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
HOW TO RATE AND REVIEW BLASPHEMOUS NUTRITION Leaving a Review on Apple Podcasts Via iOS Device 1. Open Apple Podcast App (purple app icon that says Podcasts). 2. Go to the icons at the bottom of the screen and choose “search” 3. Search for “Blasphemous Nutrition” 4. Click on the SHOW, not the episode. 5. Scroll all the way down to “Ratings and Reviews” section 6. Click on “Write a Review” (if you don’t see that option, click on “See All” first) 7. Rate the show on a five-star scale (5 is highest rating) and write a review! 8. Bask in the glow of doing a good deed that makes a difference!
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
HOW TO RATE AND REVIEW BLASPHEMOUS NUTRITION Leaving a Review on Apple Podcasts Via iOS Device 1. Open Apple Podcast App (purple app icon that says Podcasts). 2. Go to the icons at the bottom of the screen and choose “search” 3. Search for “Blasphemous Nutrition” 4. Click on the SHOW, not the episode. 5. Scroll all the way down to “Ratings and Reviews” section 6. Click on “Write a Review” (if you don’t see that option, click on “See All” first) 7. Rate the show on a five-star scale (5 is highest rating) and write a review! 8. Bask in the glow of doing a good deed that makes a difference!
Welcome back to blasphemous nutrition. I'm your host, Aimee, a double degree nutritionist who can curse in multiple languages. I want to spend the next couple of episodes on scientific literacy and why there's just like so much bullshit out there that gets promoted as science, when it only appears to make things more confusing for everyone. This is an area I am likely to get salty about and a place where I struggled to show some grace. So I'm hoping that you forgive me if I go off the rails, but I am going to do my best to stay level headed. I can't promise that you'll feel any more clearer when we are done. However, I do think you'll have a better understanding on why things appear so asinine and why it seems we can't make a decision on anything. All right, make sure you've got your smelling salts, buckle yourself in and let's get started. Hey Rebels, welcome to Blasphemous Nutrition. Consider this podcast your pantry full of clarity, perspective, and the nuance needed to counter the superficial health advice so freely given on the internet. I'm Aimee, the unapologetically candid host of Blasphemous Nutrition and a double degreed nutritionist with 20 years experience. I'm here to share a more nuanced take. On living and eating well to sustain and recover your health. If you've found most health advice to be so generic as to be meaningless, We're so extreme that it's unrealistic, and you don't mind the occasional f bomb. You've come to the right place. From dissecting the latest nutrition trends to breaking down published research and sharing my own clinical experiences, I'm on a mission to foster clarity amidst all the confusion, and empower you to have the health you need to live a life you love. Now let's get started. So I kind of see the issue that we have with research as coming from three primary areas, there's three primary problems. The first problem is that what we actually see what even makes it to publication is already a skewed example. One of these most fundamental problems in research is that everything that we have access to is already skewed. There is a strong bias towards publishing research with mostly positive results. I mean, finding something is way more exciting than not finding anything, right? Additionally, if you are a researcher and you find something new, you have way more opportunities for career advancements. Then if you don't contribute something new and novel to the scientific community, What gets funded and what gets published is strongly based upon novelty. Or driven by incentives that aren't about truth, but more about publishability. What's going to get read in publications. This makes more money for publishers and also has the chance to secure a researcher's career. So the system is strongly incentivized to look for what's new, especially in medicine and overlook, confirming what has already been studied. So what we have out there is not often backed by multiple studies to strengthen evidence. And this is not to say that these studies don't exist. Many many studies are run, but never published because they conclude null results. And therefore, Are rather unpublishable. This is referred to as the file drawer problem and it refers back to the analog days when this research was literally tucked away in a file drawer somewhere and forgotten about. Now occasionally a scientist will be caught massaging data to look for signals that don't actually exist. Brian Wansink who's 20 year career in research was subsequently found to be riddled with scientific sloppiness and outright manipulation of data. Was dismissed under this cloud of disgrace from Cornell University back in 2019. This was a huge deal in the nutrition field because much of his work was relied upon and used publicly as well as privately. He was one of the primary researchers in the two thousands to break into pop culture with his book, mindless eating. And like rats, when you find one, you know, there's a whole slew of them hiding in the dark. With career possibilities and human ego on the line. It's not terribly hard to imagine this outcome of bias. And intended or even unconscious skewing of research questions, methodology, statistical analysis, and publication bias, being a problem of significance in the research that we have access to. The second problem is that what's been published is not always validated by additional research. And I alluded to this before. Validation studies to confirm an existing positive outcome are not done frequently enough often again, due to their lack of novelty. Brian Nozick is a University of Virginia researcher in psychology, and he's been spearheading this return to the validity of research and open science. He set out to reproduce results from psychology research and found that even something as simple as running existing data a second time. Rarely lead to the same outcome in his field. While this was actually initiated within his own work, when he set out to see how prevalent it was in the social science field, he was stunned to find that it was a very prevalent problem, showing that 60% of studies chosen to be reproduced actually failed to achieve the same results. In the show notes, I've included an interview with Nosek. So you can learn a little bit more about the nuance behind this and the issue of reproducibility in the science field. So one might be inclined to say, well, yeah, but these are, you know, psychology is a soft science, so this is totally unsurprising. But similar alarming observations have been found in cancer research as well. With 88% of results. From what were considered landmark studies in the field being on reproducible. And when it comes to cancer research, like we want to know what the fuck is going on, and we want to make sure that we're headed in the right direction. Right. And I'm not even going to touch on Alzheimer's because I don't know. I don't know if there's been any reproducible research in Alzheimer's, but I do know that what we've been doing for the last 20 years has created a lot of drugs that don't do shit for people. Um, so we're kind of still shooting in the dark there. And I wouldn't be surprised if statistics in that field were just as alarming. So with cancer research when landmark papers, these huge discoveries, right? When several of these papers were looked at and researchers tried to reproduce the same results from these groundbreaking studies 88% of the time they were unable to get the same result. So I'm not filled with a lot of confidence right now but like, fuck, what the hell are we supposed to do? So the research that exists, particularly when it is novel, really needs to be repeated to ensure that what we are seeing is factual. More often than not, this does not get done. And much of what we think we know might not actually be accurate. This is also part of the reason why there seems to be so much flip-flopping in science. Things get thrown out into the public before they have the time or the ability to be verified. And this brings me to the next problem, the game of telephone and the manipulation of statistics for marketability. Studies of various quality get thrown out into the public all the time. We need to be aware that journalists are not skilled at reading and interpreting science. They do not teach scientific literacy and statistical analysis in journalism school. So what gets disseminated is also what is catchy, what is novel and likely to get clicks on news sites. But even before the internet newspapers had to be sold and headlines were extremely importanT. the news business is in the business of selling news. Not necessarily deeply researched evidence and facts, even if we don't seem to be able to collectively define what fact is anymore. So we have this problem where those who are largely responsible for holding the megaphone are not well-suited to discern if something which is also publishable is in fact accurate and quality research worthy of the town crier. That said. I cannot speak to the rationale behind why other organizations such as the American medical association or the FDA might also be disseminating horrible advice and information. I am. Not going to get into that here today. I have no reasonable conclusion for some of the behavior I'm seeing these days. So moving right along. One important aspect, particularly when it comes to health sciences and public health advice is this important distinction between absolute risk and relative risk. The absolute risk is indicative of certainty. So for instance, If it is 90% likely you will be killed by the Ebola virus. If you get it. You want to know the impact of an intervention on alleviating the risk of death from Ebola? Relative risk refers to the probability that something will have an impact in case you get exposed. So let's say there's a new drug that's very promising and it suggests that it is 70% effective at preventing death from a Bola. That's fantastic news. Like that's phenomenal. However, Ebola is transmitted through body fluids and it's difficult to catch if you're more than three feet or one meter away from somebody. It's also prevalent in few areas of the world. My relative risk of catching Ebola, living in the Northern part of the world is very slim. Uh, 70% reduction of death from something I have less than a 1% risk of catching in the first place. Just doesn't really impress me too much. So there's no logical reason for me to have Ebola medication on hand, just in case any more than it's logical for me to carry snake bite remedies into the Arctic circle. However, if I'm traveling to an area of the world to do volunteer medical work and there's an outbreak, but for some reason I have to go. I'm going to be proactive about taking some with me just in case. My absolute risk of catching. It becomes astronomically higher. And with a 90% fatality rate, a 90% absolute risk of dying. If I get it and it's untreated. I don't want to take those chances. So this is the difference between relative risk and absolute risk. It has been said that regarding relative risk and absolute risk that, and I'm quoting here. Absolute measures should not be used in observational studies of associative relationships, nor should relative measures be used in clinical trials of causative relationships. Basically, this means that if you're smart about your research and you are aiming for accuracy and truth and how this information is disseminated. Do not discuss absolute risk when looking at an observational study and don't be talking about relative risk. If you're using a clinical trial. Determining causal relationships. Now. An excellent example of this that has impacted each and every one of us is the 95% reduction of COVID death with vaccination. So this is relative risk, not absolute risk. And I would not be blasphemous if I didn't go here. The risk of death from COVID was very dependent upon one's age and pre-existing health conditions. Those with obesity, metabolic syndrome, cardiovascular disease, and especially those over 70 are at much higher risk of death and severe illness from COVID 19. Healthy children were not dying of COVID. Those under 35 by and large had an easy go of it unless they had pre-existing conditions. The risk of death among young and healthy people was very small. However when the first remedies came out, we were told accurately that the research indicated a 95% relative risk reduction of death and hospitalization. That's what the paper said. Whether or not that turned out to be true is something I'm not going to go into. That paper was reporting relative risk reduction, not absolute risk reduction. But this was not advertised by the media such and the Facebook hired effect. Checkers seem to miss that. Additionally, as the weeks went on, the narrative changed from the risk of hospitalization and death to the risk of disease acquisition. We heard this stuff from officials in high places that these treatments prevented transmission. Even though it was grossly evident by the summer of 2021. From that outbreak that happened in Massachusetts. This narrative prevailed long after people saw with their own eyes, that this was not the case. And that narrative was global. With many Europeans being told their vaccine would prevent their grandmother's death. Dissenting opinions were ostracized. And there were several careers that were ruined. I witnessed a lot of shape-shifting of this story. As people tried to make sense of this cognitive dissonance between what their trusted officials were telling them and what they were seeing with their own eyes. Like people needed something to believe in. I get that. And people suffered greatly while the emperor wore no clothes. So. Due to the misrepresentation of the research and other shenanigans. We have a situation now where some people are understandably mistrustful of science. And the authority. Social media posts that go viral, want to dismiss skeptics as troglodytes, but this is not the first time that populations have suffered at the hands of science. If you don't know about Tuskegee, go look that up now. Okay. and hot topics still exhausts the fuck out of me. I am moving on now. Another problem is that observational research is disseminated as suggestive of cause. But this is often assumed too soon. And without sufficient enough power to warrant such a suggestion. Observational studies are considered weaker data because they are an observation in a natural environment, such as collecting data about what a population eats. And looking for signs and signals about nutrition-related diseases. We can't ascertain causal relationships here with any certainty, but we can note strong observations. And this is because we can't take into account all of the different things that might lead to a specific observation. These are called confounding variables. And this is where this suggestion, that high meat diets cause heart disease come from. This is also where the association between smoking and disease was noted and became overwhelmingly impossible to ignore. Because it would be grossly unethical to do an interventional study where we made people smoke one to two packs a day for a decade. The observation seen here was dismissed for a very long time and most ardently by tobacco companies. There's a double-edged sword here. Right? And this is part of the reason why this argument about me and health outcomes continues to wage on.. I will say, however, and you may remember this from episode four. Flushing out the facts of the plant-based paradigm. That the strength of association for smoking related diseases was far stronger than the association we see for meat related diseases. And I'm air quoting there. So the argument here will continue and remain a, he said, she said debate for the foreseeable future. The real problem is when we take observational data, do not reveal the strength of association, the strength of the evidence that we see and then disseminate that information, suggesting that it is causal. We cannot reach certainty of cause through observation. And when media ignores these details between relative risk and absolute risk of an association, we get gross over reactions and panic over absurdities. Like. That stupidly impotent study published last year, suggesting that erythritol intake causes heart disease. Okay. I feel my blood pressure rising. This study actually looked at a population with very high risk of cardiovascular disease. Many had already had a heart attack. They were hypertensive diabetic or even had heart failure and they were included in this study. And then they measured the erythritol levels in their blood, but never bothered to fucking ask them about the intake of the erythritol from their diet. erythritol is produced in the body. And All production is increased when cells are under oxidative stress. Uh, something that is happening in overt disease. Blood levels of erythritol are also associated with obesity. A condition that is also linked to increased oxidative stress. So then they checked in after three years and noted that, oh, those who have the highest level of serum erythritol were more likely to have cardiovascular events. Never mind that diabetes, hypertension, a history of heart attack and existing heart failure also grossly increased the risk of a cardiovascular event. And that erythritol appears to be produced as a by-product of a strained and sick system. Anyway, this study measured blood levels of erythritol call in sick people and then took eight healthy people and gave them dietary erythritol. So gave them an erythritol supplement and then measure their blood levels before and after and showed. Hey, if you take erythritol tall. Orally. It increases your plasma levels. So then the researchers took these two studies, one of them observational. Noting people in poor health. I have higher earth natal rates in their blood and tend to die of cardiovascular disease. And then an interventional study. If we give people a resveratrol, their blood levels in grace. And then they coalesced this into a single paper with a final conclusion that erythritol in the blood appears to be associated with increased disease risk. So then the media goes out. There's this vitality of panic that 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 my local whole foods. Many of these flash in the pan one-off studies that get shoved out and induced panic or on par with this level of quality. Always read between the lines. And if you can get your hands on the primary paper, read what it says and see how it might be different than what the media outlets are suggesting. Maybe it's being suggested that a compound causes cancer or a compound cures cancer, but that study was done in a Petri dish. Maybe it's an observational study, but they don't disclose if they took into account confounding variables or they missed obvious confounders, such as smoking or preexisting health conditions. Maybe the observational study is them observing. 50 people. Well, we can't really make any big grandiose conclusions taking a look at 50 people./ While randomized controlled trials are considered the gold standard in science. They also have their own limitations. Here, we aim to find causal relationships between single factors. The impact of a medication on the glucose levels of men over the age of 50 who have diabetes, but no other diseases, for instance, These RCTs, or randomized controlled trials, are very valuable contributions so long as you fit into the demographic being studied. So let's take this instance. Let's say this study is done and let's say they even are able to repeat the study successfully in this group of men over 50, with just diabetes as a health condition. And then it's used as the foundation for some sexy, expensive new diabetes medication. What we do not yet know is how does it impact the glucose of women? Does it matter if she's pre or post-menopausal. How does it impact younger men with diabetes? What if this person taking the medication has other health conditions super, super common in this demographic, but having other preexisting health conditions are considered confounding variables and are often excluded from the research pool. We would ideally like to know how this medication could interact with other medications or how it might impact other concurrent diseases within the patient. So you see the real world is way too complex for RCTs to be as gold, as standard as we really wish they could be. We often find the limitations of an intervention long after it's been in the public for 20 years or so. And there's enough data then accumulated. To have a better understanding. And this is why you see things like Vioxx and other medications out for a significant period of time and then pulled because they discover, oh, whoops. It turns out there was this big problem that we didn't see in the initial research. So interventional studies and observational studies both have a place. Both hold value. Both have limitations. In the game of telephone from researcher intent to publication, to news outlets or public health officials sharing their thoughts or suggestions based upon the data. Is its own game of telephone. And this is why I say we cannot blindly trust the science and we should be extremely skeptical of trusting anyone who says otherwise, Science is an ever evolving field of finding out what we believe to be true based upon what we find to be untrue over time. We have very strong evidence that gravity is real. And lots of evidence to support the earth being round, but when it comes to curing illnesses and optimizing vitality, There are still a lot of unknowns. My personal bias tends to be a naturalistic one. I hold a bit more credibility. And what has allowed humanity to survive for as long as we have. I look to history as an indicator of what might be more correct than other things. This is certainly not infallible. It tends to make me skeptical of the new and shiny. I need more time to feel confident in a new product or a new idea. I think having people who embrace 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. And I would argue that the healthiest societies are the ones that allow for differing opinions to be at the same table, because we see one another's fallacies way more clearly than we see our own. If our true goal is arriving at health and not ego validation for our own self righteousness, we ought to be more willing to entertain opinions that differ from ours. We ought to be more willing to question our own assumptions and to recognize that being misled by human emotion and self-preservation is a human trait that none of us are exempt from. All right. Next week, I'm going to offer you an antidote to the heartburn that I've just given you with this episode. I'll be interviewing Victoria laFont. Victoria is the founder of the LaFont agency, which is a marketing agency based on having a bias- conscious interpretation of scientific literature. That then gets used to create practical content for health practitioners. I think her understanding of both marketing and scientific literacy is unique. And she's going to share some tips on scientific literacy and how we commoners without statistics degrees and research chops can better ascertain the shit science from the promising gold nuggets that are presented in media outlets. Until next time, my friends. Thank you so much for tuning in. Please do me a favor, leave a review in iTunes service Spotify, take a screenshot of that review and send it to me. At blasphemous nutrition@gmail.com. And I will ensure that you are first in line to receive my scientific literacy cheat sheet that will help you better understand. The quality of science based upon the type of science done. And kind of coalesce some of the concepts that we talked about today and that we'll be talking about with Victoria so that you can feel more comfortable and confident in taking a look at media published reviews of the scientific literature. Until next time, my friends. Stay salty. If you have found some Nuggets of Wisdom, make sure to subscribe, rate, and share Blasphemous Nutrition with those you care about. As you navigate the labyrinth of health advice out there, remember, health is a journey, not a dietary dictatorship. Stay skeptical, stay daring, and challenge the norms that no longer serve you. If you've got burning questions or want to share your own flavor of rebellion, slide into my DMs. Your stories fuel me, and I love hearing them. Thanks again for tuning in to Blasphemous Nutrition. Until next time, this is Aimee signing off, reminding you that truth is nuanced, and any dish can be made better with a little bit of sass. Any and all information shared here is for educational and entertainment purposes only and is not to be misconstrued as offering medical advice. Listening to this podcast does not constitute a provider client relationship. Note, I'm not a doctor, nor a nurse, and it is imperative that you utilize your brain and your medical team to make the best decisions for your own health. The use of information on this podcast or materials linked to this podcast are at the user's own risk. No information nor resources provided are intended to be a substitute for professional medical advice, diagnosis, or treatment. Be a smart human and do not disregard or postpone obtaining medical advice for any medical condition you may have. Seek the assistance of your health care team for any such conditions and always do so before making any changes to your medical, nutrition, or health plan.