White Coat Underground

Smelting: gerund, the act of catching smelt (a small Great Lakes fish) by dipping a bucket in the water during the smelt run season: ex. Smelting is like shooting fish in a barrel.

Sometimes it’s too easy. You see, when you criticize someone for being wrong, that’s one thing, but when you imply that they are wrong because their entire world-view is incorrect, well, sometimes you get a response.

In a piece last week I was very critical of a new diet and it’s creator, and she apparently watches the web, because she came by to comment.

From reading her website and her comment, I get the distinct impression that, like many people, she is sincere in her wrongness, and probably a good person as well. But as we’ve discussed before, being sincere does not excuse someone from ethical culpability.

As you recall, I criticized her, perhaps too broadly (and perhaps not) for claiming that INFLAMMATION was the ONE CAUSE OF ALL DISEASE, and that her special diet could fix that. Of course, as far as she is concerned, her ideas are far more nuanced, so let’s let her speak for herself and see where I got it wrong.

PalMD implies that I claim that inflammation is the root of all disease. In fact, I titled an article “Inflammation: The Root of All Disease?” The question mark specifically alludes to and challenges some of the more breathless reporting on the topic from the mainstream media.

If you read more than a line or two of what I’ve written on the subject (including punctuation), I think you’ll find my views to be a bit more nuanced:

I had not realized that she is actually a skeptic. My apologies. You see, after that all-important question mark, I sensed some of that same very breathlessness that she described, as in this, which immediately follows the question mark:

Hay fever, heart disease, depression, and diabetes…four very different conditions with one common denominator: Inflammation is at the root of all four. And that’s just the beginning!

And I did note the punctuation this time—an exclamation point to be precise, the mark of all thoughtful skeptics. And the next paragraphs do not go on to debunk any hyperbolic claims. Just sayin’. But back to her response.

Of course I don’t suggest that inflammation is the root of all disease. That’s ridiculous. But I do believe that chronic low-level inflammation is a contributing factor to the most common degenerative diseases suffered by Western cultures–heart disease, cancer, dementia, diabetes, obesity, etc. This view is fairly mainstream.

Since the diseases she lists account for most disease in North America, I’m sticking by “root of all disease”, but if you’d like, I can change it to, “the root of 99% of all important disease in North America.” And no, the view you present is not mainstream among those of us who study and treat human disease.

Of course I don’t claim that all inflammation is bad–or the same. Inflammation is a necessary and beneficial part of the immune response. Chronic, unproductive, systemic inflammation, however, is a problem and it is this latter variety that is primarily driven by diet and lifestyle. Again, a widely held view.

Once again, not so much.

If you accept the two previous statements, you might go looking for information on how to modify your diet to one less likely to provoke or exacerbate systemic inflammation. When you do, you’ll quickly find an unwieldy and contradictory set of injunctions: Omega-3 fats are good. Omega-6 fats are bad (sometimes.) Antioxidants are good. Sugar is bad. Fiber is good. Saturated fat is bad. And so on.

These guidelines don’t address the fact that some foods are high in both sugar and antioxidants or both omega-3 and omega 6 fats. They also don’t say much about the effect of single foods in the context of a mixed and varied diet or how to combine “anti-inflammatory foods” into an otherwise balanced, nutritious diet. The rating system that I developed is a proposed solution to these difficulties.

[...]

At the very least, following the guidelines outlined in my book results in a healthful and balanced diet that conforms with widely held nutritional principles.

Neither I, nor most physicians accept these statements regarding “inflammation”. Most experts, like you, find that focusing on what Michael Pollan has called “nutritionism” is fatally reductionist. It is a common practice among so-called alternative practitioners to take what is sensible, mainstream advice and sex it up, as your book does. As you say in your final paragraph, what you’re really offering is usual dietary advice, with a patina of improbable claims.

While I don’t necessarily agree with everything he’s written, Pollan’s advice about diet is simple, free, and rather correct: “Eat food. Not too much. Mostly plants.”

Comments

  1. #1 6EQUJ5
    July 27, 2009

    “Faith is believing in something you know isn’t true.” -Mark Twain

    She may suspect that her ‘theory’ isn’t true, but that won’t stop her from having fun believing in it. In which case, yes, she’s lying.

  2. #2 antipodean
    July 27, 2009

    How does she integrate the fact that meta-analyses of the large RCTs of antioxidants show that they are bad for you?

  3. #3 R E G
    July 27, 2009

    In my experience, people who create alternate realities, and truly believe in them are bipolar.

    Believing that you have special insight, are misunderstood, and are the only one with the “true” solution, is pretty typical of a manic state.

    In any case, labelling them as bipolar, reduces the level of evil I attribute to them. The ones who create alternate realities knowingly and for profit are truly evil.

  4. #4 The Perky Skeptic
    July 28, 2009

    ‘Scuse me? Not all bipolar folks live in an alternate reality, thanks. Some of us are quite attached to the real world.

    Now that I think on it, though, I only started living a truly rational life after I got medicated, which is… thought-provoking.

  5. #5 Jon H
    July 28, 2009

    I’m not fat! I’m inflamed.

  6. #6 The Blind Watchmaker
    July 28, 2009

    “Inflammation” is becoming another word, like “energy” that is tossed about so much in the alt lit that it is almost becoming useless. It has real meaning, but the real meaning is not understood by those tossing it about. Their readers don’t understand it either, but it is sciency enough to sound like the writer really must know their stuff.

  7. #7 antipodean
    July 29, 2009

    Watchmaker

    “Immune System” “Natural” and “Clinically-proven” are the other ones being tossed around at the moment…

  8. #8 DLC
    July 31, 2009

    Gah. too much satellite TV. the snake-oil salesmen
    (I won’t mention names, but you probably know who they are)
    keep on selling the crap, even after having been told by the FTC to stop. They use “Clinically Proven” or “Based on proven science” or similar language even though they put up a quack miranda warning in fine print on the screen at the same time.
    And what really bugs me is that suckers fall for it and order the junk.