and healthier.  They move to counties that are considered “nice” and are also more expensive.  Negative people are more likely to end up with bad health and bad finances.  They live in the less-desirable areas they can afford.  So angry tweets and heart disease end up being correlated if you divvy up the data by county.  Same old, same old:  it’s adherers vs. non-adherers.

Which means …

But I don’t consider that an angry tweet or anything.

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Take a look at this headline from a Shape magazine online article – but I’m warning you, if you’re prone to head-bang-on-desk incidents like I am, you’d best don your helmet before continuing.

Low Carb Diet Linked to Shorter Life Expectancy

That’s the headline.  Here’s the subhead:

If your healthy diet doesn’t include breads, rice, oats, and other whole grains, you may be missing out on a huge health perk, says new science.

And here’s the opening paragraph:

Swearing off carbs may mean forgoing health perks as well: People who ate more whole grains throughout their lives lived longer than those who didn’t, reports a new study in the JAMA Network Journals.

Better eat your bread and other grains, because a low-carb diet is linked to an early death.  That’s the takeaway message.  So obviously, the study being reported by the Shape magazine writer compared low-carb diets to diets rich in whole grains, right?

Wrong.  The study wasn’t about low-carb diets at all.  The headline and the opening paragraph are both complete nonsense.  Hardly a week goes by when I don’t see some goof in the media misinterpret a study (often with help from the researchers), but I ignore most of those articles these days simply because they’re so common.

But this article … wow … I found myself asking the same question I often ask when politicians give speeches:  Is this goofball knowingly dishonest, or just plain stupid?

So let’s put on our Science For Smart People hats and ask some questions about the study that prompted the Shape reporter (and others, no doubt) to conclude that a low-carb diet is linked to shorter life expectancy.

Q: Is this a clinical study or an observational study?

A: It’s an observational study.  Actually, researchers dug data out of two ongoing observational studies.  Here’s a quote from the study abstract:

We investigated 74,341 women from the Nurses’ Health Study (1984–2010) and 43,744 men from the Health Professionals Follow-Up Study (1986–2010), 2 large prospective cohort studies.

I’ve written about those studies before.  The Reader’s Digest version is that they’re based on occasional food questionnaires, which are notoriously unreliable.  Whenever I see a new analysis of the same old data from either one of these studies, I know it’s time to roll my eyes and walk away.  Move along folks, nothing to see here.  But for the sake of argument, let’s assume food questionnaires are reliable and observational studies actually tell us something useful.

Q: What was the actual difference?

A:  Well, you can refer to the abstract for the details, but here’s what got the researchers and members of the media all excited:

After multivariate adjustment for potential confounders, including age, smoking, body mass index, physical activity, and modified Alternate Healthy Eating Index score, higher whole grain intake was associated with lower total and CVD mortality but not cancer mortality…. We further estimated that every serving (28 g/d) of whole grain consumption was associated with a 5% lower total morality or a 9% lower CVD mortality, whereas the same intake level was nonsignificantly associated with lower cancer mortality.

So people eating whole grains had lower mortality.  Which leads to the next question …

Q:  Compared to what?

A:  Well, from the headline in Shape magazine online, you’d think researchers compared diets rich in whole grains to low-carb diets.  But like I said before, that’s not the case.  All this data shows is that people who ate more whole grains were less likely to die prematurely.  So … if a person eats more whole grains, wouldn’t that mean he or she is eating less of something else?  Which leads us to ask …

Q: If A is linked to B, could it be because of C?

A:  That’s the $64,000 question.  And the answer in this case is almost certainly yes.  Whole grains are associated with better health outcomes, but that’s because people who eat whole grains usually choose them over refined grains.  This study was conducted at Harvard, which trumpeted the results in the media and promoted the idea that there’s something especially health-enhancing about whole grains.  Here’s a quote about the study from a Harvard press release:

“This study further endorses the current dietary guidelines that promote whole grains as one of the major healthful foods for prevention of major chronic diseases,” said Qi Sun, assistant professor in the Department of Nutrition and senior author of the study.

Wow, so it turns out the government dietary guidelines are correct!  We just proved it here in our government-funded study!  (The NIH funded the study, according to the same press release.)  People who ate more whole grains lived longer, so that proves whole grains — in and of themselves — are good for you.

Uh-huh.  But here are some quotes from a different Harvard press release, commenting on earlier data extracted from the same two observational studies:

Refining wheat creates fluffy flour that makes light, airy breads and pastries. But there’s a nutritional price to be paid for refined grains. The process strips away more than half of wheat’s B vitamins, 90 percent of the vitamin E, and virtually all of the fiber. It also makes the starch easily accessible to the body’s starch-digesting enzymes.

A growing body of research shows that returning to whole grains and other less-processed sources of carbohydrates and cutting back on refined grains improves health in myriad ways.

Eating whole instead of refined grains substantially lowers total cholesterol, low-density lipoprotein (LDL, or bad) cholesterol, triglycerides, and insulin levels. Any of these changes would be expected to reduce the risk for cardiovascular disease.

More recent findings from this study (the Nurses’ Health Studies I and II) and the Health Professionals Follow-Up Study suggest that swapping whole grains for white rice could help lower diabetes risk: Researchers found that women and men who ate the most white rice—five or more servings a week—had a 17 percent higher risk of diabetes than those who ate white rice less than one time a month.

In other words, the supposed magic of whole grains comes down to them being a somewhat better choice than refined grains that jack up blood sugar, triglycerides, insulin, etc.  That tells us absolutely nothing about the health effects of whole grains vs. no grains.

The researchers noted that “replacing” one serving per day of red meat with whole grains was also associated with lower mortality.  I put “replacing” in quotes because people in these studies don’t check a box that says I am now swapping one serving of red meat for one serving of whole grains in my daily diet.  Those daily servings are the result of number-crunching by the researchers.  Their conclusion just means that given what they consider a “serving,” people who ate one serving less of red meat and one serving more of whole grains lived longer.

As I’ve explained before, the “red meat” in these studies most often comes in the form of pizza, burritos, deli sandwiches, hot dogs, etc. – in other words, processed meats that are served with a generous helping of white flour.  So when the researchers inform the media that “replacing” red meat with whole grains was associated with greater longevity, it could simply be the result of comparing people who eat pizza for dinner to people who eat chicken, vegetables and brown rice for dinner.  That doesn’t tell us diddly about what would happen to your health if you swapped a steak for a plate of whole-wheat pasta.

The folks at Harvard may understand that (not that you can tell from their conflicting press releases), but the reporter from Shape magazine clearly doesn’t.  She somehow managed to interpret this study as demonstrating a link between low-carb diets and an early death, even though the data doesn’t deal with low-carb diets at all.

To illustrate the depth of the stupidity, let’s take the smoking analogy I used in Science For Smart People and extend it a bit.  Suppose we conduct an observational study of smokers and find that those who smoke filtered cigarettes have lower rates of lung cancer than those who smoke unfiltered cigarettes.  The proper conclusion is that filtered cigarettes might be a better option than unfiltered cigarettes.  It would be stupid to conclude that our study proves filtered cigarettes are good for you.

But our Shape magazine reporter took that level of stupidity a step further.  To borrow a phrase from the comedy Tropic Thunder, she went full retard.  Her headline is the equivalent of reading a press release about our observational study on smoking and then writing a headline like this:

Non-Smoking Linked To Higher Cancer Rate

Like I said, I can’t tell if she’s being intentionally dishonest or is just plain stupid.  Either way, it’s not comforting to know she writes for a major health and fitness magazine.

You may now bang your head on your desk.

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It’s January, which means millions of people are either already on a weight-loss diet or considering one.  If you watch TV this time of year, you can’t help but see ads for Jenny Craig, NutriSystem, Weight Watchers and all the other usual suspects.  So many options out there … which one should people choose?

Well, let’s suppose you were offered these choices:

On one plate, you’ve got a slice of grass-fed beef, some eggplant and green vegetables drizzled in olive oil, and perhaps a small sweet potato.  On the other plate — wait, make that in the other glass – you’ve got a brew of FAT FREE MILK, WATER, SUGAR, COCOA (PROCESSED WITH ALKALI), CANOLA OIL, MILK PROTEIN CONCENTRATE, FRUCTOSE, GUM ARABIC, CELLULOSE GEL, MONO AND DIGLYCERIDES, HYDROGENATED SOYBEAN OIL, HIGH FRUCTOSE CORN SYRUP, POTASSIUM PHOSPHATE, MALTODEXTRIN, SOY LECITHIN, CELLULOSE GUM, CARRAGEENAN, NATURAL AND ARTIFICIAL FLAVOR, SODIUM BICARBONATE, SUCRALOSE AND ACESULFAME POTASSIUM (NONNUTRITIVE SWEETENERS), SODIUM CITRATE, CITRIC ACID.

That brew in the glass contains 18 grams of sugar, by the way.

So which meal should you choose?  Why, the glass of Slim-Fast, of course.  (How many of you guessed it from the list of ingredients?)

I know the Slim-Fast is a better option because a group of (ahem) experts says so.  Here are some quotes from an article on the NPR site, and from an article in U.S. News:

Despite the buzz about paleo and raw food diets, a new ranking of the 35 top diets puts these two near the bottom of the list.

Why?

I’m guessing it’s because the list was created by a bunch of nutritionists who still believe the same old anti-fat, anti-salt, hearthealthywholegrains nonsense they’ve been preaching for years.

The U.S. News & World Report rankings are based on evaluations by a panel of doctors, nutritionists and other health experts. For each diet, the experts evaluated short-term and long-term weight loss, ease of adherence, and how the advice stacked up against current dietary guidelines.

… and how the advice stacked up against current dietary guidelines.  In other words, the diets may as well have been ranked by the guiding lights at the USDA.

One expert concluded that “a true paleo diet might be a great option: very lean, pure meats, lots of wild plants.” But the problem, according to the report, is that it’s too difficult to follow in modern times.

Well, yes, if you tried to go out and track down a Megaloceros giganteus, you’d be sorely disappointed.  But the paleo diet is about eating nutrient-dense whole foods and avoiding Neolithic foods, not recreating the exact diets of our caveman ancestors.

The experts say that in avoiding dairy, grains and other mainstays of the modern diet, paleo followers may miss out on key nutrients.

Yeah, that’s why Custer kicked ass at Little Big Horn.  The Sioux and Cheyenne were perpetually weak and sick from a lack of dairy, grains, and other mainstays of the modern diet.

The paleo diet, by the way, was ranked 35th out of 35 – you know, because it lacks those mainstays of the modern diet.  The Slim-Fast diet – which requires consuming shakes that contain all those ingredients I listed above, including hydrogenated soybean oil –was ranked 13th.

Meanwhile, a  vegetarian diet was ranked 11th … because while we shouldn’t give up grains and other mainstays of the modern diet, giving up a mainstay of the modern diet is fine and dandy if the mainstay is meat.  And while the paleo diet was ranked last largely because it’s “too difficult to follow in modern times,” apparently switching to a vegetarian diet isn’t difficult at all.

Here’s what the U.S. News article said about the vegetarian diet:

As a health diet, vegetarianism is solid. It’s decent at producing rapid weight loss, according to experts, and is strong in other areas, such as heart health and nutritional completeness, that arguably are more important.

But if you take a vegetarian diet and remove the grains while adding meat, it’s no longer nutritionally complete, according to the (ahem) experts.

As for heart health, well geez, that must explain why vegetarians don’t die of heart disease.  No, wait … I seem to recall that they do.  As I recounted in a previous post, Bill Clinton’s own vegan-promoting doctor warned him against eating bread:

When Caldwell Esselstyn spotted a picture of him on the Internet, eating a dinner roll at a banquet, the renowned doctor dispatched a sharply worded email message: “I’ll remind you one more time, I’ve treated a lot of vegans for heart disease.”

And in another post, I quoted from a study titled Mortality Among British Vegetarians:

The mortality of both the vegetarians and the nonvegetarians in this study is low compared with national rates. Within the study, mortality from circulatory diseases and all causes is not significantly different between vegetarians and meat eaters.

Hmmm, kind of makes you wonder if these diet rankings are a bunch of poppycock.

The U.S. News article included a link to the panel of experts who ranked the diets.  I’ve never heard of most of them, but I have heard of Dr. David Katz.  He created something called the NuVal system, which is supposed to help shoppers choose healthier foods at the grocery store.  Foods are ranked from 100 (excellent) to zero (might just kill you.)  I wrote about NuVal in a previous post.  Here are how some foods rank on Dr. Katz’s NuVal scale:

Post Shredded Wheat ‘N Bran – 91
Silk Soymilk Light – 82
Silk Soy Milk Chocolate – 68
Chicken Breast (boneless) – 39
Turkey Breast – 31
Ham – 27
Coconuts (husked) – 24

So according to Dr. Katz, a big bowl of wheat is an excellent choice.  A cup of chocolate soy milk containing 17 grams of sugar is a good choice.  But a chicken breast, a turkey breast, a slice of ham or a coconut is a bad choice.  No wonder he thinks Slim-Fast is better for you than a paleo diet.

The #1 ranked diet was the DASH diet.  Here’s what U.S. News has to say about it:

DASH was developed to fight high blood pressure, not as an all-purpose diet. But it certainly looked like an all-star to our panel of experts, who gave it high marks for its nutritional completeness, safety, ability to prevent or control diabetes, and role in supporting heart health.

The theory: Nutrients like potassium, calcium, protein and fiber are crucial to fending off or fighting high blood pressure. You don’t have to track each one, though. Just emphasize the foods you’ve always been told to eat (fruits, veggies, whole grains, lean protein and low-fat dairy), while shunning those we’ve grown to love (calorie- and fat-laden sweets and red meat). Top it all off by cutting back on salt, and voilà!

But if you take way the whole grains and low-fat dairy and add in some red meat, it’s now a paleo diet and the ranking drops from first to last — 22 spots lower than the Slim-Fast diet.  Yeah, that makes perfect sense.  And the extremely low level of salt allowed on the DASH diet is not only unnecessary for most people, it might actually be bad for your health, according to a study published recently in the New England Journal of Medicine.

So here’s what we’ve got with the U.S. News diet rankings:  the same group of idiots who’ve been pushing low-fat, low-salt, low-meat diets for decades were asked to rank diets and – surprise! – they chose the low-fat, low-salt, low-meat diets as the best … which means ordinary folks looking for advice to help them fulfill that New Year’s resolution to lose weight will read that a diet of meats and vegetables isn’t good for them.  Nope, a decent diet is based on meal-replacement shakes that include FAT FREE MILK, WATER, SUGAR, COCOA (PROCESSED WITH ALKALI), CANOLA OIL, MILK PROTEIN CONCENTRATE, FRUCTOSE, GUM ARABIC, CELLULOSE GEL, MONO AND DIGLYCERIDES, HYDROGENATED SOYBEAN OIL, HIGH FRUCTOSE CORN SYRUP, POTASSIUM PHOSPHATE, MALTODEXTRIN, SOY LECITHIN, CELLULOSE GUM, CARRAGEENAN, NATURAL AND ARTIFICIAL FLAVOR, SODIUM BICARBONATE, SUCRALOSE AND ACESULFAME POTASSIUM (NONNUTRITIVE SWEETENERS), SODIUM CITRATE, CITRIC ACID.

Head. Bang. On. Desk.

And that’s why the same people will be making the same weight-loss resolution next year.  And the year after that.  And the year after that.

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I receive email alerts from MedPageToday online.  Here’s the headline for a recent alert:

Stroke Rounds: Less Educated Smokers at Higher Stroke Risk

The article is about a large observational study conducted in Denmark.  The conclusions drawn by both the investigators and the reporter approach head-bang-on-desk levels of mushy thinking.  Let’s take a look:

The combination of a low level of education — a marker of socioeconomic status — with smoking appears to increase risk of stroke, especially in men, according to one of the first studies to analyze social inequality and stroke risk.

Social inequality and stroke risk?  Someone is studying that?  That had me scratching my head already.  Turns out the study was funded by something called the Danish Cancer Society Commission of Social Inequality in Cancer.  (And as Dave Barry would say, I am not making this up.)  I don’t know why the Social Inequality division of a national cancer society is mucking around in the field of social inequality in stroke risk, but apparently they felt the need.  Anyway …

In a pooled cohort of more than 68,000 people, lower education and current smoking led to 134 (95% CI 49-219) extra cases of ischemic stroke per 100,000 person-years in men, the authors wrote.

“The combined effect of low education and current smoking was more than expected by the sum of their separate effects on ischemic stroke incidence,” wrote Helene Nordahl, MS, PhD, of the University of Copenhagen, and her co-authors online in Stroke.

So don’t smoke unless you have a college degree, which apparently will provide you with some protection against strokes.

This particular example of the impact of socioeconomic position on risk was “quite interesting and novel” and “the most surprising finding of our study,” Nordahl told MedPage Today.

The impact of socioeconomic position … you know where they’re going with this, right?  They’re going to make a case that smokers with less education are having more strokes because of their lower socioeconomic status – and by gosh, someone (meaning the government) needs to do something about it.

Overall, the combination of exposure to smoking, low level of education, and hypertension on ischemic stroke was associated with 566 extra cases among men and 438 among women, compared with those who had no exposure to the three risk factors.

I’m not sure how you avoid exposing yourself to a low level of education, but I suppose refusing to respond to the greeter at Wal-Mart could help.

“In order to reduce social inequality in stroke we need to challenge disparities in unhealthy behaviors, particularly smoking,” Nordahl told MedPage Today.

Yeesh … I hope the goal of reducing social inequality in strokes doesn’t find its way to the United States.  Given the crowd currently running Washington, the result would be more strokes among wealthy people.

The social differences in risk of stroke have been a topic of interest for health research for a number of years, Nordahl told MedPage Today.

So let’s talk about those social differences.  Normally when studies like this are conducted and published in the U.S., reporters assume people lower on the socioeconomic ladder have worse health outcomes because of inferior healthcare.  The unfairness of U.S. medicine and all that.  If only we had a socialized system where everyone is equal, by gosh, we wouldn’t see these disparities.

I remember reading an article along those lines awhile back in our local socialist rag – excuse me, local newspaper.  The article pointed out that people living in Williamson County (where I happen to live) have lower rates of heart disease, cancer, etc., and suggested perhaps we need to find a way to move more poor people here so they’ll be healthier.  Clearly those well-to-do folks in Williamson County are enjoying superior healthcare. Oh, the unfairness of it all.

But wait … this study about stroke and social inequality was conducted in Denmark, which already has socialized medicine.  Since the researchers couldn’t blame inferior healthcare, they seem determined to blame “exposure” to a low level of education.  Must be the education disparity, ya see.

It’s the same problem we see over and over with conclusions drawn from observational studies:  researchers and reporters can’t seem to grasp that the data is nothing more than the result of comparing different kinds of people — and I’m not just talking about health-related studies.  Fuzzy-thinking conclusions about cause-and-effect have led to mistaken beliefs about education as well.  (The Denmark study researchers seem determined to pull off the unusual feat of engaging in fuzzy thinking about both health and education.)

I remember reading about the relationship between income and education in a book about economics.  (Sorry, don’t remember which one.)  The author noted that people who earn college degrees have higher incomes than those who don’t, and people who earn degrees from an Ivy-League school have much higher incomes.  Most people assume this means going to college will raise your future income, and going to an Ivy-League college will seriously raise your income.  Cause and effect.  So let’s make sure everyone goes to college, and we’ll end poverty.  (Just ask all those kids taking on $100,000 in student-loan debt to get a degree in Art History.)

But as the author explained, those correlations don’t prove cause-and-effect at all.  As he recounted in the book, it occurred to some researchers that perhaps people who attend Ivy-League schools have significantly higher incomes because they’re smart enough to attend an Ivy-League school.  There is, after all, a very strong correlation between IQ and income.

So the researchers went out and found thousands of people who had been accepted into an Ivy-League college but, for one reason or another, decided not to attend.  Guess what?  On average, they were just as financially successful as people who earned degrees from Ivy-League schools.  In other words, if you’re smart enough and hard-working enough to be accepted into Harvard, you’re probably going to do very well in life – even if you choose to attend a state university instead.

To a large extent, the same goes for the correlation between a college degree and a higher income.  Yes, there are many high-paying jobs you’d probably never get without attending college – good luck landing a job as a CPA without a degree – but according to the author of the book on economics, people who earn college degrees end up with higher incomes largely because they have higher IQs and more discipline on average than people who don’t attend college.

In other words, they’re different.  I’ve written before about what Dr. Mike Eades calls adherers vs. non-adherers.  (I think of them as conscientious people vs. people who don’t give a @#$%.)  As Dr. Eades pointed out years ago, adherers regularly end up with better health outcomes.  In drug studies, for example, the adherers get better results than the non-adherers even if they’re in the placebo arm of the study.   That means it’s not the drug making the difference.  Perhaps they just take better care of themselves in ways the study investigators don’t measure.  Perhaps their lives are less of a mess, so they’re less stressed.

One factor that separates adherers from non-adherers is the degree to which they are motivated by possible future consequences.  Adherers plan ahead and act accordingly.  Non-adherers are more likely to live for today.  I can think of all kinds of ways being motivated by future outcomes would cause an adherer to think and act differently:

  • That soda would taste good, but I don’t want to become fat and diabetic.
  • Those French fries smell awesome, but the broccoli would be better for me.
  • There are a lot of good shows on TV, but I need a good workout more than I need entertainment.
  • I’d like to go hang out with my friends, but I need to study so I can get good grades and get into a good school.
  • I’d love to own that new car, but I need to save more money to invest or use to start my own business.
  • Yeah, he’s hot as all get out, but he doesn’t seem to have any kind of work ethic and would probably be a lousy provider if we got married and had kids.  Pass.

You get the idea.  Compared to non-adherers, adherers are more likely to take care of themselves, so they’re healthier.  They think about long-term consequences, so they study and get better grades, probably go to college, are more willing to defer fun and gratification now if it means a higher income later, so they end up better off financially.

Then they move somewhere pleasant where the homes are bigger and more expensive – like Williamson County, for example.  The local schools end up being highly ranked because the smart adherer children of the smart adherer parents study and do their homework and pay attention in class.

Then researches and reporters notice how those well-to-do people have better local schools and lower rates of heart disease and cancer and stroke, and they think they’ve spotted social inequality that might need a government cure.

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