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	<title>Comments on: Observational studies</title>
	<atom:link href="http://www.proteinpower.com/drmike/statistics/observational-studies-2/feed/" rel="self" type="application/rss+xml" />
	<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/</link>
	<description>A critical look at nutritional science and anything else that strikes my fancy.</description>
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		<title>By: Desmond</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-2/#comment-220276</link>
		<dc:creator>Desmond</dc:creator>
		<pubDate>Sun, 05 Jul 2009 16:39:05 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-220276</guid>
		<description>Dear Mike,
 I have copies of Protein Power and Life Plan and also read the experiences of the redoubtable explorer and dietary &quot;guinea pig&quot; Viljalmur Steffansson.

Would you be willing to agree that his experiences while wintering on the Hudson Bay amounted to an &quot;observational study&quot; which generated a number of Null Hypotheses, including long term  &quot;lo carb&quot; is injurious, and scurvy will result from lack of vegetables or fruit, while the period at Bellevue and after, was a &quot;crossover design&quot; study, albeit on a sample size of two, (Steffansson and Anderson switched from  &quot;ordinary diet&quot; to the Inuit Diet) which provided no supporting evidence for the Hypotheses? I was interested in the observation of &quot;pure protein&quot; poisoning resulting from a few days of eating little or no fat with animal protein.

I&#039;m glad thatyou keep flying the flag of proper metabolic science, so that the health of diabetics, the overweight, those with the prospect of longevity reducing condition may be promoted using the results of tested measurement rather than the &quot;observations&quot; of Congressional Sub-Commitees and the Surgeon-General.

I also imagine that Viljalmur Steffansson would be delighted that &quot;fish oils&quot; are now promoted as a healthy food supplement. It would in keeping with his experiences on the Hudson Bay.

My own foods are beef, fish, eggs, chicken, cheese, olive oil, nuts, tomato, onions, yoghurt milk and coffee. My supplement is &quot;cod liver oil. When asked, I call my way of eating: home cooked good food, otherwise &quot;lo carb&quot; or ketogenic.
Thank you for your good work.

Desmond
Msc Stats (40 years ago)

&lt;em&gt;Re: Stefansson.  Observing is different than an observational study.  But both are useful for generating hypotheses that can be tested with randomized, controlled trials.&lt;/em&gt;</description>
		<content:encoded><![CDATA[<p>Dear Mike,<br />
 I have copies of Protein Power and Life Plan and also read the experiences of the redoubtable explorer and dietary &#8220;guinea pig&#8221; Viljalmur Steffansson.</p>
<p>Would you be willing to agree that his experiences while wintering on the Hudson Bay amounted to an &#8220;observational study&#8221; which generated a number of Null Hypotheses, including long term  &#8220;lo carb&#8221; is injurious, and scurvy will result from lack of vegetables or fruit, while the period at Bellevue and after, was a &#8220;crossover design&#8221; study, albeit on a sample size of two, (Steffansson and Anderson switched from  &#8220;ordinary diet&#8221; to the Inuit Diet) which provided no supporting evidence for the Hypotheses? I was interested in the observation of &#8220;pure protein&#8221; poisoning resulting from a few days of eating little or no fat with animal protein.</p>
<p>I&#8217;m glad thatyou keep flying the flag of proper metabolic science, so that the health of diabetics, the overweight, those with the prospect of longevity reducing condition may be promoted using the results of tested measurement rather than the &#8220;observations&#8221; of Congressional Sub-Commitees and the Surgeon-General.</p>
<p>I also imagine that Viljalmur Steffansson would be delighted that &#8220;fish oils&#8221; are now promoted as a healthy food supplement. It would in keeping with his experiences on the Hudson Bay.</p>
<p>My own foods are beef, fish, eggs, chicken, cheese, olive oil, nuts, tomato, onions, yoghurt milk and coffee. My supplement is &#8220;cod liver oil. When asked, I call my way of eating: home cooked good food, otherwise &#8220;lo carb&#8221; or ketogenic.<br />
Thank you for your good work.</p>
<p>Desmond<br />
Msc Stats (40 years ago)</p>
<p><em>Re: Stefansson.  Observing is different than an observational study.  But both are useful for generating hypotheses that can be tested with randomized, controlled trials.</em></p>
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		<title>By: seyont</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-206382</link>
		<dc:creator>seyont</dc:creator>
		<pubDate>Fri, 13 Mar 2009 19:38:17 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-206382</guid>
		<description>I get it now.  An observational study is sort of a triple-blind study.  The researchers do not know what experiment was performed, on whom it was performed, or even &lt;i&gt;if&lt;/i&gt; it was performed.  They grab a bunch of people and dream up an experiment which could plausibly have produced the correlations they see.

&lt;em&gt;I think you&#039;ve got it.&lt;/em&gt;</description>
		<content:encoded><![CDATA[<p>I get it now.  An observational study is sort of a triple-blind study.  The researchers do not know what experiment was performed, on whom it was performed, or even <i>if</i> it was performed.  They grab a bunch of people and dream up an experiment which could plausibly have produced the correlations they see.</p>
<p><em>I think you&#8217;ve got it.</em></p>
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		<title>By: Daedala</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-201942</link>
		<dc:creator>Daedala</dc:creator>
		<pubDate>Tue, 13 Jan 2009 23:09:20 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-201942</guid>
		<description>Er, I forgot to say thank you. Thanks. :)

&lt;em&gt;No problem.  You&#039;re more than welcome.&lt;/em&gt;</description>
		<content:encoded><![CDATA[<p>Er, I forgot to say thank you. Thanks. <img src='http://www.proteinpower.com/drmike/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> </p>
<p><em>No problem.  You&#8217;re more than welcome.</em></p>
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		<title>By: Daedala</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-201855</link>
		<dc:creator>Daedala</dc:creator>
		<pubDate>Tue, 13 Jan 2009 03:20:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-201855</guid>
		<description>My sister&#039;s a reasonably sane adult; if she didn&#039;t want to do it, she just wouldn&#039;t, rather than make excuses -- much less make excuses after the fact. Anyway, it&#039;s hard to make up a tonsillectomy. I&#039;ll go with the coincidence hypothesis. Perhaps too much change at once (even if it was technically good change) contributed.</description>
		<content:encoded><![CDATA[<p>My sister&#8217;s a reasonably sane adult; if she didn&#8217;t want to do it, she just wouldn&#8217;t, rather than make excuses &#8212; much less make excuses after the fact. Anyway, it&#8217;s hard to make up a tonsillectomy. I&#8217;ll go with the coincidence hypothesis. Perhaps too much change at once (even if it was technically good change) contributed.</p>
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		<title>By: Daedala</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-201839</link>
		<dc:creator>Daedala</dc:creator>
		<pubDate>Mon, 12 Jan 2009 13:52:14 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-201839</guid>
		<description>Hey, Dr. Mike. I promised my sister I would ask you a question.

She has tried low carb several times, and liked it -- until she got sick. Every single time, her immune system would crash. Bronchitis, sinusitis, tonsilitis, strep throat, etc.: she&#039;d &lt;i&gt;always&lt;/i&gt; get some kind of infection. She doesn&#039;t remember what plan she was doing, sadly, and I don&#039;t that she was taking more than a multivitamin. Do you have any ideas of what she could do to try low carb again without making herself sick? I&#039;d really appreciate some suggestions, though I know you can&#039;t diagnose, etc.; it&#039;s hard to find a doctor who really understands low carb. I&#039;d like to tell her something more specific than &quot;try all the supplements listed in PP.&quot;

Any ideas?

&lt;em&gt;I have no ideas.  I&#039;ve treated at least 10,000 patients with low-carb diets, and I&#039;ve never had one report this kind of history.  Since the immune system is primarily a system that relies on protein and good quality fats for optimum function, it is difficult to fathom how one&#039;s immune system &quot;would crash&quot; when given plenty of these.  Perhaps your sister really doesn&#039;t want to go on low-carb and is using this as an excuse.  Or perhaps these problems were simply coincidental, i.e., she was going to get strep throat, sinusitis, etc. anyway, and it just happened to coincide with her starting the diet.

I once had a patient who was 17 years old who was about 280 pounds.  Her parents brought her to my office insisting that she go on &#039;my&#039; diet.  I laid it all out for her and she seemed enthusiastic.  But later her mother called and told me that her daughter got ill whenever she tried to do the diet so she (the daughter) was going to try something else.  Two years later, the  daughter came back weighting well over 300 pounds.  She had decided (instead of her mother deciding for her) that she wanted to lose the weight.  I asked her why she wanted to do low-carb again if it made her sick the first time around.  She told me that she told her mother that to get her mother off her back.  She (my patient) then proceeded to lose - on a low-carb diet - to 135 pounds without a hitch.  I used her as one of the poster children for how effective a low-carb diet is for weight loss in lectures I gave.&lt;/em&gt;</description>
		<content:encoded><![CDATA[<p>Hey, Dr. Mike. I promised my sister I would ask you a question.</p>
<p>She has tried low carb several times, and liked it &#8212; until she got sick. Every single time, her immune system would crash. Bronchitis, sinusitis, tonsilitis, strep throat, etc.: she&#8217;d <i>always</i> get some kind of infection. She doesn&#8217;t remember what plan she was doing, sadly, and I don&#8217;t that she was taking more than a multivitamin. Do you have any ideas of what she could do to try low carb again without making herself sick? I&#8217;d really appreciate some suggestions, though I know you can&#8217;t diagnose, etc.; it&#8217;s hard to find a doctor who really understands low carb. I&#8217;d like to tell her something more specific than &#8220;try all the supplements listed in PP.&#8221;</p>
<p>Any ideas?</p>
<p><em>I have no ideas.  I&#8217;ve treated at least 10,000 patients with low-carb diets, and I&#8217;ve never had one report this kind of history.  Since the immune system is primarily a system that relies on protein and good quality fats for optimum function, it is difficult to fathom how one&#8217;s immune system &#8220;would crash&#8221; when given plenty of these.  Perhaps your sister really doesn&#8217;t want to go on low-carb and is using this as an excuse.  Or perhaps these problems were simply coincidental, i.e., she was going to get strep throat, sinusitis, etc. anyway, and it just happened to coincide with her starting the diet.</p>
<p>I once had a patient who was 17 years old who was about 280 pounds.  Her parents brought her to my office insisting that she go on &#8216;my&#8217; diet.  I laid it all out for her and she seemed enthusiastic.  But later her mother called and told me that her daughter got ill whenever she tried to do the diet so she (the daughter) was going to try something else.  Two years later, the  daughter came back weighting well over 300 pounds.  She had decided (instead of her mother deciding for her) that she wanted to lose the weight.  I asked her why she wanted to do low-carb again if it made her sick the first time around.  She told me that she told her mother that to get her mother off her back.  She (my patient) then proceeded to lose &#8211; on a low-carb diet &#8211; to 135 pounds without a hitch.  I used her as one of the poster children for how effective a low-carb diet is for weight loss in lectures I gave.</em></p>
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		<title>By: Dave</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-201684</link>
		<dc:creator>Dave</dc:creator>
		<pubDate>Sat, 10 Jan 2009 17:04:29 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-201684</guid>
		<description>Pollan&#039;s definition of &quot;food&quot; is basically non-industrial food as opposed to engineered foodlike substances, e.g. an apple vs. an apple energy bar. Given that, it&#039;s the only part of that statement that holds any water.</description>
		<content:encoded><![CDATA[<p>Pollan&#8217;s definition of &#8220;food&#8221; is basically non-industrial food as opposed to engineered foodlike substances, e.g. an apple vs. an apple energy bar. Given that, it&#8217;s the only part of that statement that holds any water.</p>
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		<title>By: Verimius</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-201598</link>
		<dc:creator>Verimius</dc:creator>
		<pubDate>Fri, 09 Jan 2009 18:56:37 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-201598</guid>
		<description>I have seen Michael Pollan&#039;s fatuous statement, &quot;Eat food. Not too much. Mostly plants.&quot; all over the internet. What I have not seen is any discussion about the first of the three parts. What the heck are we supposed to eat if not food? Grass? Wood? Sand?

I lost respect for the man after I read &quot;The Omnivore&#039;s Dilemma&quot;. At the end of this work he moralizes extensively after shooting a feral pig. Absent was any recognition that killing is sometimes a necessity. He would have felt differently if he had to feed a hungry family.</description>
		<content:encoded><![CDATA[<p>I have seen Michael Pollan&#8217;s fatuous statement, &#8220;Eat food. Not too much. Mostly plants.&#8221; all over the internet. What I have not seen is any discussion about the first of the three parts. What the heck are we supposed to eat if not food? Grass? Wood? Sand?</p>
<p>I lost respect for the man after I read &#8220;The Omnivore&#8217;s Dilemma&#8221;. At the end of this work he moralizes extensively after shooting a feral pig. Absent was any recognition that killing is sometimes a necessity. He would have felt differently if he had to feed a hungry family.</p>
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		<title>By: Paul B.</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-201595</link>
		<dc:creator>Paul B.</dc:creator>
		<pubDate>Fri, 09 Jan 2009 18:44:45 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-201595</guid>
		<description>&quot;Eat food. Not too much. Mostly plants.&quot;  Sounds like a living hell to me.  If you don&#039;t live forever it will certainly feel like it.  Someone--I think it was MSNBC--ran a contest for viewers to come up with their own 2-3-2 guide to eating.  Winner:  &quot;Ate plants.  Lots of them.  Still hungry.&quot;

&lt;em&gt;Brilliant&lt;/em&gt;!</description>
		<content:encoded><![CDATA[<p>&#8220;Eat food. Not too much. Mostly plants.&#8221;  Sounds like a living hell to me.  If you don&#8217;t live forever it will certainly feel like it.  Someone&#8211;I think it was MSNBC&#8211;ran a contest for viewers to come up with their own 2-3-2 guide to eating.  Winner:  &#8220;Ate plants.  Lots of them.  Still hungry.&#8221;</p>
<p><em>Brilliant</em>!</p>
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		<title>By: Pam Maltzman</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-201560</link>
		<dc:creator>Pam Maltzman</dc:creator>
		<pubDate>Fri, 09 Jan 2009 09:35:33 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-201560</guid>
		<description>Dr. E., you mention that you are allergic to cats.  There is one breed, the Siberian cat, which apparently naturally lacks the protein in its saliva that irritates many people.  Supposedly about 70% of allergic people can tolerate them.  This cat was imported from--where else--Siberia.  It has a triple coat to keep warm in the harsh winters.

This is a relatively new breed of cat for the U.S.  But if you are ever willing to consider having a cat again (since MD loves cats), this might be a good compromise.

&lt;em&gt;I&#039;ll pass the info along.&lt;/em&gt;</description>
		<content:encoded><![CDATA[<p>Dr. E., you mention that you are allergic to cats.  There is one breed, the Siberian cat, which apparently naturally lacks the protein in its saliva that irritates many people.  Supposedly about 70% of allergic people can tolerate them.  This cat was imported from&#8211;where else&#8211;Siberia.  It has a triple coat to keep warm in the harsh winters.</p>
<p>This is a relatively new breed of cat for the U.S.  But if you are ever willing to consider having a cat again (since MD loves cats), this might be a good compromise.</p>
<p><em>I&#8217;ll pass the info along.</em></p>
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		<title>By: Isabella</title>
		<link>http://www.proteinpower.com/drmike/statistics/observational-studies-2/comment-page-1/#comment-201551</link>
		<dc:creator>Isabella</dc:creator>
		<pubDate>Fri, 09 Jan 2009 03:43:25 +0000</pubDate>
		<guid isPermaLink="false">http://www.proteinpower.com/drmike/?p=2266#comment-201551</guid>
		<description>Dear Dr. Mike,

Vegetarian brain shrinkage alert!  PETA now demands that fish be called &quot;Sea Kittens.&quot;  In doing this, they hope to make fish less appealing by encouraging people to identify them with cuter pet-type animals:

http://www.peta.org/sea_kittens/

Really, I&#039;m not making this up!

&lt;em&gt;What total drivel.  Problem is that it&#039;s aimed at children.&lt;/em&gt;</description>
		<content:encoded><![CDATA[<p>Dear Dr. Mike,</p>
<p>Vegetarian brain shrinkage alert!  PETA now demands that fish be called &#8220;Sea Kittens.&#8221;  In doing this, they hope to make fish less appealing by encouraging people to identify them with cuter pet-type animals:</p>
<p><a href="http://www.peta.org/sea_kittens/" rel="nofollow">http://www.peta.org/sea_kittens/</a></p>
<p>Really, I&#8217;m not making this up!</p>
<p><em>What total drivel.  Problem is that it&#8217;s aimed at children.</em></p>
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