Quotulatiousness

September 16, 2014

When the “best nutrition advice” is a big, fat lie

Filed under: Government, Health, Media, Science — Tags: , , , , — Nicholas Russon @ 10:17

Rob Lyons charts the way our governments and healthcare experts got onboard the anti-fat dietary express, to our long-lasting dietary harm:

… in recent years, the advice to eat a low-fat diet has increasingly been called into question. Despite cutting down on fatty foods, the populations of many Western countries have become fatter. If heart-disease mortality has maintained a steady decline, cases of type-2 diabetes have shot up in recent years. Maybe these changes were in spite of the advice to avoid fat. Maybe they were caused by that advice.

The most notable figure in providing the intellectual ammunition to challenge existing health advice has been the US science writer, Gary Taubes. His 2007 book, Good Calories, Bad Calories, became a bestseller, despite containing long discussions on some fairly complex issues to do with biochemistry, nutrition and medicine. The book’s success triggered a heated debate about what really makes us fat and causes chronic disease.

The move to first discussing and then actively encouraging a low-fat diet was largely due to the work of Dr. Ancel Keys, who is to the low-fat diet movement what Karl Marx is to Communism. His energy, drive, and political savvy helped get the US government and the majority of health experts onboard and pushing his advice. A significant problem with this is that Keys’ advocacy was not statistically backed by even his own data. He drew strong conclusions from tiny, unrepresentative samples, yet managed to persuade most doubters that he was right. A more statistically rigorous analysis might well show that the obesity crisis has actually been driven by the crusading health advisors who have been pushing the low-fat diet all this time … or, as I termed it, “our Woody Allen moment“.

Rob Lyons discussed this with Nina Teicholz, author of the book The Big Fat Surprise:

Once the politically astute Keys had packed the nutrition committee of the AHA and got its backing for the advice to avoid saturated fat, the war on meat and dairy could begin. But a major turning point came in 1977 when the Senate Select Committee on Nutrition, led by Democratic senator George McGovern, held hearings on the issue. The result was a set of guidelines, Dietary Goals for the United States [PDF], which promoted the consumption of ‘complex’ carbohydrates, and reductions in the consumption of fat in general and saturated fat in particular.

By 1980, this report had been worked up into government-backed guidelines — around the same time that obesity appears to have taken off in the US. The McGovern Report inspired all the familiar diet advice around the world that we’ve had ever since, and led to major changes in what food manufacturers offered. Out went fat, though unsaturated fat and hydrogenated oils were deemed less bad than saturated fat, so vegetable oils and margarines became more popular. In came more carbohydrate and more sugar, to give those cardboard-like low-fat ‘treats’ some modicum of flavour.

Yet two recent reviews of the evidence around saturated fat — one led by Ronald Krauss, the other by Rajiv Chowdhury — suggest that saturated fat is not the villain it has been painted as. (The latter paper, in particular, sparked outrage.) As for fat in general, Teicholz tells me: ‘There was no effort until very late in the game to provide evidence for the low-fat diet. It was just assumed that that was reasonable because of the caloric benefit you would see from restricting fat.’

Teicholz also debunks the wonderful reputation of the Mediterranean Diet (“a rose-tinted version of reality tailored to the anti-meat prejudices of American researchers”), points out the role of the olive oil industry in pushing the diet (“Swooning researchers were literally wined and dined into going along with promoting the benefits of olive oil”), and points out that we can’t even blame most of the obesity problem on “Big Food”:

Which leads us to an important third point made by Teicholz: that the blame for our current dietary problems cannot solely, or even mainly, be placed at the door of big food corporations. Teicholz writes about how she discovered that ‘the mistakes of nutrition science could not be primarily pinned on the nefarious interests of Big Food. The source of our misguided dietary advice was in some ways more disturbing, since it seems to have been driven by experts at some of our most trusted institutions working towards what they believed to be the public good.’ Once public-health bureaucracies enshrined the dogma that fat is bad for us, ‘the normally self-correcting mechanism of science, which involves constantly challenging one’s own beliefs, was disabled’.

The war on dietary fat is a terrifying example of what happens when politics and bureaucracy mixes with science: provisional conclusions become laws of nature; resources are piled into the official position, creating material as well as intellectual reasons to continue to support it; and any criticism is suppressed or dismissed. As the war on sugar gets into full swing, a reading of The Big Fat Surprise might provide some much-needed humility.

QotD: The real value of work

Filed under: Health, Quotations — Tags: , , — Nicholas Russon @ 00:01

People without meaningful work and copious free time don’t write symphonies or create great works of art. They don’t live a life of the mind. They drink too much, or get in fights, or watch a lot of internet porn, or commit crimes. They don’t contribute to the economy or culture, as a rule. They just…exist. And it goes on like that, sometimes for generations.

Labor is the fate of all humankind. Always has been. We work to live. Work gives shape and meaning to our lives. It’s not just the income we derive from it; it’s the knowledge that we are able to function as adults in the wider world, and provide for ourselves and our families. It’s feeling the satisfaction of having contributed something to the maintenance of civilization, even if it means we haul trash away or keep the grass mowed. It’s all honorable work, necessary work, and not something to be ashamed of.

It’s not an outrage, it’s just the way things are. To try and embitter people about that, to make them feel that the natural order of things is unfair, is just to do an enormous amount of harm to the very people you’re claiming to want to help.

Monty, “We’re now living in a post-labor Utopia. Have you heard about this?”, Ace of Spades HQ, 2014-02-06

September 10, 2014

QotD: Smoking and drinking

Filed under: Health, Quotations, Wine — Tags: , — Nicholas Russon @ 00:01

Apart from all the other arguments, you’re a fool to smoke if you like the taste of drink. It isn’t the cigarette you smoke with your glass of wine or whisky that damages the taste of it it’s all the ones you smoked yesterday and the day before and last week. Your senses are chronically anaesthetized. Really, smokers could afford to consider what they’re certainly missing as well as what they’re in danger of getting.

After much pondering I think I understand a basic reason why a glass of something reviving is so welcome in the early evening. Partly, of course, it’s just that, to revive, to relax, but its also a convenient way of becoming a slightly different person from your daytime self, less methodical, less calculating — however you put it, somebody different, and the prospect of that has helped to make the day tolerable. And, conversely, it’s not having that prospect that makes the day look grim to the poor old ex-boozer, more than missing the alcohol as such.

Changing for dinner used to be another way of switching roles. Coming home from work has a touch of the same effect. Writers haven’t got that advantage — when they finish work they’re at home already. So perhaps they need that glass of gin extra badly. Any excuse is better than none.

Kingsley Amis, Everyday Drinking: The Distilled Kingsley Amis, 2008.

September 2, 2014

The suddenly unsettled science of nutrition

Filed under: Government, Health, USA — Tags: , , — Nicholas Russon @ 14:58

After all the salt uproar over the last year or so, perhaps it was inevitable that other public health consensus items would also come under scrutiny. Here’s Ace having a bit of fun with the latest New York Times report on fat and carbohydrates in the modern diet:

One day there will be a book written about this all — how a “Consensus of Experts” decided, against all previous wisdom and with virtually no evidence whatsoever, that Fat Makes You Fat and you can Eat All the Carbohydrates You Like Because Carbohydrates Are Healthy.

This never made a lick of sense to me, even before I heard of the Atkins diet.

Sugar is a carbohydrate. Indeed, it’s the carbohydrate, the one that makes up the others (such as starches, which are just long lines of sugar molecules arranged into sheets and folded over each other).

How the hell could it possibly be that Fat was Forbidden but SUGAR was Sacred?

It made no sense. A long time ago I tried to get a nutritionist to explain this to me. “Eat more fruit,” the nutritionist said.

“Fruit,” I answered, “is sugar in a ball.”

But the nutritionist had an answer. “That is fruit sugar,” the she told me.

“Fruit sugar,” I responded, “is yet sugar.”

“But it’s not cane sugar.”

“I don’t think the body really cares much about which particular plant the sugar comes from.”

“Sugar from a fruit,” the nutritionist now gambited, “is more natural than processed sugar.”

“They’re both natural, you know. We don’t synthesize sucrose in a lab. There are no beakers involved.”

“Well, you burn fruit sugar up quicker, so it actually gives you energy, instead of turning into fat!”

“Both sugars are converted into glycogen in the body. There can be no difference in how they produce ‘energy’ in the body because both wind up as glycogen. I have no idea where you’re getting any of this. It sounds like you’re making it all up as you go.”

This is Science,” the nutritionist closed the argument.

Eh. It’s all nonsense. Even cane sugar contains, yes, fructose, or fruit sugar, and fruits contain sucrose, or cane sugar.

August 31, 2014

Politispeak – describing a slower rate of increase as an absolute cut in funding

Filed under: Cancon, Government, Health, Politics — Tags: , , , — Nicholas Russon @ 11:20

Paul Wells says the almost forgotten leader of Her Majesty’s loyal opposition in Parliament is doing his job, but illustrates it with a great example of how political rhetoric sometimes warps reality in favour of a more headline-worthy claim:

Here’s what he said: “After promising to protect all future increases to provincial transfers, Conservatives announced plans to cut $36 billion, starting in 2016,” Mulcair told the CMA. “This spring, Conservatives will announce, with great fanfare, that there is now a budget surplus. I’m here today to tell you that an NDP government would use any such surplus to, first and foremost, cancel those proposed cuts to health care.”

This needs parsing, but first, let’s let Mulcair finish: “Mr. Harper, it’s time to keep your word to protect Canadian health care. After giving Canada’s richest corporations $50 billion in tax breaks, don’t you dare take $36 billion out of health care to pay for them!” He said that part in English, then repeated it in French, which has become the way a Canadian politician delivers a line in italics.

Well. Let’s begin with the $36 billion. In December 2011, Jim Flaherty, then the federal finance minister, met his provincial colleagues to announce his plans for health transfers after a 10-year deal set by Paul Martin ran out in 2013-14. The 2004 Martin deal declared that cash transfers to the provinces for health care would increase by six per cent a year for 10 years. Harper simply kept implementing the Martin scheme after he became Prime Minister.

What Flaherty announced, without consulting with the provinces first, was that health transfers would keep growing at six per cent through 2016-17. Then, they would grow more slowly — how slowly would depend on the economy. The faster GDP grows, the faster transfers would grow. But, if the economy tanked, the rate of growth could fall as low as three per cent per year. Flaherty said this scheme would stay in place through 2023-24.

Add up all the shortfalls between three per cent and six per cent over seven years and you get a cumulative sum of $36 billion. Despite what Mulcair said, this isn’t a “cut,” it’s a deceleration in increases. And $36 billion is the gap’s maximum amount. If the economy shows any health, the gap will be smaller.

We could have fun complaining that Mulcair calls something a “cut” when it extends what is already the longest period of growth in federal transfer payments in Mulcair’s lifetime. But it’s more fun to take him at his word. He promises to spend as much as $6 billion a year in new tax money on health care. Mulcair couldn’t buy much influence over health policy with that money; he would simply send larger cheques to provincial governments. If he has other plans for the federal government, he’d have to pay for them after he’d sent that up-to $6-billion cheque to the provinces.

Emphasis mine.

August 30, 2014

QotD: We are slaves to our stomachs

Filed under: Health, Humour, Quotations — Tags: , , — Nicholas Russon @ 00:01

How good one feels when one is full — how satisfied with ourselves and with the world! People who have tried it, tell me that a clear conscience makes you very happy and contented; but a full stomach does the business quite as well, and is cheaper, and more easily obtained. One feels so forgiving and generous after a substantial and well-digested meal — so noble-minded, so kindly-hearted.

It is very strange, this domination of our intellect by our digestive organs. We cannot work, we cannot think, unless our stomach wills so. It dictates to us our emotions, our passions. After eggs and bacon, it says, “Work!” After beefsteak and porter, it says, “Sleep!” After a cup of tea (two spoonsful for each cup, and don’t let it stand more than three minutes), it says to the brain, “Now, rise, and show your strength. Be eloquent, and deep, and tender; see, with a clear eye, into Nature and into life; spread your white wings of quivering thought, and soar, a god-like spirit, over the whirling world beneath you, up through long lanes of flaming stars to the gates of eternity!”

After hot muffins, it says, “Be dull and soulless, like a beast of the field — a brainless animal, with listless eye, unlit by any ray of fancy, or of hope, or fear, or love, or life.” And after brandy, taken in sufficient quantity, it says, “Now, come, fool, grin and tumble, that your fellow-men may laugh — drivel in folly, and splutter in senseless sounds, and show what a helpless ninny is poor man whose wit and will are drowned, like kittens, side by side, in half an inch of alcohol.”

We are but the veriest, sorriest slaves of our stomach. Reach not after morality and righteousness, my friends; watch vigilantly your stomach, and diet it with care and judgment. Then virtue and contentment will come and reign within your heart, unsought by any effort of your own; and you will be a good citizen, a loving husband, and a tender father — a noble, pious man.

Jerome K. Jerome, Three Men in a Boat (to say nothing of the dog), 1889.

August 24, 2014

QotD: Hypochondria

Filed under: Health, Humour, Quotations — Tags: , , , — Nicholas Russon @ 00:01

It is a most extraordinary thing, but I never read a patent medicine advertisement without being impelled to the conclusion that I am suffering from the particular disease therein dealt with in its most virulent form. The diagnosis seems in every case to correspond exactly with all the sensations that I have ever felt.

I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch — hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into — some fearful, devastating scourge, I know — and, before I had glanced half down the list of “premonitory symptoms,” it was borne in upon me that I had fairly got it.

I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever — read the symptoms — discovered that I had typhoid fever, must have had it for months without knowing it — wondered what else I had got; turned up St. Vitus’s Dance — found, as I expected, that I had that too, — began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically — read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Bright’s disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. Cholera I had, with severe complications; and diphtheria I seemed to have been born with. I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee.

I felt rather hurt about this at first; it seemed somehow to be a sort of slight. Why hadn’t I got housemaid’s knee? Why this invidious reservation? After a while, however, less grasping feelings prevailed. I reflected that I had every other known malady in the pharmacology, and I grew less selfish, and determined to do without housemaid’s knee. Gout, in its most malignant stage, it would appear, had seized me without my being aware of it; and zymosis I had evidently been suffering with from boyhood. There were no more diseases after zymosis, so I concluded there was nothing else the matter with me.

I sat and pondered. I thought what an interesting case I must be from a medical point of view, what an acquisition I should be to a class! Students would have no need to “walk the hospitals,” if they had me. I was a hospital in myself. All they need do would be to walk round me, and, after that, take their diploma.

Then I wondered how long I had to live. I tried to examine myself. I felt my pulse. I could not at first feel any pulse at all. Then, all of a sudden, it seemed to start off. I pulled out my watch and timed it. I made it a hundred and forty-seven to the minute. I tried to feel my heart. I could not feel my heart. It had stopped beating. I have since been induced to come to the opinion that it must have been there all the time, and must have been beating, but I cannot account for it. I patted myself all over my front, from what I call my waist up to my head, and I went a bit round each side, and a little way up the back. But I could not feel or hear anything. I tried to look at my tongue. I stuck it out as far as ever it would go, and I shut one eye, and tried to examine it with the other. I could only see the tip, and the only thing that I could gain from that was to feel more certain than before that I had scarlet fever.

I had walked into that reading-room a happy, healthy man. I crawled out a decrepit wreck.

Jerome K. Jerome, Three Men in a Boat (to say nothing of the dog), 1889.

August 18, 2014

Salt studies and health outcomes – “all models need to be taken with a pinch of salt”

Filed under: Health, Science — Tags: , , , — Nicholas Russon @ 08:41

Colby Cosh linked to this rather interesting BMJ blog post by Richard Lehman, looking at studies of the impact of dietary salt reduction:

601 The usual wisdom about sodium chloride is that the more you take, the higher your blood pressure and hence your cardiovascular risk. We’ll begin, like the NEJM, with the PURE study. This was a massive undertaking. They recruited 102 216 adults from 18 countries and measured their 24 hour sodium and potassium excretion, using a single fasting morning urine specimen, and their blood pressure by using an automated device. In an ideal world, they would have carried on doing this every week for a month or two, but hey, this is still better than anyone has managed before now. Using these single point in time measurements, they found that people with elevated blood pressure seemed to be more sensitive to the effects of the cations sodium and potassium. Higher sodium raised their blood pressure more, and higher potassium lowered it more, than in individuals with normal blood pressure. In fact, if sodium is a cation, potassium should be called a dogion. And what I have described as effects are in fact associations: we cannot really know if they are causal.

612 But now comes the bombshell. In the PURE study, there was no simple linear relationship between sodium intake and the composite outcome of death and major cardiovascular events, over a mean follow-up period of 3.7 years. Quite the contrary, there was a sort of elongated U-shape distribution. The U begins high and is then splayed out: people who excreted less than 3 grams of salt daily were at much the highest risk of death and cardiovascular events. The lowest risk lay between 3 g and 5 g, with a slow and rather flat rise thereafter. On this evidence, trying to achieve a salt intake under 3 g is a bad idea, which will do you more harm than eating as much salt as you like. Moreover, if you eat plenty of potassium as well, you will have plenty of dogion to counter the cation. The true Mediterranean diet wins again. Eat salad and tomatoes with your anchovies, drink wine with your briny olives, sprinkle coarse salt on your grilled fish, lay it on a bed of cucumber, and follow it with ripe figs and apricots. Live long and live happily.

624 It was rather witty, if slightly unkind, of the NEJM to follow these PURE papers with a massive modelling study built on the assumption that sodium increases cardiovascular risk in linear fashion, mediated by blood pressure. Dariush Mozaffarian and his immensely hardworking team must be biting their lips, having trawled through all the data they could find about sodium excretion in 66 countries. They used a reference standard of 2 g sodium a day, assuming this was the point of optimal consumption and lowest risk. But from PURE, we now know it is associated with a higher cardiovascular risk than 13 grams a day. So they should now go through all their data again, having adjusted their statistical software to the observational curves of the PURE study. Even so, I would question the value of modelling studies on this scale: the human race is a complex thing to study, and all models need to be taken with a pinch of salt.

Update: Colby Cosh followed up the original link with this tweet. Ouch!

August 14, 2014

QotD: How to create a depressive society

Filed under: Health, Media, Politics, USA — Tags: , , , , — Nicholas Russon @ 00:01

The widespread perception that almost everyone else was a moron — why, just look at the things people post and say on the Internet! – would facilitate a certain philosophy of narcissism; we would have people walking around convinced they’re much smarter, and much more sophisticated and enlightened, than everyone else.

Marinating in the perception that most people are stupid, hateful, sick, and needlessly cruel would undoubtedly alter people’s aspirations and ambitions in life. Why strive to create a new invention, miracle cure, remarkable technology, or wondrous innovation to help the masses? It would be pearls before swine, a gift to a thoroughly undeserving population that had earned its miserable circumstances. The hopeless ignorance and hateful philosophies of the great unwashed might, however, spur quiet calls for the restoration of a properly thinking aristocracy to help steer society in the correct direction.

If we wanted to build a society designed to promote depression, we would want to make children seem like a burden. Children are a smaller, slightly altered version of ourselves; Christopher Hitchens described parenthood as “realizing that your heart is running around in somebody else’s body.” To hate life, you have to hate children. If they are a form of immortality — half of our genetic code and half of our habits, good and ill, walking around a generation later — then a depressive society would condition its members to hate the possibilities of their future.

If we wanted to build a society designed to promote depression, we would want to make old age seem to be a horrible fate. (It is the only alternative to death!) Our depressive society would want to not merely celebrate youth, but we would want to constantly reinforce the sense that one is approaching mental and physical obsolescence. A celebrity who appeared much younger than her years would be celebrated and everyone would openly demand to know her secret. The unspoken expectation would be that anyone could achieve the same result if she simply tried hard enough. We would exclaim, “Man, he’s getting old!” in response to those who didn’t look the same as when we first saw them.

We would want to make sure that appearances not merely counted, but that attractiveness is preeminent. That anonymous and yet public realm of the Internet would ensure that anyone in the world could safely mock the appearance of others to a public audience and then return to picking Cheetos out of his chest hair.

Jim Geraghty, “Robin Williams and Our Strange Times: Does our society set the stage for depression?”, National Review, 2014-08-12.

August 13, 2014

Pessimism from the Rational Optimist

Filed under: Africa, Health — Tags: , — Nicholas Russon @ 00:02

Matt Ridley is somewhat uncharacteristically concerned about the major Ebola outbreak in west Africa:

As you may know by now, I am a serial debunker of alarm and it usually serves me in good stead. On the threat posed by diseases, I’ve been resolutely sceptical of exaggerated scares about bird flu and I once won a bet that mad cow disease would never claim more than 100 human lives a year when some “experts” were forecasting tens of thousands (it peaked at 28 in 2000). I’ve drawn attention to the steadily falling mortality from malaria and Aids.

Well, this time, about ebola, I am worried. Not for Britain, Europe or America or any other developed country and not for the human race as a whole. This is not about us in rich countries, and there remains little doubt that this country can achieve the necessary isolation and hygiene to control any cases that get here by air before they infect more than a handful of other people — at the very worst. No, it is the situation in Liberia, Sierra Leone and Guinea that is scary. There it could get much worse before it gets better.

This is the first time ebola has got going in cities. It is the first time it is happening in areas with “fluid population movements over porous borders” in the words of Margaret Chan, the World Health Organisation’s director-general, speaking last Friday. It is the first time it has spread by air travel. It is the first time it has reached the sort of critical mass that makes tracing its victims’ contacts difficult.

One of ebola’s most dangerous features is that kills so many health workers. Because it requires direct contact with the bodily fluids of patients, and because patients are violently ill, nurses and doctors are especially at risk. The current epidemic has already claimed the lives of 60 healthcare workers, including those of two prominent doctors, Samuel Brisbane in Liberia and Sheik Umar Khan in Sierra Leone. The courage of medics in these circumstances, working in stifling protective gear, is humbling.

Ebola outbreak in west Africa

QotD: Abstention

Filed under: Health, Humour, Quotations — Tags: , — Nicholas Russon @ 00:01

Earlier this year I went off the booze for a few weeks, a purely voluntary move, let it be said. Among other things, I thought might be interesting to look at life from the Other Side. So to speak.

It wasn’t quite what I’d expected. Ex-topers, those warned off by the doc, will tell you emotionally that if they’d known how much better they were going to feel with, out it, they’d have given it up years before they actually had to. This is a pathetic lie, designed to make you look like the one who’s missing out and motivated by their hatred and envy of anybody who’s still on it. In fact, not only is one’s general level of health unaffected by the change, but daily ups and downs persist in the same way.

I discovered early on that you don’t have to drink to build yourself a hangover. There were mornings when I groaned my way to consciousness, wondering dimly whether it was port or malt whisky that had polluted my mouth and dehydrated my eyes, until I remembered that it could only have been too much ginger beer and late-night snooker. Then, the next morning, I would feel fine, or at least all right, with the same mysterious lack of apparent reason.

[...]

As regards other parts of the system, my liver no doubt benefited from its sudden lay-off, but it didn’t send me any cheering messages to say so. My mental powers seemed unaltered, certainly unimproved — I was no less forgetful, short on concentration, likely to lose the thread or generally unsatisfactory than I had been before. But now I had no excuse. That was the only big difference: when I was drinking I had the drink to blame for anything under the sun, but now it was all just me. A thought that must drive a lot of people to drink.

I hope I haven’t discouraged anyone who might be thinking of taking a short or long holiday from grape and grain. The easiest part is the actual total not drinking, much easier than cutting it down or sticking to beer or anything like that. Very nearly the hardest part is putting up with the other fellow when he’s drinking and you’re just watching him. At such times you’re probable not much fun yourself either. Fruit juice and company don’t mix.

Kingsley Amis, Everyday Drinking: The Distilled Kingsley Amis, 2008.

July 28, 2014

QotD: Absinthe

Filed under: Health, History, Quotations — Tags: , — Nicholas Russon @ 00:01

True absinthe (the name is from a Greek word meaning “undrinkable”) has been illegal in most places for a long time. It is, or was, flavoured with the herb wormwood, which, as the French authorities noticed after years of using absinthe in their army to combat fever, “acts powerfully on the nerve-centres, and causes delirium and hallucinations, followed in some cases by idiocy” (Encyclopaedia Britannica). The perfectly wholesome successors to absinthe are flavoured with anise, or aniseed. The result always reminds me, not unpleasantly, of those paregoric cough-sweets children ate before the war, and I see that paregoric does contain aniseed, but throws in opium, camphor and benzoic acid as well, so I am probably just being nostalgic. Anyway, when recipes call for absinthe, as they can still do if their compilers and revisers have been too ignorant or lazy to make the change, use Pernod or Ricard instead.

Kingsley Amis, Everyday Drinking: The Distilled Kingsley Amis, 2008.

July 23, 2014

In statistical studies, the size of the data sample matters

Filed under: Health, Science, USA — Tags: , , , , , — Nicholas Russon @ 08:49

In the ongoing investigation into why Westerners — especially North Americans — became obese, some of the early studies are being reconsidered. For example, I’ve mentioned the name of Dr. Ancel Keys a couple of times recently: he was the champion of the low-fat diet and his work was highly influential in persuading government health authorities to demonize fat in pursuit of better health outcomes. He was so successful as an advocate for this idea that his study became one of the most frequently cited in medical science. A brilliant success … that unfortunately flew far ahead of its statistical evidence:

So Keys had food records, although that coding and summarizing part sounds a little fishy. Then he followed the health of 13,000 men so he could find associations between diet and heart disease. So we can assume he had dietary records for all 13,000 of them, right?

Uh … no. That wouldn’t be the case.

The poster-boys for his hypothesis about dietary fat and heart disease were the men from the Greek island of Crete. They supposedly ate the diet Keys recommended: low-fat, olive oil instead of saturated animal fats and all that, you see. Keys tracked more than 300 middle-aged men from Crete as part of his study population, and lo and behold, few of them suffered heart attacks. Hypothesis supported, case closed.

So guess how many of those 300-plus men were actually surveyed about their eating habits? Go on, guess. I’ll wait …

And the answer is: 31.

Yup, 31. And that’s about the size of the dataset from each of the seven countries: somewhere between 25 and 50 men. It’s right there in the paper’s data tables. That’s a ridiculously small number of men to survey if the goal is to accurately compare diets and heart disease in seven countries.

[...]

Getting the picture? Keys followed the health of more than 300 men from Crete. But he only surveyed 31 of them, with one of those surveys taken during the meat-abstinence month of Lent. Oh, and the original seven-day food-recall records weren’t available later, so he swapped in data from an earlier paper. Then to determine fruit and vegetable intake, he used data sheets about food availability in Greece during a four-year period.

And from this mess, he concluded that high-fat diets cause heart attacks and low-fat diets prevent them.

Keep in mind, this is one of the most-cited studies in all of medical science. It’s one of the pillars of the Diet-Heart hypothesis. It helped to convince the USDA, the AHA, doctors, nutritionists, media health writers, your parents, etc., that saturated fat clogs our arteries and kills us, so we all need to be on low-fat diets – even kids.

Yup, Ancel Keys had a tiny one … but he sure managed to screw a lot of people with it.

H/T to Amy Alkon for the link.

July 12, 2014

Sriracha factory dispute – “THIS PROBLEM NEEDS TO BE TAKEN CARE OF NOW, NOT LATER!!!!!”

Filed under: Bureaucracy, Business, Government, Health, USA — Tags: , , — Nicholas Russon @ 00:03

Sriracha rooster sauceSriracha fans were relieved when the Huy Fong plant in California was allowed to re-open after a farcical ‘elf-and-safety’ shakedown (original story here). Reason‘s Zenon Evans has more on the behind-the-scenes bullshit that triggered the near-national panic among hot sauce consumers:

The public just got some new insight into one of the last year’s spiciest (and fishiest) political kerfuffles: the push by the city council of Irwindale, California to shut down Huy Fong Foods, the makers of Sriracha hot sauce. The tireless freedom-of-information requesters at MuckRock yesterday published internal council documents, revealing theatrically furious communication among the local government officials and a desire to exploit regulations to force the company into submission.

[...]

The newly revealed memos and emails show that some members of government were actually “happy to report the scent of chilies” emanating when production began in 2012, but, a year later Ortiz and Councilman David Fuentes, who also lived near the factory (and also ultimately recused himself from the matter), saw a total shutdown as the first and only appropriate course of action.

“I just received notice that the odor at this place is very strong. We must proceed with SHUT DOWN immediately,” demanded Ortiz in an email, despite the fact that he had previously applauded how much safer that part of town had become since the $80 million business moved in.

Fuentes was even more adamant. “THIS PROBLEM NEEDS TO BE TAKEN CARE OF NOW, NOT LATER!!!!!,” he emailed his fellow council members in October. Notably, he also suggested that “if we need to shut them down for non compliance, then let’s do what we have to do.”

Although it’s not clear exactly what Fuentes meant by “non compliance” or if the council made moves based on his plot, the city did sue Huy Fong and got a judge to order a partial shutdown in November, even though that the judge acknowledged a “lack of credible evidence” regarding the health risk claims. Likewise, California’s health regulators stepped in and changed their own food rules in December as they demanded a 30-day hold on operations, which created fear of a national Sriracha shortage.

July 11, 2014

DSM-5 turns “everyday anxiety, eccentricity, forgetting and bad eating habits into mental disorders”

Filed under: Health, Media — Tags: , , , — Nicholas Russon @ 08:46

Helene Guldberg reviews Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life by Allen Frances.

Frances’ arguments about the dangers of inflating psychiatric conditions and psychiatric diagnosis are persuasive — maybe more so because he honestly admits to his own role in developing such an inflation. He is keenly aware of the risks of diagnostic inflation ‘because of painful firsthand experience’, he writes. ‘Despite our efforts to tame excessive diagnostic exuberance, DSM-IV had since been misused to blow up the diagnostic bubble’. He is particularly concerned about the exponential increase in the diagnosis of psychiatric conditions in children, writing: ‘We failed to predict or prevent three new false epidemics of mental disorder in children — autism, attention deficit, and childhood bipolar disorder. And we did nothing to contain the rampant diagnostic inflation that was already expanding the boundary of psychiatry far beyond its competence.’

Take Attention Deficit Hyperactivity Disorder (ADHD), which is ‘spreading like wildfire’. This diagnosis is applied so promiscuously that ‘an amazing 10 per cent of kids now qualify’, Frances writes. He points out that in the US, boys born in January are 70 per cent more likely to be diagnosed with ADHD than boys born in December. The reason diagnosing ADHD is so problematic is that it essentially is a description of immaturity, including symptoms such as ‘lack of impulse control’, ‘hyperactivity’ or ‘inattention’. Boys born in January are the youngest in their school year group (in the US) and thus they are more likely to be immature; in the UK, the youngest children in a school classroom are born in August, and so here, August-born kids are more likely to be diagnosed with ADHD. We have medicalised immaturity.

[...]

Until 1980, the DSMs were ‘deservedly obscure little books that no one much cared about or read’. DSM-I (published in 1952) and DSM-II (published in 1968) were ‘unread, unloved and unused’. Now, says Frances, this ‘bible’ of psychiatry ‘determines all sorts of important things that have an enormous impact on people’s lives — like who is considered well and who sick; what treatment is offered; who pays for it; who gets disability benefit; who is eligible for mental health, school vocational and other services; who gets to be hired for a job, can adopt a child, or pilot a plane, or qualifies for life insurance; whether a murderer is a criminal or mental patient; what should be the damages awarded in lawsuits; and much, much more’.

Today, as a result of various trends, including the impact of the DSMs, many human behaviours, quirks, eccentricities and woes which in the past would have been seen as parts of the rich tapestry of life are now branded mental disorders.

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