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Medical Research?
Posted: 11 October 2011 09:52 AM   [ Ignore ]
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I’ve been reading the various threads and checking links in the alternative medicine forum with interest.  In addition, I subscribed to a medical and health abstracting service a while ago, mostly to read about aging and cardiac treatments since they related to me.  The articles were in well respected, peer reviewed medical and nutrition journals, mostly from medical schools and universities.

Consider the following:

1.  Many articles stress that all one had to do was eat a healthful diet, and one would not need any supplements.

2.  We fluoridate water because most people don’t get enough fluoride.

3.  We use iodized salt because many people don’t get enough iodine.

4.  A recent study showed that many people don’t get enough potassium in their diets, and a higher ratio of sodium to potassium was related to earlier death.

5.  A recent study showed that many people don’t get enough magnesium in their diets, and a lower level of magnesium was related to earlier death.

6.  A recent study showed that many people don’t get enough lithium in their diets, and a lower level of lithium was related to earlier death.

7.  After many years of warning of the dire effects of taking more vitamin D than 400 I.U. daily, now we are told that older people should take at least 2,000 I.U. a day.

8.  A number of older studies show that the intestines of older people are much less efficient at absorbing nutrients so even if they eat an adequate diet, they are likely to be deficient in many vitamins and minerals.

9.  A number of studies show that older people have lower rates of metabolism so they eat less.  This also means they get lower amounts of micro-nutrients.

I’m sorry, but as a physical scientist I have to question how much of medical research is really science and how much is pseudo-science.  While I can’t go along with the alternative medicine weirdos, I’m not sure how much of the “real” medical research is
valid.

Occam

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Posted: 11 October 2011 10:10 AM   [ Ignore ]   [ # 1 ]
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I agree, Occam. Much of the ‘real’ research is weak, especially when discussing vitamins and minerals. And then there is the fact that the vitamin/mineral manufacturers are held to any significant standards.

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Posted: 11 October 2011 10:16 AM   [ Ignore ]   [ # 2 ]
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The problem here is, I believe, what had been said previously by macgyver, that much of this research is based on epidemiological studies. I am still young (and relatively healthy) enough not to pay much attention to most of this stuff, but I smoke I am quite aware of the problems with the data related to smoking and its impact on our health. According to numbers from WHO and CDC on smokers prevalences and lung cancer death rates, Czech Republic has less smokers than Spain, but death from lung cancer in CR is twice as common as in Spain. I know I am only comparing two countries here, but the picture actually gets more confusing once we add more countries. And if we add life expectancy to the equation, the negative impact of smoking on our health disappears completely. As far as I can tell, most epidemiological studies need to be taken with a grain of salt.

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Posted: 11 October 2011 10:33 AM   [ Ignore ]   [ # 3 ]
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You are quite right, George.  The trouble is that grain of salt should be so big that it would raise our blood pressure and kill us.  smile

Your example points out that we are affected by an extremely complex set of factors.  Research is done based on one factor, so it’s almost impossible to track down the effects of other, hidden factors.  As such, we get a great deal of scientific sounding, well documented reports that are way off base.

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Posted: 11 October 2011 10:56 AM   [ Ignore ]   [ # 4 ]
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I certainly wouldn’t call it pseudoscience, but maybe ‘emerging science’ is a better term. Problem is that there are SO many variables to control that these studies can’t be anything more than tentative. It’s easy to say that we should just discount anything that isn’t physics or math, or that isn’t double-blind-placebo-controlled. But that’s not a useful response, especially given the potential harm or benefit that could be elucidated by these studies. (We need to know how to cure diseases; we need to know if ingredients are healthy or harmful, and in what quantities).

I think the idea with supplements is that whatever supplementation medical science finds is essential will be included perforce in our diet. (E.g., as with iodized salt). The rest, beyond eating a healthy diet, is unnecessary. The one possible issue is with Vitamin D, and with older people and/or people who don’t get regular sun exposure. But by all accounts that’s a small percentage, and the data is arguably still preliminary.

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Posted: 29 November 2011 05:03 AM   [ Ignore ]   [ # 5 ]
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I will tell you what my Dr. said to me about supplements long ago.  He said, first there are some ailments that can cause a need for supplements but if you don’t have any of the ailments, eat a balanced diet and quit throwing your money away.  Also he said if you use supplements when you don’t really use need them, all you are doing is making your urine expensive.  So with that advice, all I try to do is keep my urine inexpensive.

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Posted: 29 November 2011 03:18 PM   [ Ignore ]   [ # 6 ]
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Occam. - 11 October 2011 09:52 AM

I’ve been reading the various threads and checking links in the alternative medicine forum with interest.  In addition, I subscribed to a medical and health abstracting service a while ago, mostly to read about aging and cardiac treatments since they related to me.  The articles were in well respected, peer reviewed medical and nutrition journals, mostly from medical schools and universities.

Consider the following:

1.  Many articles stress that all one had to do was eat a healthful diet, and one would not need any supplements.

2.  We fluoridate water because most people don’t get enough fluoride.

3.  We use iodized salt because many people don’t get enough iodine.

4.  A recent study showed that many people don’t get enough potassium in their diets, and a higher ratio of sodium to potassium was related to earlier death.

5.  A recent study showed that many people don’t get enough magnesium in their diets, and a lower level of magnesium was related to earlier death.

6.  A recent study showed that many people don’t get enough lithium in their diets, and a lower level of lithium was related to earlier death.

7.  After many years of warning of the dire effects of taking more vitamin D than 400 I.U. daily, now we are told that older people should take at least 2,000 I.U. a day.

8.  A number of older studies show that the intestines of older people are much less efficient at absorbing nutrients so even if they eat an adequate diet, they are likely to be deficient in many vitamins and minerals.

9.  A number of studies show that older people have lower rates of metabolism so they eat less.  This also means they get lower amounts of micro-nutrients.

I’m sorry, but as a physical scientist I have to question how much of medical research is really science and how much is pseudo-science.  While I can’t go along with the alternative medicine weirdos, I’m not sure how much of the “real” medical research is
valid.

Occam

And yet, with the exception of flouride and iodine, there are no convincing studies that show a benefit if you supplement the diet with any of these things. The problem is that most if not all of these studies are retrospective studies and some of them jump from one scrap of evidence to an unsupported conclusion.  The study you site above about older individuals being less efficient at absorbing nutrients is a good example. That may be true but it then takes a leap of faith to assume they are not getting enough nutrients ( maybe their needs are less) and another leap of faith to assume that this leads to disease, and yet another lea of faith to assume that giving more nutrients will fix the problem ( maybe their receptors are already saturated and the extra they take in will just pass right through). I see this happen a lot when these sorts of studies are released. people dont realize how many unsupported assumptions they are making

You need to be very careful about putting to much faith in preliminary studies such as these. As the recent prospective randomized study of Vitamin E and prostate cancer has shown.. vitamins and minerals are not harmless.

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Posted: 29 November 2011 07:38 PM   [ Ignore ]   [ # 7 ]
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I certainly agree with you Macgyver, but then, how much credence should we give to the vitamin E study you referenced?  LOL

Sorry, couldn’t help it. smile

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Posted: 29 November 2011 08:04 PM   [ Ignore ]   [ # 8 ]
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Occam. - 29 November 2011 07:38 PM

I certainly agree with you Macgyver, but then, how much credence should we give to the vitamin E study you referenced?  LOL

Sorry, couldn’t help it. smile

Occam

Well this is really the point. The media treats all studies as though they are equal and so the public gets the idea that science is flip flopping on thing when in fact its not. Science and medicine are evolving all the time and theories become discarded or reinforced as more and better evidence becomes available. Retrospective population studies are the first, easiest , cheapest but also the least reliable studies to be done. They are an important starting point for scientific inquiry, but if it were up to me they would never be released to the public since they really dont give us reliable information to base any decisions on.  Unfortunately much of what you see and hear in the media are usually these sorts of studies because media outlets always want to be the first to report things even if the data isn’t really meant for public consumption

The Vitamin E study i referenced was a double blind placebo controlled study involving 35,533 men from 427 study sites in the United States, Canada, and Puerto Rico. That’s about as good a study as your going to get. I think we can give it a lot of credence. Certainly i think we can say that any thought of using Vit E to prevent prostate cancer should be abandoned

Here’s the link: http://jama.ama-assn.org/content/306/14/1549

Whenever you read about a study ask yourself.. is it a retrospective study or a prospective study? Is it double blinded? How many subjects were studied? What have previous studies found and how were they done? are there other confounding variables they didnt take into account?  If you do this it will help you understand some of the conflicting data you seem to be getting. Thats the way science works.. and it usually works well. You just have to learn to ignore the scientifically illiterate media that is constantly bombarding you with incomplete and inaccurate information.

[ Edited: 29 November 2011 08:12 PM by macgyver ]
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Posted: 29 November 2011 08:24 PM   [ Ignore ]   [ # 9 ]
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I thnk macgyver hit the nail on the head. There are multiple levels of evidence from different kinds of studies that are graded in a pretty clear and systematic way, and the level of evidence for a particular hypothesis changes over time, generally going from low-quality and usually positive evidence to higher-quality and most often negative evidence. The confusion comes when this information is filtered through the media, and when attempts are made to produce general recommendations based on incomplete or low-level evidence. All the nuance and complexity is lost and simple, overly confident statements are made which then appear to be contradicted by subsequent overly confident and simplified statements. Skepticism is just as necessary when dealing with this as with alternative medicine.

The question is what is the most reliable epistemological approach of those available, not what is the perfect approach. I like to paraprase Winston Churchill: “[Science] is the worst form of [epistemology], except for all those other forms that have been tried.”

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Posted: 30 November 2011 10:22 AM   [ Ignore ]   [ # 10 ]
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dougsmith - 11 October 2011 10:56 AM

I certainly wouldn’t call it pseudoscience, but maybe ‘emerging science’ is a better term.

I like that. It’s basically what I told my cousin who said those medical researchers don’t know what their talking about. (She’s into every kind of woo you can imagine, from homeopathy to acupuncture.)

Even a young, stumbling form of science is better than no science at all.

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Posted: 30 November 2011 12:10 PM   [ Ignore ]   [ # 11 ]
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I certainly agree, Macgyver.  I just couldn’t help being a bit of a wise-ass. 

And on the other end of a well constructed, double-blind study such as the vitamin E one you mentioned, there is anecdotal evidence which can, surprisingly, agree.  For example, quite a few years ago, when vitamin E was a big thing I was taking 400 I.U. a day.  My doctor spotted an elevated PSA and I had radiation for six just beginning, tiny malignencies in my prostate.  smile

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Posted: 01 December 2011 08:51 PM   [ Ignore ]   [ # 12 ]
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Thanks for the good info guys.  smile  I have taken the news announcements about medicine to be true, known, good info for a long time.  But have been more skeptical in the past years.  I didn’t realize that they would ever announce emerging science, its those damn sound bites, they are so short that they make it sound like its known.  big surprise  “9 out of 10 people are malnourished” sounds much more certain than, “9 out of 10 people are malnourished, according to a preliminary study sampling 50 people conducted by the Discovery Institute.”  LOL

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Posted: 05 December 2011 03:42 PM   [ Ignore ]   [ # 13 ]
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will tell you what my Dr. said to me about supplements long ago.  He said, first there are some ailments that can cause a need for supplements but if you don’t have any of the ailments, eat a balanced diet and quit throwing your money away.  Also he said if you use supplements when you don’t really use need them, all you are doing is making your urine expensive.  So with that advice, all I try to do is keep my urine inexpensive.

Just visited this post as it effects all of us over 60, and this is almost word for word what my doc. told me at my check up two weeks ago. I asked him about supplements (i’ve been taking for over 10 years) and he said with a balanced diet you’re pissing (literally) your money away. He also said that fish oil pills will lower your triglycerides. He takes 3 daily and recommended that I do the same. About 1,000 mg. Anyone else do this?

Cap’t Jack

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Posted: 05 December 2011 03:57 PM   [ Ignore ]   [ # 14 ]
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thevillageathiest - 05 December 2011 03:42 PM

will tell you what my Dr. said to me about supplements long ago.  He said, first there are some ailments that can cause a need for supplements but if you don’t have any of the ailments, eat a balanced diet and quit throwing your money away.  Also he said if you use supplements when you don’t really use need them, all you are doing is making your urine expensive.  So with that advice, all I try to do is keep my urine inexpensive.

Just visited this post as it effects all of us over 60, and this is almost word for word what my doc. told me at my check up two weeks ago. I asked him about supplements (i’ve been taking for over 10 years) and he said with a balanced diet you’re pissing (literally) your money away. He also said that fish oil pills will lower your triglycerides. He takes 3 daily and recommended that I do the same. About 1,000 mg. Anyone else do this?

Cap’t Jack

I take fish oil supplements, along with eating sardines and almonds for their omega 6,3 acids.  At the beginning of last year, my cholesterol level had went up, so I cut most of the junk food out of my diet and started taking the pills - my cholesterol was quite a bit lower at the end of the year.

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Posted: 05 December 2011 04:45 PM   [ Ignore ]   [ # 15 ]
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I took my kids for a checkup to an optometrist who recommended that they take fish oil supplements. I have enough kids to have kept the doctor busy for almost an hour, so I went on the internet to find out what Dr. Google had say on this. From what I could find, the evidence that fish oil has any proven benefit on our health is inconclusive. I showed it to the eye doctor who responded that there is enough of evidence to show that the fish oil stuff works. He said, she said. Anyway, I decided not to give my kids anything.

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