Meta-Research Debunks Medical Study Findings 261
jenningsthecat writes "From The Atlantic comes the story of John Ioannidis and his team of meta-researchers, who have studied the overall state of medical research and found it dangerously and widely lacking in trustworthiness. Even after filtering out the journalistic frippery and hyperbole, the story is pretty disturbing. Some points made in the article: even the most respected, widely accepted, peer-reviewed medical studies are all-too-often deeply flawed or outright wrong; when an error is brought to light and the conclusions publicly refuted, the erroneous conclusions often persist and are cited as valid for years, or even decades; scientists and researchers themselves regard peer review as providing 'only a minimal assurance of quality'; and these shortcomings apply to medical research across the board, not just to blatantly self-serving pharmaceutical industry studies. The article concludes by saying, 'Science is a noble endeavor, but it's also a low-yield endeavor ... I'm not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life.' I've always been somewhat suspicious of research findings, but before this article I had no idea just how prevalent untrustworthy results were."
Re:Reality check (Score:3, Informative)
You ARE aware of the placebo effect, right? It is a BIG problem for big pharma ...
http://www.newscientist.com/article/mg18524911.600-13-things-that-do-not-make-sense.html [newscientist.com]
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"The Inner Space (of Mind), not Outer Space is the FINAL frontier."
Re:For example (Score:5, Informative)
That's one of my favorites... or the presumption that eating fat makes you fat.
People seriously do not understand nutrition or how diet and exercise work. Lately, I have been doing an kind of experiment for the people around me. First, for about a month or more, I started riding my bicycle to work. I was working it hard. Then, after it was established that I had been riding my bike for at least a month, I started on a low-carb diet. Within two weeks people started to notice the weight loss. Some still wanted to believe it was the bicycle riding. I had to lay it out to them what the deal was. Exercise burns carbs and then fat. Trouble is, the carbs we take in our daily diet still outnumbers that which I burn from riding 10 miles each day. It is only after I limited the intake of carbs that a difference could be made and observed.
Here's why I did it like this:
People don't listen for more than a few sentences and are especially resistant when the information conflicts with what they think they know. Eating fatty meats is contrary to their beliefs about what a weight loss program should contain so they simply refused to accept it. Hell, even many doctors don't yet fully acknowledge that making your body burn fat will reduce cholesterol. (Hello? cholesterol is fat floating in the blood!)
Having lost almost 30 lbs in a 6 week period has been noticed by all and the evidence is right in front of their faces. I lost the weight, and this is what I have been eating.
Re:For example (Score:3, Informative)
You have to accept that the body metabolizes carbohydrates and other calories in completely different ways. It's far from pseudoscience. It's a basic knowledge that we all already knew.
Um, no. Do yourself a favor and listen to the man. You're spitting out pseudo-scientific nonsense that's been fed to you by like-minded people who also have no clue what they're talking about. The only thing that matters as far as weight is concerned is calories in versus calories out.
Re:For example (Score:4, Informative)
Not healthy, dude, and Ketosis is not your friend. In the short term, ok, you're probably not going to kill yourself. In the long term, you're going to burn lean muscle, including some important ones like, oh, I don't know ... the heart. And by "long term" I mean "you crossed the line 20 days ago". I suggest you stop. Being overweight may be bad for you, but starvation diets are far worse.
Re:For example (Score:1, Informative)
No competent doctor will tell you exercise is the only way to lose weight. It is well known that your diet AND exercise are key players in controlling body mass. But I'm very glad that you're taking care of yourself now!
As for your statement about cholesterol, it is not a fat. It is a separate class of molecules used to make hormones, and we cannot burn cholesterol for fat. It seems like you're mixing up high levels of blood cholesterol and high levels of fats in the blood. Your body can create both fat and cholesterol anew from the food that you eat, be it protein, fat, or carbs. This storage occurs after eating a meal i.e. when your body is in a well-fed state. The process of making fat and cholesterol is stopped when your body needs to do work and expend energy. Your body turns fat into energy, especially in the muscle. Prolonged vigorous exercise preferentially uses fat for energy over carbohydrates. This is why you need to get your heart rate high and sustained for a fair amount of time to provoke weight loss. Otherwise, you'll only be burning carbs. If your exercise and regular metabolism - heart beating, lungs, brain activity - doesn't burn more calories than you consume, you'll never lose the weight. That's why changing your diet and changing how much you exercised helped.
30 lbs in 6 weeks is very dramatic. Make sure you see your doctor (or one that you trust, since you seem to have beef with some of them) to make sure that your body is adjusting alright to these dramatic changes.
Re:For example (Score:5, Informative)
"Reduce the primary source of fuel so that it will use the secondary source of fuel. It's really that simple."
No, it isn't.
The (almost) only direct source of "fuel" for the organism is sugar (glucose), full stop*1.
Anything else the body ingests or stores has to be reduced to sugar (usually by means of the krebs cycle) prior to be "burned".
While this is a very basic simplification, this, and the fact that the blood can carry a limited level of sugar at a time, is what explains, at a whole body level, everything else.
Like...:
* Since you can only burn sugar, sugar-equivalent contents is all that counts for weight imballance (of course, within limits: you can't just stop your ingestion of, say, oligoelements). That's what we really talk about when we talk about food calories.
* If you directly eat sugar (glucose), the sugar will be immediatly burn, but since your blood has limited sugar carriage capacity, you should be continously eating like a hummingbird to sustain that, so you usually just can't eat sugar in excess.
* If you eat carbs, they'll be transformed into sugar and burned. Any carb in excess will be stored as glucogen in your liver. If there's still carbs in excess once your liver can't hold any more glucogen, it will be transformed into fat and stored under your skin.
* If you eat fat, it will be transformed into sugar and burned. Any fat in excess will be stored under your skin unless you are so low in glucogen (which usually won't happen) that part of the fat is transformed into glucogen and stored in the liver.
* If you eat proteins, they'll be used for structural development (like muscle mass). Usually, anything in excess will be trashed away, unless you are very low in sugar, carbs and fat intake (it usually doesn't happen) in which case, it will be uneffitiently transformed into sugar and then, burned.
* To explain for long term weigth, all that's needed is accounting for your ballance between ingested calories and burned calories: if you eat more calories than you burn, your weight increases; if you eat less, you lose weight.
For a practical example:
If you eat less carbs and more fat to the point that daily calories stay the same, You Will Not Lose Weight (but in the long run you will develop cardiovascular illness).
If you eat less carbs and more proteins to the point that daily calories stay the same, You Will Not Lose Weight (but in the long run you will destroy your liver).
Given the ballance between ingress and burn, you can obviously go two (complimentary) routes:
1) Eat less calories. Sustaining a varied and ballanced diet, only eating less, is the way any sensible nutritionist will suggest since it's the easiest to do properly long term and the easiest to lead to you changing your habits. But as long as you stay to the First Principle "eat less calories", and within sensible limits, you will get it right.
2) Burn more calories. That's where exercise and rising your basal metabolism come into account. Aerobic exercise is an obvious recomendation, but other less obvious things like lowering your home thermostat 3~4 degrees in winter will have it's effect too. Again, it's not what you do, but what you achieve with regards of burned calories.
Everything else about diets is about making acceptable for you to eat less calories/burn more calories (like, unless you are a kind of iron-man you won't have the will for strengh training like weight lifting unless you go heavy on sugars; the same with aerobics, like long distance running or bycicling unless you go heavy on carbohidrates, or you'll probably break your diet if you are just told "eat exactly the same as you did, only on third the quantities", so you are offered a diet with much less calories but about the same or even more volume so you feel satiated, or you'll probably will abandon a diet if you don't see fast results at least at the beginning, so you are offered a diet very low in calories for the first weeks so you fastly see your efforts are
Re:For example (Score:3, Informative)
I'm starting to think the very term 'Carbs' is meaningless from a health standpoint. Our digestive tracts are so long to handle the complex carbohydrates found in green vegetables and related sources - it is not required for the simple starches and sugars that are also lumped in together as carbs. You just said something that is technically true, but terribly misleading, in much the same way as showing nine homeless bums in the same room with Bill Gates, telling us what their average income is, and not giving a damn what some people would assume about poverty in America from the evidence you've supplied. You're correcting a technical point, but it sounds like you're saying the first poster is wrong about his conclusions instead, and that's how many people are going to take it.
While we are at it, there's naturally occurring sugars and synthettic sugars, and even though glucose is a naturally occurring sugar, it has one important difference from all the more complex sugars - it directly crosses the blood/brain barrier. We need some clear words to descrivbe the three types of sugars as separate health factors. We probably need several other new words to let people discuss this with more light than heat being shed. Despite this, here's trying to say it with only a few, rather basic phrases substituted for single words.
If you're like most Americans, you need to eat more carbs and to eat fewer carbs. See how nonsensical that sounds, until it's rephrased: We need to eat more complex carbs, as found in vegetables, and fewer simple starches and many fewer sugars.
Also, gluten is found chiefly in wheat, not oats or rice. Gluten may not be that much of a health factor for most people - the evidence is not conclusive, at least yet. But we probably need some clear way to distinguish the starchy food type that has lots of gluten from all the other starchy foods that have less or even trivial amounts, or again, disscussions are mostly heat not light.
Re:For example (Score:3, Informative)
That's a gross oversimplification of a complicated process. The 1st law of thermodynamics isn't useful when considering factors like hunger, satiation, fat mobilization and storage, basal metabolic rate. Yes, you can override the internal wiring that regulates energy intake and use that simple equation, but it's kind of like telling someone building an airplane that all that matters is F=M*A. It's not all that helpful.