In which Joe Jackson's wisdom about cancer is apparently not validated

Everything
Everything gives you cancer
Everything
Everything gives you cancer
There’s no cure, there’s no answer
Everything gives you cancer -

Joe Jackson

I don't write about nutrition as much as other topics because I'm not as knowledgeable about it as I am about, say, cancer, vaccines, and what constitutes good medical evidence. (I am, however, trying to become more knowledgeable.) Even so, I was thinking. After my post a week ago in which über-quack Joe Mercola unexpectedly gave a glowing introduction to a paean of praise for bacon and my post yesterday in which a credulous fellow by the name of David Freedman who fancies himself a skeptic castigated Tara Parker-Pope for her views on nutrition and obesity and launched a broadside against his entire profession (or at least that segment of it dedicated to health reporting), I've been thinking. Apparently, read meat causes cancer. No, processed meat like bacon causes cancer. OK, it's both read meat and processed meat. Wait, genetically modified grain causes cancer (well, not really). No, aspartame causes cancer. No, this food coloring or that one causes cancer.

Clearly, Joe Jackson was right! Everything gives you cancer!

That means you can avoid cancer by avoiding processed meats, red meat, GMO-associated food (no, probably not), aspartame, food colorings, or anything "unnatural." Or so it would seem from reading the popular literature and sometimes even the scientific literature. Of course, it's not so surprising that there would be a lot of noise out there on this topic. As I like to say to my medical students, life is a sexually transmitted fatal disease that eventually gets us all, but most of us would like to delay the inevitable as long as possible and remain as healthy as possible for as long as possible. One of the most obvious ways to do accomplish these twin aims is through diet. While the parameters of what constitutes a reasonably healthy diet have been known for decades, diet still ranks high on the risk of concerns regarding actions we take on a daily basis that can increase our risk of various diseases. Since cancer is disease (or, I should say, cancers are diseases) that many, if not most, people consider to be the scariest, naturally we worry about whether certain foods or food ingredients increase our risk of cancer.

Thus was born the field of nutritional epidemiology, a prolific field with thousands of publications annually. Seemingly, each and every one of these thousands of publications gets a news story associated with it, because the media love a good "food X causes cancer" or "food Y causes heart disease" story, particularly before the holidays. As a consequence, consumers are bombarded with what I like to call the latest health risk of the week, in which, in turn, various foods, food ingredients, or environmental "toxins" are blamed and exonerated for a panoply of health problems, ranging from the minor to the big three, cardiovascular disease, diabetes, and cancer. It's no wonder that consumers are confused, reacting either with serial alarm at each new "revelatory" study or with a shrug of the shoulders as each new alarm joins other alarms to produce a tinnitus-like background drone. Unfortunately, this cacophony of alarm also provides lots of ammunition to quacks, cranks, and crackpots to tout their many and varied diets that, they promise, will cut your risk of diseases like cancer and heart disease to near zero—but only if adhered to with monk-like determination and self-denial. (Yes, I'm talking about you, Dean Ornish, among others.)

All of this is why I really wanted to write about an article I saw popping up in the queue of articles published online ahead of print about a month ago. Somehow, other topics intervened, as did my vacation and then the holidays, and somehow I missed it last week, even though a link to the study sits in my folder named "Blog fodder." Fortunately, it just saw print this week in its final version, giving me an excuse to make up for my oversight. It's a study by one of my research heroes (despite his occasional misstep), John Ioannidis. It comes in the form of a study by Jonathan D. Schoenfeld and John Ioannidis in the American Journal of Clinical Nutrition entitled, brilliantly, Is everything we eat associated with cancer? A systematic cookbook review.

Now, when John Ioannidis says a "systematic cookbook review," he is being literal. He really means "a systematic cookbook review." Basically, he and Schoenfeld went through The Boston Cooking School Cookbook and tested whether various ingredients described and used in the recipes in the cookbook had been tested for an association with cancer and what was found. What I love about John Ioannidis is embodied in the methodology of this study:

We selected ingredients from random recipes included in The Boston Cooking-School Cook Book (28), available online at http://archive.org/details/bostoncookingsch00farmrich. A copy of the book was obtained in portable document format and viewed by using Skim version 1.3.17 (http://skim-app.sourceforge. net). The recipes (see Supplementary Table 1 under “Supplemental data” in the online issue) were selected at random by generating random numbers corresponding to cookbook page numbers using Microsoft Excel (Microsoft Corporation). The first recipe on each page selected was used; the page was passed over if there was no recipe. All unique ingredients within selected recipes were chosen for analysis. This process was repeated until 50 unique ingredients were selected.

We performed literature searches using PubMed (http://www. ncbi.nlm.nih.gov/pubmed/) for studies investigating the relation of the selected ingredients to cancer risk using the following search terms: “risk factors”[MeSH Terms] AND “cancer”[sb] AND the singular and/or plural forms of the selected ingredient restricted to the title or abstract. Titles and abstracts of retrieved articles were then reviewed to select the 10 most recently published cohort or case-control studies investigating the relation between the ingredients and cancer risk. Ingredient derivatives and components (eg, orange juice) and ingredients analyzed as part of a broader diet specifically mentioned as a component of that diet were considered. Whenever ,10 studies were retrieved for a given article, an attempt was made to obtain additional studies by searching for ingredient synonyms (eg, mutton for lamb, thymol for thyme), using articles explicitly referred to by the previously retrieved material, and broadening the original searches (searching simply by ingredient name AND “cancer”).

How can you not love this guy?

His results were also not that surprising. First, he noted that for 80% of the ingredients his methodology identified there was at least one study examining its cancer risk. That's forty ingredients, which he helpfully lists: veal, salt, pepper spice, flour, egg, bread, pork, butter, tomato, lemon, duck, onion, celery, carrot, parsley, mace, sherry, olive, mushroom, tripe, milk, cheese, coffee, bacon, sugar, lobster, potato, beef, lamb, mustard, nuts, wine, peas, corn, cinnamon, cayenne, orange, tea, rum, and raisin. He also notes that these ingredients represent many of the most common sources of vitamins and nutrients in a typical US diet. In contrast, the ten ingredients for which no study was identified tended to be less common: bay leaf, cloves, thyme, vanilla, hickory, molasses, almonds, baking soda, ginger, and terrapin. One wonders how almonds aren't considered under nuts, but that's just me being pedantic.

One also wonders whether "Dr." Robert O. Young, alkalinization quack extraordinaire, who claims that cancer is due to too much acid and that alkalinization is the answer, has heard about no studies for baking soda, which to him, along with a vegan-based diet that is allegedly "alkalinizing," is part of the "alkaline cure" for everything from cancer to sepsis to heart disease. Now, if you type "baking soda cancer" into the PubMed search box, you'll actually pull of over 350 articles. However, none of them appear to be epidemiological studies. This reminds me. I need to look into that literature and do a post about it again. But I digress.

Let's get back to the meat of the study itself. (Sorry, I couldn't resist.)

Having identified the studies and meta-analyses, Schoenfeld and Ioannidis next extracted the data from the studies, looked at the quality of the studies, the size and significance of the effects reported, how specific they were, and whether there were indications of bias in any of them. The results they found were all over the map, with about the same number of studies finding increased compared to decreased risks of malignancy, and, as before, Schoenfeld and Ioannidis provide a helpful list:

Author conclusions reported in the abstract and manuscript text and relevant effect estimates are summarized in Table 1. Thirty-nine percent of studies concluded that the studied ingredient conferred an increased risk of malignancy; 33% concluded that there was a decreased risk, 5% concluded that there was a borderline statistically significant effect, and 23% concluded that there was no evidence of a clearly increased or decreased risk. Thirty-six of the 40 ingredients for which at least one study was identified had at least one study concluding increased or decreased risk of malignancy: veal, salt, pepper spice, egg, bread, pork, butter, tomato, lemon, duck, onion, celery, carrot, parsley, mace, olive, mushroom, tripe, milk, cheese, coffee, bacon, sugar, lobster, potato, beef, lamb, mustard, nuts, wine, peas, corn, cayenne, orange, tea, and rum.

The statistical support of the effects was weak (0.001 # P , 0.05) or even nonnominally significant (P . 0.05) in 80% of the studies. It was also weak or nonnominally significant, even in 75% of the studies that claimed an increased risk and in 76% of the studies that claimed a decreased risk (Table 1).

To boil it all down, what we have here are a bunch of studies that report an association between a food or food ingredient and either increased or decreased risk of various cancers, but the vast majority of them have very weak effect sizes and/or nominal statistical significance. Next, Schoenfeld and Ioannidis looked at ingredients for which meta-analyses existed and found 36 relevant effect size estimates based on meta-analyses. Many of these meta-analyses combined studies using different exposure contrasts, such as highest quartile/lowest quartile versus another measure, such as the highest versus lowest consumption. Only 13 meta-analyses were done by combining data on the same exact contrast across all studies. As one would expect when one pools diverse studies, meta-analyses tended to find smaller effects than individual studies, as shown in the following table from the paper (click to embiggen):

As I said, these findings are all over the map. Now, if you really want to see how chaotic the literature examined by Schoenfeld and Ioannidis is, take a look at the effect sizes found for ingredients for which there have been more than ten studies:

As you can see, it's quite complex and all over the map, although there are a few ingredients for which the studies do appear to be fairly consistent, such as bacon being associated consistently with a higher risk of cancer. Bummer. Or is it? Let's continue with Schoenfeld and Ioannidis' analysis. What they found is rather disturbing. First, they report that although 80% of the studies they examined reported positive findings (i.e., a positive association between the food or ingredient studied and some form of cancer):

...the vast majority of these claims were based on weak statistical evidence. Many statistically insignificant “negative” and weak results were relegated to the full text rather than to the study abstract. Individual studies reported larger effect sizes than did the meta-analyses. There was no standardized, consistent selection of exposure contrasts for the reported risks. A minority of associations had more than weak support in meta-analyses, and summary effects in meta-analyses were consistent with a null average and relatively limited variance.

In other words, there are lots of studies out there that claim to find a link, either for increased risk or a protective effect, between this food or that ingredient and cancer, but very few of them actually provide convincing support for their hypothesis. Worse, there appear to be a lot of manuscript-writing shenanigans going on, with the abstract (which usually means, I note, the press release) touting a strong association while the true weakness of the association is buried in the fine print in the results or discussion sections of the paper. Given that most scientists tend not to read each and every word of a paper unless they're very interested in it or it's highly relevant to their research, this deceptive practice can leave a false impression that the reported association is stronger than it really is. Yes, I realize that we as scientists should probably be more careful, but a combination of time pressures and the enormous volume of literature out there make it difficult to do so. Moreover, as Schoenfeld and Ioannidis note in their discussion, although they didn't cover the entire nutritional epidemiology literature for all these ingredients (which would be virtually impossible), their search strategy was "representative of the studies that might be encountered by a researcher, physician, patient, or consumer embarking on a review of this literature." In other words, they tried to search the literature in a way that would bring up the most commonly cited recent studies.

The effect is likely to be even worse for the lay public, who get information filtered through press releases that tend to amplify the same problem (lack of proper caveats and discussion of how nominal or marginal the association actually is when examined critically). After all, university press offices are not generally known for their nuance, and reporters tend to want to cover stories they deem interesting. Marginal studies are less interesting than a study with a strong, robust result. So studies all too often tend to be presented as though they have a strong, robust result, even when they don't. This is facilitated by another problem observed by Ioannidis, namely the wide variety and inconsistency in definitions and exposure contrasts. This, argue Schoenfeld and Ioannidis, make it easier for reporting biases to creep into the literature.

There's also the issue of reporting bias, which could easily be more acute in nutritional epidemiology. The reason is that there is, understandably, a huge public interest in what sorts of foods might either be protective against or cause cancer. In an accompanying editorial, Michelle M. Bohan Brown, Andrew W Brown, and David B Allison, while noting that Schoenfeld and Ioannidis' work does indeed suggest that everything we eat is associated with cancer in some way, also note that their study reports evidence of publication bias:

They [Schoenfeld and Ioannidis] found that almost three-fourths of the articles they reviewed concluded that there was an increased or decreased risk of cancer attributed to various foods, with most evidence being at least nominally significant. It appears, then, that according to the published literature almost everything we eat is, in fact, associated with cancer. However, Schoenfeld and Ioannidis proceeded to show that biases exist in the nutrient-cancer literature. The fidelity of research findings between nutrients and cancer may have been compromised in several ways. They identified an overstating of weak results (most associations were only weakly supported), a lack of consistent comparisons (inconsistent definitions of exposure and outcomes), and possible suppression of null findings (a bimodal distribution of outcomes, with a noticeable lack of null findings).

Brown et al note that the sources of these sorts of biases have been well known for a long time and can lead to self-deception. The types of bias most responsible for positive findings appear to include what is known as "white hat bias" ("bias leading to distortion of research-based information in the service of what may be perceived as ‘righteous ends’”), confirmation bias (in which overstated results match preconceived views, so that the authors overstating the results don't adequately consider the weaknesses of their work), and, of course, publication bias. These biased results are then disseminated to the public through the lay media. As Brown et al note:

The implications of Schoenfeld and Ioannidis’ analysis may be important for nutritional epidemiology even more broadly. Numerous food ingredients are thought to have medicinal properties that are not sufficiently supported by current knowledge—for example, coffee “curing” diabetes (11). These distortions can also be used to demonize foods, as shown by the longstanding presumption that dietary cholesterol in eggs contributes to heart disease (12). Causative relations between various foods and diseases likely do exist, but the evidence for many relations is weak, although conclusions about these relations are stated with the certainty one would expect only from the most strongly supported evidence.

Indeed. Another implication, not noted by either Schoenfeld and Ioannidis or Brown et al, is that weak research findings suggesting a link between this food or that food and cancer, not only lead to the inappropriate demonization of some foods but to quackery. Anyone who has been a regular reader of this blog or who has followed the "alternative medicine" online underground will immediately note that quacks frequently tout various "superfoods" or supplements chock full of various food ingredients believed to have protective effects against various diseases as the cure for what ails you, be it cancer, heart disease, diabetes, or whatever. Publishing studies with weak associations tarted up to look stronger than they really are only provides fuel for these quacks. Indeed, there is one site run by a Sayer Ji that devotes much of its news section to publishing stories and abstracts describing such studies. I'm referring to GreenMedInfo, which routinely publishes posts with titles like Avocado: The Fat So Good It Makes Hamburger Less Bad; Black Seed - 'The Remedy For Everything But Death'; and 5 Food-Medicines That Could Quite Possibly Save Your Life. And that's just one example. Mike Adams, for instance, does the same sort of thing, just yesterday posting articles claiming that various foods can "lower blood pressure fast" and that the "Paleo diet" combined with vitamin D and avoiding food additives can reverse multiple sclerosis. Not surprisingly, the same sorts of hyperbole can regularly be found on The Huffington Post, and touted by supplement sellers. Even mainstream media outlets like MSNBC get into the act.

Of course, in all fairness, in science, most studies should just be published and let the chips fall where they may. It's unfair to blame the authors of nutritional epidemiology studies for how their studies are used and abused. It is not unfair to blame them if they use poor methodology or the strength and significance of their findings in the abstract and hide their weakness by burying it deep in the verbiage of the results or discussion sections. If Schoenfeld and Ioannidis are correct, this happens all too often. Obviously, their sample is a fairly small slice of the nutritional epidemiological literature and as such might not be representative, but given the methods used to choose the studies examined I doubt that if Schoenfeld and Ioannidis had gone up to 100 foods they would have found anything much different.

Unfortunately, in almost the mirror image to the nutrition alarmists, one also sees a disturbing temptation on the part of those who represent themselves as scientific to go too far in the other direction and point to Schoenfeld and Ioannidis' study as a convenient excuse to summarily dismiss nutritional epidemiological findings linking various foods or types of foods with cancer or other disease. For example, the American Council on Science and Health (ACSH) did just that in response to this study, gloating that it proves that its dismissal of food health scares are insignificant. Well, actually, many scares are insignificant, but surely not all of them are. The ACSH also almost goes into conspiracy theories when it further claims that the mainstream media except for a couple of UK newspapers, such as The Guardian, ignored the study. Although arguably this particular study didn't get huge coverage, it's going a bit far to claim that the mainstream media ignored it. It didn't; the study was featured on Boing-Boing, The Washington Post, Reason, Cancer Research UK, and others. Of course, one can't help but note that the ACSH is the same organization that has referred to advocating organic foods as "elitist", likes to disparagingly refer to questions about links between environment and cancer as "chemophobia," and been very quick to dismiss the possibilities that various chemicals might be linked to cancer, as so famously parodied on The Daily Show. a few years ago. We must resist the temptation to go too far in the opposite direction and reflexively dismiss even the possibility of such risks as the ACSH is wont to do, most famously with pesticides and other chemicals.

Indeed, as was pointed out at Cancer Research UK, the real issue is that individual studies taken in isolation can be profoundly misleading. There's so much noise and so many confounders to account for that any single study can easily miss the mark, either overestimating or underestimating associations. Given publication bias and the tendency to believe that some foods or environmental factors must cause cancer, it's not too surprising that studies tend to overestimate effect sizes more often then they underestimate them. Looking through all the noise and trying to find the true signals, there are at least a few foods that are reliably linked to cancer. For instance, alcohol consumption is positively linked with several cancers, including pancreatic, esophageal, and head and neck cancers, among others. There's evidence that eating lots of fruit and vegetables compared to meat can have protective effects against colorectal cancer and others, although the links are not strong, and processed meats like bacon have been linked to various cancers, although, again, the elevated risk is not huge. When you boil it all down, it's probably far less important what individual foods one eats than that one eats a varied diet that is relatively low in red meat and high in vegetables and fruits and that one is not obese.

So what can be done? It would be a good thing indeed if the sorts of observations that Ioannidis has made lead to reform. Between Schoenfeld and Ioannidis' study and the accompanying editorial several remedies have been proposed that are not unlike steps that have been imposed on clinical trials of therapies and drugs: increased use and improvement of clinical trial and observational study registries; making raw data publicly available; making supporting documentation such as protocols, consent forms, and analytic plans publicly available; and mandating the publication of results from human (or animal) research supported by taxpayer funds. I must admit that the last of these is already a requirement, as is registration of all taxpayer-supported clinical trials at ClinicalTrials.gov, but the other proposals could also help.

Finally, I'll finish with a quote from the editorial by Brown et al:

As Schoenfeld and Ioannidis (6) highlighted, comprehensive approaches to improve reporting of nutrient-disease outcomes could go a long way toward decreasing repeated sensational reports of the effects of foods on health. However, none of these debiasing solutions address the fundamental human need to perceive control over feared events. Although scientists may have ulterior motives for looking for nutrient-disease associations, the public is always the final audience. It is therefore imperative that we spend less time repeating weak correlations and invest the resources to vigorously investigate nutrient-cancer and other disease associations with stronger methodology, so that we give the public lightning rods instead of sending them up the bell tower.

That last remark refers to Ben Franklin's lightning rod and how churches used to think that ringing bells would protect against lightning strikes when in fact ringing bells only put the bell ringers in danger from lightning, which often struck bell towers because bell towers were usually the highest buildings in most towns. It's a metaphor that fits, because the superstition about lightning before the lightning rod could divert devastating lightning strikes from bell towers is not unlike the irrational beliefs about food-cancer links that all too often predominate even today. The answer is more rigorous science and less hype over preclinical results that haven't yet been translated to humans yet and preliminary results in humans.

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-btw- I like "Stepping Out" better..

I might sum up the views of those I survey more succinctly as -' Modernity causes cancer'- with the vegan proviso of: 'as do any animal products'.

Amongst the Paleos and natural food-faddists,: modern food products are depleted of nutrients, contaminated with additives and - horror of horrors- perverted away from their original state by GM. Processing and modern methods destroy meat and dairy as well, making them toxic and carcinogenic

They believe in primaeval purity: our ancestors lived long, healthy lives unaffected by chronic illness and cancer because they lived off the bounty of the earth ( edit to : vegetarian bounty, for vegans). Thus the natural life force, respendently flowing throughout all creation, in its healing, natural efficacy , took care of any ills.

The vegans even more, look to phytonutrients inherent in the 'rainbow' of fruits and vegetables which prevent cancer
as their magical elixir- which -btw- can be extracted and sold as supplements.

Tampering with Nature causes cancer.

By Denice Walter (not verified) on 11 Jan 2013 #permalink

The amount of foods which are bad for you is directly proportional to the amount of quacks who want to see their names in the Daily Mail (over here, if the DM prints an article about health it's usually safe to assume it's horseshit).

@ Peebs:

Can that be expressed in an equation ?

By Denice Walter (not verified) on 11 Jan 2013 #permalink

Denice Walter - That is a straw man argument there. The claim is not that nobody ever got sick in the past - of course they did, a lot - but that people suffered less chronic disease when they were not eating a Western processed-food diet. That seems to be very well demonstrated by studies of modern populations. Likewise, it is a fact that modern diets do have reduced content of some nutrients and beneficial substances, not just "amongst" people whom you are calling names [that's called an ad hominem argument, by the way], but as they sit on the store shelves. As for meat, there is reason to suspect that factory-farmed grain-fed processed red meat increases cancer and heart disease risks more than did the wild grass-fed red meat that most of our ancestors ate. Everyone is free to do with this information what they will, including totally ignoring it and eating what they have been taught to find tastiest.

@jane

As for meat, there is reason to suspect that factory-farmed grain-fed processed red meat increases cancer and heart disease risks more than did the wild grass-fed red meat that most of our ancestors ate.

Citation needed. Show me the evidence that suggests that eating, say, modern cured sausage has a greater risk for cancer or heart disease than wild, grass-fed, traditionally cured sausage, just as an example.

there is reason to suspect that factory-farmed grain-fed processed red meat increases cancer and heart disease risks more than did the wild grass-fed red meat that most of our ancestors ate

Citations, please.

@Jane
Care to cite your caveman chronic disease data?

-=b

By baravelli (not verified) on 11 Jan 2013 #permalink

Denice,
I've never been asked that one before.

I just refer to it as my Third Law and have done for years.

Unfortunately the passage of time has made me forget my Second Law so technically I should really promote it.

if the DM prints an article about health it’s usually safe to assume it’s horseshit

Time for the obligatory reference to Ben Goldacre --
"[T]he Daily Mail does have an ongoing ontological program to divide all inanimate objects into ones that will either cause or cure cancer."

By herr doktor bimler (not verified) on 11 Jan 2013 #permalink

I found this in regard to the Daily Fail:
"The Daily Mail (who, Ben Goldacre points out, have "an ongoing project to divide all the inanimate objects in the world into ones that either cause or prevent cancer"..."

By Old Rockin' Dave (not verified) on 11 Jan 2013 #permalink

Well, I suppose he's correct it he's talking about chronic diseases assocaited with aging--not much cause to worry about Parkinsons, Alzheimers, Type II diabetes if you expect to die in your late 20's/early 30's.

I found this in regard to the Daily Fail:
I will demand credit for priority as soon as my comment comes out of moderation.

By herr doktor bimler (not verified) on 11 Jan 2013 #permalink

but that people suffered less chronic disease when they were not eating a Western processed-food diet

When one dies before chronic disease can take hold, one will indeed not suffer from it. Most sane people would prefer the increased rate of chronic disease.

Don't aflotoxins cause hepatomas? And certainly a number of natural viruses cause cancer (HPV, hepatitis B, EBV, etc). Not to mention the fact that the very reason yew bark and periwinkles are useful in treating cancer is because they contain potentially carcinogenic compounds that can also be used to treat cancer, in the right situation. There is nothing about being "natural" that makes something safe.

@ jane:

And who said that "nobody got sick"...
I am -btw- referring to specific alt media mavens ( e.g. Gary Null) who promote the idea that our ancestors lived long, healthy lives free of chronic illness and cancer- they died by accident and in wars( curiously, no mention of VPDs). If we were to avoid the adulterated food products of decadent modernity, we too could live to ages of 140 ( more recently, I'vee heard 150).

By Denice Walter (not verified) on 11 Jan 2013 #permalink

correction: I'VE

By Denice Walter (not verified) on 11 Jan 2013 #permalink

@ Peebs:

There has got to be a way that we can express your 3rd ( or is it your 2nd) law.
I'm hearing something like... the Number of bad foods ( BF) is a function of the Number of Quacks( Q) ...yadda yadda... Daily Mail ( DM).
SOMEONE here will run with that, I suspect.

By Denice Walter (not verified) on 11 Jan 2013 #permalink

I sincerely hope so Denice, then I could quote it and sound so much cleverer than I really am.

I thought of my three little rules in around '85/86. The first is also a 'Directly Proportional' one.

The amount of 'Helpers' surrounding a casualty at a major disaster is always directly proportional to the amount of television cameras filming it.

As I say, Number 2 is long lost in the mists of time so perhaps 3 should become 1.

"The claim is not that nobody ever got sick in the past – of course they did, a lot – but that people suffered less chronic disease when they were not eating a Western processed-food die"

As everyone has pointed out, that needs a citation.

Furthermore, has it ever occurred to you that, possibly, we didn't LIVE long enough to develop chronic illnesses - you know, illnesses which typically arise with AGE?

1. Meta studies studying the whole group are likely to not pickup even devastating effects on minorities without prior or outside knowledge. F'instance, would these studies, by themselves (no, not you CDC), pick up adverse events on celiacs or hemophiliacs? Even a complete die-off might be within the range of uncertainty for the study.

2. In western Europe and Japan, our population scale food experiments are viewed with caution.

3. Labels do have a point. It is clear that in the US that the food industry has been evading sharing content information that is desired by many customers, for a long, long time.

Margarine with large amounts of transfats is now considered unhealthy. Only a relatively few years ago, those in the vanguard of awareness, educated consumers and the minority food scientists themselves, were castigated as weirdos etc, denounced by "right thinking people" including some prominent skeptic organizations, for making a "silly" stink.

I would rather have a scannable label that takes me to a webpage with more detailed information including notable biological varietal information, QA test ranges on shipping product, fat profiles and notable additives that are commonly questioned, whether deemed reasonable or not.

4. Diverse people and groups criticize food. Certainly some of the natural food crowd doesn't like industrially manufactured supplements. And yes there have been humongous management failures with GMO manufactured products, like the tryptophan meltdown.

5. The FDA has been shown many times to be a highly politicized organization that plays favorites.

Accurate labels allow individuals to decide for themselves and their own circumstances what they shell out their hard earned money for without intermediaries imposing collective/centralized decisions on them.

I can decide for myself whether I have bacon on some mornings. If so I would like to have the option of knowing how much nitrate/nitrite is in it, perhaps with fat and trace mineral/metal profiles available from better brands.

Darwy, you beat me to it. Our ancestors lived much shorter lives than we currently enjoy. I think folks have this idea that the human body is made to live 100 or so years and it is up to us to take care of it, but in fact, the body is made to live half to 3/4 that and we prolong it with nutrition and medicine. I can't cite that, but I'm sure one of you can.

@ Darwy:

Aha! You betray your education by the establishment.
Me too.

But seriously, woo-meisters indict 'unnatural' foods, toxins, pollutants and pharmaceuticals ( especially vaccines) as causing all manner of illness**. What is produced by science is obviously inferior to whatever Nature intended.

Natural health advocates possibly believe that somehow illness doesn't develop naturally- from within- but is foisted upon a healthy organism by intrusions from without- de-natured food, toxins, contaminants, poisons, meds.

It reminds me a bit of primitive beliefs that death is caused by witchcraft- a person doesn't just die, an external force has to be involved somehow.

Cancer, ASDs, hiv/aids and SMI are therefore products of corporate malfeasance, not the result of genetics and enviromental conditions... they wouldn't have occured without external interference. Or so they tell us.

Attributing bad outcomes to external causes is a way of raising self-esteem as attributing successful endeavors to internal ( personal) abilities and actions does as well.

** let me qualify that: I'm not saying that there is no harm in these products BUT we can't attribute most problems to them as alt med does.

By Denice Walter (not verified) on 11 Jan 2013 #permalink

prn,

Margarine with large amounts of transfats is now considered unhealthy. Only a relatively few years ago, those in the vanguard of awareness, educated consumers and the minority food scientists themselves, were castigated as weirdos etc, denounced by “right thinking people” including some prominent skeptic organizations, for making a “silly” stink.

Citation, please, on the people on the vanguard of awareness who made a stink about margarine.

Diverse people and groups criticize food.

True. This neither makes them right nor wrong, nor justified in their view (regardless of whether it's right or wrong).

By Mephistopheles… (not verified) on 11 Jan 2013 #permalink

@herr doktor bimler:
You can have the credit. I'll take the cash.

By Old Rockin' Dave (not verified) on 11 Jan 2013 #permalink

The Daily Fail? Ah, you mean The Forger's Gazette?

By Phoenix Woman (not verified) on 11 Jan 2013 #permalink

I think this approach to nutrition an cancer is destined to fail in the long term. Making math correlations are not going to give us a correct picture of the problem due the quantum nature of the biology. Is like physics trying to understand the world prior to the quantum mechanics revolution.

Yes, you can make a mathematical figure that works, but will be wrong in essence.

These cancer studies without a genetic map of the people and other parameters are pointless.

From prn

And yes there have been humongous management failures with GMO manufactured products, like the tryptophan meltdown.

Wait, what?
I have no idea what you are talking about.
Citation, please.

Actually, never mind. Google is my friend. I found this article.
So, this is a claim from Jeffrey Smith about his bête noire, GMOs? All I need to know, until shown more supportive evidence. Funny how the number of deaths goes from 36 to 100, from one web page to the next.

Funny also how an issue related to the supplement market - which is very alt-med oriented - has been laid down at the feet of Big Pharma. Reminds me of two parents arguing about "your" son.

By Heliantus (not verified) on 11 Jan 2013 #permalink

A few people have mentioned the UK's Daily (Hate) Mail newspaper's seemingly endless campaign to divide everything in the world into two not necessarily distinct groups - those that cause and those that cure cancer. Well, here's the link:

The (New) Daily Mail Oncological Ontology Project

http://dailymailoncology.tumblr.com/

By Rich Scopie (not verified) on 12 Jan 2013 #permalink

...and FWIW, I've now nabbed a copy of that cookbook in .pdf and Kindle format.

WIN!

Also in regards to the chronic illness canard: another reason why more people seem to have chronic illnesses now is that many of them can be maintained for years with effective medical treatment. In the Goode Olde Days, heart failure, kidney failure, chronic bronchitis and other such diseases would be lethal in a short time, from effects of the illness or complications such as pneumonia or septicemia. These conditions may not be curable, but they can now be treated effectively for many years.
So, yes, back then, chronic illnesses weren't such a problem - after all, dead people don't complain.

Oh my! They're at it again.

Today Dan Olmsted ( AoA) takes on " Suicide, Mayhem and the Rx Effect":
after pointing to a recent string of "excellent articles" ( AJW, Hyla Cass, Teresa Conrick, Adriana Gamondes ) which have appeared at his blog, he calls for a "robust discussion" about meds and violence.

"The failure to ask, let alone answer, these questions is endemic to the drug-sponsored media and medical culture we're living in".

Obviously he looks to alt media to instruct us all about the dangers of pharmaceuticals for mental illness.

( continued)

By Denice Walter (not verified) on 12 Jan 2013 #permalink

Anti-vaccinationists attribute many ills, including ASDs, to vaccines- and seem to me- already primed to accept one of anti-psychiatry's greatest tropes: meds prescribed for mental illness CAUSE mental illness. Sites like PRN and Natural News have always been purveyors of this message:
many articles, books, videos and films are readily accessible at those sites ( or available for a fee).

Here are a few considerations for any who would go along:

Doesn't that timeline seem a bit wonky?
Do the effects of meds reach back in time to cause the symptoms that lead the patient's family to seek help from a doctor? Can we suppose that those who are given powerful meds are really 'alright' to begin with? OR, did they have a REASON to seek out medical assistance or were they forced to by school systems or had to see a physician because they got into trouble with the law?

Some alt med advocates would have you believe that powerful, psychotropic drugs are just handed out nearly randomly to youngsters who have minuscule problems: they're slightly nervous, sad or shy; they don't pay attention in class or occasionally argue with adults. Gary Null calls this "pathologising everyday life". In other words, these kids have no real problems that the attention of a caring parent or teacher couldn't fix. Or else they eat junk food. Or lack niacin.

Don't you think that those solutions have already been tried? And even studied?

Some alt med advocates deny that mental illness ever existed prior to the introduction of meds- which sounds curiously similar to Olmsted's "autism didn't exist prior to mercury poisoning/ an increased vaccine schedule" and whatever new factors pop up in his fevered imagination next.

And in line with my comments yesterday: they believe that ASDs and mental illness come from WITHOUT- not that they are facts of internal physiology, development, biochemistry and genetics although shaped by the physical and social environment over time.

A certain percentage of people will have mental illness, SMI, developmental disorders and ASDs. In the old days, we did not see those most seriously affected because they were in institutions. Often meds are a last-ditch effort to keep people with serious problems OUT of institutions- which exist in diminshed numbers even today.

I would venture that many of the children with ASDs whose parents need intensely care for them ( and write of their many difficulties @ AoA or TMR) and many youngster with SMI who get into trouble today would have been in institutions if they lived in previous eras.

Web woo-meisters will never mention that, I do. They would have you believe that institutions of the past were primarily populated by people who were unfairly imprisoned there and who were perfectly alright; in short, they deny the reality of mental illness.

By Denice Walter (not verified) on 12 Jan 2013 #permalink

after pointing to a recent string of “excellent articles” ( AJW, Hyla Cass, Teresa Conrick, Adriana Gamondes )

At $450 an hour, one would think Cass might be able to afford a decent Web designer. She does, however, trump Oz's wearing scrubs by showing up for a TV food segment in not just a lab coat but also with a stethoscope around her neck. You're a psychiatrist, Hyla. Just finish the job and put on a head mirror.

Orac wrote:

a varied diet that is relatively low in red meat

I've been told one should eat this lots of times, but I don't recall ever being told low relative to what. Low compared to the avg American diet? To the Eskimo one? To Gary Null's?

By Andreas Johansson (not verified) on 12 Jan 2013 #permalink

Obviously he looks to alt media to instruct us all about the dangers of pharmaceuticals for mental illness.

Didn't I hear the guy from the NRA also screeming about the dangers of pharmaceuticals for mental illness?
Screeming it, doesn't make it true.

Citation, please, on the people on the vanguard of awareness who made a stink about margarine.

Eh, Udo Erasmus was on correctly* about trans-fats a quarter-century ago. I don't know that I would call that "a relatively few years ago." Then again, he also went whole hog for Johanna Budwig.

* A negative review from Sally Fallon invoking the hempseed-oil defense is always a good sign, but I haven't read the book she's writing about.

@ Andreas Johansson:

Hah! Seriously. One of our regular commenters recently quipped about 'red meat' being Coho salmon.

I would expect that, based on your location, you might be eating salmon frequently. I had rainbow trout yesterday and often buy salmon- one of the few things I know how to cook properly.

I am acquainted with a gentleman who is always carrying on about and searching for a particular type of "Norwegian salmon" which costs real money.

Red meat like that I'll try.

By Denice Walter (not verified) on 12 Jan 2013 #permalink

@ Renate:

Another guy shrieking about this is Alex Jones - for whom Mike Adams of Natural News often substitutes on the former's internet radio show.
May the circle be un-broken.

By Denice Walter (not verified) on 12 Jan 2013 #permalink

@ Denice Walter,
I heard the NRA guy on Dutch television and I was a bit flabbergasted. I can imagine he doesn't like firmer weapons-regulations, but screeming doesn't win an argument and blaming medications for psychiatric patients for what happened in Newtown, isn't a way to win an argument either.

Well off-topic, but unsettling given it's BMJ.

Never minding the article itself for a moment, look at this rash of correspondence to BMJ in response to a News piece (which is unfortunately not open-access):

18th Dec: Viera Scheibner (who fails to declare her anti

17th Dec: Hilary Butler (who leaves out that she is the founder of the NZ anti-vaccine group, IAS)

17th Dec: Suzanne Humphries

16th Dec: Viera Scheibner

And so on. (The first response is from John Stone.)

I can't help noting, too, that all those with clear anti-vaccine interests (running anti-vaccine organisations, etc) fail to declare that they have competing interests.

Opps, that went out in an unfinished state. Mentally delete the portions starting in '(who' ! ;-)

Sorry - trying to dash this off in a spare moment of time.

I for one would like a clear definition of what counts as "genetically modified". For example, the wild relatives of wheat drop their seeds as soon as they ripen, while domesticated wheat holds them tightly and has to be threshed. That's a genetic modification, it's been mapped on the wheat genome, and the evidence is that it was fixed in just a couple dozen wheat generations, pretty much as soon as people began carrying the seeds off to storage rather than eating them in the field like good paleos did. So if I'm on a paleo diet, can I eat domesticated wheat?

(which is unfortunately not open-access)

Given that the seven-day "free trial" appears to have been implemented by Patrick McGoohan on a bad day, I'm thinking it's a wash. (Logged in: yes. Works: no.)

From Peeping Times:

"What foods cause cancer?"

"They all do ... and we're having second thoughts about oxygen."

By Joseph Hertzlinger (not verified) on 12 Jan 2013 #permalink

@ Grant:

I notice that too. Martin Hewitt also manages an appearance.
If your so-called writing appears at both whale.to and Age of Autism, you HAVE a competing interest.

By Denice Walter (not verified) on 13 Jan 2013 #permalink

In other news:

@ Age of Autism, Katie Wright attempts to write comedy: her results are laughable - but not for the reason she imagines-
she believes that SB experts, like Dr Offit, would not call the current flu "an epidemic" because they did not call ASDs an epidemic.
Hint: they didn't call ASDs an epidemic because they're not an epidemic.

MIke Adams @ Natural News reports un-expected suicides/ deaths by truth- tellers and other rebels- who- like him- dared to reveal the NWO's motives and agenda. He informs us that he is not suicidal and he does not participate in dangerous sports so if he shows up dead, you'll know who done him in.

TMR celebrates a year of providing bad science, mis-information, self-aggrandisement and hand-wringing.

I've been following them from the start and oddly, it seems like much more than a year.

By Denice Walter (not verified) on 13 Jan 2013 #permalink

The point Mikey was making by declaring his mental health was if he tunrs up dead, seemingly by suicide, we'll all know he was really murdered.

He was writing about that 26-year-old Internet freedom fighter (Swartz?) who killed himself a few days ago. Mikey contends the government had him "suicided" because he was becoming a problem.

I guess Mikey flatters himself by thinking he too might be a target to be silenced by the government.

By Marc Stephens … (not verified) on 13 Jan 2013 #permalink

Sorry Denice; I basically repeated what you said. I didn't see the reference to the "truth tellers" like Swartz until after I posted.

By Marc Stephens … (not verified) on 13 Jan 2013 #permalink

@Marc Stephens Is Insane, you have taught me something - Marc Stephens and Mikey are insane!

@Ken

So if I’m on a paleo diet, can I eat domesticated wheat?

With any fad diet it is a safe bet to assume that wheat is verboten.

By Militant Agnostic (not verified) on 13 Jan 2013 #permalink

MIke Adams @ Natural News reports un-expected suicides/ deaths by truth- tellers and other rebels- who- like him- dared to reveal the NWO’s motives and agenda.

I recommend ignoring the attempts of rancid scum-sucking low-lifes to use Swartz's death for their own agenda (and to promote themselves as Swartz's equals), and focus instead on the tributes and eulogies from his family and friends.
http://boingboing.net/2013/01/12/aaron-swartzs-memorial-servi.html

By herr doktor bimler (not verified) on 13 Jan 2013 #permalink

@ herr doktor bimler:

MIke Adams has made a habit of using unfortunate deaths from any cause- cancer, mass shootings, suicides- that he can relate, either by far association or via self-aggrandisement, to further is own agenda or stoke his self-praise engine.

I thought that the Steve Jobs examples were low but this time he has certainly outdone himself.

It should be noted that Mike must now be hoping and praying that his cohort Alex Jone's recent antics with Piers Morgan will bring mass media attention to him as well.

I certainly hope so.

By Denice Walter (not verified) on 13 Jan 2013 #permalink

ALEX JONES'

By Denice Walter (not verified) on 13 Jan 2013 #permalink

Anj:Heads up on potential quackery:

http://sponauglewellnessinstitute.com/tag/dr-rick-sponaugle/

Sponaugle doesn’t seem to do anything blatantly woo, but he does appear to lean that way.

@Anj, Dr. Sponaugle is using IV hydrogen peroxide to treat Lyme and other tick-borne infections. He claims to use a proprietary intravenous mold toxicity treatment therapy, and as well as other intravenous treatments to block Herxheimer reactions from happening. A Herxheimer reaction is a potentially fatal reaction. I could be wrong, but it sounds like quackery if he claims to be able to block certain 'Herxheimer-causing brain chemicals' from activating, as he describes.

Dr. Sponaugle claims to treat shingles with IV hydrogen peroxide and vitamin C. Hydrogen peroxide is natural, so he says it safe to infuse it. The American Association of Quantum Medicine's embryological wisdom and advanced inner therapy treatment also sounds rather questionable to me. Do you not consider any of the that as woo? I highlighted a few things from his website for you.

http://www.youtube.com/watch?v=CYL-agSO3MU

http://sponauglewellnessinstitute.com/wellness-programs/lyme-disease-ly…

Dr Sponaugle will, as stated above, perform an extensive analysis of your gastrointestinal function because your gut provides 70 percent of your immune system. Through the utility of intravenous toxin removal and intravenous nutritional therapy, Dr Sponaugle will enhance your immune system’s natural ability to kill the Lyme spirochete and other tick borne infections.

After your initial consultation, Dr Sponaugle will determine exactly what must be done to optimize your immune system’s kill power and in what stages, staging is extremely important in producing successful kill of the Lyme spirochete and other tick borne infections. Dr Sponaugle will design an individual treatment plan including the use of various herbals to optimize immune function, and the precise time at which we can begin your intravenous “Lyme kill” treatment.

Dr Hooper, medical director of Real Time Mold Toxin lab in Dallas, Dr Sponaugle is 30 to 1, the top mold toxicity doctor in all of North America. Furthermore, Dr Hooper’s data analysis has demonstrated that Dr Sponaugle’s proprietary “intravenous mold toxicity therapy” removes more mold toxins in two weeks than any other center can remove in three months. Dr Sponaugle has spent years designing the proprietary blend of his intravenous toxin removal therapy.

Dr Sponaugle has measured the surge of “electrifying” brain chemicals that occurs during the Herxheimer reaction in hundreds of Lyme patients. Excessive toxin surge during an effective Lyme kill produces a surge of excitatory neurotransmitters that subsequently cause a surge of electrical current throughout your brain and body.

Using his brain chemistry expertise, Dr Sponaugle has designed a protocol to block these specific brain chemicals from activating receptors on the brain and peripheral nervous system. This greatly ameliorates the suffering Lyme patients typically experience as the Herxheimer reaction.

Shingles:http://sponauglewellnessinstitute.com/shingles/

The Sponaugle protocol for treating Shingles is to up regulate our patient’s immune kill power by removing toxins that shut down the immune system and the implementation of herbal medicines that stimulate natural killer cell production. In addition, we use intravenous Vitamin C and or Hydrogen Peroxide for a more direct viral kill. Our natural killer cells release Hydrogen Peroxide when they attack bacteria, viruses and cancer cells.

http://www.aaqm.org/?page_id=79

He is also citing the American Association of Quantum Medicine in Las Vegas, Nevada. They use embryological wisdom and advanced inner therapies, and cite the Townsend Letter for their sources. They are offering classes like the one described below:

come to learn viscus palpation and clinical neuromuscular assessment techniques based on embryological wisdom and other inner physician advanced therapies. Many have expressed the need to be more precise in differentiating organ damage in different clinical conditions and even requested being personally assessed as part and parcel of the live clinical demonstrations. Plus, we have some practitioners in need of board certification or who want to renew their annual board certification, which requires live attendance at this one seminar annually.

It's a shame he is attracting clients by advertising as a rapid drug detox center. I think the safest and most effective way off those substances is a slow, controlled taper, combined with counseling and lifestyle changes, not rapid detox with IV hydrogen peroxide and who knows what else. Thumbs down for his clinic!

Fortune cookie please...

By Marc Stephens … (not verified) on 13 Jan 2013 #permalink

Wait, Orac! you forgot the most deadly substance of all, and it's in ALL OF OUR FOODS!
Dire Danger Warnings ! Shout it from the Rooftops!
I'm talking about a dangerous industrial solvent, cleaning fluid, corrosive and poisonous to the extent that brief immersion in it can kill. Why hasn't anyone warned the public about the dangers of Dihydrogen monoxide ? This stuff kills hundreds, possibly even thousands of people annually, and there's hardly ever a news story about it!

other intravenous treatments to block Herxheimer reactions from happening. A Herxheimer reaction is a potentially fatal reaction

Perhaps it is in the real world... but in the self-referencing circles of snake-oil salesmen, "Herxheimer reaction" is a shorthand way of telling the customer "The medicine makes you feel half-dead? That proves it's working! It's not the medicine, it's the toxins being forced out of your body!"

The MMS crowd talk about Herxheimer reactions a lot to explain the vomiting and diarrhea consequent to drinking bleach and bathing in it and enematising it and injecting it.

Sponaugle has seen the success of the MMS merchants in separating fools from their money and decided he can do the same, replacing 'bleach' with 'hydrogen peroxide'.

The popularity of the term is proof (as if any more were required) that Alt-Med marketers are not only grifters, but *lazy* grifters, who can't be bothered dreaming up their own bullsh1t from scratch but simply read what other grifters are doing and recycle it under their own name.

By herr doktor bimler (not verified) on 14 Jan 2013 #permalink

Perhaps it is in the real world… but in the self-referencing circles of snake-oil salesmen, “Herxheimer reaction” is a shorthand way of telling the customer “The medicine makes you feel half-dead? That proves it’s working! It’s not the medicine, it’s the toxins being forced out of your body!”

On a Google seaarch, I get first a reference to a Wikipedia page, which seems to provide some real information.
After that one I get at least 3 links to snake-oil salesmen, like:
http://biovedawellness.com/2010/02/the-herxheimer-reaction-feeling-wors…
http://www.healingnaturallybybee.com/articles/heal2.php
and
http://www.healingnaturallybybee.com/articles/heal2.php
After that one, I think the next ones seems to be more in line with reality.

hdb,

I have to admit I have wondered over the years just how many of the marketers are peddling these things in an entirely cynical manner - i.e. that they know perfectly well their products are nonsense.

(As opposed to the 'practitioners', who perhaps/likely for the most part believe in what they are doing.)

@Grant

I think that over time they may even come to believe their own bull$h1t over time.

By Militant Agnostic (not verified) on 14 Jan 2013 #permalink

"This just in: human saliva has be proven to cause cancer. But only if swallowed in small quantities over a very long period of time..."

(God, I miss Carlin.)

On a Google seaarch, I get first a reference to a Wikipedia page, which seems to provide some real information.

Googling for "Herx" leads you quickly into the Lyme-Disease / Morgellons magical-thinking morass. In the abbreviated form, it has become a shibboleth of true-believer membership -- a 'Credo quia absurdum' expression of faith. You mention your Herx experiences to prove to other Chronic-Lyme believers that you are One of Them, and not a reality-based skeptic.

By herr doktor bimler (not verified) on 14 Jan 2013 #permalink

"Herx Morgellons" -- 38,500 Google hits.
"Herx Lyme" -- 211,000 Ghits.
"Herx MMS" --180,000 Ghits.
"Herx silver" -- 39,100 Ghits.

By herr doktor bimler (not verified) on 14 Jan 2013 #permalink

After that one, I think the next ones seems to be more in line with reality.
Is this in line with reality?

Evidently just another quack:
Dr Marra provides care and consulting for lyme disease, chronic fatigue, fibromyalgia and other tick borne diseases in Seattle

By herr doktor bimler (not verified) on 14 Jan 2013 #permalink

Allegedly, ~100 of the ~120 complaints about Lymerix, the allegedly failed vaccine for Lyme disease, were submitted by the same two providers. The statement begins at @43:47, but specifically @44:35 - 44:60 in the video at: http://onpoint.wbur.org/2012/07/03/tracking-lyme-disease

Here's the FDA docket's page on the vaccine. The same ND or her daughter/sister is listed on the last line. Is the information to confirm that statement about the 100 complaints listed online somewhere?

http://www.fda.gov/ohrms/dockets/ac/01/slides/3680s2.htm

One last Google experiment --
"Herx + chelation" -- 67,200 hits.
"herx + herbalism" -- 33,700 Ghits.
"herx + naturopathy" -- 117,000 Ghits.

By herr doktor bimler (not verified) on 14 Jan 2013 #permalink

Is this in line with reality? Endotoxins and cytokines cause friable tissues on impaired detox pathways, so you should use Alka Seltzer Gold and warm lemon water to treat.

http://www.drsusanmarra.com/services/herxheimer-reaction-herx

No, I don't think so. Perhaps the list you got was a bit different. That link wasn't at the first page I got.
This one was:
http://www.preventionandhealing.com/articles/Healing-Crisis-by-Herxheim…
I don't think that one is in line with reality. I didn't look at all the links. I'm pretty sure there is a lot of rubbish, as there is always.

General advice: Never say "google X and follow the Nth link", because you are not in the same bubble as the person next to you.

@ Martin
I know that. That's why I provided some bs links.