David Freedman responds to criticism of his CAM apologia

@Orac: Ouch…that’s gonna leave a mark

Truth be told, I like Freedman’s response far less even than his original article. Any time you have to show your credentials or resort to name-dropping to make a point, it’s a sign your argument has no merit. “Believe me, not because the evidence supports my argument, but because I went to Harvard.” Unfortunately, in the real world, that’s often how things work, but it’s not how science SHOULD work, and it’s not persuasive. Evidence means more than the name of your alma mater.

The other really bizarre thing about this Atlantic article (well, ONE of the other really bizarre things about this Atlantic article) is the claim that CAM practitioners spend more time with and are more caring about patients than traditional doctors. That may or may not be true, but either way, it’s NOT an argument in favor of CAM, it’s an argument about our current healthcare system (which doesn’t always permit doctors to spend as much time with each patient as they and/or the patient might like) and the way we train doctors in medical school. A kind and caring quack is still a quack for all that.

What bothers me about all this is the way CAM is infiltrating medicine by way of so-called “integrative medicine”. The more widespread it becomes, the more difficult it is to stop, because people like Freedman are easily bewitched by credentials. Never mind that reiki and homeopathy are completely implausible, never mind that homeopaths are so crazy they actually think you can use “potentized mustard gas” as treatment for mustard gas burns (yes, they’ve actually tried that! I blogged about that recently as part of a post on the history of chemical warfare), no, never mind all that! the University of Maryland Medical Center is doing this stuff now, so it MUST be useful, right?

Thank you for the excellent rebuttal of this nonsense and an informative summary of some CAM tactics of which I was previously unaware. Nutrition and lifestyle modification as CAM? They’ve been part of conventional (scientific) medicine, as taught in mainstream medical schools, for decades! I’d be surprised to find primary care physician in the U.S. who doesn’t regard them as critical. To make the mistake of equating diet/lifestyle control with CAM is sloppy thinking but forgivable (except in the case of a journalist supposedly researching an article on the subject). Deliberately conflating the two is shameful.

Nutrition and lifestyle modification as CAM? They’ve been part of conventional (scientific) medicine, as taught in mainstream medical schools, for decades!

Hasn’t the doctor saying “Cut down on booze and women” been a punchline for, like, ever?

Freedman says:

“scienceology,” a quasi-religious faith in a set of closely held beliefs that are dressed up in the trappings of science and kept immune to any counter-evidence or -opinion.

Orac replies:

As I pointed out in a followup comment, the correct term is “scientism,” which is a favorite charge against skeptics and scientists favored by all manner of cranks

Hmmm, this isn’t the definition of “scientism” I was accustomed to. I thought “scientism” is “attempts to apply science to areas it doesn’t generally apply to, such as ethical decisions, subjective emotions and personal tastes” (also known as the “Can science prove that a sunset is beautiful (that you love your mother / that Verdi’s music is great / etc.) ?” gambit). Those who (mis)employ the term usually thus defend their faith in certain factual claims against demands for evidence.

What Freedman defines as “scienceology” is either a) best articulated as “being dogmatic” or b) not even a thing.

An uninspired drizzle drips from the mist-enshrouded grey sky and I feel morose. Reading about Freedman didn’t help.

A few things: I wonder if the decision to create a neologism, “scienceology”, when a synonym – “scientism”- already exists, had anything remotely to do with the fact that it sounds like “Scientology”. Let readers unawares associate sceptics with the followers of a despised *cult*. How clever!

If IM and CAM modalities are admittedly no better than placebo, is there really *no* difference? The first one I can think of is obviously monetary: useless treatments waste money whereas cheap or free placebos, although basically useless, are readily available**. I read accounts of charlatans who gross in the 8-figure range USD. CAM and IM are enriching practitioners, manufacturers of supplements, and publishers. For example, ardent followers may now have Mike Adams exclusively streamed for only $24 a month! Woo is a huge business. My late father, when he encountered something hateful or stupid, would derisively remark, “Well, at least it creates jobs.” I must disagree with him in this instance.

Having pseudo-science infiltrate medical schools and national magazines provides additional “street cred” to woo-meisters who are already pumped up on endorphins from their endless workouts as well as braggadocio unimpeded by higher mental functioning. The *lack* of criticism by educated people ( boards of med schools or national magazines) adds to charlatans’ mounting confidence as they spread their wings undertaking new endeavors. It makes them sound safe and acceptable to a general audience.

Another new service: Gary Null now provides free nutritional counselling by phone to customers. It is done by nutritionists and ( supposed) dieticians who advise clients about what supplements to buy. He prefaces this by relating how he has cured “thousands” of serious ills ( cancer, AIDS, CV, ad nauseum) in this manner. Isn’t this “diagnosing and treating” illness without… you know? I suspect that he isn’t the only one.

I hate using the term “enabling” but isn’t that what lack of criticism does?

** here is an ancient placebo: put a charm on a chain and wear it around your neck. You’ll feel better.

All that said, Freedman does touch on a good point. Mainstream medicine doesn’t do as well as we might hope with the sympathy, attentiveness, and related issues. (For many reasons, not least time pressure.) And CAM practitioners do better in that limited respect. So to the extent Freedman meant to say that mainstream medicine should ideally do better on that, while dumping the woo, I’d actually agree.

This is hardly a new observation – it’s been discussed here many a time – but it does mean that he’s not completely wrong.

@ Recovering Cam User: Thank you for illustrating my point.
A person who follows health regimes like those endorsed by our web woo-meisters could easily blow a couple hundred a month on supplements and a highly restricted diet (vegan, raw, organic)- not to mention so-called treatments- that might be better spent persuing interests and entertainment with family or friends. What’s the harm in a nice dinner out or a movie? It won’t make you *better* although you might *feel* better.However if the money is already spent on CAM ,it isn’t available for enjoyable placebos.

Freedman says, “…let me share a few observations and thoughts that I suspect will be completely lost on you.” A few responses leap immediately to mind: 1) Then why are you sharing them?; 2) You arrogant prick; 3) You could not have picked better words to shut down any discussion had you gone at it for a week. After reading the rest of Freedman’s reply (in the context of Orac’s post above), I find number 2 to be the most fitting, both in words and number.

I think that whatever improved outcomes, if there actually are any, that come from CAM treatments known to be no more effective than placebo when studied properly can be, at least in part, explained by what I like to call “self-referral bias”.
We have all seen patients who, when told they have early diabetes and need to change their diet and exercise more, do basically nothing. It can be hard to motivate these folks, who usually feel just fine and therefore feel no real compulsion to change.
Those who decide to seek out and pay, out of pocket (usually) to see a CAM provider are signaling, with their time and money, a willingness to change. Hence better outcomes.

@TBruce–
I was thinking more about when Orac said a Nobel Prize in a field doesn’t give you expertise in every field. But point well taken.

I’m glad things are starting to heat up. What we need to emphasize over and over is that while science-based medicine has its problems that need to be worked out, quackery is never the answer. Hell no to IM!

Scienceology….

In addition to it being a pointless neologism, and in addition to it sounding suspiciously like Scientology, and in addition to it being a complete misunderstanding of our complaints, doesn’t Freedman know that “scienceology” would, logically, be “the study of science”? And what, honestly, would be wrong with studying science? It might be a bit “meta”, a bit self-referential, but there’s no logical reason why one couldn’t study science, or perhaps the practice of science. That would seem an entirely reasonable thing to do, and quite unlike what he was describing.

That’s why the other neologism, “scientism”, was coined; the “-ism” suffix is more commonly found with religious doctrines (Catholocism, Protestantism, Methodism, etc), aesthetic forms (Modernism, Dadaism, Impressionism, etc), and things like that. Not that we really need that word either; “dogma” is adequate, and also sufficiently pejorative to meet Freedman’s needs.

Another thing that really struck me about his response was the comment that we are being closed-minded. This is a typical response to criticism by cranks; I’m not saying Freedman is a crank, but the fact that the criticism is so frequently leveled by them is illustrative. There is none so blind to their own closed-mindedness than a closed-minded person. And Freedman strikes me as at least somewhat closed-minded — he is closed to the possibility that there is indeed harm in allowing CAM to have a veneer of unearned legitimacy. (I’ve met people far more closed-minded; that Chuck fellow in the last thread who was going on about homeopathy for burns and gout was just about the most closed-minded person I’ve met recently who wasn’t actually nuts. Chuck had decided what worked, and nothing whatsoever, even months of agony from gout, is going to persuade him otherwise. That’s impressive. Pointless, but impressive.)

There are a lot of people who equate “open-minded” with “friendly” and “closed-minded” with “hostile”. And furthermore, they confuse “friendly” with “doesn’t attack my assertions, or at least not too much.” But is it really friendly to let nonsense go unchallenged, at least nonsense with a potential to hurt people? I don’t care what God you do or do not believe in; for the most part, that won’t hurt anybody. You can believe in invisible purple unicorns if that’s what feels right to you. But if you tell me that homeopathy works, and I should try it, then I’m going to rebut that. People have died by using homeopathy instead of actual treatments. (Yes, they seriously have. There’s the harm.)

It’s probably good to be diplomatic when correcting a friend, and you have to choose your moments; it’s not worth alienating a friend over their decision to do cleanses or whatever, as long as they’re not directly threatening their health that way — just as it’s not worth alienating a friend over them spending lots of money on their ceramic unicorn collection of whatever. And when something *is* threatening their health, then you need to talk to them, give them the information, and let them decide what to do with it, respecting whatever they choose — they are your friends, after all.

But articles in the print media are another matter. These are disseminated over a wide audience, and so the potential for harm due to misinformation is much greater. It is the duty of bloggers and journalists alike to respond vociferously to such things, as the opportunity presents itself.

This entry, and the string of comments that follows, is one of the best things I’ve seen on the internet in quite a while.

John Smith (or are you the Doctor?):

As soon as your local homeopathic con man gets paid $12 of someone else’s money to see each each patient, the faster we will will see him drop the fuzzy concern and pass out the vials of magic water in 5 minute appointments.

This.

Quacks who are paid for consultations do indeed spend lots of time with their patients. This is because that’s the part they’re paid for. Quacks who are paid for the treatments and not so much for the consultations, however, spend very little time with their patients. Case in point: one of those chelation docs who had killed a patient was found to spend less than five minutes with each patient, then leave the patient unattended while the chelation occurred. I’ve heard the same thing about many docs at various dubious cancer clinics as well. Notably, these are people who are paid primarily for how many treatments are performed, not by the hour (though the chelationist was found to be billing insurers for long consultation sessions despite only spending five minutes, if that, with each patient on many sessions).

So not only is it not an argument that we should use alt med in order for patients to get doctors who spent time with them and show real concern for them, it’s not even true that alt med doctors spend more time with their patients. Some of them do, certainly, but definitely not all. In fact, there are alt med practitioners who are much worse about this than an overworked GP who knows that if he spends an extra five minutes with you, that only means his next patient loses five minutes from their session.

Would anyone argue that it is OK for any other professional to tell lies because it makes their client feel better? How would that work with a lawyer, or a car mechanic?

I can only assume that those who defend this practice in medicine are unaware of the dishonesty at the core of most CAM modalities.

What about adding politicians to that list?

Surely lying to make potential voters feel comfortable voting for them is their profession?

With lawyers I was thinking more along the lines of, “Relax, as long as you wear these lucky socks the jury will definitely acquit”. Or with a mechanic, “No your brakes are fine, as long as you sprinkle this magic water on your car every day…”

Is it really bait and switch if they actually believe it? I get the impression that many, many CAM advocates genuinely believe that conventional doctors don’t advocate lifestyle changes.

Yes. However, they are applying the technique out of ignorance, instead of intent to deceive.

Krebiozen: You nailed it. CAM concepts of nutrition bear more resemblance to religious doctrines than they do to any sort of objective reality. Most of them are based on assigning moral attributes (good or evil) to individual foods or food ingredients; they’re basically systems of taboos and totems.

@ebohlman

they’re basically systems of taboos and totems

I hadn’t taken the idea quite that far, but I think you’re right. If we all had powerful beliefs like that about behavior that really is bad or good for us, I guess we would all be healthier. Perhaps part the trouble is that there are few foods that science tells us are absolutely bad, or good. It’s difficult to get passionate about moderation.

I’m just recovering from a kidney stone (had the stent removed to day). For the whole two-week episode, from the pain-level 10 stay in urgent care, through controlling the symptoms with Vicodin, anti-nausea suppositories and anti-inflammatories, and the procedure to zap the stone when it got stuck in the ureter, I kept wondering to myself, “What state would I be in now if I was relying on CAM to get me through this?” Would any transient placebo effect from, say, acupuncture really make a dent in the excruciating agony of the stone making its way down (and what about when it got embedded – a bit of chiropractic to help it on its way?)

Yes, my urologist gave me shorter shrift than I would have liked sometimes, but I have the information about which calcium oxalate foods to avoid now, and he’s doing a urine work-up give him more information for preventive measures.

I think the bottom line is, when it comes to REAL health issues, give me SBM any day, and not a guy with “basically a glass of water in one hand and a huge invoice in the other,” no matter touchy-feely he is.

I think the bottom line is, when it comes to REAL health issues, give me SBM any day, and not a guy with “basically a glass of water in one hand and a huge invoice in the other,” no matter touchy-feely he is.

QFT. Count me as another satisfied SBM customer. I even have a complex, chronic neurological condition, but fortunately one of the most treatable through (actual) medication: ADHD.

Now I’m about 10 years too old to have been diagnosed with it as a child, as today’s elementary school kids are screened for, but I can tell you that I was a very hyperactive and classic ADD kid from a very young age. I got the gene, like 1-2% of the population (equally prevalent in males and females, BTW). If I had been diagnosed as a child, my life would have been far less plagued with anxiety and trouble due to my inability to concentrate on schoolwork I didn’t want to do. Typical ADHD problems, from all the stories I’ve read.

I was lucky and made it through college with a degree and some work experience, but soon I hit a wall in terms of what I could accomplish in my career due to my inability to focus on certain aspects of software development I didn’t want to work on (or rather that my brain was preventing me from being able to focus my train of thought on, despite my deepest desire to be able to do so). Many people with this condition who are older than myself and didn’t know of the existence of this condition, as I was, turn to alcohol, drugs, dangerous lifestyles, and often make complete messes out of their lives due to this neurological difference (in the prefrontal cortex, and science discovers more of the details every year).

So I had to go through a very unfortunate period of clinical depression and anxiety in my 20’s before I finally dragged myself to get diagnosed by a psychiatrist and prescribed the appropriate pills for my particular neurology (personalized medicine! Imagine that!). In my case it was a combo of bupropion (Wellbutrin SR) and methylphenidate (Ritalin). Without them, I wouldn’t be able to live a normal life, in terms of mood and ability to concentrate on the things that matter. With SBM, and a lot of hard work, I have my dream job (programmer at Google) and no side effects from the pills to speak of.

Now there is a mini “big Pharma conspiracy” I could point out, but it’s not the one the woo-ists would like to believe. The problem is that the system is structured such that the drug companies make the most money from advertising drugs that they have patented. The really good ADHD drugs are all off-patent, so you never seem them advertised. The last time I saw a banner ad for adult ADHD it was for some medication specifically for people who can’t take the usual stimulant-based drugs, and not something that was actually more effective. So there’s no real push out there to pull in the vast number (perhaps several million in the U.S. alone) of adults with ADD who would have to, like myself, specifically seek out (and perhaps deal with the stigma of both “mental illness” and “psychiatry” in their worldview) the so-called allopathic medicine that is in fact extremely effective for me, and countless others (not all people with ADD benefit from medication, but many do).

I feel really bad for the folks out there who are missing out on the opportunity to avail themselves of inexpensive and effective medicines and treatments because of their irrational fears of doctors and anti-government paranoia. Like the guy in the previous thread with gout. I wonder what wacky bottles of homeopathic ju-ju he would recommend for my complex / chronic condition.

@ Pete: You’ve just come through one of the most painful experiences, with the great non-invasive medical care that is modern day western medicine. Had you gone to a CAM practitioner who decided to try a variety of alt therapies, you could have suffered through a ruptured ureter, shock and died.

Our noted philosopher Denice Walter has concisely summed it up. Some people remember the good old days fondly, when doctors with little in their arsenal of effective treatments had the time to do some hand-holding, had few tests to pinpoint a diagnosis and targeted treatments. As a consequence, there were no negotiations with insurance companies to justify expensive diagnostic tests and “exploratory” surgeries that patients underwent “might” find a treatable condition…if you didn’t die first from peritonitis.

So easy now to turn on the TV to watch Dr. Oz and his latest woo, espouse “alternatives”, discuss healthy diets along with the latest woo such as Reiki, immune boosting treatments, homeopathy and other nonsense…coupled with big pharma conspiracy and “government interference”…all complicit in the scam to remove patients’ choice. It’s called the dumbing down of medicine for the people.

From the Atlantic article: “These top scientists almost to a person agreed…Most mainstream drugs don’t help most patients much with chronic, complex disease”

I thought about these words this morning when reading a Wall St. Journal op-ed piece about the 30th anniversary of the discovery of HIV, the virus that causes AIDS.

The article made the point that 30 years on, we still don’t have an effective HIV vaccine (though significant progress on this difficult problem has been made). What we do have are highly effective anti-retroviral drugs that have turned AIDS from from a short-term death sentence into a long-term manageable chronic illness where people routinely live 20 years or more after diagnosis.

What has woo given us in the fight against HIV? Rank quackery that costs lives.

“…the Society of Homeopaths are holding a conference in London next week featuring the work of Peter Chappell, who also claims he can make an immediate impact on the Aids epidemic using music encoded with his Aids remedies.

“Right now,” he says, “Aids in Africa could be significantly ameliorated by a simple tune played on the radio.” Damningly, contemptibly, not one single person from the homeopathy community has spoken out to criticise this lunacy.

And of course our own rather grand Patrick Holford, Britain’s leading nutritionist, who sells bottles of vitamin pills with his beaming face printed on them, writes, in the “fully revised and updated” 2004 edition of his 500,000 copy best seller “The Optimum Nutrition Bible”, the alarming words: AZT, a drug still routinely used alongside other drugs in Aids treatment, “is proving less effective than vitamin C”…

Peddlers of nonsense treatments – and newspapers – trade in emotive anecdotes. Three million people died last year of Aids, and that figure elicits insufficient emotion, outrage, and coverage, because it is the polar opposite of an emotive anecdote. Nature outguns any man-made weapon, and it remains our greatest challenge. Our greatest impediment is wishful, brutal stupidity.”

– Ben Goldacre

MESSAGE BEGINS——————————-

Shills and Minions,

I’m sure you’re all wondering, as I was, where your delightful, new drone went. Surely it would have followed the conversation from the previous thread to spout its cheery, “little engine that could” aphorisms. Fret not my marvelous monkeys, the ladies on level 7 have recalled it for some adjustments. I’m sure it will show up sooner or later. On to other business . . .

Shill Walters (DL, Class VII,), your triumph over the treacly postmodernist indoctrination you faced in your tertiary education never ceases to impress us up here at PharmaCOM Orbital. I am suggesting that you receive yet another commendation for your keen intellect and cogent posts. Your insight into the frailties of your species is as helpful to our cause as it is enriching to your bank account.

Your honored place in the history of the Corpus and the records of Terran Subjugation Unit VII is something the other Shills and Minions would do well to emulate.

Stay Vigilant. Stay Evil.

Lord Draconis Zeneca, VC, iH7L
Forward Mavoon of the Great Fleet, Suzerain of V’tar and Pharmaca Magna of Terra
Glaxxon PharmaCOM Orbital HQ 0010101101001

————————MESSAGE ENDS

The really good ADHD drugs are all off-patent, so you never seem them advertised. The last time I saw a banner ad for adult ADHD it was for some medication specifically for people who can’t take the usual stimulant-based drugs, and not something that was actually more effective. So there’s no real push out there to pull in the vast number (perhaps several million in the U.S. alone) of adults with ADD who would have to, like myself, specifically seek out (and perhaps deal with the stigma of both “mental illness” and “psychiatry” in their worldview) the so-called allopathic medicine that is in fact extremely effective for me, and countless others

@Krebiozen:

If you want people to not eat something, you can spread rumors that it’s made with human flesh (“Did you know that they use fetal tissue to grow GMOs…”) But a positive incentive is harder to come by, and promoting moderation and balance is harder still. And what about the idea that people should make dietary choices based on sound principles rather than their hopes and fears?

Reminds me of a recent column in some magazine, I think it was the Audubon Society. A conservationist wrote about how, paying a visit to Madagascar, he found that someone had been telling villagers that eating sea turtles was deadly, in an apparent attempt to protect endangered species. He didn’t think it was right to lie, and decided to talk to the villagers and tell them instead why he thought they shouldn’t kill turtles. He thought afterward that his talk didn’t get across very well, and one reason for the confusion was that he happened to be wearing a beard in the style of an imam, so people had come expecting him to expound on what the Koran said about sea turtles.

Pete! Aieeee! I am glad to hear you are recovering — I’ve never had one of those, and I hope I never will.

“What state would I be in now if I was relying on CAM to get me through this?”

Pretty much like most pre-1900ish (I am not a medical professional) folk:

Writhing in pain for days, and possibly dying. (sorry, can’t quickly find mortality figures

My dearest Lord Draconis:

Ever since I was a pale- but very pretty- waif, shivering in the miserable drizzle outside the Opera House where I would sell my violets to the fine ladies who were arriving there- oh, they were so lovely in their silken frocks and velvet wraps, swathed in ropes of South Sea pearls, dripping Columbian emeralds from their shell-like ears- I vowed even then: I would be a fine lady too one day- and a dark one- I would wear fine clothes and drip emeralds. *And* I would be the equal of *gentlemen*: in intellect, cunning, and evil- plus, I’d be a lot better looking, so people would like me even more.

Now that I’ve arrived and got the goods wot I wanted and a friggen title on top of it: I must confess that we are basically battling brave maverick wankers- not one of them even got enough wits about themself to figure out what the f–k we’re talking about most of the time. It is so f–king pathetic and lame! We got all the smarties. They’re all on our side. Come on, now! where’s the challenge! It’s like shooting fish in a barrel for cripes’ sake!

I do thank you for making all of this possible, despite my existential dilemma. I shall persevere and continue on my path of inspirational and fashion-conscious evil. Darling, I couldn’t have done it without you!

Most sincerely yours, DW, DL VII

** BTW, I might feel slightly less morose if there were a few more parties.

I suspect some sock puppet may have invaded out thread again with cannabis indica extract. They used all sorts of heavy duty drugs like tincture of opium, ether and copious amounts of alcohol before modern pharmacology. I think I would stick to modern drugs that are titrated correctly.

@ Liz Ditz: I too have been lucky, never having suffered with passing kidney (or gall stones which can get caught in the common bile duct). I seen enough patients to understand the excruciating pain that they suffer through as well as a gangrenous gall bladder, necessitating a very long surgery, extended recovery that my brother dealt with.

I would much prefer titrated pain relief for the intra-operative period, so much more reliable.

When Freedman makes his opening salvo at Orac and the commenters on Orac’s blog*, the first thing I thought was:

umadbro?

When he starts making up words like “scienceology”, the first thing I thought was:

Troy Maclure: Just ask this Scientician!
{cut to guy in lab coat next to a microscope}
Lab Coat Guy: Uhh…
{cut back to Troy}
Troy Maclure: He’ll tell your that…

Seriously, Mr. Freedman, if that is your real name and if you’re reading this, kindly grow the hell up.

Between hard science and patient experience there lies a long bumpy, twisty road that needs to be MUCH more acknowledged.

Why do you think people keep paying for CAM services, even while they have insurance for conventional drug treatments?

I have always felt much better being treated by CAM practitioners, it’s not a new accusation that doctors make you wait, and then spend a short, impersonal time with you; this is an old complaint.

You can blame it on time-consuming insurance requirements, quacks and gullible people all you want. Oh and while it can be dangerous to wait too long to seek conventional treatment, CAM treatments are generally much lighter on dangerous side effects and much less invasive.

Um, yes? Not sure what you’re point is.

I guess my point is some alternative treatments or diets may be worth trying first, before drugs or other intervention becomes necessary. Here’s an example. Say you are in the very early stages of type II diabetes. I don’t have the citation handy, but I have read that for some people even with full blown diabetes six months on Atkins and they can go off their medication permanently. I have actually seen this more than once, and did read the original papers as this concerns my family, but if this is not well-known I will dig up the reference (it’s probably easily googled).

One advantages of this approach over other diet and exercise approaches is that it is easier to follow, as weight loss is less dependent on calorie restriction and constant exercise, and cravings are under control. The more modest diet restrictions most doctors prescribe are actually harder to follow, as every dieter knows.

So it would make sense for every person who presents with early symptoms of stage II diabetes to be placed on a (perfectly healthy) diet of protein, good fats such as nuts and olive oil, berries, and salads and non-starchy vegetables for six months BEFORE trying other forms of therapy (including other dietary changes) and certainly before any drug intervention (unless the stages are advanced enough to warrant it in the short term of course). This could save billions if practiced on a wide scale. And no bad side effects.

But this will never happen. Currently, it seems most doctors recommend lifestyle changes, but don’t really seem to expect them to be followed and are very willing to non-judgmentally prescribe meds when people don’t exercise or lose weight successfully or whatever, so there is much less pressure.

I suspect that many people are like me, and do their own research, use both types of medical services as it feels right. I do think there is something to the charge that most medical practitioners undervalue lifestyle changes, or don’t keep up with the latest nutritional research, so I am sure to especially research those on my own.

Another point I may have brought up before here, so sorry if I am repeating myself, but I recently learned that an estimated 10% of people may be needle phobic, and as any visit to a doctor now requires having blood drawn many people may be avoiding conventional treatment out of a fear that they may be embarrassed to admit to.

@ Isabel: I review a few alt med websites and radio shows. Followers are actively frightened away from SBM treatments and offered a plethora of supplements as substitutes. Cures for serious illness are offered as a matter of course via articles, shows, e-books, seminars, films, and lectures ( naturalnews.com). The perpetrators of these illusions present themselves as innovative researchers, far ahead of standard medicine, when they are actually *salesmen* hawking nearly useless products which are available untested legally *only* because of a loop-hole called DSHEA.

A few days ago ( @ progressiveradionetwork.com), the guru told how a woman who had used his products was able to discard her meds for high bp. Other tales are spun about easy cures for ills like cancer, HIV/AIDS, Alzheimer’s, diabetes, MS, ASD/LD, SMI, CV- the list is nearly endless. Phone consults with a nutritionist or dietician ( as if they were the same!) are offered free at the sales phone number.( BTW: untreated high bp can lead to many serious complications including heart attack, stroke, damage to vision and kidney fx.)

This has nothing to do with freedom of choice: it is a deliberate mis-information campaign, taking advantage of the public’s natural fears about medical intervention and loss of control at the hands of doctors. They gain the trust of customers through mis-representation.

“I have always felt much better being treated by CAM practitioners, it’s not a new accusation that doctors make you wait, and then spend a short, impersonal time with you; this is an old complaint.”

Well I’ve had good treatment from both. I’ll admit the chiropractor and the specialist physio both did me some good in terms of mobility of recalcitrant joints. But far and away the best was the specialist anaesthetist who knew more, a great deal more, about dealing with chronic pain than either of them.

I posted a long reply and it is still held up in moderation for some reason.

I am not advocating that people follow gurus, I am simply saying that average patient experience does not necessarily equal the latest, bestest science in action at all times.

And that it is way less stressful going to alternative therapists.

Of course the average isn’t going to be equal to the best, in any field: that’s how comparatives work. The answer is to work to improve things, not throw them away because not all the children are above average.

For that matter, even acknowledging that sCAM artists can spend more time and be more supportive, how exactly does that justify them taking money for treatments which do nothing?

EXACTLY. This is the point Mr. Freedman can’t seem to grasp. He keeps trying to claim that since some conventional treatments can induce a placebo effect in the patient, that means any alternative treatment that also works as a placebo is just as good. It’s not, for all the reasons that have been exhaustively documented here in all the posts about his article.

As for Freedman’s notion that alt-med practitioners do a better job than doctors at providing things like nutritional counselling – maybe he should have a chat with Gary Null about that. (Cheap shot, I know, but perfect example…) If someone’s been trained in a completely unscientific treatment system *cough* Homeopathy! *cough*, how could you possibly trust their advice about any other health issues? Based on completely anecdotal reports from relatives and friends, the nutritional counselling often consists of being immediately diagnosed with food allergies (without any reliable testing being done, of course) – milk, pork, wheat, or whatever food group they’re blaming for everything that week – and a recommendation to take supplements that just happen to be sold right in your friendly neighbourhood naturopath’s office!

“By advocating CAM, you’re saying that people should do the equivalent of nothing.”

I just said I am not advocating it.

” CAM doesn’t do anything for real illness.”

Sometimes it does. Some of the diets mentioned do work for some conditions. I don’t know what happened to my long reply. A message said it was going into moderation but it never appeared. Unfortunately I didn’t save it.

“Do you get that point?”

Yes, I have been here before and I understand about the self-correction of science.

“usually much worse off than if you had just dealt with the problem up front using science based medicine. ”

I haven’t seen a lot of evidence for this, just anecdotal evidence usually referring to serious cases. In many cases people just get better on their own. In some cases an alternative diet might work and save them having to take dangerous meds.

My main point was that there are many factors affecting treatment options. I disagree with your conclusion that my best option in all cases is to go to the health clinic that my grad student insurance covers and follow their recommendations.

Isabel, if you read today’s article by Orac you will learn he is in the midst of some heavy duty work demands (trying to get grants, I have posts that are still in moderation so they may have been lost — not a big deal). If you have evidence that CAM does anything worthwhile then post the journal, title, date and authors of the papers that support your opinion.

And, I shall also repeat that special diets are not CAM, but part of conventional medicine. You should play around this website: http://whatstheharm.net/alternativemedicine.html

Because what do we call CAM modalities that work? Real medicine.

Isabel:

I have a 40-year-old relative who weighs 350 lbs and is on 3 blood pressure meds among many others.

So you have accompanied this relative to the his/her doctor’s appointment and noted that no lifestyle information was provided. You have personally discussed this lack of information with his/her doctor.

Now, since your long comment is taking a long time to get moderated, perhaps you can tell us what the journal, title, date and authors of those papers that support your opinion.

Speaking of blood pressure medications: I have a child who has been on them since he was fourteen years old. He has a genetic heart condition called hypertrophic cardiomyopathy with obstruction. The heart muscle has grown abnormally and his mitral valve has been damaged due to the increased pressure.

This brings up two things:

1) Do you really know everything about your relative’s diagnosis?

2) What CAM treatment do you think would be effective for my son’s diagnosis, which occurs in about one in a thousand people? Be sure to provide the journal, title, date and author of the paper that supports you statements.

Um, Isabel…I suggest you also check the internet for Atkin’s diet and the formation of renal calculi and also kidney failure…before you tout the Atkin’s diet for weight loss.

@ Chris: A very long road ahead of you to preserve your child’s health and, I know you are on top of the latest research.

“bunch of crap that endangers people with undetected diabetes”

Do you have a citation for that?

This is what I am talking about. So now a person is afraid to tell their doctor because the doctor thinks it is a bunch of crap. I should be able to tell my doctor I would like to go on the diet, and get tested for whatever the doctor thinks is relevant first. Your hostile attitude makes the situation worse.

Basically I am ignoring the controversial and brief “induction phase” of Atkins which is optional anyway, so I am referring to cutting back dramatically on processed foods, bread and starches, and adding no special supplements (also optional even if you are following it ‘strictly’). Not going overboard on meat or dairy (another myth), and eating lots of fish, non-starchy vegetables, salads, berries, nuts, nut flours, eggs, avocados, small servings of beans and sweet potatoes. How is not adding starches or sugars or processed grains to one’s diet ‘dangerous’ when these are not even foods (bread, pasta) one is likely to come across in nature?

This can be a useful diet for people who are at risk of developing diabetes, as an alternative to other diets, or who need to lose weight to lower blood pressure, and especially those who are wheat or gluten intolerant. It is also easy to follow because cravings are lessened. It may not be suitable for everyone, but “crap”?

Isabel:

This can be a useful diet for people who are at risk of developing diabetes, as an alternative to other diets, or who need to lose weight to lower blood pressure, and especially those who are wheat or gluten intolerant.

Except nothing you wrote was really CAM, that is what real medicine does. As noted, the stuff that works and is documented as working is real medicine. It is not CAM, and diets like that were researched in by real medicine before sCAMsters decided to steal the ideas.

Except it is known to be effective for Type 2 diabetes! Have you the documentation that it works for Type 1 diabetes?

And as for high blood pressure, how effective is it for genetic forms? Or the type of heart condition my son has?

Also, what percentage of the population is gluten intolerant? And how does it work for those with tree nut allergies?

And what berries and fruit do not contain sugars like fructose?

The experience will probably be very alienating, impersonal, and uncomfortable and they will undoubtedly order blood work and I am one of the 10% of people who are needle-phobic, so it’s yet another reason to avoid going if possible

Oh, for Hippocrates’ sake! I’m “needle-phobic” too, but I suck it up because I know how important blood tests are as a diagnostic tool. At my last physical my doctor noted that my blood test showed I have low iron (something I never would have figured out on my own) and recommended…iron supplements, taken with vitamin C to enhance absorption! And a Google search turned up a set of instructions for increasing iron-rich food in your diet on the website of a completely mainstream hospital.

One thing I mentioned in my other post is that I don’t believe most doctors emphasize lifestyle changes enough, and they criticize (my health care provider recently did) diets like Atkins which can be really helpful, and are perfectly healthy, and don’t take enough of an organized stand about unhealthy aspects of our diets.

This is nonsense. My doctor always asks about diet and exercise habits when I see her for checkups, and when I started having blood pressure issues the FIRST recommendation I got was to try the DASH diet and increase my physical activity. I did still need medication in addition to lifestyle changes and my blood pressure is now under control.

And the reason a doctor wouldn’t recommend the Atkins diet is that there are valid concerns about the long-term health impacts (e.g. increased risk of heart disease, impaired kidney function, osteoporosis, colon cancer…) The CAM canard that conventional medicine doesn’t recognize the benefits of diet and lifestyle changes is completely baseless.

“@Isabel: Oh, did you call for a citation and never actually provide any to back up your assertions?”

Because people are demanding I provide citations, and then not providing them themselves (as you did).

“Oh, for Hippocrates’ sake! I’m “needle-phobic” too, but I suck it up”

Ah, yes, obviously anyone who does take your approach is morally deficient, so the hell with them. A very compassionate, realistic approach.

“concerns about the long-term health impacts (e.g. increased risk of heart disease, impaired kidney function, osteoporosis, colon cancer…) ”

Citations please?

“Except it is known to be effective for Type 2 diabetes! Have you the documentation that it works for Type 1 diabetes? ”

I said Type 2 in my earlier comment, just forgot to add it. Of course I did not mean Type 1, calm down.

“And what berries and fruit do not contain sugars like fructose?”

All contain fructose, but berries have a lot more fiber.

“As for sugars not being in a “natural” diet,”

I said “adding” sugars, and earlier specifically referred to processed sugars. Of course sugars are part of a natural diet. Honestly, I am trying to write a cohesive comment on a blog post, not writing and checking and rechecking a scientific article.

“why humans have been using starches in diets for at least ten thousand years ”

some have, certainly not all populations. And probably few to the extent that we do today in industrialized countries.

It’s funny reading some posts at SBM, I am struck by the attitude that supplements such as herbs and various teas are not harmless just because they are natural, vs the idea that food is food, just avoid fatty meats and eat fruits and vegetables and eat a reasonably balanced diet and you’ll be fine, everything else is bunk. All “food” is fine, just watch out for those “herbs”.

Isabel, you need to read this post:
http://www.sciencebasedmedicine.org/index.php/we-get-mail/

I can’t believe I’m stepping onto this, but…. Someone once said that “CAM is like climate change,” in other words, a point of cultural and ideological divisiveness.

Freedman offers the assessments of many MDs at the Mayo Clinic. Many hundreds of others are at work every day applying and evaluating the approaches and therapies called “integrative medicine” in medical schools and hospitals. The Institute of Medicine is the center of reputable, credible medical knowledge in this country. It hosted a national Summit on Integrative Medicine and the Health of the Public in 2009. The American Academy of Pediatrics has had for three years a section on Complementary and Integrative Medicine. It is hard to understand the objections here, to say nothing of the hostility.

Although it may be infuriating to hear for participants here, integrative medicine has long since passed the tipping point of acceptance and credibility. This is due to the widespread acceptance by the public over 30-plus years (paying out of pocket) and the very deliberate examination and research on its approaches and therapies conducted over 20-plus years. Forget 3,000 years of acupuncture in Asia.

I am anything but a practitioner or even user of any alternative therapies, but as I’ve looked at this phenomenon it seems to me that it reflects attitudes that we admire deeply in America: thinking and acting “outside the box;” and creating more tools that provide use and effectiveness. We love these attributes elsewhere.

I encourage everyone to reconsider the importance of inquiry, examination and trial all across our health and medical landscape, including that which is experienced in real-world settings, not only within Random Controlled Trials. There will be much, much more integrative practice and thinking in the years ahead, in particular as its preventive qualities become more widely known.

@ Chris: Coconut oil must be good…Joe Mercola sells it on his website as does Whole Foods (clever daughter refers to the emporium as Whole Paycheck).

I personally like the coconut, pineapple juice and rum in a pina colada.

Isabel, why not “Google” coconut oil and look at the Wikipedia site for information on coconut oil…and why not look at margarine labels at the grocery…there are some excellent, non hydrogenated margarines made with olive oil. Better yet, look up some recipes for olive oil dips…simply yummy with crusty baguettes or sour dough breads.

Isabel, I have high cholesterol due to genetics. Through diet and exercise I pushed the numbers down to normal. Then the numbers went up, even though I was still swimming 2000 yards and eating very little fat. My liver decided my levels were too low, so it pumped up its production of squalene and cholesterol. I am not allowed coconut oil, and am a big fan of olive oil, but not a fan of margerine. Hence, my question.

Now, I asked for actual evidence that it is not harmful. Especially since I have been given a reason for not using it. You provided only an unsupported statement. If you claim it is “a staple and not considered harmful” for people like me, or anyone else it is up to you to provide that evidence.

In the future, when you start making claims: be prepared to back them up. Don’t get prissy when we ask for evidence. It would help you if you actually provided the cites first.

Absolutely nothing you advocated for other than the coconut oil is CAM. And what is interesting, in the realm of specialty diets you skipped ketogenic diets for intractable epilepsy. But while it can help with seizures, it causes other problems.

Because, whether you like it or not: it is a bit more complicated than than you think.

Taylor, you seem to be new here. I suggest you investigate this blog a bit more. Especially the “argument from antiquity” on acupuncture. Do yourself a favor and use the handy little search box on the upper left of this page.

@Isabel:

However, unlike other animal based saturated fats or hydrogenated plant fats it is not harmful.

[Citation Needed]

As if I had to add that 🙂

Oh the other hand, the risks of saturated fats and cardiovascular disease are documented. Here is just one link, it’s citations include pathways to hundreds of other experiments and reviews that agree.

Jakobsen, MU; O’Reilly, EJ; Heitmann, BL; Pereira, MA; Bälter, K; Fraser, GE; Goldbourt, U; Hallmans, G et al. (2009). “Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies”. The American journal of clinical nutrition 89 (5): 1425–32. doi:10.3945/ajcn.2008.27124. PMC 2676998. PMID 19211817

But Isabel won’t give a citation, because she can’t. It would screw up her confirmation bias that she so carefully tends like a little black hearted garden.

Isabel, please provide some evidence for your statements. We aren’t just going to take the word of somebody we met on the Internet.

“It is possible you might benefit from eating it. Oh, well.”

You know, repeating yourself is not evidence. It’s quite simple…cite your claims and the conversation will move forward.

But coconut oil is and long has been a common food, a staple even, of populations that do not appear damaged by it. There is no evidence that it is harmful, so why would I need to prove that it is safe?

“But Isabel won’t give a citation, because she can’t.”

JayK, the paper you cite makes no distinction between the long chain saturated fats typically found in animal products and the medium chain saturated fats that coconut oil is almost entirely composed of.

Here’s a couple of references from the same journal, one of which also deals with nuts and eggs, two other extremely nutritious foods that have been foolishly banned by the medical establishment.

Frank B. Hu, JoAnn E. Manson, and Walter C. Willett
Types of Dietary Fat and Risk of Coronary Heart Disease: A Critical Review J Am Coll Nutr February 2001 20:5-19

Marie-Pierre St-Onge,Aubrey Bosarge,Laura Lee T. Goree, and Betty Darnell. Medium Chain Triglyceride Oil Consumption as Part of a Weight Loss Diet Does Not Lead to an Adverse Metabolic Profile When Compared to Olive Oil J Am Coll Nutr October 2008 27:547-552

Orac, it would be really nice to know why my posts are being frequently moderated (or lost/censored in one case). I could then modify my posting behavior accordingly, rather than face this unpredictable moderating. I can’t find anything specific on your about page, I did look there. I don’t think I am posting excessively considering the amount of replies to my posts, and my comments are not often long and haven’t contained links. Thanks.

JohnV:

I’ve had comments with a single link in them also end up in the moderation bin/spam bucket, but that at least isn’t the case for you.

I have had posts without links or profanity put into moderation. Sometimes the system here is just flaky.

Yes, two citations.

That’s it? No response after all that nagging to post references?

It would be better if the moderated posts posted at the end of the thread.

I did post a response last night, but it is in moderation. Since Orac is really busy I’ll give you the short answer:

Your studies do not support what you say. You have presented no real evidence that “CAM” is worthwhile. Plus after actually buying a real coconut, I can say that the coconut water is nothing like coconut “milk”, and the flesh is not at all oily (but very yummy). So all I can figure out is that “coconut oil” is a highly processed product that uses many coconuts for just one jar. Personally I prefer my foods to be less processed and much less concentrated.

What an ignorant response. Clearly I won this argument and you are flailing. The primary literature paper certainly does discuss coconut oil. The other paper showed how the idea that eggs or nuts need to be limited or avoided is also bunk, in fact all three sources of fats are healthy.

I have no idea how I am supposed to respond to your anecdote about buying a coconut.

I am not trying to show evidence that CAM works. I am calling into question the dichotomy put forth in these discussion between “CAM” and “SBM”. I am calling into question the idea that AMA approved care = the latest science. It often doesn’t, as I have easily demonstrated.

How many lives were lost because people were told for decades to use hydrogenated oils instead of coconut oil? Or because people avoided nuts (proven heart-healthy) and instead ate more trans fats?

Isabel, you really are making no sense. You were recommending coconut oil for all sorts of things, but show no evidence that it is safe or even helpful.

Isabel I have been following this debate/what your statements are about coconut oil…by the way sans any citations from peer-reviewed journal or from the American Dietitic society about the value of coconut oil…pubmed citations will do…but sites from “nutritionists”, naturapaths, internet purveyors of coconuts are unacceptable.

Are your strong convictions about the benefits due to something that you read somewhere, or your intuition or some other unacceptable “resource”…then be a big girl and state:

I don’t remember where I heard about coconut oil’s nutritional value or,

I read about coconut oil at an alernative medical site totally lacking in any studies or,

I myself market the stuff on the internet or,

I am just a silly uneducated troll.

“You were recommending coconut oil for all sorts of things”

wtf????????? I never did this at all!

“but show no evidence that it is safe or even helpful.”

wtf? I just showed that it was not dangerous, as other popular saturated fats are. So it can substitute for those harmful fats!! Therefore it is helpful.

“..by the way sans any citations from peer-reviewed journal or from the American Dietitic society about the value of coconut oil…”

Are you MAD???? I purposely used the same journal that was used as evidence against coconut oil (supposedly, but not in reality) right here on this thread. Are you saying you are now not happy with this journal selection?

“..but sites from “nutritionists”, naturapaths, internet purveyors of coconuts are unacceptable. ”

Again I used the same journal used on this thread. There are tons of coconut oil articles out there. Tons. Do your own research.

“I am just a silly uneducated troll.”

What on earth are you talking about?

“It may be a little less damaging than other saturated fats as it contains predominantly lauric and myristic acids which elevate LDL cholesterol less than the palmitic acid that predominates in animal fats’

Right. And “not going rancid” is not bad either. right?

“I disagree. Being a little less damaging isn’t the same as doing you good.”

No harm has been shown. So it is not “a little less damaging”. If someone substituted coconut oil for animal fats in baking for example, or coconut milk as a sauce base (as many southeast asian culturess do all the time in curry sauces etc) it would be beneficial if they have a medical need to avoid long-chain saturated fats. I never made any claims other than that, although there do appear to be other benefits. In one of the papers I cited it mentions weight loss, you might want to check that paper for references if you are interested.

“coconut oil will make you fat, and will elevate your LDL cholesterol.”

Citation? And you seem to be talking about over-eating, which is an entirely different subject. I was suggesting substitution so how do you get *more* weight gain, and whatever else? That sounds like nonsense to me.

“And so what? Diets and food choices are not CAM. ”

That is not my point. My point is that woo comes from AMA and FDA approved sources as well as “CAM”.

And it is equally harmful. Possibly even more so, on a larger scale in any case, the wide-scale attempts to get people to eat less (or totally eliminate) common, nutritious (and in the case of eggs and coconut, very affordable) foods.

In reference to my research into low-carb diets that I mentioned earlier in the thread, that my medical provider disapproved of, I just came across this interesting article in the LA Times, Dec. 20, 2010, called A Reversal on Carbs:

“Fat is not the problem,” says Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health. “If Americans could eliminate sugary beverages, potatoes, white bread, pasta, white rice and sugary snacks, we would wipe out almost all the problems we have with weight and diabetes and other metabolic diseases.”

…

In a 12-week study published in 2008, Phinney and his colleagues put 40 overweight or obese men and women with metabolic syndrome on a 1,500-calorie diet. Half went on a low-fat, high-carb diet. The others went on a low-carb, high-fat diet. The low-fat group consumed 12 grams of saturated fat a day out of a total of 40 grams of fat, while the low-carb group ate 36 grams of saturated fat a day — three times more — out of a total of 100 grams of fat.

Despite all the extra saturated fat the low-carb group was getting, at the end of the 12 weeks, levels of triglycerides (which are risk factors for heart disease) had dropped by 50% in this group. Levels of good HDL cholesterol increased by 15%.

In the low-fat, high-carb group, triglycerides dropped only 20% and there was no change in HDL.

The take-home message from this study and others like it is that — contrary to what many expect — dietary fat intake is not directly related to blood fat. Rather, the amount of carbohydrates in the diet appears to be a potent contributor.

“Position of the American Dietetic Association and Dieticians of Canada: Dietary Fatty Acids”

Sounds like an appeal to authority to me. Where did they even get that figure? They trash coconut oil in the table, but there is no citation, and o explanation in the text. This is very typical. Coconut oil has been completely cleared of wrongdoing, but these lies keep being repeated.

What is the source of the table in this “position paper”, and on the statements in the table about lauric acid and the other MCFA’s found in coconut oil?

@ Krebiozen: re “appeals to authority”

Ah yes! Alt med doesn’t hang with dieticians’ associations in the US, UK, or Canada. A recommendation is often the “kiss of death” for them if it comes from the “Man” ( or is it the “Woman” in charge?). In fact, the woo-meisters/ nutritionists I track appear to have declared open war on those “fascists” carrying meal charts. I guess that “registered” part (RD)-and the”MS”- gets to them. I wonder why?

Coconut oil is clearly one of their faves: Mercola even believes it may have an impact against Alzheimer’s amongst its many wonders( Mercola.com 1/18/11; Orac, here; 1/19/11). Others tout its boiling point or suchlike- which contributes to my boiling point.

( returns to holiday/ vacation)

Isabel,
I came across more from Walter C. Willett, M.D. of Harvard, not about carbohydrates this time, but regarding coconut oil. He says, among other things:
“But, for now, I’d use coconut oil sparingly. Most of the research so far has consisted of short-term studies to examine its effect on cholesterol levels. We don’t really know how coconut oil affects heart disease. And I don’t think coconut oil is as healthful as vegetable oils like olive oil and soybean oil, which are mainly unsaturated fat and therefore both lower LDL and increase HDL. Coconut oil’s special HDL-boosting effect may make it “less bad” than the high saturated fat content would indicate, but it’s still probably not the best choice among the many available oils to reduce the risk of heart disease.”

“may make it “less bad” than the high saturated fat content would indicate, but it’s still probably not the best choice among the many available oils to reduce the risk of heart disease.””

Where is the evidence that MCFAs have the same effect as LCFA-rich animal fats? The only citations I have seen on this thread, and correct me if I am wrong, assume the MCFAs are dangerous because they are saturated, like the LCFAs in animal fats.

Anyway I originally quoted him because he practically described a low-carb diet as the most healthy. His position statement on coconut oil seems very vague and opinionated. And I like how he admits you’ll need to use it if you are making Thai food. I guess the Thai people are doomed!

“I don’t think that’s surprising, as heart disease is a a disease of excess, which is why it occurs primarily in developed countries. To assume it has anything to do with coconut oil is pure speculation”

Yet you *are* assuming that it does, which is why you said:

“Until then, I’m treating coconut oil as I do other saturated fats, as a treat to be consumed in moderation.”

The paper you link to is from 14 years old and referencing a single, earlier study of only 14 patients.

Why not just use it, but not in excess? I see no reason to limit my usage. Demonization of foods is a bad road to head down.

Comment in moderation, only one link, hardly any profanities, not especially long. SB spam filter is baffling.

I don’t think I have much more to add to this discussion. I’ll just add an apposite quote from Ben Goldacre:

The most important take-home message with diet and health is that anyone who ever expresses anything with certainty is basically wrong, because the evidence for cause and effect in this area is almost always weak and circumstantial…