Nutrition science can be likened to a convoluted puzzle, filled with debates, uncertainties, ambiguities, misconceptions, and misleading outcomes.
There was a time when I contemplated delving into the field of nutrition, but I'm now relieved that I didn't. It's undeniably fascinating, yet alarmingly deceptive. Some might even say corrupted.
The significance of basic nutrition
Undoubtedly, a fundamental understanding of nutrition is crucial for averting fatal consequences. Numerous known deficiencies resulting from inadequate diets can lead to death or life-threatening illnesses. It seems logical, then, to assume that consuming all essential nutritional elements automatically translates to good health. However, simply "not dying" does not equate to being healthy.
So, what does it mean to be healthy? That is the million-dollar question, and despite the proclamations of various authoritative nutritional organizations, we still lack a complete answer.
If we truly understood what constitutes a healthy diet, then individuals who adhere to such diets wouldn't succumb to food-related diseases. Yet, they do, don't they?
Once again, we are faced with the realization that this statement itself is flawed. It assumes that we possess comprehensive knowledge of food-related diseases.
But do we? Do we genuinely understand them?
To some extent, the answer is "yes." Nutritional science has identified numerous mechanisms within the human body that contribute to disease when they malfunction. For instance, a deficiency in vitamin A can lead to blindness, while a lack of iron can result in anemia.
However, when it comes to studying and effectively treating major diseases like cancer, heart disease, stroke, Alzheimer's, and diabetes, we are still grappling with complex puzzles. To be fair, scientific research has produced a plethora of findings, but what we truly seek remains elusive: a cure or highly effective prevention strategies.
The pitfalls of experimentation
Discovering the intricate relationship between nutrition and health necessitates robust experimentation. This is precisely what nutritional science strives to achieve. However, scientists encounter a multitude of challenges along the way.
Firstly, conducting proper experimental studies, such as randomized clinical trials, in nutrition is exorbitantly expensive. The same can be said for other forms of nutritional research.
Consequently, who often foots the bill for these studies? Frequently, it is the food companies themselves—the very entities that produce the foods under investigation. This creates an inherent conflict of interest.
After all, which food company would willingly finance a study with millions of dollars only to discover that their product is unhealthy, or worse? I venture to say none.
Major research studies that have produced groundbreaking discoveries have been sponsored by industry giants like Pepsi, Coca-Cola, Nestlé, Cargill, dairy industry players, sugar industry stakeholders, meat and soy industry representatives, and even pharmaceutical companies.
What does this mean for the integrity of the studies? It may mean nothing at all, or it may mean everything.
Secondly, conducting controlled clinical trials on human subjects presents its own set of challenges. Ethically, researchers cannot confine individuals to controlled environments like lab rats for the purpose of experimentation.
Consequently, less controlled studies are often employed, albeit with reduced reliability compared to highly controlled experiments.
The last bastion of nutritional "science"
What does modern nutritional science primarily rely on to yield results? The predominant methodology employed is called epidemiology.
According to Wikipedia, "epidemiology is the study and analysis of the distribution (who, when, and where), patterns, and determinants of health and disease conditions in defined populations."
In essence, epidemiology is an observational form of study, not an experimental one.
Scientists observe large groups of people, either through self-report studies utilizing questionnaires or by examining specific population groups and studying certain relationships over a period of time.
This approach offers advantages such as lower costs and the ability to study multiple markers simultaneously. Notably, studying defined populations has yielded numerous notable findings.
However, there is a glaring downside to epidemiology—it lacks accuracy.
Initially, epidemiology was designed to generate hypotheses that could later be tested through experimental studies. Its purpose was never to definitively prove anything. It cannot establish causality; it can merely establish a connection between two variables, such as meat consumption and heart disease.
Whether this connection is causal or coincidental remains unknown until properly tested in a controlled experimental trial, which unfortunately rarely occurs. And when it does, the situation worsens.
Dr. John Ioannidis is well aware of this issue. In a paper addressing various fields of medical research, including nutrition, he discovered that 80% of non-randomized studies (such as epidemiology) turned out to be incorrect when subjected to rigorous experimental trials. A staggering 80%! This implies that flipping a coin would yield more accurate results.
Imagine a condom company advertising with the slogan: "You'll be safe... 20% of the time."
The quandary of dietary advice
Many of the epidemiological findings have generated sensational headlines in newspapers and even medical journals—akin to clickbait.
The World Health Organization (WHO) and its research arm, the International Agency for Research on Cancer (IARC), conducted a comprehensive overview in 2015, concluding that meat, particularly processed and red meat, is associated with various types of cancer, notably colorectal, pancreatic, and prostate cancer.
To arrive at this conclusion, the IARC relied on epidemiological studies that revealed a correlation between cancer and meat consumption.
However, as I previously mentioned, it is yet to be determined whether this correlation is causal or coincidental.
Furthermore, the risk rates reported were 17% for red meat and 18% for processed meat, which may seem significant.
However, when placed into context, these numbers lose their impact. I won't delve into the intricacies of relative and absolute risk here, but suffice it to say that these figures represent relative risks.
Let's consider the context further. One of the success stories of epidemiology is the link between smoking and lung cancer.
Studies have shown that smoking significantly increases the risk of developing lung cancer—a monumental achievement for epidemiology.
When we examine the risk numbers associated with smoking, a stark contrast emerges. Smokers face a 15 to 30 times higher chance of developing and dying from lung cancer, equivalent to a risk increase of 1500% to 3000%.
In comparison, the risk values associated with meat and cancer are a mere 17% and 18%. Can you discern the discrepancy between these findings?
It's worth noting that even with risk levels of 1500% to 3000%, epidemiology cannot establish causality definitively. It's very likely, but not proven.
Nevertheless, it becomes considerably more probable. On the statistical front, according to the Bradford-Hill criteria, any risk number below 200—a twofold increase or 200% relative risk—is not considered a causal link and is likely due to confounding factors or bias.
Once again, meat and cancer are associated with risk values of 17% and 18%.
Despite this, the WHO and IARC have classified red meat with a 17% risk as a type 2A carcinogen (probably carcinogenic to humans), while processed meat with an 18% risk is classified as a type 1 carcinogen (carcinogenic to humans), akin to smoking.
I am not saying this is wrong. The point is, noboby can say it's right either.
The conundrum of dietary advice
To clarify matters, let me emphasize that I do not advocate for or against any particular form of eating or dieting here. I am not a health professional, and I have no intention of demonizing the WHO or IARC. The reported numbers may indeed be accurate and even causal.
My question is: Why do physicians, doctors, nutritionists, and dieticians present these findings as if they were established, proven concepts? Why does the WHO present them that way when, in reality, they are not?
Could it be that there are no other alternatives?
There is only one other option for health professionals: admitting that we don't know.
It may not be reassuring, but it could be the most honest answer. The truth is, we don't know which foods cause cancer or many other prevalent diseases. Perhaps these diseases are not even related to food at all.
Please don't quote me on that.
Certainly, this was just one example, but further exploration, reading additional articles, watching videos, or examining studies independently will reveal numerous similar cases.
Nutritional science heavily relies on observational studies and epidemiology, which is far from ideal.
Depending on something that is wrong 80% of the time is far from desirable, even in non-life-and-death situations.
Would you entrust your decisions to something so unreliable?
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