Saturday, 18 October 2008

Bad Science

Don't interpret anything I put on this blog as advice. No siree. I will not tell you what to do or how to do it. It is a collection of my own personal experiences and view on life, the universe and everything. No matter what I write or how I write it, it is NOT advice. If you seek to follow any of it then I am happy to answer any questions but really, the choice is yours. That is until now. There will now follow some advice - and let me state this as clearly as I can:

You MUST buy 'Bad Science' by Ben Goldacre. In case you are in any doubt about this advice I will repeat it. You MUST buy 'Bad Science' by Ben Goldacre. At the very least, put it on your Christmas list!

Let me explain.....

Paleo Types
If you have found this blog then you are probably a paleo dude already. You will have shunned conventional dietary advice and turned the food pyramid upside down - enjoying lots of fats (including saturated), eggs and red meat. You are probably as scared of cholesterol as you are of your own shadow.

Furthermore, you have probably looked at a lot of opinion from reasonably qualified doctors such as Dr Michael Eades and Dr John Briffa to give you intellectual comfort to your decision to go paleo and ignore the low fat, complex carb and calorie counting model (LFC4).

In addition you might well lack formal medical qualifications but might have tackled some medical papers. You will have found Eades and Briffa pretty useful to guide you through this minefield and from them will have learned a thing or two about medical research, how to read a medical paper and the world of medicine as a whole.

Finally, you probably recognise media bias - not least against saturated fat (and indeed detect a certain hysteria surrounding it). You will be aware of, amongst other things, the medicalisation of our very lives - every ache and feeling, every limitation of our being, the infomercialisation of medicine and health advice in general, and a certain 'noise' created by celebrity detox plans and plain old bad advice form quacks and assorted others in white coats.

You will have realised from you own experience (visible abs and 'normal' cholesterol tests from your doctor, and maybe even a reduction in some meds), that the paleo model is healthful and pretty easy to follow.

This is where Ben Goldacre's 'Bad Science' comes in.

What is Bad Science?
Goldacre is an NHS doctor and journalist with a gift for communication. He has a regular column in The Guardian (which along with Charlie Brooker's 'Screenburn' is the main reason I read the paper), and an excellent website .

Goldacre is a one man crusade against the bullshit which obscures science. In particular, media fuelled bullshit around medicine, nutrition and general quackery.

In both his newspaper articles, book and on his website, he tackles everything from shoddy journalism on scientific issues to new age quackery and the rise of the celebrity nutritionism business. Goldacre goes after big game! In fact such is the scale of his agenda and such is the size of his intended target that you can relax knowing that this guy is the real deal and somebody worth listening to, as there must be a thousand lawyers out there trying to nail him. But his case would appear to be water-tight. Go Ben!

Goldacre takes your hand and leads you through several medically oriented 'news storms' from the past decade - back to the cold hard data. He explains the origin of the data, comments on its quality, notes flaws in methodology and then looks at the conclusions. He then turns your head around so you can see how far you have come. The distance between the edge of these media storms and the science underneath them is pretty scarily far.

From MMR and other health scares, through 'Brain Gym' and on to nutritionists such as Gillian McKeith and pill peddlers such as Patrick Holford, Goldacre coolly draws out the facts of the story and assembles them in a way that will make you look at just about every science story covered in the popular media with increased skepticism and a (more) critical eye.

What is more is that this book also serves as a rough guide to scientific methodology, giving you some useful tools with which to dissect research and get a feel at the outset whether the conclusion that follows is likely to be up to much (Dr Mike Eades, Tamir Katz and Anthony Colpo are also excellent at this).

He recognises the confusion that surrounds science and the fear of mathematics/science in general. He observes our mistrust of much of the medical industry and the underlying profession. He addresses the fiscal influence of 'big pharma' on both doctors and the media - and the media's part in hyping up a storm to flog advertising space and increase sales/viewers. His spotlight searches out 'bad science' wherever it may exist - and he isn't afraid to upset the apple cart in pursuit of this objective.

He goes further and notes our own innate weaknesses - appreciation for patterns when what we are seeing is actually random. The romance of a 'maverick scientist' fighting big pharma and the government for the sake of parents and their sickly kids ("won't someone purleez think of the kids?"). Such emotionally charged stories have massive currency to the media. He takes time addressing these personal interest stories knowing the media loves a story that will connect to you in a way that bypasses your logic and strikes you with that fear of 'what if it were my kid?'

We are a reactionary species and our sense of flight of fight kicks in all to often when a more rational approach my be more productive. Science is of no use to the scared, only running or fighting.

Once we have calmed down, only then can we look at the data and reassure ourselves accordingly.

Questioning Paleo
I am all to aware that my simple paleo filter is not rooted in science. I trust that as I have achieved my current level of health and fitness more easily than using a low-fat diet with lots of cardio, then I must be doing something right (that and the fact that my doctor keeps rolling his eyes each time I turn up for a medical as if to say "You are fit as a fiddle so why the hell are you here?).

It is easy for us to lose sight of the broader picture and become as entrenched in our paleo view as the low fat brigade are in their model. There would appear to be a growing body of evidence to suggest that the low carb model has real benefit with little drawback, but we have to be careful with how far we extrapolate that evidence to our current idea of what it is to be paleo.

Diet Delusion

If there was one disappointment for me in the book it is where Goldacre alludes to the fact that we all know what is meant by a healthy lifestyle and healthy food,

  • "If I was writing a lifestyle book it would have the same advice on every page, and you'd know it all already. Eat lots of fruit and vegetables, and live your whole life in every way as well as you can: exercise regularly as part of your daily routine, avoid obesity, don't drink too much, don't smoke, and don't get distracted from the real, basic, simple causes of ill health."
The fact is we don't 'know it already' and fifty years of low fat dogma have distracted us from the real, basic and simple causes of ill health. The advice to 'avoid obesity' isn't that simple for many people.

But to criticise him on this point is rather parochial - he has bigger fish to fry and this is but one small part of the scientific fog that he is endeavouring to cut through.

Personally I think that this is easily the most important book to any paleo-dude's collection after Gary Taubes' 'Good Calories, Bad Calories'. If you found GCBC a bit difficult in places then fear not, Bad Science is way more accessible.

I actually sent an email to Ben Goldacre about GCBC when it first came out, but sadly he didn't seem too enthralled by it. Having read Bad Science I am sure he would find it enthralling - tackling as it does an abuse of science by both governments, business (including pharma) and the media. It covers exactly the kind of ground Bad Science does and it would be really interesting to hear his views on both Taubes' tome and the lipid hypothesis in general.

Goldacre's book is worthy of massive success. Guys like him, Taubes, Eades and for the religiously inclined, Richard Dawkins, have a gift for communication; an ability to clearly and concisely explain complex issues and basically to look through the bullshit. They can lead you through some tough topics after which you feel intellectually stimulated and indeed smarter. All done with a side-order of humour.

Ultimately this book is a call to arms for us to empower both ourselves and our kids with the tools to understand scientific method, to support scientific endeavour and to eschew the bullshit that infects our lives and blights society, be it from pharma, government, the 'meeja' or some new-age missive. It is a manifesto in support of critical thinking.

I genuinely think that the paleo crowd are already on the path Goldacre is trying to map out. He would personally be a massive asset to the paleo movement - all we need do is have a whip round to get him GCBC!


Walter said...

I searched my local library for Bad Science and found Taubs' book by the same name. Its about the cold fusion debacle.

Asclepius said...

Hi Walter - yeah "Bad Science: The Short Life and Weird Times of Cold Fusion" is on my 'to read' list.

I really recommend Ben Goldacre's 'Bad Science'.