March 16, 2017

A nod and a wink:  Decoding academic text about diet and health

Academic text is notoriously difficult to read.  It can even be difficult for fellow academics to make much out of it. That fact lay behind one of the few compliments I have ever received from a fellow academic.  Ken Rigby once said to me: "John, we don't always agree with you but at least we can understand what you are saying".

See what you can make out of the excerpt below from JAMA.  It is from an editorial about the effect of diet on health.



Did you get the idea that the editorial is rubbishing the whole idea that diet has any significant effect on health?  That IS what it is saying in a cautious academic way.  It even nominates the chief reason why the existing studies are inconclusive.  The mention is super-brief but it is there.  Its inclusion is so brief that it is only a nod and a wink to readers in the know.  The mention is:  "particularly socioeconomic factors".  That's pretty vague isn't it?  What does it mean?  Does it set off any alarm bells?

It is in fact put in such a away as to avoid setting of alarm bells. It is designed to avoid highlighting something that is HUGELY politically incorrect:  The fact that the poor tend to experience more illness and tend to die young.  Mentioning that fact out in the open is likely to cause huge eruptions about justice and the like from Leftists -- and the innocent messenger of truth can get shot for telling that truth.  Chris Brand, for instance, got fired from a tenured university teaching job for mentioning that not all pedophiles are equal.

So the fact glided over in this case is that social class is seldom mentioned in medical research, not because it is unimportant but because it is in fact hugely important.  It is not going too far to say that most apparent diet effects are in fact simply social class effects.  The current dietary craze about the evils of sugar, for instance, is based on research which ignores social class.  The poor drink more fizzy, sugary  drinks so any evidence that sugar is bad for you may really be just another demonstration that the poor have more health problems.  The research will be presented as an association between the drink and health while the real thing going on is an association between the drinker and health.

So what we have here is an elite conspiracy to cover up an unpleasant truth.  To hang a conspiracy on the single paragraph I have reproduced would of course be absurd.  What is not absurd is the fact that this is only one pebble on the beach:  The great majority of research papers on diet completely ignore social class.  The writers concerned will usually be well up on the social class tree but mentioning social class is odious to them.

And there is a huge price to pay for that embarrassment.  By ignoring the possibility that what looks like a diet effect is in fact a social class effect, the papers concerned are rendered moot.  They prove nothing and are no evidence for anything.  Vast tracts of the medical literature might as well not have been written.

And perhaps the saddest thing of all is that most medical researchers would be aware of possible class effects in their data.  Social class is one of the most powerful predictors of ill-health that there is.  Any time class IS measured it does reveal itself as an important associate of whatever type of ill-health is being studied.  So for the sake of political correctness, researchers do and report work that is meaningless.  By ignoring social class, they completely waste their time and efforts.  So what we see above is just a nod and a wink where there should be a major scandal.

I suppose we have to be be thankful that the truth is still out there -- as it is above -- for those who know how to read it.

A bit more on the politics of the matter:  The editorial by the JAMA editors excerpted above was in response to an article by Micha et al. which they published in the same issue of the journal.  The article is rubbish.  It is all based on "estimates" that take the existing poorly controlled literature as gospel.  But because what Micha et al. did was completely conventional, the editors apparently felt obliged to publish it.  They should have rejected it but to do so would have put them at odds with the whole racket that is the conventional narrative about diet and health.  So they opted to put their doubts in a cautious editorial only.

REFERENCE: Noel T. Mueller  et al. "Attributing Death to Diet: Precision Counts" JAMA. 2017;317(9):908-909. doi:10.1001/jama.2017.0946




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