nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Friday, June 18, 2010

How Do We Merge Thousands Of Bits Of Health Advice Into Meaningful Action?

Eat brown rice, do this, don't do that...does all of it really matter?

I decided to write this post, despite my aversion to giving health advice.  If you need that, see your doctor, or there are thousands of books and websites that will advise you on everything from dating to constipation.

Nostrums was created to look beyond this superficial and puerile level of information on research and health policy.

I'll set the stage by this paragraph from the NY Times Health Blog (June 15):
"Now a new study from researchers at Harvard reports that Americans who eat two or more servings of brown rice a week reduce their risk of developing Type 2 diabetes by about 10 percent compared to people who eat it less than once a month. And those who eat white rice on a regular basis — five or more times a week — are almost 20 percent more likely to develop Type 2 diabetes than those who eat it less than once a month."
Brown rice is just white rice without the bran layer stripped off.  As you might imagine, leaving bran in the product--which is fiber--does all the good things bran does, including an improvement in blood sugar regulation.  That makes this study not all that revealing.  So, do what you want about brown rice.

What's more interesting, and the point of this post, is the cumulative effect of thousands of these articles each year reporting research on health benefits and risks.

Do they add up to anything, really?  Each "effect," described by the research studies is an isolated finding.  In order to show that the effect, beneficial or harmful, is actually occurring behind the scenes, all other effects, or variables, had to be excluded ("controlled for" in the jargon).  That's the way science works, generally.  There are some tools for handling more than one variable at a time (I'll continue to use that word instead of "potential effect"), but it gets terribly complicated very quickly as the number of variables rises, and the likelihood that anything will surface from the complex mish-mash goes way down.

Bear with me here.  Take a step back from cloning in on something like brown rice and its influence on our health, and ask whether in the context of a thousand other everyday things that could have an impact on our blood sugar regulation (and the disorder associated with it, diabetes), are we talking about something that's really of benefit?  If you are inactive, have a family history of diabetes, are overweight, taking any one of a dozen medications that effect blood sugar (the list goes on forever), how likely is it that you can change your diet from white to brown rice and expect anything to happen?

Very few of the media reports ever admit to this in their reporting of the Latest Great Discovery, because it undercuts the impression they're trying to create.  If you knew it probably doesn't do squat to eat brown rice in "real" life, then the article is a waste.

We're assaulted with thousands of these bits and pieces of advice over time.  Put them all together and the "new" content, stuff that's really helpful, beyond what common sense would tell you, is practically nil.  There are very few that are strikingly prescriptive (usually a "don't ever do this"), but it's been my experience that a lot of those come from an unregulated alternative medicine market (remember Laetrile, from peach pits?)

My advice is to throw most health advice into a big bag in your head under the label of General Info For Validation By Common Sense, and take it all with a grain of...well...rice.

Doc D

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