Any Diet Will Do

Apropos of my essay last time on how we put too much faith in the products that are sold with fancy scientific jargon and magic-sounding ingredients, here are two examples from this week’s news.

The first is an article from the Journal of the American Medical Association (JAMA) explaining a comparison of several different research studies on the effectiveness of the various popular diets, the ones people love to argue about with friends and neighbors as celebrities hype one or the other on TV talk shows.  After reviewing “59 eligible articles reporting 48 unique randomized trials (including 7286 individuals) and compared with no diet,” trials of such programs as Atkins, Zone, Weight Watchers, Jenny Craig, and a few others, they found that low-fat and low-carbohydrate diets were most effective but with little difference from one plan to the next.  The conclusion of their research was that doctors should continue the “practice of recommending any diet that a patient will adhere to in order to lose weight.”  There is no magic in the diet itself.  If there is any magic at all, it’s in the discipline to stick to the diet – and you can’t buy that!

The second example made me laugh, until I remembered that, for the reasons mentioned last time, many people take this seriously.  It’s called “5 Foods That Keep You Young.”  The slide show and related articles are crammed with those trigger words (shown in bold) that we hear every day in health-related promotions.  For example, an “Avocado and Oat Facial mask” will “hydrate and exfoliate your face” or use a “Red Wine Mask” for the wrinkles.  Next for your face they offer pumpkin seeds with “tons of zinc” to lock in moisture and increase collagen production.  For our hair we need vitamins A and C, protein, omega-3 fatty acids, and more zinc.  Try some walnuts.  Don’t forget your fingernails, which require iron, beta-carotene, folate, and vitamin C from dark green vegetables.  Your eyes need plenty of lutein and zeaxanthin.  And to put a smile on that wrinkle-free face, try some “endorphin-releasing foods like chocolate and ice cream.”

There was once a day when people could eat well and keep their weight down without mention of all these magical ingredients and programs.  Then we discovered fast food, processed foods and a sedentary lifestyle.  Before long people were eating unhealthy diets and being overweight.  Now we act like victims of the clown, the king and big business and expect to be rescued by science and technology.  As part of this over-reaction we look to the US government to dictate dos and don’ts for school menus.  For many Americans an ordinary grocery store is not good enough, and we spend billions of dollars on dietary supplements, just in case.  This is not how we managed in the past.

The solution to this problem does not come from the outside.  All we really need is a little discipline, critical thinking and perspective.

Are We Over-scienced?

In this highly technological age, it seems we have become too dependent on science to provide all the answers.  We are prone to look to and take at face value the judgments of scientists on many questions that are easily answered with common sense and experience.  Furthermore, when advertisers come up with impressive, scientific-sounding phrases or make reference to some arcane scientific concept, we are too overwhelmed and impressed to challenge the conclusions.

During my master gardener training we were given a good example.  A neighbor asks, “What’s the best time to trim my tree in front?”  The neighbor rightly understands that there are more ideal times for trimming certain trees, times of year when the tree will be less stressed.  Before answering, the master gardener wonders why the neighbor wants to trim the tree.  The neighbor responds, “Every time I mow the lawn that low branch hits me in the face.”  The right answer of when to trim the tree has moved from the realm of science into the realm of common sense.  “Trim off the branch before you mow the lawn again.”

A second example came a few weeks ago from a health report on local television news.  The essence of the story can be summed up as:  It’s summer and the grocery store has a good stock of nice, fresh fruit, which is good for you.  Buy it and eat it.  There was a lot of talk about the health benefits and antioxidants, but the main message was to eat fruit.

My grandmother was born in Eastern Europe in the 1890s.  After immigrating to the US, she lived near New York City and kept a small vegetable garden in the backyard.  She knew that fruits and vegetables were good for you.  Her mantra during meal times was, “Eat your green stuff!”  No one had to tell her about antioxidants and other exotic components of fruits and vegetables.  It was just common knowledge.  Just like most people today, Grandma didn’t know what an antioxidant was or how they were good for you, but unlike most people today, it wouldn’t have mattered to her at all.

Finally, this headline made the fluffy news recently:  “Huge Weddings Lead to Better Marriage, Says New Study.”  I read several different articles on this research report from the National Marriage Project at the University of Virginia primarily because the headlines were so misleading.  The facts are:  they interviewed 418 couples and split them up by size of their wedding, yielding two or more smaller sampling groups.  They found that those with larger weddings, more than 150 guests reported themselves as happy more often – not that they were consistently happier.  No evidence shows that the large wedding led to happiness or the tendency to stay married.  (Correlation does not prove causation.)  More likely some conditions that led to a happy marriage were also more conducive to having a big wedding:  greater financial resources and a larger support system to name just two.  Finally, the study followed the couples for only 5 years, which is hardly a long time for a marriage, and depended on self-reporting, which has highly questionable validity.  A big wedding is not, as the headline suggests, a key to a happier marriage.

The trouble today is that we depend too much on scientific recommendations and scientific jargon and not enough on what we already know.  Advertisers constantly try to wow us or scare us with the results of research studies and trigger words like antioxidants, justice, organic, sustainable, and probiotics, or chemicals, low testosterone, mercury, quantum mechanics and carbon dioxide.  (Whatever happened to Beta-carotene?) They know we daydream about and will pay good money for magic answers to lose weight, to get rich and to stay married, all the while knowing in our hearts that all these are only achievable with hard work.

As Antidepressant Lawsuits Wind Down

Here is some food for thought about drug companies, perspective and economic understanding.

The first story is a summary of the on-going battle between the drug companies and the families of youths who committed suicide after taking antidepressants.  The drug companies were targets of hundreds of lawsuits until “a decision made by the Food and Drug Administration 10 years ago this fall that required drug makers to include a ‘black box’ warning that says that antidepressants can cause suicidal behavior in adolescents. In 2007, the warning was broadened to include young adults.”  Interestingly, of those many lawsuits, most were settled out of court, but of the ones that went to trial the drug companies lost only one.  It’s a reasonable conclusion that depressed people would have a tendency to commit suicide with or without the drugs, so it’s a little hard to blame the drugs.  That didn’t stop a few lawyers from making a career out of this type of litigation and collecting many settlements from companies who are rightly leery to leave the decision up to a jury and to spend countless hours and dollars on trials and appeals.  Still there is considerable controversy over whether the side effects of antidepressant drugs are safe and may possibly be to blame for suicides.

On the other side of the coin, one expert witness at the FDA hearings feared that such a strong warning would scare adolescents away from drugs they really needed.  Since then a medical journal from London, FMJ, has published some highly criticized research showing a reduction in usage of the drugs and an increase in suicides.  (Remember correlation does not prove causation.)  Meanwhile the University of Maryland joins the discussion with a paper stating:  "Lithium used as a drug treatment for major mental disorders such as bipolar disorder and depression is effective in reducing the risk of both attempted and completed suicide.”  Although the black box warning greatly reduced the inclination to sue, the disagreements over this issue continue.

I thought these were interesting reports alone, but coincidentally, it came to my attention on the same day that there is a proposal in Congress to loosen restrictions on buying drugs on line from Canada and other foreign countries, allowing people to buy them for less.  

Now I am no fan of the drug companies, especially as they interrupt every other TV program to remind me to ask my doctor about the latest prescription pill; but I can sympathize a bit with their position.  They must invest heavily in research and development, running into many dead ends and jumping through regulatory hoops, to develop and get FDA approval for the drugs we need, while facing pressure from the government to keep prices down and a long line of potentially costly lawsuits.  But the minute we hear of an epidemic like Ebola, the first question everyone asks is:  “Why isn’t there a drug or vaccine for that?”

Put yourself in their shoes just for a minute.  You work really hard to produce a drug that’s 99% effective with the prospect of having 99 cured customers who resent you because they think they paid too much and one other customer hiring a lawyer to punish you for not being perfect.  I think it would be a little disheartening.

Too Much Pride?

As I read yet another article about pride, this one where an openly gay gubernatorial candidate plans to march in a pride parade in Maine, I wonder whether all this emphasis on pride makes any sense in this context.  What is pride?  When is it appropriate, and when is it constructive?

For years our religious leaders and philosophers have told us that pride is not a good thing.   It’s one, some say the worst, of the seven deadly sins.  “It is identified as believing that one is essentially better than others, failing to acknowledge the accomplishments of others, and excessive admiration of the personal self.”  Plenty of examples flow from the Bible and other sources warning of the dangers of pride, that it “goeth before destruction, and a high mind before the fall."

Positive examples that come to mind concern pride for accomplishments or positive behavior.  We tell our children to be proud of themselves for athletic or academic accomplishments.  Even if they are not successful, the act of making an honest effort merits whatever good feelings we can pass along.  This positive feedback is meant not to make them feel superior or to encourage them to look down on others, but to motivate them to continue to work and excel.  In this sense, it’s hardly a sin.

We don’t expect our children to be proud of poor behavior, nor do we encourage them to be proud of a trait or characteristic they have no control over.  There is no pride in failure.  Likewise, should they be proud of being blond or of being right-handed?  This makes no sense.  There is no motivational value.  Working to become more right-handed is wasted effort.

In this regard, doesn’t it also seem strange to be proud to be of a particular heritage – Irish, Italian, African or even American?  This circumstance was beyond your control.  It’s not like being a good student, a good parent or a good citizen.  You can feel confident that people of your heritage had strong values and positive traits some of which you may (or may not) have inherited.  But without showing evidence of those positive traits, there is no reason to feel personal pride.  You can be proud of your country for its positive history or strong values, proud or your actions in defending the country or working to make it better, but to be proud merely of the fact that you were born there rather than somewhere else is a vacant concept.  You had no control over your mother’s itinerary.  This type of pride is merely a way of giving yourself permission to feel superior on the basis of nothing you did:  no skill or knowledge, no effort or accomplishment – feeling superior for the sake of feeling superior, lording it over others based on your place of birth.  There is nothing less “American” than that notion,  and it is the exact kind of thinking that leads to all sorts of discrimination.

To me then all these pride-about-characteristics movements with their goal of “fighting to eliminate discrimination and promote equality” seem like an effort to fight this vacant pride that breeds discrimination with a loud, countervailing dose of equally vacant pride – to stand up to the discriminators by exercising the same arrogance, the same unfounded feelings of superiority, hoping somehow that it all equals out in the end.

Instead it makes much more sense to be proud of not discriminating, of trying to treat everyone else with respect - proud of a behavior.  That’s an accomplishment.  It's something you can control and that’s something to be proud of.