..man, proud man,
Dress’d in a little brief authority,
Most ignorant of what he’s most assur’d…

From Measure for Measure by Wm Shakespeare

The web has been alive with commentary the past few weeks since Denise Minger lobbed her first cannonball of a critique across the bow of The China Study, the vessel T. Colin Campbell, Ph.D. rode to fame and bestsellerdom.  Seems like everyone is now jumping into the fray and gunning for poor Dr. Campbell, who early on in the fracas made a few halfhearted attempts to fight back but has now fled the scene.  I’ve been laying low watching it all play out, and so now figured it’s about time I add my two cents worth to the debate. But first a little history.

I met Dr. Campbell about ten years ago (five or so years before the publication of the popular book The China Study) when we both spoke at the same conference.  He was a nice enough man who spoke about the work he and his team had done in China gathering the data published in the massive 894 page monograph Diet, Life-style and Mortality in China (pictured above left).  As Dr. Campbell presented his data ‘demonstrating’ the superiority of a plant-based diet and demonizing protein of animal origin, I didn’t think much about it because the data was all in the form of observational studies, which, as all readers of this blog should know by now, despite often showing correlation don’t prove causation.  My lecture, which followed Dr. Campbell’s, was, as you might imagine, a lecture of a different sort.  Then we both sat on a panel after our talks and fielded questions.  And were both cordial to one another.

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As if trying to pull meaning out of the medical literature weren’t difficult enough as it is, a new study demonstrates yet another obstacle to easy understanding: the adherer effect.

We’ve all seen the headlines.  Statins improve bone health.  Statins prevent cancer.  Statins make us smarter.  Low-fat diets improve longevity.  All these headlines and others like them are followed by articles describing studies seeming to show that subjects taking certain medications (usually statin drugs, it seems) or following a particular diet have improvements in health and/or longevity.  The promise of these articles is that if we all take the medication or follow the lifestyle choice, we, too, will reduce our risk of [fill in the blank] or live longer.  But will we?

Maybe so.  But not for the reason most people think.

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The news is abuzz with reports of the latest study to come out showing that eating meat, especially red meat, kills us off before our time.  (You can read some of the reporting here, here, here and here.)  Google shows 547 new articles about this study.

Although this study is totally worthless from a causality perspective because it is an observational study, it does serve to confirm the biases of those non-critical thinkers who have already bought into the idea that meat is bad.  To give you an example of such a soft thinker, here is the second comment on the blog post about this study in the New York Times.

I could have told you that 30 years ago. I been a vegetarian for 47 years and I have never seen vegetarians die from heart disease or cancer. They died from basic infectious diseases and malnutrition. Make no mistake it is harder to be a vegetarian than a carnivour but your body does not expel everying [sic] that is in the meat especially red meat.

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I’ve had a number of people email me about a new study appearing in the Archives of Internal Medicine purportedly showing that statins really do provide benefit to those who take them regularly.  As you can see from the heading of an email piece I pasted above, even Medscape is all over this article and blasting it out to physicians all over the world.

I’m sad to say that this is the same kind of paper I would have been taken in by 20 years ago before I really understood how to read the scientific literature critically.  In fact, I would have used it myself to justify giving statins to all kinds of people, and I’m sure other physicians are doing so right now.  But I would have been in error to base my prescribing on this paper, and all the other docs out there giving statins like they were candy are in error as well.

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First I would like the heartily thank everyone who took the time to send me a comment on how to make this blog better both functionally and in content.  I read every single suggestion, and appreciated every one.  I’ll try to incorporate as many of the functional changes as I can within the design framework I have and within the limits of my pocketbook.  To demonstrate my profound gratitude for all the blog topic selections, I’m going to put up a post that absolutely no one asked for. But only because I’ve had it rattling around in my brain for the past week.

One view of the value of epidemiology

A day almost never passes without someone sending a comment my way about some recent study, plucked by the media from the hundreds published that same day, showing that low-carb diets cause brain fog or decreased longevity or cancer of some type or any number of conditions any of us would rather not have.  These comments always  end with the plaintive request, is there any truth to this?

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