h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

There are hundreds and hundreds of research studies that are not funded by drug companies, mine included. Dismissing our work because other research is drug company funded is rather disingenuous, and to be honest makes me feel a rather angry.

Our department does not take funding from drug companies at all, and we ae doing at least four randomised controlled trials at the moment, have finished another two, and have one more coming up. Two of our proffessors edit major journals. We are not marginal crackpots. We are not alone, by all means be cynical of drug company I cited two of them above. When people run marathons for cancer research it goes to organisations such as ours.

agreed. generalizations are always bad.

I did not mean to infer anything about anything other than drug companies themselves. I was reacting to stories I've read recently regarding shortages of common drugs because they're unprofitable, about a drug company that recently patented a long established treatment to prevent premature child birth raising the costs from around $10 to several hundreds, about several promising drug trials being unfunded because the drugs for various reasons can't be patented and therefore unprofitable and how after a drug becomes generic the companies will make insignificant changes just to create a new high priced version.

One example that saddens me is the the problems we're experiencing due to the overuse of antibiotics (both in humans and especially livestock) that could be completely overcome if we would use bacteriophage virus treatments when practical. The soviets relied on bacteriophages for decades and all their research is going to waste because western drug companies aren't interested at all because live viruses can't be patented.

But no, Z, I meant absolutely aspersions to any work or research you're involved with.

I apologize that it came across that way.

[edit] "I meant absolutely *NO* aspersions"...

I will admit to having absolutely no medical qualifications. I will also admit to confirmational bias when I read medical studies. I like the ones that confirm my personal experiences and what I already believe a lot better than the ones that don't. All I can contribute to any discussion of this sort is anecdotal and considered by researchers to be of little scientific value. But, just because my experiences are not scientific doesn't mean that they are invalid.

One of the most frustrating things to me as a layperson is knowing who and what to believe. There are "experts" who say that the lipid hypothesis is true and those who say that it isn't. So I'm not going to spend a lot of time looking up old studies I've read to find and post the links. But I do know how certain foods and ways of eating make me feel. And I know what happened to my husband when, against his own better judgment, he strictly followed his doctor's advice about nutrition as it relates to heart disease and diabetes.

True story. Many of you know that for many years I had a long coated chihuahua named Annie. She was a rescue dog who had broken ribs and concussion from being kicked by her former owner. We took her to the vet regularly and as she aged (she was 14 months when we got her) we kept getting compliments from the vet about how well she was doing and what a great job we were doing with her.

Well, one year, on her annual check-up and vaccination trip, we got a new vet who had just joined the practice. He checked her over and remarked that she was extremely healthy, her weight was perfect and that she had the healthiest mouth for a dog her age that he'd ever seen. Then he asked me what brand of dog food I fed her. I told him that she never ate dog food, that I cooked all of her meals for her, that she had a balanced diet of meat protein and fat with a little fresh fruit and veg, that her favorite snack was apple slices spread with peanut butter and that the reason her teeth and gums were so healthy was because I gave her bones to gnaw. At which point, in absolute horror, he informed me that I was going to kill her if I fed her like that.

In spite of the fact that she was healthier than she should have been for her age, especially considering her early history of abuse, he was upset because I wasn't feeding her in the way his preconceived opinions told him a dog should be fed. I will add here that she lived to a ripe old age and was extremely active until just a few weeks before she died. She was also a happy dog, partly because she was fed things that she actually liked.

I really am going someplace with this. In my totally unqualified opinion, American doctors are not given good nutritional information in medical school and that what they are taught is market driven. It is also my totally unqualified opinion that American doctors don't treat diabetes or heart disease either one properly as a result of this poor training. I could write a book about my husband's experiences and how every thing he was told to do made him worse instead of better. I realize that none of you want to hear it, so I'm not going to bore you with it.

I could write another book about my personal experiences dieting and with food allergies. I won't bore you with that either. But to put things as succinctly as possible, in my totally unqualified opinion, sugar is evil, grains are dangerous for me and many others, and saturated fat is NOT going to give me heart disease.

If one wants to read the literature properly you have to do a systematic review- and not just pick whatever supports you A87726900

>>> But, just because my experiences are not scientific doesn't mean that they are invalid.

Experiences are subject to all sorts of confirmation biases..My own experiences aren't valid either! My experiments are valid, but my experiences aren't valid scientific evidence.

My experience is that I have been vegan for four days and I feel great. This paper is convincing evidence that dairy products increase the risk of stroke http://stroke.ahajournals.org/content/early/2012/04/19/STROKEAHA.111.641944.abstract.

Have you thought of learning to evaluate the evidence yourself? It isn't that hard to do so. Make a start with a book called 'How to read a paper' and start to look at the different types of studies. http://www.amazon.co.uk/How-Read-Paper-Evidence-Medicine/dp/0727915789

Nutrition is hideously complex and still evolving, and what we do know constantly changes, but I do think that you are seeing scientific uncertainty and filling in the gaps with a conspiracy that just isn't there.

I know that my own medical education did give me the tools to critically appraise the literature, and keep up to date with it, and it wasn't market driven.

Sugar is evil - agreed!

(Unless you are a diabetic who has very low blood sugar and is about to die, in which case it's useful..)

Grains are dangerous for me and many others - but not for everyone, but just they are not great for many people.

Saturated fat is NOT going to give me heart disease. - I think we don't know about this one yet. But as it's got more energy in it than I really need for my day-to-day life I try not to eat too much of it.

Z, thank you. I'll check out those links later. It's board meeting night and I have to get off of here and do mundane things like write checks, copy reports, etc.

I'm not sure how the blisters in my mouth and rash on my trunk and arms from eating wheat shows signs of conformational bias unless it is somehow connected to the placebo effect. As far as the IF is concerned and the marked reduction of inflammation and relief of arthritis pain is concerned, I suppose that could be the placebo effect. Whatever it is, I know I do have less pain when I follow an IF schedule than when I don't. I don't actually give a toss if it is my mind doing it or the eating schedule itself. It works for me. And I also know that eating one cookie/doughnut/whatever makes me crave the entire plate of them and the ensuing crash always happens.

Make that binge and crash.

Ooh, your personal experiences are valid for *you*, and should be acted on... but I don't think that you can extrapolate them to others. Well you can advise your friends and that's great. But I can't take my own experience and extrapolate it to my patients.

I have exactly the same experiences with sugar as well, and it makes sense when I see the physiology of insulin and glycaemic load.

Maybe we could agree on two basic facts?

Studies funded by medical companies are more likely to be looking for a method of treating the symptoms rather than cure whatever caused them.

Studies funded by other means might actually look beyond the symptoms and focus on what caused the symptoms.

This might differ from country to country, I've no idea at all.

Or do you always go for 'treatment first, cure later?'

See, the customers (patients) are getting mixed messages, or at least that's how I feel...

I haven't read any of the articles you link to, I'm too tired and don't feel I have the time. However, I once read that somebody said if you need to lose weight you need to choose a diet you can stick to. That sounded logical to me. LCHF is perfect for me if I want to lose weight and still feel healthy and well nourished. It's good for my blood sugar levels, too. If I start the day eating grains (muesli), it doesn't even take two hours until I'm hungry again. If I don't eat anything, I'm fine. If I have proteins and fat and no carbs, it'll last me for many hours.

Bel, I react the exact same way. I can do the IF (Intermittent Fasting) just fine as long as I don't eat breakfast. As soon as I have breakfast, especially if it contains cereal or other items made from grain, I am hungry withing a couple of hours and have a hard time fasting. And I find a low carb diet much less likely to cause me to be hungry in general.

I think we all have to do what works for us and what makes us feel the best. For me, a diet of meat/fish/seafood/dairy and vegetables works the best. I can eat a little fruit and not get hungry, but not a lot. As soon as I add a lot of starch, grains and sugar I'm hungry, bloated and generally miserable. I eat more fat than is supposedly good for me, but that is what makes food taste good and meals enjoyable. Plus, I just don't believe that saturated fat is evil. I don't eat any vegetable oils or trans fats. I use butter, olive oil, coconut oil and whatever natural fats cook out of my meats. And I eat full fat dairy. I don't have problems with hunger and weight gain until I start adding in the starches, sugars and grains, especially the last two.

Hyp, the funny thing is, I never noticed that muesli in the morning isn't good for me until I had done the LCHF diet and went back to 'normal' eating. I love muesli, but I hardly ever have it any more. Or bread for that matter. Not for breakfast, anyway, when I have to go and work afterwards.

All my life I've heard that museli is super healthy and that breakfast is the most important meal of the day. That may be true for some people, but it sure isn't for you or me either one.

I understand your new-found sensitivity. I recently decided to do weight watchers, partly because Kelli had such great results with it and because I read yet another report about how it is the best weight loss diet out there. I did ok the first week, but by the second week I was hungry all the time and was eating fruit and veg all day long to try and fill me up because they are zero points.

After so long eating satisfying portions of meat and fat, I was absolutely hungry all the time eating low fat with only small servings of lean protein. And by week 3 of weight watchers I had regained all of the weight I lost the first week, probably because I was eating more carbohydrate than I was used to having.

So I decided I'd combine the weight watchers and the IF. That didn't work because the extra carbohydrate on WW made it too miserable to do the fasting. So I'm back with my lower carb approach and IF. After 3 days on this, I've lost 3 pounds and am fasting today without hunger.

You, Ti, me - and half of Sweden, I think. Admittedly, I've never tried any of the other diets, but since I've had such great results (and without being hungry once in six! weeks), I'd do the LCHF any time I felt I'd need to she a few pounds within a few weeks.

Bel, you were so small when I saw you that I can't imagine you needing to lose much weight. I have decided that I have to stay with low carb and IF for my health, even if I never lose another ounce.

Hyp, I've put on a lot of weight since you saw me. I'm fine with that as long as I have still clothes that fit. However, I'd rather lose a few kg than go and buy new clothes.

Ti

Studies funded by drug companies are going to be investigating whether products they can sell actually work. Whether these products cure or treat is fairly irrelevant to them, what is important is 'can we sell this'.

The drug company is a business to make money, and they make money by selling drugs, before they can sell the drug they have to demonstrate that it works. The proof the regulators and the medical profession demand is the most robust form of proof available - a clinical trial. If the drug company didn't have to do a clinical trial they wouldn't bother, they'd just sell the drug, but the regulations don't let them be sold without proper trials.

Whether it's a treatment or cure doesn't matter too much to a drug company, - they are interested in the bottom line : cash.. Ok if a drug company had two drugs, one that treated, and one that cured they'd go for the one that treated if they could get away with it. But what would happen is that the next drug company would find a small variation on the one that cured and sell it to undercut the competition. There have been numerous situations where a drug that cures the cause has won against one that treats a symptom, (H Pylori and gastric ulcers, for example).

A drug company isn't going to fund a trial into something that isn't their product, and why should they? They are profit making companies.

Sometimes the drug company trials do show that the drugs don't work, and they end up not being used. There are various scandals where the drug companies have been found to hush up information, but these are scandals because they are the exception to the norm.



But before you get to the drug trial you need to find out more about the causes of disease, and that's where the basic science comes in. These investigators are nearly always at universities, and are usually funded by government or charitable grants.

Now the questions they are answering are going to be different from ones that the drug companies area interested in, usually they aren't even going to be interested in treatments, but are instead going to be looking at causes and mechanisms of disease. They will often do studies of diet to see it's affect on If they find a cause and can think of a potential treatment they are going to want to test it to see if it works, and they are going to have to get funding to do that.

Usually the funding will come from government grant or from charity, but sometimes they will enter into an arrangement with a drug company to fund or part fund a trial. At the very least the drug company will usually provide the free drug Yes, I don't deny that there is sometimes pressure to bury the results of these trials if they are not favourable, but giving into that pressure would often cause the end of the career of the investigators, so they are very rare and again a big scandal when it's found out. Every week studies are published which result in the drug company that funded it loosing money , or even going bankrupt.

Understood. Dieting is more practical than having to buy a new wardrobe.