March 14, 2024 • 28 mins
Episode Summary:
In this episode of Blasphemous Nutrition, host Aimee delves into the topic of scientific literacy and the challenges of trusting scientific research. She highlights three primary problems with research: publication bias, lack of validation, and the manipulation of statistics for marketability. Aimee discusses the limitations of observational studies and the importance of distinguishing between absolute risk and relative risk. She emphasizes the need for critical thinking and skepticism when interpreting scientific information and concludes by acknowledging the complexity of health and the importance of considering differing opinions in the pursuit of truth.
Key Takeaways:
- Research is often skewed due to publication bias, with a strong bias towards publishing studies with positive results.
- Validation studies to confirm existing research findings are not done frequently enough, leading to a lack of reproducibility.
- The game of telephone from researcher intent to publication to media dissemination can distort scientific information.
- Observational studies provide valuable observations but cannot establish causal relationships with certainty.
- Randomized controlled trials (RCTs) are considered the gold standard but have limitations in capturing real-world complexity.
Notable Quotes:
- "We cannot blindly trust the science and we should be extremely skeptical of trusting anyone who says otherwise." - Aimee
- "The real world is way too complex for RCTs to be as gold a standard as we really wish they could be." - Aimee
Resources:
Photography by: Dai Ross Photography
Podcast Cover Art: Lilly Kate Creative
Blasphemous Nutrition on Substack
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome back to blasphemousnutrition.
I'm your host, Aimee, a doubledegree nutritionist who can
curse in multiple languages.
I want to spend the next coupleof episodes on scientific
literacy and why there's justlike so much bullshit out there
that gets promoted as science,when it only appears to make
things more confusing foreveryone.
This is an area I am likely toget salty about and a place
(00:23):
where I struggled to show somegrace.
So I'm hoping that you forgiveme if I go off the rails, but I
am going to do my best to staylevel headed.
I can't promise that you'll feelany more clearer when we are
done.
However, I do think you'll havea better understanding on why
things appear so asinine and whyit seems we can't make a
(00:44):
decision on anything.
All right, make sure you've gotyour smelling salts, buckle
yourself in and let's getstarted.
Hey Rebels, welcome toBlasphemous Nutrition.
Consider this podcast yourpantry full of clarity,
perspective, and the nuanceneeded to counter the
superficial health advice sofreely given on the internet.
(01:06):
I'm Aimee, the unapologeticallycandid host of Blasphemous
Nutrition and a double degreednutritionist with 20 years
experience.
I'm here to share a more nuancedtake.
On living and eating well tosustain and recover your health.
If you've found most healthadvice to be so generic as to be
meaningless, We're so extremethat it's unrealistic, and you
(01:27):
don't mind the occasional fbomb.
You've come to the right place.
From dissecting the latestnutrition trends to breaking
down published research andsharing my own clinical
experiences, I'm on a mission tofoster clarity amidst all the
confusion, and empower you tohave the health you need to live
a life you love.
Now let's get started.
(01:53):
So I kind of see the issue thatwe have with research as coming
from three primary areas,there's three primary problems.
The first problem is that whatwe actually see what even makes
it to publication is already askewed example.
(02:13):
One of these most fundamentalproblems in research is that
everything that we have accessto is already skewed.
There is a strong bias towardspublishing research with mostly
positive results.
I mean, finding something is waymore exciting than not finding
anything, right?
Additionally, if you are aresearcher and you find
(02:35):
something new, you have way moreopportunities for career
advancements.
Then if you don't contributesomething new and novel to the
scientific community, What getsfunded and what gets published
is strongly based upon novelty.
Or driven by incentives thataren't about truth, but more
about publishability.
What's going to get read inpublications.
(02:57):
This makes more money forpublishers and also has the
chance to secure a researcher'scareer.
So the system is stronglyincentivized to look for what's
new, especially in medicine andoverlook, confirming what has
already been studied.
So what we have out there is notoften backed by multiple studies
to strengthen evidence.
(03:18):
And this is not to say thatthese studies don't exist.
Many many studies are run, butnever published because they
conclude null results.
And therefore, Are ratherunpublishable.
This is referred to as the filedrawer problem and it refers
back to the analog days whenthis research was literally
(03:39):
tucked away in a file drawersomewhere and forgotten about.
Now occasionally a scientistwill be caught massaging data to
look for signals that don'tactually exist.
Brian Wansink who's 20 yearcareer in research was
subsequently found to be riddledwith scientific sloppiness and
outright manipulation of data.
(03:59):
Was dismissed under this cloudof disgrace from Cornell
University back in 2019.
This was a huge deal in thenutrition field because much of
his work was relied upon andused publicly as well as
privately.
He was one of the primaryresearchers in the two thousands
to break into pop culture withhis book, mindless eating.
And like rats, when you findone, you know, there's a whole
(04:22):
slew of them hiding in the dark.
With career possibilities andhuman ego on the line.
It's not terribly hard toimagine this outcome of bias.
And intended or even unconsciousskewing of research questions,
methodology, statisticalanalysis, and publication bias,
(04:43):
being a problem of significancein the research that we have
access to.
The second problem is thatwhat's been published is not
always validated by additionalresearch.
And I alluded to this before.
Validation studies to confirm anexisting positive outcome are
not done frequently enough oftenagain, due to their lack of
(05:06):
novelty.
Brian Nozick is a University ofVirginia researcher in
psychology, and he's beenspearheading this return to the
validity of research and openscience.
He set out to reproduce resultsfrom psychology research and
found that even something assimple as running existing data
a second time.
Rarely lead to the same outcomein his field.
(05:29):
While this was actuallyinitiated within his own work,
when he set out to see howprevalent it was in the social
science field, he was stunned tofind that it was a very
prevalent problem, showing that60% of studies chosen to be
reproduced actually failed toachieve the same results.
(05:50):
In the show notes, I've includedan interview with Nosek.
So you can learn a little bitmore about the nuance behind
this and the issue ofreproducibility in the science
field.
So one might be inclined to say,well, yeah, but these are, you
know, psychology is a softscience, so this is totally
unsurprising.
But similar alarmingobservations have been found in
(06:13):
cancer research as well.
With 88% of results.
From what were consideredlandmark studies in the field
being on reproducible.
And when it comes to cancerresearch, like we want to know
what the fuck is going on, andwe want to make sure that we're
headed in the right direction.
Right.
And I'm not even going to touchon Alzheimer's because I don't
(06:35):
know.
I don't know if there's been anyreproducible research in
Alzheimer's, but I do know thatwhat we've been doing for the
last 20 years has created a lotof drugs that don't do shit for
people.
Um, so we're kind of stillshooting in the dark there.
And I wouldn't be surprised ifstatistics in that field were
just as alarming.
(06:56):
So with cancer research whenlandmark papers, these huge
discoveries, right?
When several of these paperswere looked at and researchers
tried to reproduce the sameresults from these
groundbreaking studies 88% ofthe time they were unable to get
(07:19):
the same result.
So I'm not filled with a lot ofconfidence right now but like,
fuck, what the hell are wesupposed to do?
So the research that exists,particularly when it is novel,
really needs to be repeated toensure that what we are seeing
(07:39):
is factual.
More often than not, this doesnot get done.
And much of what we think weknow might not actually be
accurate.
This is also part of the reasonwhy there seems to be so much
flip-flopping in science.
Things get thrown out into thepublic before they have the time
or the ability to be verified.
And this brings me to the nextproblem, the game of telephone
(08:02):
and the manipulation ofstatistics for marketability.
Studies of various quality getthrown out into the public all
the time.
We need to be aware thatjournalists are not skilled at
reading and interpretingscience.
They do not teach scientificliteracy and statistical
analysis in journalism school.
So what gets disseminated isalso what is catchy, what is
(08:25):
novel and likely to get clickson news sites.
But even before the internetnewspapers had to be sold and
headlines were extremelyimportanT.
the news business is in thebusiness of selling news.
Not necessarily deeplyresearched evidence and facts,
even if we don't seem to be ableto collectively define what fact
(08:50):
is anymore.
So we have this problem wherethose who are largely
responsible for holding themegaphone are not well-suited to
discern if something which isalso publishable is in fact
accurate and quality researchworthy of the town crier.
That said.
I cannot speak to the rationalebehind why other organizations
(09:13):
such as the American medicalassociation or the FDA might
also be disseminating horribleadvice and information.
I am.
Not going to get into that heretoday.
I have no reasonable conclusionfor some of the behavior I'm
seeing these days.
So moving right along.
One important aspect,particularly when it comes to
(09:36):
health sciences and publichealth advice is this important
distinction between absoluterisk and relative risk.
The absolute risk is indicativeof certainty.
So for instance, If it is 90%likely you will be killed by the
Ebola virus.
If you get it.
(09:57):
You want to know the impact ofan intervention on alleviating
the risk of death from Ebola?
Relative risk refers to theprobability that something will
have an impact in case you getexposed.
So let's say there's a new drugthat's very promising and it
suggests that it is 70%effective at preventing death
from a Bola.
That's fantastic news.
(10:18):
Like that's phenomenal.
However, Ebola is transmittedthrough body fluids and it's
difficult to catch if you'remore than three feet or one
meter away from somebody.
It's also prevalent in few areasof the world.
My relative risk of catchingEbola, living in the Northern
part of the world is very slim.
Uh, 70% reduction of death fromsomething I have less than a 1%
(10:41):
risk of catching in the firstplace.
Just doesn't really impress metoo much.
So there's no logical reason forme to have Ebola medication on
hand, just in case any more thanit's logical for me to carry
snake bite remedies into theArctic circle.
However, if I'm traveling to anarea of the world to do
volunteer medical work andthere's an outbreak, but for
(11:02):
some reason I have to go.
I'm going to be proactive abouttaking some with me just in
case.
My absolute risk of catching.
It becomes astronomicallyhigher.
And with a 90% fatality rate, a90% absolute risk of dying.
If I get it and it's untreated.
I don't want to take thosechances.
So this is the differencebetween relative risk and
(11:25):
absolute risk.
It has been said that regardingrelative risk and absolute risk
that, and I'm quoting here.
Absolute measures should not beused in observational studies of
associative relationships, norshould relative measures be used
in clinical trials of causativerelationships.
(11:47):
Basically, this means that ifyou're smart about your research
and you are aiming for accuracyand truth and how this
information is disseminated.
Do not discuss absolute riskwhen looking at an observational
study and don't be talking aboutrelative risk.
If you're using a clinicaltrial.
(12:09):
Determining causalrelationships.
Now.
An excellent example of thisthat has impacted each and every
one of us is the 95% reductionof COVID death with vaccination.
So this is relative risk, notabsolute risk.
And I would not be blasphemousif I didn't go here.
(12:32):
The risk of death from COVID wasvery dependent upon one's age
and pre-existing healthconditions.
Those with obesity, metabolicsyndrome, cardiovascular
disease, and especially thoseover 70 are at much higher risk
of death and severe illness fromCOVID 19.
Healthy children were not dyingof COVID.
Those under 35 by and large hadan easy go of it unless they had
(12:58):
pre-existing conditions.
The risk of death among youngand healthy people was very
small.
However when the first remediescame out, we were told
accurately that the researchindicated a 95% relative risk
reduction of death andhospitalization.
That's what the paper said.
(13:20):
Whether or not that turned outto be true is something I'm not
going to go into.
That paper was reportingrelative risk reduction, not
absolute risk reduction.
But this was not advertised bythe media such and the Facebook
hired effect.
Checkers seem to miss that.
Additionally, as the weeks wenton, the narrative changed from
(13:41):
the risk of hospitalization anddeath to the risk of disease
acquisition.
We heard this stuff fromofficials in high places that
these treatments preventedtransmission.
Even though it was grosslyevident by the summer of 2021.
From that outbreak that happenedin Massachusetts.
This narrative prevailed longafter people saw with their own
(14:02):
eyes, that this was not thecase.
And that narrative was global.
With many Europeans being toldtheir vaccine would prevent
their grandmother's death.
Dissenting opinions wereostracized.
And there were several careersthat were ruined.
I witnessed a lot ofshape-shifting of this story.
As people tried to make sense ofthis cognitive dissonance
(14:25):
between what their trustedofficials were telling them and
what they were seeing with theirown eyes.
Like people needed something tobelieve in.
I get that.
And people suffered greatlywhile the emperor wore no
clothes.
So.
Due to the misrepresentation ofthe research and other
shenanigans.
(14:46):
We have a situation now wheresome people are understandably
mistrustful of science.
And the authority.
Social media posts that goviral, want to dismiss skeptics
as troglodytes, but this is notthe first time that populations
have suffered at the hands ofscience.
If you don't know aboutTuskegee, go look that up now.
(15:08):
Okay.
and hot topics still exhauststhe fuck out of me.
I am moving on now.
Another problem is thatobservational research is
disseminated as suggestive ofcause.
But this is often assumed toosoon.
And without sufficient enoughpower to warrant such a
suggestion.
Observational studies areconsidered weaker data because
(15:29):
they are an observation in anatural environment, such as
collecting data about what apopulation eats.
And looking for signs andsignals about nutrition-related
diseases.
We can't ascertain causalrelationships here with any
certainty, but we can notestrong observations.
(15:49):
And this is because we can'ttake into account all of the
different things that might leadto a specific observation.
These are called confoundingvariables.
And this is where thissuggestion, that high meat diets
cause heart disease come from.
This is also where theassociation between smoking and
disease was noted and becameoverwhelmingly impossible to
(16:10):
ignore.
Because it would be grosslyunethical to do an
interventional study where wemade people smoke one to two
packs a day for a decade.
The observation seen here wasdismissed for a very long time
and most ardently by tobaccocompanies.
There's a double-edged swordhere.
Right?
And this is part of the reasonwhy this argument about me and
(16:34):
health outcomes continues towage on..
I will say, however, and you mayremember this from episode four.
Flushing out the facts of theplant-based paradigm.
That the strength of associationfor smoking related diseases was
far stronger than theassociation we see for meat
(16:56):
related diseases.
And I'm air quoting there.
So the argument here willcontinue and remain a, he said,
she said debate for theforeseeable future.
The real problem is when we takeobservational data, do not
reveal the strength ofassociation, the strength of the
evidence that we see and thendisseminate that information,
(17:18):
suggesting that it is causal.
We cannot reach certainty ofcause through observation.
And when media ignores thesedetails between relative risk
and absolute risk of anassociation, we get gross over
reactions and panic overabsurdities.
Like.
That stupidly impotent studypublished last year, suggesting
(17:40):
that erythritol intake causesheart disease.
Okay.
I feel my blood pressure rising.
This study actually looked at apopulation with very high risk
of cardiovascular disease.
Many had already had a heartattack.
They were hypertensive diabeticor even had heart failure and
(18:01):
they were included in thisstudy.
And then they measured theerythritol levels in their
blood, but never bothered tofucking ask them about the
intake of the erythritol fromtheir diet.
erythritol is produced in thebody.
And All production is increasedwhen cells are under oxidative
(18:26):
stress.
Uh, something that is happeningin overt disease.
Blood levels of erythritol arealso associated with obesity.
A condition that is also linkedto increased oxidative stress.
So then they checked in afterthree years and noted that, oh,
those who have the highest levelof serum erythritol were more
(18:50):
likely to have cardiovascularevents.
Never mind that diabetes,hypertension, a history of heart
attack and existing heartfailure also grossly increased
the risk of a cardiovascularevent.
And that erythritol appears tobe produced as a by-product of a
strained and sick system.
(19:10):
Anyway, this study measuredblood levels of erythritol call
in sick people and then tookeight healthy people and gave
them dietary erythritol.
So gave them an erythritolsupplement and then measure
their blood levels before andafter and showed.
Hey, if you take erythritoltall.
Orally.
It increases your plasma levels.
(19:31):
So then the researchers tookthese two studies, one of them
observational.
Noting people in poor health.
I have higher earth natal ratesin their blood and tend to die
of cardiovascular disease.
And then an interventionalstudy.
If we give people a resveratrol,their blood levels in grace.
And then they coalesced thisinto a single paper with a final
conclusion that erythritol inthe blood appears to be
(19:54):
associated with increaseddisease risk.
So then the media goes out.
There's this vitality of panicthat this low calorie sweetener
is killing us, nevermind.
That our highly stressed,isolated, and poorly fed society
might be killing us.
And now I can't get swerve at mylocal whole foods.
(20:15):
Many of these flash in the panone-off studies that get shoved
out and induced panic or on parwith this level of quality.
Always read between the lines.
And if you can get your hands onthe primary paper, read what it
says and see how it might bedifferent than what the media
outlets are suggesting.
Maybe it's being suggested thata compound causes cancer or a
(20:39):
compound cures cancer, but thatstudy was done in a Petri dish.
Maybe it's an observationalstudy, but they don't disclose
if they took into accountconfounding variables or they
missed obvious confounders, suchas smoking or preexisting health
conditions.
Maybe the observational study isthem observing.
(21:00):
50 people.
Well, we can't really make anybig grandiose conclusions taking
a look at 50 people./ Whilerandomized controlled trials are
considered the gold standard inscience.
They also have their ownlimitations.
Here, we aim to find causalrelationships between single
(21:21):
factors.
The impact of a medication onthe glucose levels of men over
the age of 50 who have diabetes,but no other diseases, for
instance, These RCTs, orrandomized controlled trials,
are very valuable contributionsso long as you fit into the
demographic being studied.
(21:43):
So let's take this instance.
Let's say this study is done andlet's say they even are able to
repeat the study successfully inthis group of men over 50, with
just diabetes as a healthcondition.
And then it's used as thefoundation for some sexy,
expensive new diabetesmedication.
What we do not yet know is howdoes it impact the glucose of
(22:07):
women?
Does it matter if she's pre orpost-menopausal.
How does it impact younger menwith diabetes?
What if this person taking themedication has other health
conditions super, super commonin this demographic, but having
other preexisting healthconditions are considered
(22:28):
confounding variables and areoften excluded from the research
pool.
We would ideally like to knowhow this medication could
interact with other medicationsor how it might impact other
concurrent diseases within thepatient.
So you see the real world is waytoo complex for RCTs to be as
(22:49):
gold, as standard as we reallywish they could be.
We often find the limitations ofan intervention long after it's
been in the public for 20 yearsor so.
And there's enough data thenaccumulated.
To have a better understanding.
And this is why you see thingslike Vioxx and other medications
out for a significant period oftime and then pulled because
(23:12):
they discover, oh, whoops.
It turns out there was this bigproblem that we didn't see in
the initial research.
So interventional studies andobservational studies both have
a place.
Both hold value.
Both have limitations.
In the game of telephone fromresearcher intent to
publication, to news outlets orpublic health officials sharing
(23:35):
their thoughts or suggestionsbased upon the data.
Is its own game of telephone.
And this is why I say we cannotblindly trust the science and we
should be extremely skeptical oftrusting anyone who says
otherwise, Science is an everevolving field of finding out
(23:56):
what we believe to be true basedupon what we find to be untrue
over time.
We have very strong evidencethat gravity is real.
And lots of evidence to supportthe earth being round, but when
it comes to curing illnesses andoptimizing vitality, There are
still a lot of unknowns.
(24:19):
My personal bias tends to be anaturalistic one.
I hold a bit more credibility.
And what has allowed humanity tosurvive for as long as we have.
I look to history as anindicator of what might be more
correct than other things.
This is certainly notinfallible.
(24:39):
It tends to make me skeptical ofthe new and shiny.
I need more time to feelconfident in a new product or a
new idea.
I think having people whoembrace new technologies as
equal as valuable, because,well, someone's gotta be willing
to try it out first.
Right.
It's just not going to be me.
There is room for all of it.
(25:00):
And I would argue that thehealthiest societies are the
ones that allow for differingopinions to be at the same
table, because we see oneanother's fallacies way more
clearly than we see our own.
If our true goal is arriving athealth and not ego validation
for our own self righteousness,we ought to be more willing to
(25:22):
entertain opinions that differfrom ours.
We ought to be more willing toquestion our own assumptions and
to recognize that being misledby human emotion and
self-preservation is a humantrait that none of us are exempt
from.
All right.
(25:43):
Next week, I'm going to offeryou an antidote to the heartburn
that I've just given you withthis episode.
I'll be interviewing VictorialaFont.
Victoria is the founder of theLaFont agency, which is a
marketing agency based on havinga bias- conscious interpretation
of scientific literature.
That then gets used to createpractical content for health
practitioners.
(26:03):
I think her understanding ofboth marketing and scientific
literacy is unique.
And she's going to share sometips on scientific literacy and
how we commoners withoutstatistics degrees and research
chops can better ascertain theshit science from the promising
gold nuggets that are presentedin media outlets.
Until next time, my friends.
(26:23):
Thank you so much for tuning in.
Please do me a favor, leave areview in iTunes service
Spotify, take a screenshot ofthat review and send it to me.
At blasphemousnutrition@gmail.com.
And I will ensure that you arefirst in line to receive my
(26:44):
scientific literacy cheat sheetthat will help you better
understand.
The quality of science basedupon the type of science done.
And kind of coalesce some of theconcepts that we talked about
today and that we'll be talkingabout with Victoria so that you
can feel more comfortable andconfident in taking a look at
(27:05):
media published reviews of thescientific literature.
Until next time, my friends.
Stay salty.
If you have found some Nuggetsof Wisdom, make sure to
subscribe, rate, and shareBlasphemous Nutrition with those
you care about.
As you navigate the labyrinth ofhealth advice out there,
remember, health is a journey,not a dietary dictatorship.
(27:30):
Stay skeptical, stay daring, andchallenge the norms that no
longer serve you.
If you've got burning questionsor want to share your own flavor
of rebellion, slide into my DMs.
Your stories fuel me, and I lovehearing them.
Thanks again for tuning in toBlasphemous Nutrition.
Until next time, this is Aimeesigning off, reminding you that
(27:52):
truth is nuanced, and any dishcan be made better with a little
bit of sass.
Any and all information sharedhere is for educational and
entertainment purposes only andis not to be misconstrued as
offering medical advice.
Listening to this podcast doesnot constitute a provider client
(28:13):
relationship.
Note, I'm not a doctor, nor anurse, and it is imperative that
you utilize your brain and yourmedical team to make the best
decisions for your own health.
The use of information on thispodcast or materials linked to
this podcast are at the user'sown risk.
No information nor resourcesprovided are intended to be a
(28:33):
substitute for professionalmedical advice, diagnosis, or
treatment.
Be a smart human and do notdisregard or postpone obtaining
medical advice for any medicalcondition you may have.
Seek the assistance of yourhealth care team for any such
conditions and always do sobefore making any changes to
your medical, nutrition, orhealth plan.
Welcome back to blasphemousnutrition.
I'm your host, Aimee, a doubledegree nutritionist who can
curse in multiple languages.
I want to spend the next coupleof episodes on scientific
literacy and why there's justlike so much bullshit out there
that gets promoted as science,when it only appears to make
things more confusing foreveryone.
This is an area I am likely toget salty about and a place
(00:23):
where I struggled to show somegrace.
So I'm hoping that you forgiveme if I go off the rails, but I
am going to do my best to staylevel headed.
I can't promise that you'll feelany more clearer when we are
done.
However, I do think you'll havea better understanding on why
things appear so asinine and whyit seems we can't make a
(00:44):
decision on anything.
All right, make sure you've gotyour smelling salts, buckle
yourself in and let's getstarted.
Hey Rebels, welcome toBlasphemous Nutrition.
Consider this podcast yourpantry full of clarity,
perspective, and the nuanceneeded to counter the
superficial health advice sofreely given on the internet.
(01:06):
I'm Aimee, the unapologeticallycandid host of Blasphemous
Nutrition and a double degreednutritionist with 20 years
experience.
I'm here to share a more nuancedtake.
On living and eating well tosustain and recover your health.
If you've found most healthadvice to be so generic as to be
meaningless, We're so extremethat it's unrealistic, and you
(01:27):
don't mind the occasional fbomb.
You've come to the right place.
From dissecting the latestnutrition trends to breaking
down published research andsharing my own clinical
experiences, I'm on a mission tofoster clarity amidst all the
confusion, and empower you tohave the health you need to live
a life you love.
Now let's get started.
(01:53):
So I kind of see the issue thatwe have with research as coming
from three primary areas,there's three primary problems.
The first problem is that whatwe actually see what even makes
it to publication is already askewed example.
(02:13):
One of these most fundamentalproblems in research is that
everything that we have accessto is already skewed.
There is a strong bias towardspublishing research with mostly
positive results.
I mean, finding something is waymore exciting than not finding
anything, right?
Additionally, if you are aresearcher and you find
(02:35):
something new, you have way moreopportunities for career
advancements.
Then if you don't contributesomething new and novel to the
scientific community, What getsfunded and what gets published
is strongly based upon novelty.
Or driven by incentives thataren't about truth, but more
about publishability.
What's going to get read inpublications.
(02:57):
This makes more money forpublishers and also has the
chance to secure a researcher'scareer.
So the system is stronglyincentivized to look for what's
new, especially in medicine andoverlook, confirming what has
already been studied.
So what we have out there is notoften backed by multiple studies
to strengthen evidence.
(03:18):
And this is not to say thatthese studies don't exist.
Many many studies are run, butnever published because they
conclude null results.
And therefore, Are ratherunpublishable.
This is referred to as the filedrawer problem and it refers
back to the analog days whenthis research was literally
(03:39):
tucked away in a file drawersomewhere and forgotten about.
Now occasionally a scientistwill be caught massaging data to
look for signals that don'tactually exist.
Brian Wansink who's 20 yearcareer in research was
subsequently found to be riddledwith scientific sloppiness and
outright manipulation of data.
(03:59):
Was dismissed under this cloudof disgrace from Cornell
University back in 2019.
This was a huge deal in thenutrition field because much of
his work was relied upon andused publicly as well as
privately.
He was one of the primaryresearchers in the two thousands
to break into pop culture withhis book, mindless eating.
And like rats, when you findone, you know, there's a whole
(04:22):
slew of them hiding in the dark.
With career possibilities andhuman ego on the line.
It's not terribly hard toimagine this outcome of bias.
And intended or even unconsciousskewing of research questions,
methodology, statisticalanalysis, and publication bias,
(04:43):
being a problem of significancein the research that we have
access to.
The second problem is thatwhat's been published is not
always validated by additionalresearch.
And I alluded to this before.
Validation studies to confirm anexisting positive outcome are
not done frequently enough oftenagain, due to their lack of
(05:06):
novelty.
Brian Nozick is a University ofVirginia researcher in
psychology, and he's beenspearheading this return to the
validity of research and openscience.
He set out to reproduce resultsfrom psychology research and
found that even something assimple as running existing data
a second time.
Rarely lead to the same outcomein his field.
(05:29):
While this was actuallyinitiated within his own work,
when he set out to see howprevalent it was in the social
science field, he was stunned tofind that it was a very
prevalent problem, showing that60% of studies chosen to be
reproduced actually failed toachieve the same results.
(05:50):
In the show notes, I've includedan interview with Nosek.
So you can learn a little bitmore about the nuance behind
this and the issue ofreproducibility in the science
field.
So one might be inclined to say,well, yeah, but these are, you
know, psychology is a softscience, so this is totally
unsurprising.
But similar alarmingobservations have been found in
(06:13):
cancer research as well.
With 88% of results.
From what were consideredlandmark studies in the field
being on reproducible.
And when it comes to cancerresearch, like we want to know
what the fuck is going on, andwe want to make sure that we're
headed in the right direction.
Right.
And I'm not even going to touchon Alzheimer's because I don't
(06:35):
know.
I don't know if there's been anyreproducible research in
Alzheimer's, but I do know thatwhat we've been doing for the
last 20 years has created a lotof drugs that don't do shit for
people.
Um, so we're kind of stillshooting in the dark there.
And I wouldn't be surprised ifstatistics in that field were
just as alarming.
(06:56):
So with cancer research whenlandmark papers, these huge
discoveries, right?
When several of these paperswere looked at and researchers
tried to reproduce the sameresults from these
groundbreaking studies 88% ofthe time they were unable to get
(07:19):
the same result.
So I'm not filled with a lot ofconfidence right now but like,
fuck, what the hell are wesupposed to do?
So the research that exists,particularly when it is novel,
really needs to be repeated toensure that what we are seeing
(07:39):
is factual.
More often than not, this doesnot get done.
And much of what we think weknow might not actually be
accurate.
This is also part of the reasonwhy there seems to be so much
flip-flopping in science.
Things get thrown out into thepublic before they have the time
or the ability to be verified.
And this brings me to the nextproblem, the game of telephone
(08:02):
and the manipulation ofstatistics for marketability.
Studies of various quality getthrown out into the public all
the time.
We need to be aware thatjournalists are not skilled at
reading and interpretingscience.
They do not teach scientificliteracy and statistical
analysis in journalism school.
So what gets disseminated isalso what is catchy, what is
(08:25):
novel and likely to get clickson news sites.
But even before the internetnewspapers had to be sold and
headlines were extremelyimportanT.
the news business is in thebusiness of selling news.
Not necessarily deeplyresearched evidence and facts,
even if we don't seem to be ableto collectively define what fact
(08:50):
is anymore.
So we have this problem wherethose who are largely
responsible for holding themegaphone are not well-suited to
discern if something which isalso publishable is in fact
accurate and quality researchworthy of the town crier.
That said.
I cannot speak to the rationalebehind why other organizations
(09:13):
such as the American medicalassociation or the FDA might
also be disseminating horribleadvice and information.
I am.
Not going to get into that heretoday.
I have no reasonable conclusionfor some of the behavior I'm
seeing these days.
So moving right along.
One important aspect,particularly when it comes to
(09:36):
health sciences and publichealth advice is this important
distinction between absoluterisk and relative risk.
The absolute risk is indicativeof certainty.
So for instance, If it is 90%likely you will be killed by the
Ebola virus.
If you get it.
(09:57):
You want to know the impact ofan intervention on alleviating
the risk of death from Ebola?
Relative risk refers to theprobability that something will
have an impact in case you getexposed.
So let's say there's a new drugthat's very promising and it
suggests that it is 70%effective at preventing death
from a Bola.
That's fantastic news.
(10:18):
Like that's phenomenal.
However, Ebola is transmittedthrough body fluids and it's
difficult to catch if you'remore than three feet or one
meter away from somebody.
It's also prevalent in few areasof the world.
My relative risk of catchingEbola, living in the Northern
part of the world is very slim.
Uh, 70% reduction of death fromsomething I have less than a 1%
(10:41):
risk of catching in the firstplace.
Just doesn't really impress metoo much.
So there's no logical reason forme to have Ebola medication on
hand, just in case any more thanit's logical for me to carry
snake bite remedies into theArctic circle.
However, if I'm traveling to anarea of the world to do
volunteer medical work andthere's an outbreak, but for
(11:02):
some reason I have to go.
I'm going to be proactive abouttaking some with me just in
case.
My absolute risk of catching.
It becomes astronomicallyhigher.
And with a 90% fatality rate, a90% absolute risk of dying.
If I get it and it's untreated.
I don't want to take thosechances.
So this is the differencebetween relative risk and
(11:25):
absolute risk.
It has been said that regardingrelative risk and absolute risk
that, and I'm quoting here.
Absolute measures should not beused in observational studies of
associative relationships, norshould relative measures be used
in clinical trials of causativerelationships.
(11:47):
Basically, this means that ifyou're smart about your research
and you are aiming for accuracyand truth and how this
information is disseminated.
Do not discuss absolute riskwhen looking at an observational
study and don't be talking aboutrelative risk.
If you're using a clinicaltrial.
(12:09):
Determining causalrelationships.
Now.
An excellent example of thisthat has impacted each and every
one of us is the 95% reductionof COVID death with vaccination.
So this is relative risk, notabsolute risk.
And I would not be blasphemousif I didn't go here.
(12:32):
The risk of death from COVID wasvery dependent upon one's age
and pre-existing healthconditions.
Those with obesity, metabolicsyndrome, cardiovascular
disease, and especially thoseover 70 are at much higher risk
of death and severe illness fromCOVID 19.
Healthy children were not dyingof COVID.
Those under 35 by and large hadan easy go of it unless they had
(12:58):
pre-existing conditions.
The risk of death among youngand healthy people was very
small.
However when the first remediescame out, we were told
accurately that the researchindicated a 95% relative risk
reduction of death andhospitalization.
That's what the paper said.
(13:20):
Whether or not that turned outto be true is something I'm not
going to go into.
That paper was reportingrelative risk reduction, not
absolute risk reduction.
But this was not advertised bythe media such and the Facebook
hired effect.
Checkers seem to miss that.
Additionally, as the weeks wenton, the narrative changed from
(13:41):
the risk of hospitalization anddeath to the risk of disease
acquisition.
We heard this stuff fromofficials in high places that
these treatments preventedtransmission.
Even though it was grosslyevident by the summer of 2021.
From that outbreak that happenedin Massachusetts.
This narrative prevailed longafter people saw with their own
(14:02):
eyes, that this was not thecase.
And that narrative was global.
With many Europeans being toldtheir vaccine would prevent
their grandmother's death.
Dissenting opinions wereostracized.
And there were several careersthat were ruined.
I witnessed a lot ofshape-shifting of this story.
As people tried to make sense ofthis cognitive dissonance
(14:25):
between what their trustedofficials were telling them and
what they were seeing with theirown eyes.
Like people needed something tobelieve in.
I get that.
And people suffered greatlywhile the emperor wore no
clothes.
So.
Due to the misrepresentation ofthe research and other
shenanigans.
(14:46):
We have a situation now wheresome people are understandably
mistrustful of science.
And the authority.
Social media posts that goviral, want to dismiss skeptics
as troglodytes, but this is notthe first time that populations
have suffered at the hands ofscience.
If you don't know aboutTuskegee, go look that up now.
(15:08):
Okay.
and hot topics still exhauststhe fuck out of me.
I am moving on now.
Another problem is thatobservational research is
disseminated as suggestive ofcause.
But this is often assumed toosoon.
And without sufficient enoughpower to warrant such a
suggestion.
Observational studies areconsidered weaker data because
(15:29):
they are an observation in anatural environment, such as
collecting data about what apopulation eats.
And looking for signs andsignals about nutrition-related
diseases.
We can't ascertain causalrelationships here with any
certainty, but we can notestrong observations.
(15:49):
And this is because we can'ttake into account all of the
different things that might leadto a specific observation.
These are called confoundingvariables.
And this is where thissuggestion, that high meat diets
cause heart disease come from.
This is also where theassociation between smoking and
disease was noted and becameoverwhelmingly impossible to
(16:10):
ignore.
Because it would be grosslyunethical to do an
interventional study where wemade people smoke one to two
packs a day for a decade.
The observation seen here wasdismissed for a very long time
and most ardently by tobaccocompanies.
There's a double-edged swordhere.
Right?
And this is part of the reasonwhy this argument about me and
(16:34):
health outcomes continues towage on..
I will say, however, and you mayremember this from episode four.
Flushing out the facts of theplant-based paradigm.
That the strength of associationfor smoking related diseases was
far stronger than theassociation we see for meat
(16:56):
related diseases.
And I'm air quoting there.
So the argument here willcontinue and remain a, he said,
she said debate for theforeseeable future.
The real problem is when we takeobservational data, do not
reveal the strength ofassociation, the strength of the
evidence that we see and thendisseminate that information,
(17:18):
suggesting that it is causal.
We cannot reach certainty ofcause through observation.
And when media ignores thesedetails between relative risk
and absolute risk of anassociation, we get gross over
reactions and panic overabsurdities.
Like.
That stupidly impotent studypublished last year, suggesting
(17:40):
that erythritol intake causesheart disease.
Okay.
I feel my blood pressure rising.
This study actually looked at apopulation with very high risk
of cardiovascular disease.
Many had already had a heartattack.
They were hypertensive diabeticor even had heart failure and
(18:01):
they were included in thisstudy.
And then they measured theerythritol levels in their
blood, but never bothered tofucking ask them about the
intake of the erythritol fromtheir diet.
erythritol is produced in thebody.
And All production is increasedwhen cells are under oxidative
(18:26):
stress.
Uh, something that is happeningin overt disease.
Blood levels of erythritol arealso associated with obesity.
A condition that is also linkedto increased oxidative stress.
So then they checked in afterthree years and noted that, oh,
those who have the highest levelof serum erythritol were more
(18:50):
likely to have cardiovascularevents.
Never mind that diabetes,hypertension, a history of heart
attack and existing heartfailure also grossly increased
the risk of a cardiovascularevent.
And that erythritol appears tobe produced as a by-product of a
strained and sick system.
(19:10):
Anyway, this study measuredblood levels of erythritol call
in sick people and then tookeight healthy people and gave
them dietary erythritol.
So gave them an erythritolsupplement and then measure
their blood levels before andafter and showed.
Hey, if you take erythritoltall.
Orally.
It increases your plasma levels.
(19:31):
So then the researchers tookthese two studies, one of them
observational.
Noting people in poor health.
I have higher earth natal ratesin their blood and tend to die
of cardiovascular disease.
And then an interventionalstudy.
If we give people a resveratrol,their blood levels in grace.
And then they coalesced thisinto a single paper with a final
conclusion that erythritol inthe blood appears to be
(19:54):
associated with increaseddisease risk.
So then the media goes out.
There's this vitality of panicthat this low calorie sweetener
is killing us, nevermind.
That our highly stressed,isolated, and poorly fed society
might be killing us.
And now I can't get swerve at mylocal whole foods.
(20:15):
Many of these flash in the panone-off studies that get shoved
out and induced panic or on parwith this level of quality.
Always read between the lines.
And if you can get your hands onthe primary paper, read what it
says and see how it might bedifferent than what the media
outlets are suggesting.
Maybe it's being suggested thata compound causes cancer or a
(20:39):
compound cures cancer, but thatstudy was done in a Petri dish.
Maybe it's an observationalstudy, but they don't disclose
if they took into accountconfounding variables or they
missed obvious confounders, suchas smoking or preexisting health
conditions.
Maybe the observational study isthem observing.
(21:00):
50 people.
Well, we can't really make anybig grandiose conclusions taking
a look at 50 people./ Whilerandomized controlled trials are
considered the gold standard inscience.
They also have their ownlimitations.
Here, we aim to find causalrelationships between single
(21:21):
factors.
The impact of a medication onthe glucose levels of men over
the age of 50 who have diabetes,but no other diseases, for
instance, These RCTs, orrandomized controlled trials,
are very valuable contributionsso long as you fit into the
demographic being studied.
(21:43):
So let's take this instance.
Let's say this study is done andlet's say they even are able to
repeat the study successfully inthis group of men over 50, with
just diabetes as a healthcondition.
And then it's used as thefoundation for some sexy,
expensive new diabetesmedication.
What we do not yet know is howdoes it impact the glucose of
(22:07):
women?
Does it matter if she's pre orpost-menopausal.
How does it impact younger menwith diabetes?
What if this person taking themedication has other health
conditions super, super commonin this demographic, but having
other preexisting healthconditions are considered
(22:28):
confounding variables and areoften excluded from the research
pool.
We would ideally like to knowhow this medication could
interact with other medicationsor how it might impact other
concurrent diseases within thepatient.
So you see the real world is waytoo complex for RCTs to be as
(22:49):
gold, as standard as we reallywish they could be.
We often find the limitations ofan intervention long after it's
been in the public for 20 yearsor so.
And there's enough data thenaccumulated.
To have a better understanding.
And this is why you see thingslike Vioxx and other medications
out for a significant period oftime and then pulled because
(23:12):
they discover, oh, whoops.
It turns out there was this bigproblem that we didn't see in
the initial research.
So interventional studies andobservational studies both have
a place.
Both hold value.
Both have limitations.
In the game of telephone fromresearcher intent to
publication, to news outlets orpublic health officials sharing
(23:35):
their thoughts or suggestionsbased upon the data.
Is its own game of telephone.
And this is why I say we cannotblindly trust the science and we
should be extremely skeptical oftrusting anyone who says
otherwise, Science is an everevolving field of finding out
(23:56):
what we believe to be true basedupon what we find to be untrue
over time.
We have very strong evidencethat gravity is real.
And lots of evidence to supportthe earth being round, but when
it comes to curing illnesses andoptimizing vitality, There are
still a lot of unknowns.
(24:19):
My personal bias tends to be anaturalistic one.
I hold a bit more credibility.
And what has allowed humanity tosurvive for as long as we have.
I look to history as anindicator of what might be more
correct than other things.
This is certainly notinfallible.
(24:39):
It tends to make me skeptical ofthe new and shiny.
I need more time to feelconfident in a new product or a
new idea.
I think having people whoembrace new technologies as
equal as valuable, because,well, someone's gotta be willing
to try it out first.
Right.
It's just not going to be me.
There is room for all of it.
(25:00):
And I would argue that thehealthiest societies are the
ones that allow for differingopinions to be at the same
table, because we see oneanother's fallacies way more
clearly than we see our own.
If our true goal is arriving athealth and not ego validation
for our own self righteousness,we ought to be more willing to
(25:22):
entertain opinions that differfrom ours.
We ought to be more willing toquestion our own assumptions and
to recognize that being misledby human emotion and
self-preservation is a humantrait that none of us are exempt
from.
All right.
(25:43):
Next week, I'm going to offeryou an antidote to the heartburn
that I've just given you withthis episode.
I'll be interviewing VictorialaFont.
Victoria is the founder of theLaFont agency, which is a
marketing agency based on havinga bias- conscious interpretation
of scientific literature.
That then gets used to createpractical content for health
practitioners.
(26:03):
I think her understanding ofboth marketing and scientific
literacy is unique.
And she's going to share sometips on scientific literacy and
how we commoners withoutstatistics degrees and research
chops can better ascertain theshit science from the promising
gold nuggets that are presentedin media outlets.
Until next time, my friends.
(26:23):
Thank you so much for tuning in.
Please do me a favor, leave areview in iTunes service
Spotify, take a screenshot ofthat review and send it to me.
At blasphemousnutrition@gmail.com.
And I will ensure that you arefirst in line to receive my
(26:44):
scientific literacy cheat sheetthat will help you better
understand.
The quality of science basedupon the type of science done.
And kind of coalesce some of theconcepts that we talked about
today and that we'll be talkingabout with Victoria so that you
can feel more comfortable andconfident in taking a look at
(27:05):
media published reviews of thescientific literature.
Until next time, my friends.
Stay salty.
If you have found some Nuggetsof Wisdom, make sure to
subscribe, rate, and shareBlasphemous Nutrition with those
you care about.
As you navigate the labyrinth ofhealth advice out there,
remember, health is a journey,not a dietary dictatorship.
(27:30):
Stay skeptical, stay daring, andchallenge the norms that no
longer serve you.
If you've got burning questionsor want to share your own flavor
of rebellion, slide into my DMs.
Your stories fuel me, and I lovehearing them.
Thanks again for tuning in toBlasphemous Nutrition.
Until next time, this is Aimeesigning off, reminding you that
(27:52):
truth is nuanced, and any dishcan be made better with a little
bit of sass.
Any and all information sharedhere is for educational and
entertainment purposes only andis not to be misconstrued as
offering medical advice.
Listening to this podcast doesnot constitute a provider client
(28:13):
relationship.
Note, I'm not a doctor, nor anurse, and it is imperative that
you utilize your brain and yourmedical team to make the best
decisions for your own health.
The use of information on thispodcast or materials linked to
this podcast are at the user'sown risk.
No information nor resourcesprovided are intended to be a
(28:33):
substitute for professionalmedical advice, diagnosis, or
treatment.
Be a smart human and do notdisregard or postpone obtaining
medical advice for any medicalcondition you may have.
Seek the assistance of yourhealth care team for any such
conditions and always do sobefore making any changes to
your medical, nutrition, orhealth plan.
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