Wednesday, June 25, 2008

Petition the NIH to Weigh All Scientific Evidence

A recent comment from Lauri Cagnassola asked for support on a petition to the National Institutes of Health (NIH). Dr. Cagnassola is the managing editor of the journal Nutrition and Metabolism, and the petition is basically asking the NIH to consider all scientific evidence surrounding the issue of blood sugar control in Type 2 diabetics. Particular focus is on an NIH statement about the ACCORD study: "Intensively targeting blood sugar to near-normal levels ... increases risk of death." What makes this statement somewhat brain-dead is that it is not qualified by "using the methods for blood sugar control employed in the ACCORD study", which I believe were largely intensive drug therapy, possibly including insulin. There are plenty of good reasons to think that intensive insulin therapy could shorten your life, and this sort of blanket conclusion is dangerous, obviously, since the implication is that we should just give up on controlling blood sugar in diabetics, since presumably the cure is worse than the disease.

There is plenty of evidence, however, both anecdotal and clinical, that Type 2 diabetes is often effectively controlled through diet. See, for example, this recent study, as well as the excellent documentary "My Big Fat Diet". Proper testing of a hypothesis requires that all relevant evidence be included in evaluating that hypothesis, and the NIH appears to be only considering the narrowly defined evidence admitted by current dogmatic beliefs. The usual complaint when diet is brought up to this group of people is something like "we don't know the long term effects of a low-carbohydrate diet in patients with Type 2 diabetes." Of course you don't, because you've neither looked at the currently available evidence, nor attempted studies to gain your own evidence.

The petition is asking to change that. Of all scientific organizations involved in studying human health and making treatment or lifestyle recommendations, the NIH is one of the very few truly public institutions. It is funded by your tax dollars, and is supposed to represent the best interest of the general population, not of specific interests such as drug or food companies. Their responsibility is to consider all available evidence, since getting it wrong can literally be the difference between life and death. If you feel similarly, please sign the petition, and also consider contacting your congressional representatives. Elected officials are more sensitive to the public voice than bubble-world bureaucrats, and they hold the purse-strings for funding the NIH.

1 comment:

David Brown said...

In "Food for Nought" by Ross Hume Hall, PhD the author observes, "Organized education trains the individual to function as a narrow specialist, on the one hand, and on the other, conditions him to accept without question the technologic structures of society and to demand the fruits these structures produce everywhere."

As noted above, "Of all scientific organizations involved in studying human health and making treatment or lifestyle recommendations, the NIH is one of the very few truly public institutions. It ... is supposed to represent the best interest of the general population, not of specific interests such as drug or food companies. Their responsibility is to consider all available evidence, since getting it wrong can literally be the difference between life and death."

I see a serious problem in "Science" that has to do with the dynamic relationship between academia, commerce, and government.

Academia trains health professionals of all sorts and conditions them to rely on scientific authority rather than scientific data. At the highest levels of scientific authority it is expected that scientists will concur on important issues that affect the public health. So it is consensus of opinion, not the scientific data, that becomes all important when textbooks are written and public policy is shaped.

In nutrition science, dietetics is the authority. But dietetics apparently serves the interests of agribusiness and the food manufacturing industry.

Since the medical and public health sectors rely on dietetics for nutritional doctrine, there's no way to get past the influence of the commercial sector except perhaps through grass roots educational activity (which is what this blog is all about) or legislative action.

Unfortunately, lawmakers rely the public health sector which consists of professionals conditioned to rely on consensus of opinion. It's like a fortress that can't be penetrated.

The Nutrition and Metabolism Society is an excellent organization. And while I hope the petition has the desired effect, I'm not holding my breath.