
John Ioannidis Aims His Bazooka at Nutrition Science (2018) - aaavl2821
https://www.acsh.org/news/2018/08/24/john-ioannidis-aims-his-bazooka-nutrition-science-13357
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schizoidboy
My favorite quote from Ioannidis:

“Science is a noble endeavor, but it’s also a low-yield endeavor,” he says.
“I’m not sure that more than a very small percentage of medical research is
ever likely to lead to major improvements in clinical outcomes and quality of
life. We should be very comfortable with that fact.”

[https://www.theatlantic.com/magazine/archive/2010/11/lies-
da...](https://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-
and-medical-science/308269/)

~~~
User23
A competent medicinal chemist can spend a lifetime in drug discovery and never
get a candidate molecule out of clinical trials. I learned this from the
excellent Derek Lowe, whose blog at
[http://blogs.sciencemag.org/pipeline/](http://blogs.sciencemag.org/pipeline/)
is on my daily list.

Quote from an interview[1]: "I’ve been doing this for 27 years, and I have
never once put a drug into a pharmacy. I tell people: “If you want to know why
your prescriptions cost so much, it’s me.” I’ve done nothing but spend money
the entire time."

[1][https://www.statnews.com/2016/03/05/derek-lowe-chemist-
blogg...](https://www.statnews.com/2016/03/05/derek-lowe-chemist-blogger/)

~~~
hannob
> “If you want to know why your prescriptions cost so much, it’s me.” I’ve
> done nothing but spend money the entire time."

Sounds nice, the best evidence we have disagrees:
[https://news.ohsu.edu/2017/09/11/how-much-does-it-cost-to-
br...](https://news.ohsu.edu/2017/09/11/how-much-does-it-cost-to-bring-a-
cancer-drug-to-market)

~~~
aaavl2821
That's a widely criticized study because it ignores the cost of failure. It
only looks at the r&d investments of companies that received FDA approval for
a drug. It's like doing a study of the odds of winning the lottery, and only
analyzing people who won the lottery

Considering the fact that 90% of phase 1 drugs never get approved and that
study seems quite biased. That study conveniently assumes that all those
medicinal chemists, who've worked decades and never seen a drug approved,
simply don't exist

~~~
User23
Interestingly this contributes to why drug companies spend so much money on
advertising: it has a predictable measurable return, whereas R&D is virtually
a lottery.

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COGlory
As someone with a degree in Nutritional Science who has since left the field
for actual science (Biochemistry), I couldn't agree more. It was reasons like
this that I left.

The field was corrupted early on by the sugar lobby and it took an immense
amount of effort to simply make it ok to admit saturated fats weren't bad for
you again. Some 50 years of research negated by a deal that went down with a
very small subset of people.

The Academy of Nutritionists and Dietetics is a complete and total waste of
human effort. I've never encountered a more useless amalgamation of self-
serving pretend professionals in one organization. Everything they do is to
protect their organization and reduce entry. To even become a dietitian, after
graduating from a didactic pathway you must do a 1-2 year paid internship. And
by paid, I mean it costs you $20,000-$40,0000, you work 40+ hours a week,
including unsupervised work, which makes the legality dubious, and in exchange
you sometimes (but no always) get to take a few credits of useless grad level
classes that won't get you any further to a master's degree. And then when you
finally get certified, after an $80,000 degree and $40,000 internship, you get
to start a job that pays about $55,000/year peak, assuming you aren't some
world renowned specialist.

The people involved are just the worst. All play professionals who obsess over
trivial details like professional attire and pointless faux psychology, like
learning and motivational theory. They treat everyone like stupid children and
design the absolute worst literature and outreach, catering to the lowest
possible denominator with patronizing and condescending advice and horrible
rap songs designed to get children to eat vegetables. Meanwhile this has left
a vacuum of knowledge for anyone with two brain cells to rub together, and so
any reasonably intelligent adult instead gets sucked in by even worse pseudo-
science blogs, a phenomenon that was created and enabled by the Academy.

The kicker for me was when I took a community nutrition class that the
majority of my classmates revealed that they believed in "health at every
size" and that a registered dietitians primary function is respectful
communication, (read: participating in the delusions of patients) not
communicating important information and truths that could impact the patients
health.

That's not even getting into the absolute sham that is most nutrition research
and how much of it is funded by organizations who have a predetermined outcome
and just need to find a way to fit the facts to what they want. Nutrition
research is absolutely rampant with activist organizations trying to coopt the
field to further their related agendas.

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chx
Nutrition Science, ah yes. What would your reaction would be if I told you
that we claim that the interaction of seven billion human beings to many
thousands of previously living organisms will be the same for each of those
human beings? That's obviously nonsense. In other words, you can't just say
consuming eggs does X to everyone. You need to partition foodstuff AND
partition humans, the partitioning likely based on genetics but also probably
other factors as well and then you can describe how each partition reacts.
Those other factors likely include previous reaction of food intake... It's a
gigantic mess. Until we know a lot more, I will take every nutrition advice as
if a dead cat wrote them.
[https://en.wikipedia.org/wiki/List_of_animals_with_fraudulen...](https://en.wikipedia.org/wiki/List_of_animals_with_fraudulent_diplomas#Henrietta)

~~~
User23
It's almost as if different human populations separated by insurmountable
geographic barriers in wildly differing ecological circumstances for myriad
millennia underwent selection pressure!

~~~
dsr_
And have mixed-and-matched enough that claiming any sort of "purity" is
idiotic. We're all braided together.

~~~
jdminhbg
I don't think anyone is claiming "purity" at all. Purity, if anything, would
make things simpler.

~~~
feanaro
The operating principle is homogeneity.

Purity is a bit of a misnomer because a "perfectly" homogeneous species with
no distinctive heterogeneous groups would have to be called pure, but that's
not usually how people use the word. The implication is usually that there are
several distinct, homogeneous groups within which there is homogeneity among
its members.

Having homogeneity at some level, even if it ends up being in the form of
several homogeneous groups, allows one to make useful scientific findings and
generalizations. On the other hand, if everything was very heterogeneous, down
to each individual, it would be very hard to find a general statement
applicable to any appreciable number of individuals.

~~~
chx
> homogeneous groups, allows one to make useful scientific findings and
> generalizations. On the other hand, if everything was very heterogeneous,
> down to each individual, it would be very hard to find a general statement
> applicable to any appreciable number of individuals.

and yet it is possible we will need to end up where individual advice is the
only one working

~~~
feanaro
For some phenomena, that might turn out to be true. However, counterexamples
are fairly prominent and obvious, e.g. there is a very large subset of humans
(~all) for which antibiotics work well for almost all bacterial diseases.

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eebynight
About time. This is the type of crap that gave us "eggs are the equivalent of
smoking cigarettes", "red meat causes cancer", "Coconut oil is pure poison"
and many more...

~~~
randomsearch
“The World Cancer Research Fund report Food, Nutrition, Physical Activity and
the Prevention of Cancer provided advice on red and processed meat in 2007.

The organisation said the evidence that red and processed meats are causes of
bowel cancer is convincing. It advises that people eat no more than 500g of
red meat a week (around 70g a day) and avoid processed meats.”

[https://www.nhs.uk/live-well/eat-well/red-meat-and-the-
risk-...](https://www.nhs.uk/live-well/eat-well/red-meat-and-the-risk-of-
bowel-cancer/)

~~~
jimmy1
Studies of communities that have longitivtiy confirm this. For example, the
"Ikaria" study, a university of Athen's study of the island of Ikaria, where
males reach the age of 90 2.5 times more frequently than Americans, their diet
consisted of hardly any red meat at all (and also hardly any sugar), but
rather beans, legumes, wild local greens with lemon juice and olive oil, fish,
honey, and red wine.

~~~
floatingatoll
Was the study of this island controlled for climate, compared to a nearby
island with different diets, or compared to a distant island with similar
diets?

One of the points made by Ioannidis is that we’re far too easily swayed to
believe what sounds plausible when no one has yet asked “Could this be for
some other reason altogether that we aren’t testing for?” _and then_ tests for
those reasons. That flaw applies here: studying just one community
automatically implies that the results are invalid, simply because there’s no
evaluation of other communities that share various attributes that could be
hidden factors for the benefit.

EDIT: Per one article, that study “would try to cut through the stories and
establish the facts about Ikaria’s longevity”. It has succeeded in
establishing that, factually, Ikaria’s longevity is a thing _relative to_
other populations. It has _not_ established which of the properties of Ikaria
are responsible. (For example, perhaps the island is slightly radioactive, and
old people thrive in a slightly higher radioactivity.) Extrapolating that
their diet is responsible is an instance of the A/X error described in the
above-linked article.

------
chicob
I do believe that many of the findings of nutrition science are half baked,
provably contradictory, and ignore a plethora of factors that play a role in
the interaction between food and health.

But there's another bazooka in the room: the contemporary erosion of trust in
authority, in this case scientific authority. Ionannidis' remarks are for the
best, I think, but will add to the confusion of not only what knowledge can
the public trust but who is more apt to produce that knowledge.

Before things get better, this will inevitably widen the door not only for old
bad science in new clothes, or in the form of professional, corporation funded
research that resorts to p-hacking and such methods, but also to the further
discredit of science in general in the general population.

Having said this, I do not believe Ioannidis' work (or Ben Goldacre's for that
matter) is a tool of such agents.

Edit: After reading some comments in this thread, I have to say in all honesty
that I suspect that the ACSH's interest in Ioannidis work is disingenuous,
without putting into question the validity of his work.

~~~
nordsieck
> But there's another bazooka in the room: the contemporary erosion of trust
> in authority, in this case scientific authority. Ionannidis' remarks are for
> the best, I think, but will add to the confusion of not only what knowledge
> can the public trust but who is more apt to produce that knowledge.

The erosion of trust is _because_ of the poor quality of scientific findings
produced by Science the institution (particularly in select fields).

This is the only sustainable path forward for Science the institution. The
only alternative is a period of suppression of criticism, inevitably
contemporaneous with increasing levels of corruption, followed by massive
denunciations and outrage once the dam breaks.

Didn't really work well for the Catholic church. I can't see how it would be
any better for Science.

~~~
chicob
> The erosion of trust is _because_ of the poor quality of scientific findings
> produced by Science the institution (particularly in select fields).

So it would seem, if we considered Nutrition Science alone. But that does not
explain the process of increasing distrust in vaccination, global warming and
climate change, or even evolution, where the scientific practice has a quite
solid record and community consensus.

The erosion of authority reaches outside of Science, which to me suggests that
there might be a broader explanation beyond the specificities of each field.
In my opinion, and like you say, organized religion was one of the first
victims of this process in the past and today.

~~~
nordsieck
> The erosion of authority reaches outside of Science, which to me suggests
> that there might be a broader explanation beyond the specificities of each
> field.

In my opinion, the difference is the low cost of broadcasting ideas. Before,
if you didn't believe in a main stream idea, you could share your theories
with people near you. Now, it's easy for people who don't believe in the main
stream to form communities and reinforce each other's beliefs.

~~~
chicob
That is certainly a part of the problem. It amplifies the apparent relevance
of erroneous perspectives and furthers the idea that expertise is at hand's
reach for laypeople.

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Upvoter33
criticizing nutrition science is ... er ... a low-hanging fruit (sorry)

~~~
atoav
But exactly these kinds of sciences are part of the reason why a growing part
of the population doesn’t trust scientific research and experts anymore.

Changing something here for the better has an higher impact on society than
doing the same thing e.g. in physics.

~~~
atomical
The public doesn't trust scientific research because the local news airs
studies with controversial claims to outrage and confuse the public.

It's similar to how the YouTube algorithm selects content that will make a
person angry.

In both cases the goal is engagement.

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trimble
acsh.org == industry front group

~~~
gotocake
It really is, but it can be helpful to do more than just claim something, and
rather back it up a bit.

[https://en.m.wikipedia.org/wiki/American_Council_on_Science_...](https://en.m.wikipedia.org/wiki/American_Council_on_Science_and_Health#Accusations_of_industry_influence)

 _In 1979, the information director of the FDA said, "Whelan just makes
blanket endorsements of food additives. Her organization is a sham, an
industry front."[31] In 1980, ACSH co-founder Frederick J. Stare was chairman
of ACSH's Board of Directors and sought funding from US tobacco company Philip
Morris USA for ACSH's activities, stating that he believed financially
supporting ACSH would be to Phillip Morris' benefit.[26][27] In the early
1990s, ACSH decided to stop reporting its funding.[32] Their 1991 report shows
that many corporations contributed funds.[32] In 1982, the Center for Science
in the Public Interest (CSPI), a consumer advocacy group, published a report
on ACSH's practices that stated, "ACSH seems to arrive at conclusions before
conducting studies. Through voodoo or alchemy, bodies of scientific knowledge
are transmogrified into industry-oriented position statements."[33] CSPI
director Michael F. Jacobson said of ACSH, '"This organization promotes
confusion among consumers about what is safe and what isn't.... ACSH is using
a slick scientific veneer to obscure and deny truths that virtually everyone
else agrees with."[34]_

~~~
trimble
You're right - thank you for adding this

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Criper1Tookus
Big foods lie Eat kito and fast often that's life no sugar no bread of any
type Fibre from veg only loss weight feel great

