"that the medical establishment might've covered up and/or willfully ignored the evidence that eating a high carbohydrate diet seems to make you fat." An this is why I very much disagree with Taubes. He sounds like a 911 toofer. There is not cover up it's just a matter of no evidence. I agree there is a lot of things in the medical field that should be supported with more evidence. Doctors should not take it on the word of pharmaceutical companies that x works. So the alternative would be NIH studies, done with tax payer dollars. Fed research dollars are in very short supply, for war and freebies yes but not for research.

My point is that Taubes had no more evidence than his counter parts at the AHA. Vegans tend to be skinner that the rest of us not out of the inherent health of their diet but the lack of readily available food. The raw food vegans are even worse. We all know that a high carb., high fat, high calorie diet is a bad idea. Fat people tend to live shorter lives which has been scientifically proven. Now as to how one get to not being a fat ass there is some contention. Some say low carb. diets some push balanced diets, some push vegan diets.

The Inuits that Taubes has such a hard on for have a many things that make them unique, some of the same things that make them unsuitable for western modern life. They are a population that grew up isolated and had an unvaried diet. Their diet was not farm raised, enriched, or fortified, one of the vegan food Nazis big pet peeves. They live in a very cold environment so airborne toxins like most spores etc. do not exist, their metabolisms are high than our to keep from freezing to death. They get no sun exposure for most of the year. They have also been exposed to generations of isolated evolution allowing to them to adapt to their environment very well. Premature babies had no chance of survival and no vaccines lead to continued natural selection that we are not exposed to. The list goes on. Taubes is only focusing on their diet and even then only one aspect of it.

The study done on the Inuits prior to westernization did not conclude that they lived better, longer lives. It concluded that they suffered from few if any topical cancers. The author also noted his surprises that their diet did not negatively affect them. Which could be attributed to reduced sun exposure and isolated evolution as readily in not more so than to a low carb.
diet.

I'm not against Taubes conclusions, I support a higher protein diet and avoid refined carbs. Evidence wise he has no more solid backing that the AMA. They have observed evidence though not all that well controlled either. I wouldn't call the life experience of a cardiovascular surgeon a scientific study but I wouldn't relegate it to the realm of anecdote either.

And a ship's captain still didn't examine more Inuits than existed on the face of the Earth, every year for 15 years. That's the only hoot you'll hear from me.

Just the other day, there was all manner of jeering and hooting about the idea, per Gary Taubes' work, that the medical establishment might've covered up and/or willfully ignored the evidence that eating a high carbohydrate diet seems to make you fat.

That's odd. I could have sworn all that discussion was about whether high carb diets caused cancer, not whether they make you fat.

> the medical establishment might've
> covered up and/or willfully ignored
> the evidence

Why? Why? Why? Why? Why? Why?

Because you want it to be true. Because you want it to be true. Because you want it to be true....

the important thing to remember is that anecdotal evidence is still evidence, it's just not as strong. It can be unique to only one person, but what works for one, may work for others. That is why when you chew willow bark, it makes your headache go away. Eventually they figured out how to make aspirin form this. The problem here lies more in the levels of separation that modern docs have from where the information comes from. They believe the AMA or whatever based on the idea that "somebody over there must have done a study..." They don't have time to do studies themselves. The fact that the AMA or whatever has done no such thing, that is the important take away, and where the medical groups start flirting with negligence. There are guidelines for your ritalin too Amy, but those are even more subjective than regular meds.

Evidence is a tricky thing. For example... I understand the stance on homeopathics that Amy and many others have... however. If I take graphites 30c when my gout flares up? It goes away. Every time. For more than 5 years. Don't take the stuff? I get to the point where my big toe hurts so bad I can't walk. This is evidence for me. Not scientific, but evidence based. Placebo effect? Maybe, but I tried hundreds of different things for several years including a number of recommendations from my doctor, that all made me sick with side effects. So I can't imagine how one placebo would be better than any other.

Will it work for you? Dunno. But this is part and parcel of what Taubes is saying too, and an important point. Human beings can be quite arrogant when they think they know something. They never seem to look at what they DON'T know. Coupled with the fact that we want a one shot answer to a problem, and you have medical recommendations carrying the weight of "rules" wher ethey are based on anecdotes from the other side of the world. This is why my doctor had never heard of Singulair having mental side effects, and thought I was nuts for thinking that. Except even my ex noticed that the minute I started singulair I became a large angry bear instead of my docile self. So I went off it. Or that Seldane gave me migraines from the get-go... So I went off it. Doc says: "that cant be related to seldane it must be something else. 6mo. later seldane was pulled from the market because several people died from it.

Evidence is one thing, be even double-blind large studies can be influenced by bias. That said, if no studies are ever done, you have to be even more careful, and pay attention to your own evidence too. You are the only one to control yourself.

On a side note Amy, I finally stopped taking the Adderall, because I stopped dreaming and it killed my creativity. Since I din't know about the ADD until I was 40, I've put enough workarounds in place over all those years to live well anyway. Maybe it woulda been different had I learned about it when I was a kid, but that water is way long under the bridge...

> the important thing to remember is that
> anecdotal evidence is still evidence

Have I told you about my rheuma-tiz? It only ever gets to be a problem when it rains! Now, the doctors says I'll have to live with it, but there's this palm reader over on Wilshire who says.....

No one reads lengthy articles at links - but what the hell.

This is such a cracking read, particularly about under-reporting side effects - even if you've not got the faintest interest in anti-psychotic drugs. It's the sole reason I just renewed Rolling Stone mag.

http://www.rollingstone.com/politics/story/25569107/bitter_pill

so Crid, if what the palm reader on wilshire told you actually worked, what would you say then? Or if your Nana told you how to make a chest compress with castor oil and cinnemon, that seemed to make you feel better? But, I hear you on how this all gets outta hand, and that is that you have no skepticism for the palm reader. You don't put a reasonability test on what she says. "Go stand on your head in a corner and you'll feel better..."

What is even more important is that my big toe isn't likely to kill me, but if I had a heart condition that might. An upset stomach is different than cancer. Our expectations of medicine in all it's forms is corespondingly different.

Happily my arthritis doesn't seem to be weather related either...

"may be themselves prone to a placebo effect: the willed conviction that a new drug, presented as a breakthrough, must in fact be one, that a product sold as healing must in fact do good."

This seems like an important point to me...

Consider Piltdown Man.

For over 40 years (1912 - 1953), the cream of the world's scientists & doctors believed that this blatant forgery was authentic, and they wrote endless glowing studies & books about it. The handful of researchers who smelled something fishy were subjected to vicious scorn & ridicule. But they persisted in patiently pointing out the truth, and eventually the hoax collapsed under the weight of the evidence.

Now here's the thing. Instead of crawling away like cowards when the fabrication was exposed (I'm talking about you here, Stephan), in 1953 every prominent living scientist and doctor who had believed in the authenticity of Piltdown Man stood up like a man and admitted that he'd been fooled. And that he'd been fooled because this orangutan jaw stuck to a medieval human cranium had seemed to confirm his most cherished beliefs. That early humans had evolved large brains before they adopted an upright posture and omnivorous diet, that Eurasia in general & Western Europe in particular (rather than Africa) was the true cradle of mankind, and so on. And after being derailed for 40 years, the study of human origins got back on track. You all know about Lucy, Homo habilis, etc. And now, in 2009, scientists have almost finished sequencing the Neanderthal genome, and discovered that they were redheads. Science and medicine are self-correcting.

Scientists & doctors are human beings, so sometimes they follow the money, follow the herd, get caught up in fads, buckle under to peer pressure, get lazy, whatever. But there is a self-correcting mechanism in place. There is ALWAYS at least one researcher out there who's willing to dig till he gets at the truth about Zyprexa, no matter how hard Eli Lilly pushes it, and even if it takes 40 years.

"Because doctors are lazy and don't read the studies....his stories are rather upsetting"

The only prior alternative to flawed but self-correcting modern science & medicine was medieval ignorance.

>>There is ALWAYS at least one researcher out there who's willing to dig till he gets at the truth about Zyprexa, no matter how hard Eli Lilly pushes it, and even if it takes 40 years.

Not arguing with you, Martin.
Just making the obvious point that living patients don't always have time to wait for the true picture to emerge.

As the article says:

But it would be nine years before a comprehensive government study would reverse many of the claims that surrounded Zyprexa and other atypical antipsychotics, and raise disturbing questions about their risks. And nine years, in the pharmaceutical industry, is a lifetime.

And so the solution is internet research. Which the doctor will admit, and prescribe drugs based on what you tell him. Right!

Rolling Stone? Are you kidding me? The guys who insisted that AIDS was due to the World Health Organization's flu-shot campaign, and who back Sarah Brady's outright lying about gun laws?

> if what the palm reader on wilshire
> told you actually worked

...Then I'd weave my own anecdotal experience into the vast tapestry to of information about how health is cared for.

(Not really-- I don't do palm readers.)

Sure, you can't trust doctors to tell to handle your health blindly. And there are bad outcomes (a few) from medicines.

But to imagine that scourges like CANCER --as broadly defined in the earlier thread-- or even "fat in the diet" are getting insufficient attention from medical science is just cock-suckingly ludicrous. These horrors happen to people across the culture, including the beloveds (and selves) of all kinds of medical personnel and statisticians. If there were any, any, any value in investigating these insinuations, brilliant men and women would be all over it. Much smarter, more aggressive people than you and me are tortured by weight gain, cardiac disease and cancer.

I mean, come on. Seekers. Puh-leeeze....

Point taken, Jody & Amy. But the principle of self-correction still applies here.

At the start of the story:

Dr. Wirshing, who had a grant from Lilly to conduct clinical trials of olanzapine, was one of those enthused by the early results. He believed the hype was warranted...

"It was a very clever sort of con,", says Dr. Tyrer. "Almost the whole scientific community was conned into thinking...that this was a different and better set of drugs. The evidence, as it's all added up, has shown this to be untrue."

At the end of the story:

"The medications are helpful, but they don't work for everybody, and they have lots of side effects," Eaton says. "We tend to think of drugs as solving discrete problems...but with antipsychotics we're shooting at an invisible target".

"Schizophrenia used to be synonymous with a death sentence," Aquila says, "I can get them paying taxes". Aquila has learned...a feel for the enormity of the problem, and a sense that the solution lies in hard and incremental work...He has learned, in other words, that there is only so much the drugs can do. He has come to believe that there is no magic here.

I call that a happy ending. Doctors know much more about the limitations of their knowledge about schizophrenia, have stopped deluding themselves that there's a magic bullet, and can give at least some of their patients better lives than they would've ever imagined before. Call me a callous bastard, but the bitter truth is that some people had to suffer & die for this new understanding to come about.

"Nine years if the drug kills you is way too long" What would have happened if Eli Lilly hadn't pushed this poison pill so aggressively? It would still have taken 9 years, or maybe longer, and doctors would have still reluctantly prescribed Zyprexa for their worst cases, because it was an improvement over clozapine, which killed 2 out of every 100 patients, or thorazine, which turned patients into zombies. The fact that Eli Lilly peddled it to so many people who should've never taken it meant that a lot more people suffered & died, but it also meant that a nation-wide alarm was raised earlier.

Doctors & scientists learn from their mistakes, and the evidence always wins out in the end, even over $ 16 billion of marketing. Some poor souls are fated to suffer in the process.

I haven't read the link yet... Hadn't read most of the comments before responding earlier today...

But I don't get Jody's emphasis of the 'nine years' thing. Nine years is as long as it is, whether it's the disease that kills you or the treatment that kills you. Remember how in the 80's & 90's AIDS activists demanded accelerated science for medications? I remember one activist in the middle 90's lamenting that his demands had been answered: The resulting drugs were expensive, had painful side effects, and weren't yet all that helpful. Meanwhile, every other illness was wondering why AIDS was getting so many of the limited resources.

This is about competing interests. A society this eager to sue for bad outcomes (even when people are already sick) ought not be too snarky about medical types who move cautiously. We can't have everything.

(Ok, off to read the Stone thing.)

Good article. It calls to mind a theme of many of SJ Gould's best history of science essays. The scientific method isn't just logical machinery, it's a human process. Nobody said it was pretty! Human life is often not pretty. To wit:

> Some poor souls are fated to
> suffer in the process.

Well, yeah. But it's like they're fated to suffer, and we just happen to have all these other 'processes' rolling along, often with nakedly commercial intent... But commercial intent makes things happen, too!

Anyway, by the skin of teeth, the 3:05pm comment is affirmed. Mental illness is something that tends to happen to other people, not our best medical people.

(There are exceptions, of course. Remember that book about death recommended last month? The author has another story to tell. [TED Lecture: Shitty music alert.])

But a lot of really, really sharp guys are going to face these other horrors (cancer and heart disease) and still have years of productive work left to give.

We flatter ourselves too fondly if we think we can see simple and convenient solutions to these incredibly complicated problems, as if the brightest amongst us had their minds on other things. They don't. The bell tolls for everyone.

Crid,
The "nine years" obsession was specifically in response to Martin's point about how the correct facts finally buried the academic Piltdown man debacle after 40 or so years.

I was just making the tiny observation that clinical cock-ups, by contrast, really ought to be addressed more urgently.

I haven't read all the comments and probably won't get to it, but I figure I'll jump in anyway:

> "that the medical establishment might've
> covered up and/or willfully ignored
> the evidence that eating a high carbohydrate
> diet seems to make you fat." An
> this is why I very much disagree with Taubes.

Vlad: You obviously haven't read Taubes' book. Those are Amy Alkon's words, not his. As I understand it, Taubes' thesis is that a number of factors have converged to cause a sort of meltdown in our public health establishment. He doesn't posit a cover-up, exactly. A point he makes is that, more often than not, the people who caused this train wreck seem to have had good intentions and told the truth as they understood it.

(Though a certain amount of dubious behavior was involved, of course. I think Taubes is a bit too generous in his assumptions. But that is neither here nor there.)

Factors involved include the disintegration of the European nutritional science community during WWII, the alliance forged between George McGovern and Ancel Keys in the 1970s, the extreme specialization of today's scientists, the intervention of government agencies in science and medicine, and others. I won't attempt to explain how those factors interact - there is a reason the book is 600 pages long.

This convergence has led to a situation where many scientists don't understand the implications of their own research, and science is used more as a propaganda tool than a guide to policy. Our medical system has lost touch with reality.

Taubes is careful to point out that much more research needs to be done to establish "the carbohydrate hypothesis". But he argues the evidence for it is much better than that supporting the prevailing view.

His research confirms suspicions I've developed over the years, as someone with a passing interest in science and health. And I was utterly blown away by how he ties the evidence from various fields together to make sense of the mess. I found myself reflecting on confounding bits of information I've picked up over the years (which he does not mention), and seeing how it all fits in with the big picture he presents. His book's implications are disturbing, but it has resolved a great deal of cognitive dissonance for me.

Sorry for sounding like an infomercial, but "Good Calories, Bad Calories" is one of the most important books written in the past hundred years. Read it.

> The Inuits that Taubes has such a
> hard on for...

The word "Inuit" appears on a grand total of 4 pages in the book. Data on their lifestyle does not play a major role in his thesis. It is little more than an aside, though a very interesting one. His conclusions on the carbohydrate hypothesis are supported by a downright tedious list of studies. If you want crunchy science, the bibliography will keep you busy for a while.

>>I found myself reflecting on confounding bits of information I've picked up over the years...

GodlessRose,

You've just expressed exactly what I responded to in the Rolling Stone piece linked. (Even though - fortunately - I have no urgent personal stake in anti-psychotic drugs research.)

As has been true for eons for most of us, eating varied foods, not all one thing, is the way to go. That way you're getting some of whatever's good and not too much of whatever turns out bad.

I always research meds I"m put on, even antibiotics. I've had drs give me ones not ok for pregnancy when they knew I was pregnant. No one person can know everything. Taking care of yourself is juts common sense.

America is footing the bill for med development for the world. There is enormous pressure to get one out and start making a profit to be able to continue research on others. We can thank other countries' socialized medicine and drug price caps for that.

"Clinical cock-ups, by contrast, really ought to be addressed more urgently"

Yes. All as I was trying to say was that the reason it took "only" 9 years for the truth about this poison to come out was that so many ordinary people suffered from it. It's predecessor, thorazine, was much worse, but it lasted for over 40 years because only schizophrenics had to suffer the consequences of taking it.

"I always research meds I'm put on, even antiobotics" Exactly! The thing that struck me most about that piece was the fact that so many parents only raised concerns over Zyprexa after their children starting showing terrible side effects. If your child was having emotional problems, and your doctor prescribed some pill you'd never heard of, and you did a little research & found out that it was designed as an ultra-strength antipsychotic for the severest cases of schizophrenia, wouldn't alarm bells go off in your head? Would you think "holy shit, what is this quack trying to push on my kid!?"

No matter how greedy drug companies & doctors are, or how understaffed the FDA is, parents are the last line of defence for their children's health.

> clinical cock-ups, by contrast,
> really ought to be addressed
> more urgently

Well, again, it's competing resources. Eventually the world is going to say "Listen, we're sorry your mother has breast cancer or your brother has schizophrenia, but we have our own lives to lead over here... My daughter's trying to sell some GS cookies this weekend. Want some Thin Mints?" (etc)

> "Good Calories, Bad Calories" is
> one of the most important books
> written in the past hundred years.

Listen, Seekers...

> Read it.

When people use the command form to recommend this kind of cultural artifact, we should instinctively resist. (Years ago when cocktail party guests said "You really should see Schindler's List" with pouty faces and compassionate head tilts, I resolved to never, ever watch that movie. I'd heard of the motherfucking holocaust, thank you very much.

(See especially this example.)

> The word "Inuit" appears on a
> grand total of 4 pages in
> the book.

Well, we're not the ones who brought that element to the discussion. It was a Fellow Believer of yours.

> It is little more than an aside

Yet it's apparently charming enough to use as the selling point for the thesis.

Listen, the Inuit thing was bogus. It's faults were crystalline, casting distracting rays of deceit in all directions. If the rest of the book was as golden as you suggest, why did this happen?

Either because [A] the guy was sloppy or [B] he was in the mode.

> When people use the command form
> to recommend this kind of cultural
> artifact, we should instinctively
> resist.

Crid: If I had taken a less forceful tone, I doubt you would find it more compelling.

Though I often have trouble deciding what tone I should take. I have some Nice Guy tendencies, so I am prone to tremulousness. I find it is best to err on the side of directness.

> > The word "Inuit" appears on a
> > grand total of 4 pages in
> > the book.

> Well, we're not the ones who brought
> that element to the discussion. It was
> a Fellow Believer of yours.

As I am sure you read, I was responding to Vlad's claim that Taubes "has such a hard on for" the Inuit. How, exactly, does the fact that a third party brought up the Inuit justify his misrepresentation of Taubes' views?

Nice use of capitalization there, by the way. You are a master of the art of condescension.

> Yet it's apparently charming enough
> to use as the selling point for the
> thesis.

Of course. (Though it is hardly the only selling point, as you imply.) It can be explained quickly and easily so that anyone can understand. It gets people thinking instead of making their eyes glaze over. Dissecting the Framingham Heart Study, for instance, and showing how it actually supported the carbohydrate hypothesis and undermined the fat-cholesterol hypothesis, but has been misrepresented to the public, just takes too long and confuses a lot of folks. Discussing the varieties of lipoproteins and how they relate to heart disease, or how insulin contributes to cancer, is also problematic.

And there are other extreme examples, such as the Masai and the American all-meat diet craze of the 1920s. Some members of the latter movement were studied under controlled conditions. Those are also good to get people thinking, and hopefully motivate them to read up on the science.

Plus what Amy said.

Listen, I apoligize for using the interjection "Listen" three times in the previous comment.

It feels like you (Amy & G-Rose and Taubes and Stefan) are trying to make the case that cancer is a policy problem. But, y'know, Inter faeces et urinem nascimur and all that.

We're on a tough planet.

> If I had taken a less
> forceful tone...

... Then you'd have seemed to have less inertia from fanaticism and more from thoughtful reflection.

> a master of the art of
> condescension.

Years of practice; I was named after a Christian minister, my grandfather. To break away from that stuff, I learned to hold sharply forged weapons against people who describe the world through comforting, self-flattering illusion.

> does the fact that a third
> party brought up the Inuit
> justify his misrepresentation

Vlad's exaggeration was smaller than Taubes'. And it was a lot funnier!

> It gets people thinking instead
> of making their eyes glaze over.

No, exactly the opposite. It puts people into a fluffy zone of Rousseau-ish fantasy... A realm of dreamy belief that in a just society, where the authorities had their shit together, everything would be OK!... That if only we could live in a really natural way, we'd be healthy and happy and have great sex and straight, white teeth and thick, shiny hair.

This isn't true. The Inuit lived naturally, and their lives were for shit. Modernity insulates us from the horrors of the natural world... For a time.

There's no natural or supernatural agency that protects you from cancer and heart disease. Only the artifice of civilization can do that, and it can only do it to a limited extent. Eventually your body will betray you, no matter what you eat or where you live or how good the FDA is with drug certifications.

We get more time than most people on this planet got. Whining about the small-minded man is a bad way to spend it.

It's "masterful"! It's a "masterful product"!