Sun, Aug-06-23, 12:06
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Plan: Muscle Centric
Stats: 238/153/160
BF:
Progress: 109%
Location: UK
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Lessons from the MIND Diet Trial
Sharing Nina Teicholz's latest post on Unsettled Science:
Quote:
Lessons from the MIND Diet Trial
A case study in 'pathological science'
Gary Taubes
Introductory Note from Nina:
I’m delighted to share this post with you by Gary Taubes, a science journalist who for most of you needs no introduction. Gary single-handedly revived the carbohydrate-insulin hypothesis in his seminal book, Good Calories, Bad Calories (2007), although he had already come to fame with his 2002 New York Times Magazine cover story, “What if it’s All Been a Big Fat Lie?” No single person, be it a journalist, researcher, or other expert, has contributed more to shifting the paradigm on dietary fat and carbohydrate than Gary Taubes. It’s an honor to have him contributing here.
Introductory Note from Gary:
I have been hoping to join Substack for a while now – either as a guest or co- columnist on Nina’s site, or on my own. I’ve been looking for a timely subject that worked well as a first column. In short, it would be suitably important and interesting enough that I could detach myself from my day job, researching and writing books, and devote the attention necessary to write thoughtfully on the issue. The recent negative results from the MIND Diet Trial, as published on July 18th in the New England Journal of Medicine, seemingly demanded just such an extended discussion and so that discussion will follow this introduction.
My contributions to the newsletter will focus on the subject that has always obsessed me: the extraordinary difficulty of generating reliable knowledge in any scientific endeavor and the ridiculous ease with which researchers (indeed, all of us) can be misled. If there’s one subject I have studied as much or more than anyone alive, it is that of pathological science, a term coined in a 1953 lecture by the Nobel Laureate chemist Irving Langmuir to describe “the science of things that aren’t so.” Richard Feynman famously referred to pathological science as Cargo Cult Science, in his 1974 commencement address at Caltech, and both should be required reading for anyone interested in science, whether as an observer or professional. My first two books were on high energy physicists (Nobel Dreams, 1987) and then chemists and physicists (Bad Science, 1993) who discovered nonexistent phenomena – supersymmetry particles, in the first case, cold fusion, in the second -- and so demonstrated quite how easy pathological science can be. They were my learning experiences.
Since the early 1990s, I have focused on the manifestation of pathological science in the nexus of research on nutrition, obesity, chronic disease and public health. That’s where my expertise now lies (for those who think I have any) and where I will focus my writing, although I will not do so exclusively. Because the quality of the science in these disciplines is often so disappointing – a product, I believe, of both the training of the researchers and the expense and difficulty of rigorously testing hypotheses -- I have played with the idea of calling my newsletter or my contribution to this one “Let’s Pretend This is a Science…” I may still. I hope also to write many of the entries in the form of letters to researchers and/or editors, asking questions that seem important in the light of the work being discussed. I’m hoping that they will at least occasionally see fit to thoughtfully respond, and so we can publish a dialogue rather than a monologue.
Because I consider myself, still, a journalist, and the coverage of these subjects by my colleagues in the media inevitably influences how we perceive them – both the nutrition-related subjects themselves and the scientific research used to draw conclusions and create consensus -- I will also write often about that media coverage.
I will also apologize in advance for any errors. I will assuredly make them, if for no other reason than I am unaccustomed to writing and publishing quickly. (Regrettably, I make them even when I’m not.) I will endeavor to correct any as necessary.
Lessons from MIND
Biases in nutrition research, as with all science, range from the subtle to the blindingly obvious. Give a dietary intervention an acronym like MIND –standing, in this case, for Mediterranean-DASH Intervention for Neurodegenerative Delay – and it implies faith that the acronym delivers on what it says: benefit the human brain, delay neurodegeneration and so, perhaps, delay or prevent Alzheimer’s disease and other dementias as well. That this MIND diet encompasses virtually all of what nutrition authorities think they know about healthy eating – it’s based on whole grains and green leafy vegetables; its added fat comes mostly from olive oil; its protein from nuts, fish and poultry – may make it seem like a very good bet, but ultimately it’s a hypothesis and one that has to be tested.
Nutrition research is, in theory, at least, a serious scientific endeavor. Describing what a diet does before you’ve actually tested it establishes a presumption of truth from which it may be hard to back away. In an ideal world, this wouldn’t matter, because such a hypothesis -- that the diet does what the acronym says it does -- would be easy to test. If so, we could find out quickly enough, and no speculation would be necessary. If this diet/neurodegeneration hypothesis were wrong, then these quick and easy experiments will demonstrate as much, and we can move on.
But tests of the relationship between nutrition and chronic disease -- randomized-controlled trials of sufficient duration and power -- are not easy to do, and certainly can’t be done quickly. They’re also inordinately expensive. As a result, belief in the validity of any nutrition-related hypotheses inevitably has time to establish itself before any test is done. That’s a problem. In scientific disciplines that are unamenable to experimental tests, belief systems can easily solidify into dogma, whether they’re right or wrong. The more people who come to believe something is true, who invest themselves in its validity, and now, with the internet and social media, who assert publicly that it is true or certainly seems true, who treat assumptions as facts, the harder it is to back off those beliefs. Experimental evidence, as the MIND diet trial may now demonstrate, can be rendered irrelevant.
In this case, we should be grateful that the academic proponents of the MIND diet actually treated their catchy acronym as a hypothesis –the Mediterranean/DASH diet might delay neurodegeneration – and were willing to expend the considerable effort to test it. In nutrition and chronic disease, as we’ll discuss in coming columns, this isn’t typically the case. Perhaps equally important, the National Institutes of Health (NIH) was willing to fund the trial.
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