Article: The Corruption of Evidence Based Medicine — Killing for Profit

Well, I think there exists a problem with bias in guidelines. For instance, there are "medical managers" (I know one via my husband) whose job is to get their company's drugs into guidelines, of course by "proving" their effectiveness with clinical trials.

IF there were a good clinical trial showing a mediterrean diet helps better than statins then this would be a fact until proven otherwise by good scientific means. (I am not saying this has been proven. I don't know.)

 

There have been a number of studies carried out using the basis of a Mediterranean diet and a number of healthy diet principles have come out of this. Basically the Mediterranean diet is high in vegetable protein from pulses, relatively low in saturated fat due to lower meat consumption , higher portions of oily fish and with more unsaturated fat from olive oil. These principles are embedded in the existing healthy eating advice and guidelines and have been known for around 20 odd years?

Other studies, such as some of the more exotic diets that have a high proportion of cultured milk products in them for example, have not proven to be of any significant health benefit when you weigh up the downsides of eating too much dairy (I’m talking a bit off the top of my head...but I see a lot of studies every day and much of what is being touted is very old news and nothing new ...I suspect new to the cardiologist who doesn’t really seem to have a handle on the food industry.

There are many 100’s of pieces of evidence that support food law and guidelines.

However choosing a specific diet and labelling this as ‘the healthy way’ will never be approved , because this is always going to be misleading. This is because there is always more than one way to skin a cat when it comes to which foods you choose to eat and this is the crux of the problem with people promoting a particular diet.

In my experience the people promoting the diet always have a money making scheme behind it, whether it be a book, tv series or a slimming club etc. It could also be a feeling of self worth ...perhaps when ones medical career didn’t pan out quite as one expected?

Not pinning policy and guidelines on a particular diet is not a bias ...it’s the opposite ..and common sense, since with such a diverse range of foods to choose from....how can you pin anything down to such specificity?

There is no definitive evidence for changing advice to a particular diet plan ...and for this reason diet advice is based on guiding principles, like the benefits of fibre from fresh vegetables and fruit, reduced salt, omega 3 from oily fish, eating a balanced diet not too high in carbs or protein etc etc etc. This rolls out as recommended amounts for men, women and in the case of some products, children. The recommended amounts on food packaging are enshrined in law and are not plucked from the air or based on biased evidence...they are weighed up by a committee of experts.

The body of evidence is carefully weighed up and this informs the law. The new evidence is presented and assessed all the time. There is a robust structure in place and new guidelimes can be considered and crafted into what is already known. You can’t do that with a rigid diet plan.

I can only speak for the way food law and the industry works based on my 30 odd years of working in it.

I have no experience of the medical industry but from what I’ve heard it doesn’t sound at all similar to food ...in food you grow most of the stuff from plants and animals and so most attention in the industry is on getting enough food from A to B.....packing it or making it into something else safely, hopefully tasting nice and getting it to the retail outlet for people to buy it with enough life on it to prevent food spoilage etc.

Medicine seems quite different, so I don’t understand why people are conflating the two together ...seems a bit like conspiracy theory to me?

With regards to lobbying governments and decision makers. The lobbyists are mainly farmers and their voice is relatively weaker or stronger depending upon the governments economic policy. The farmer doesn’t care whether his wheat is made into bread, wholemeal pittas, starch, bioethanol or whatever...he just wants to know what is the best thing to plant to keep his farm going and if there is better money to be made by planting a different crop he will do it. The problem with growing things is that you need to plan a long way in advance and need a commitment up front. This is not corrupt it’s normal supply chain management.

The real issue is supply and demand and that comes down to what people are buying in the shops. In the main no food manufacturer owns the farms...they just contract the volume they forecast they will need ...and the big manufacturers of the so called unhealthy foods are at least one step away from the flour and sugar and starch that they use to make the products ...so where is this big conspiracy? It sounds too convuluted to be practical?

The reviewers of guidelines are conservative and tend to be scientists that understand metabolism, nutrition and how to read scientific papers. They spend most of their time pouring over scientific research studies. They are not politicians with an economic agenda.

In any case most governments would prefer to save money on health care costs ...but are too short term In their thinking to teach children about food in schools or encourage healthy eating campaigns ...so it seems to just boil down to the ineptitude of governments to think and plan longer than 4 years into the future. And this is the only thing I agree with Jamie Oliver on ...apart from his excellent recipe for cheesey chops.

I think this is all very different to the self regulated medical world ...sorry to blather on.

 

https://www.pharmaceutical-journal....l-culprit-insulin-resistance/20203046.article