The Gold Standard? - Part 1


Question Everything


In my health ministry, I start off every session with the statement, “where did you learn that?” I remind my participants to titrate back to the source of the information and make sure it’s credible and has their best interests in mind.


In medicine, most of the methods and standards deployed in your doctors office or local hospital are based on evidence. Be careful, because the evidence may not be what you think.

Remember - “Where did you learn that?” or where is this evidence coming from?

Medical Gold Standards


There are 2 gold standards for medical data that is used to determine what you receive from healthcare.

  1. Peer reviewed data published in major medical journals, and

  2. Randomized controlled studies that attempt to isolate cause and effect to determine causes of disease.

Today we will explore the peer-review process.


An article from the Washington Post on August 1, 2019 discusses the “peer reviewed data” gold standard of evidence, used mainly by the medical community that accepts medical insurance. https://wapo.st/2ZrrIcv?tid=ss_mail&utm_term=.f12a56ed594d


“Researchers commonly refer to peer review as the “gold standard,” which makes it seem as if a peer-reviewed paper — one sent by journal editors to experts in the field who assess and critique it before publication — must be legitimate, and one that’s not reviewed must be untrustworthy. But peer review, a practice dating to the 17th century, is neither golden nor standardized. Studies have shown that:

  • Journal editors prefer reviewers of the same gender,

  • Women are underrepresented in the peer review process.

  • Reviewers tend to be influenced by demographic factors like the institutional affiliation.

  • Shoddy work often makes it past peer reviewers.

  • At times excellent research has been shot down.

Peer reviewers often fail to detect bad research, conflicts of interest and corporate ghostwriting.”

Ghostwriting


Vioxx was promoted by ghostwritten articles. This drug lead to the sudden death of 60,000 - 500,000 people.

Ghostwriting is a particularly insidious process whereby a drug company pays for a study, often getting the result they want - that supports their new and expensive drug - and they get a doctor of high stature to put his/her name on the paper even though they had nothing to do with the study, the data, or the paper.


More from the Washington Post article:

“The editor of one journal told the Senate Finance Committee in 2010 that he suspected that at least a third of the papers submitted to his journal were ghostwritten by public relations agencies and paid for by pharmaceutical companies. Such articles have appeared in dozens of journals, and ghostwriting scandals have involved professors at the University of Pennsylvania, Brown and Harvard. Last year, court documents revealed that Monsanto ghostwrote articles that were published in peer-reviewed journals to counter research on the carcinogenicity of the pesticide glyphosate and to attack regulatory bodies.”


“Peer review has also sometimes stymied important research. Senior scientists are more likely to be asked to assess submissions, and they can shoot down articles that conflict with their own views. As a result, peer review can act as a shield to protect the status quo and suppress research viewed as radical or contrary to the established perspectives of referees. A 2015 study of 1,000 medical journal submissions found that of the papers that were eventually published, the 14 that became the most frequently cited were initially rejected. Groundbreaking studies by Sir Frank MacFarlane Burnet, Rosalind Yalow, Baruch Blumberg and others were rejected by peer reviewers, yet later led to Nobel Prizes.”

My recent blogs have been focused on nutrition as the key to health and longevity. It was ONE SINGLE STUDY in the 1950s in which the peer-review processed failed and placed America, in particular, in a chronic health crisis that continues today. Please consider rereading my blog, “The American Paradox.” That fateful study was called the “7 Country” study.

The Seven Countries Study - Gold Standard?

In the year 1958, an American scientist called Ancel Keys started a study called the Seven Countries Study, which examined the association between diet and cardiovascular disease in different countries. The study revealed that the countries where fat consumption was the highest had the most heart disease, supporting the idea that dietary fat caused heart disease.


The problem is that data was intentionally left out, including:

  • Countries where people ate a lot of fat but had little heart disease, such as Holland and Norway.

  • Countries where fat consumption was low but the rate of heart disease was high, such as Chile.

Basically, he only used data from the countries that supported his theory, a process known as cherry picking. This flawed observational study gained massive media attention and had a major influence on the dietary guidelines TODAY. For example, The American Heart Association attacked coconut oil, a fat demonized by the Seven Countries Study, in 2017.

I’m not a conspiracy theory person, so what went wrong and why are we stuck with uncorrected and outdated recommendations that are creating harm, not good? It’s simply politics, as usual. Once something is in force, everyone who could benefit from it leveraged the information to their advantage. To change the trend is like turning the Titanic.

The German physicist Max Planck (center in picture) said that science advances one funeral at a time. Or more precisely: “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it."


Don’t let one of those funerals by yours! Fats, including saturated fats, are critical to your health by reducing inflammation, providing a fuel other than sugars and carbs, and support your brain which is largely composed of fats.

The Pure Study

The Pure Study is a new population based study. That means it's a study of populations in general, without trying to restrict the behavior of the people or focus on a single change. The study concludes:

"High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke (that is, high saturated fat intake was associated with low stroke rates). Global dietary guidelines should be reconsidered in light of these findings."

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/fulltext


Harvard Medical School immediately accused the study as being misleading. But consider this:

  • A new study shows that stroke risk increases dramatically when LDL - the particle that carries cholesterol through your body - gets too low (in the range your cardiologist wants). See a previous blog titled, "When 'Bad' Cholesterol gets Too Low."

  • The PURE study indicates that saturated fats LOWER your risk of stroke.

  • LDL carries saturated fats through your body. Don't let old studies with a lack of evidence influence you. Don't rush to take statin drugs without first doing your homework- they increase your stroke risk.

See the connection? Yet, large institutions are trying to create confusion.

“Where did you learn that?”


Regarding fats including saturated fats, we have learned they are 'bad' from poor and biased evidence. To quote Dr. Richard Laudon, we learned it from "evidence-biased" medicine.

Statins - Cholesterol Lowering Drugs

Statin drugs lower your Liver's ability to produce LDL. LDL is a soap-like structure that carries fats throughout your body to where they are needed. An important role of these fats is to repair damaged tissue and reduce inflammation. Statin drugs REDUCE the benefit of the healthy PURE Study diet. Thus the American Heart Association offers two strikes against heart health.


1. They encourage an unhealthy carbohydrate-based diet.

2. They encourage lowering of LDL - that transports healthy fats through your body.

Conclusion

Don't believe everything your doctor tells you because some of their information is from "evidence-biased" studies.


Do try to understand "root-cause" medicine, that is, mechanisms of disease. With that knowledge, you cannot be fooled by the "evidence." Where did you learn that?

Be Well...




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Wisdom is better than strength. Nevertheless the poor man's wisdom is despised. And his words are not heard. Words of the wise, spoken quietly, should be heard. Rather than the shout of a ruler of fools. 

-Ecclesiastes 9:16-17

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