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Re:New research questions the evidence for health benefits o... by jeremyw on Monday September 30, 2019 @08:21PM (#21120890)
Note, all of these studies use a low standard of evidence (food questionnaires and the like), and they generate low signal (barely registering positive/negative). Read John Ioannidis @ Stanford for why these methods should banned, and why nutritional research currently produces mostly irrelevant data.

Harvard, unfortunately, has doubled-down on this style of science.

It's not helpful that the press supports these methods, without skeptical commentary.

Re:New research questions the evidence for health benefits o... by trappist on Monday September 30, 2019 @09:30PM (#21121187)
I see this as an epistemological failure in nutrition that plagues other fields as well. We have all this knowledge of human physiology and metabolism, and make very little use of it in nutrition, acting as though we can't draw logical conclusions from what we know about those things, or trust those conclusions, or at least use them to apply serious skepticism to the apparent implications of low-quality data.

For myself, until you can tell me by what means a particular food produces the claimed outcome, I dismiss your epidemiological nutrition study.

Re:New research questions the evidence for health benefits o... by o09rdk on Monday September 30, 2019 @10:26PM (#21121448)
Although I think that's reasonable at some level, I think there's dangers in it as well, in that I don't think we really know that much about metabolism or physiology in the grand scheme of things. Physiological and microbiological studies are plagued by confounds and unreplicability problems, for example, and even where it's not, our understanding is more meager than many think. Trying to tie population-level findings to physiology is great if it's possible, but I don't see it as necessary on either end, at least for awhile.

It wasn't that long ago that the role of microbiome was recognized, for example, and even now it's contentious. Conversely, scores of epidemiological findings have had nice physiological explanations that turned out to be much more complicated, like those involving saturated fat, cholesterol, and carbohydrates. DHA, omega fatty acids, etc. are similar. Physiology is complex enough that you can accommodate just about any finding.

To carry this a bit further, it can be problematic going in the other direction too, from physiology to populations. Some of the anti-sugar advocacy, for example, was rooted in lab studies that neglected the effect of fiber in digestion of fruit, so you had people advocating that whole fruit consumption be avoided based on incomplete understanding. It's hard to argue that unprocessed whole fruit is undesirable on the basis of observational nutrition studies. Someone looking at the wet lab data and advocating abandonment of whole fruits might have done well to look at those observational studies to see why different trends were occurring.

I'm not saying that tying one level to the other at some point isn't necessary. I just think one or the other level can't be dismissed out of hand just because things don't map onto each other initially. It's possible that one level provides clues that the other is missing; it's also possible to come up with plausible but wrong bridges between the two levels.

Re:New research questions the evidence for health benefits o... by andrewf on Monday September 30, 2019 @10:12PM (#21121389)
We have all this knowledge of human physiology and metabolism

I think the depth of knowledge is very uneven. We're not sure how Tylenol works. (Disclaimer: I work in software, not bioscience)

Re:New research questions the evidence for health benefits o... by nzzzz on Monday September 30, 2019 @10:49PM (#21121577)
There will never be explanations on "how paracetamol (the principal substance of tylenol) works" because.. it doesn't work. It doesn't fare better than placebo. https://www.evidentlycochrane.net/paracetamol-widely-used-in...

At least, placebos don't harm the user. There's evidence paracetamol is harmful. https://ard.bmj.com/content/75/3/552

And dosages higher than 4g/day are known to destroy the liver. Paracetamol overdose is one of the most painful way to kill yourself. Its abuse being freely sold over the counter makes it the number one cause of liver failure in the US and UK. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403265/

>Paracetamol’s toxicity is also the single biggest cause of acute liver failure in the United States. Cases have been rising for six years, according to a study published in December (Hepatology 2005;42:1364-72). By 2003, the drug accounted for just over half the cases of acute liver failure, and about half of these cases were the result of unintentional overdose.

It boggles the mind the substance has not been put under harsher control yet.

Re:New research questions the evidence for health benefits o... by circlefavshape on Tuesday October 01, 2019 @05:56AM (#21123697)
Looks to me like you're over-generalizing. From skimming that article it appears that paracetamol is ineffective against chronic page, not the headache/hangover that most people use it for
Re:New research questions the evidence for health benefits o... by trappist on Monday September 30, 2019 @10:51PM (#21121583)
That's medicine, where the use of much better techniques are feasible and appropriate than in nutrition. What I'm saying isn't true of all fields. I'd put nutrition and economics near the top of the list, and medicine much further down.
Re:New research questions the evidence for health benefits o... by jfim on Monday September 30, 2019 @08:52PM (#21121034)
> Note, all of these studies use a low standard of evidence (food questionnaires and the like)

Sounds like someone is optimizing for the number of papers written per grant dollar, as opposed to generating quality science.

Why do expensive research when you can just print a few questionnaires, get a few underpaid grad students to administer them, then trawl the data for acceptable p-values for publication?

Re:New research questions the evidence for health benefits o... by gyuserbti on Monday September 30, 2019 @08:53PM (#21121041)
I have a lot of respect for Ioannadis but also find it reprehensible to talk about banning or otherwise forbidding large classes of research. Science only progresses when unfettered; prohibitions never help. If a study is flawed, address the flaws. More information might not help, but it never hurts. These flawed studies exist for a reason -- ideal studies are usually the stuff of fantasy.
Re:New research questions the evidence for health benefits o... by Talyen42 on Tuesday October 01, 2019 @08:59AM (#21124820)
The current system is absolutely prohibiting good science from being done, through incentive structures on the faculty tenure/review process weighing heavily towards frequency/quantity of published material. faculty review processes are mostly new to the last 10-20 years ("accountability" suddenly became a thing in academia), as the quantity of published material has gone up by orders of magnitude more than the number of researchers.
Re:New research questions the evidence for health benefits o... by rmtech on Monday September 30, 2019 @08:38PM (#21120965)
Got a reference for ioannidis on this topic specifically?
Re:New research questions the evidence for health benefits o... by jeremyw on Monday September 30, 2019 @10:00PM (#21121324)
Sure, start with these. Good references, too.

Perspective: Limiting Dependence on Nonrandomized Studies and Improving Randomized Trials in Human Nutrition Research: Why and How https://academic.oup.com/advances/article/9/4/367/5055939

Implausible results in human nutrition research https://www.bmj.com/content/347/bmj.f6698

His most famous paper, Why Most Published Research Findings Are False https://journals.plos.org/plosmedicine/article?id=10.1371/jo...

Here's a talk on nutrition science methods, along with a specific audience moment with Walter Willet, former head of Harvard Nutrition dept, and advocate for his questionnaires. https://www.youtube.com/watch?v=KTAbx4i8Dyg -- https://youtu.be/KTAbx4i8Dyg?t=23m40s

Re:New research questions the evidence for health benefits o... by o09rdk on Monday September 30, 2019 @10:43PM (#21121540)
After reading the BMJ piece I wondered if any study strategy would satisfy Ioannidis, to be honest. I came away from it feeling like his calls to eliminate observational studies and smaller randomized trials are misleading in that he seems to believe that all realistic studies should be eliminated.

He seems to be in favor of large randomized-controlled comprehensive diet protocols, for example, where many aspects of diets are manipulated simultaneously. He dismisses them too, though, for very good reasons. Given that there were additional reasons to be skeptical of such studies he didn't mention, I was left wondering if his pleas for study designs should be heeded very much (as opposed to his criticism of specific flaws). I love his work, but am wondering if it's best approached as worst-case criticism rather than an inspiration for what to do.

Re:New research questions the evidence for health benefits o... by jeremyw on Monday September 30, 2019 @11:57PM (#21121902)
That's interesting. I read him (in total) as being quite optimistic about the way forward, if intertia and self-interest can be overcome.

He's listed as an author in a number of nutritional and other studies. One might see those as leaning in his direction, if he's willing to be mentioned.

You might contact him if you have additional doubts.