Nutritional Epidemiology - NY Times commentary - Thoughts?

Nutritional Epidemiology - NY Times commentary - Thoughts?

by Kristen -
Number of replies: 3

I would be interested to hear the classes comments about an article I read recently in the NY Times titled Why Nutrition is so Confusing. Here is the link: 

http://www.nytimes.com/2014/02/09/opinion/sunday/why-nutrition-is-so-confusing.html?_r=0

In particular, about the following passages: 

"Here’s another possibility: The 600,000 articles — along with several tens of thousands of diet books — are the noise generated by a dysfunctional research establishment. Because the nutrition research community has failed to establish reliable, unambiguous knowledge about the environmental triggers of obesity and diabetes, it has opened the door to a diversity of opinions on the subject, of hypotheses about cause, cure and prevention, many of which cannot be refuted by the existing evidence. Everyone has a theory. The evidence doesn’t exist to say unequivocally who’s wrong."

"And they do what are called observational studies, observing populations for decades, documenting what people eat and what illnesses beset them, and then assume that the associations they observe between diet and disease are indeed causal — that if people who eat copious vegetables, for instance, live longer than those who don’t, it’s the vegetables that cause the effect of a longer life. And maybe they do, but there’s no way to know without experimental trials to test that hypothesis."

"As it is, we have a field of sort-of-science in which hypotheses are treated as facts because they’re too hard or expensive to test, and there are so many hypotheses that what journalists like to call “leading authorities” disagree with one another daily."

Thoughts??

 

 

 

 

 

 

 

 

In reply to Kristen

Re: Nutritional Epidemiology - NY Times commentary - Thoughts?

by Cindy -

Good find, Kristin! Hopefully we will have time on Friday to discuss this article, especially in light of the Ioannidis article we read last week. 

In reply to Kristen

Re: Nutritional Epidemiology - NY Times commentary - Thoughts?

by Ruby -

Hi Kristen,

 

I think you got the jist spot on that diet, lifestyle and disease is a minefield!  In reading the article the author quotes that in 1960 fewer than 13% of Americans were obese.  I bet in 1960 there were other diseases that the public were suffering from.  I don't know specifically about the US but I just watched a documentary about health in the 20th century in the UK; in 1960 there were far more children that had dental disease, infectious disease, people suffered a lot more from respiratory aliments from coal dust and smoking and British diet consisted of post war ration modifications which was white bread margarine and tea full of sugar.  People were thinner in 1960 but they certainly were not healthier and they had shorter life expectancy to boot.  In addition the author doesn’t really tackle malnutrition amongst minority communities in the USA in the 1960s.  I can’t remember the statistic but I went to an exhibition here in the city and in Oakland and San Francisco alone there were a horrific amount of starving children and mothers of African American descent in the 60s and 70s.  My point is that 1960 was no wonderland as the author seems to use his reference from. 

 

Since most Western countries have undergone the epidemiological shift, the major burdens on our health services are those that relate to chronic disease, many of them related to the obesity epidemic.  But I have to say I’m not sure what specific points the author was trying to make.  It sounded like a complaints session!  I guess he was saying that we waste money on this inexact science.  Another angle is that nutrition varies in different cultures and in the West is dominated by marketing.  Rather than focus on an individuals nutritional intake, should we not be looking at imposing larger public health measures, such as reducing sugar in children's cereals like they have done in Europe.  Big time measures like that are easier to measure in the long term.  

 

See you Friday,

 

Ruby 

In reply to Ruby

Re: Nutritional Epidemiology - NY Times commentary - Thoughts?

by Kristen -

Ruby - you have a good point about health in the 1960s. 

I think that the author is arguing that you can't make any causal inferences from observational epidemiology! And the only way to truly understand biological/causal relationships is through RCTs. I thought this was a pretty dramatic point  but it speaks to the media and public's weakening confidence in the science of epidemiology. It also speaks to the modern era of "black-box" epidemiology.

Here is a great quote from Kreiger's 1994 paper "Epidemiology and the web of causation":

"Epidemiologists widespread practice of treating disease mechanisms as a 'black box' will soon render the discipline incapable of making meaningful contributions to understanding disease etiology" 

And this was written 20 years ago!!