Posted on February 18, 2010 07:09:04 AM
I had never intended to write about climate. It is too far from the things I know about. But recent events have unleashed a Palin-esque torrent of comments from people who clearly know even less about it than I do. In any case, it provides a good context to think about trust in science,
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Earthrise from moon. (click to enlarge)
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My interest in it, apart from little matters like the future of the planet, lies in the reputation of science and scientists.
I have been going on for years now about the lack of trust in science, and the extent to which it is a self-inflicted problem. The latest reactions to the developments at the University of East Anglia and the IPCC may show the nature of the problem with dreadful clarity,
Many of us came into science because, apart from the sheer beauty of nature, it seemed like one of the few honest ways of earning a living. Most scientists that I know still think like that, but recent
events invite some reexamination of honesty in science.
How dishonest is science?
The first thing to say is that I have never come across anything in my own field that would qualify as fraud, or even dishonest. I did once have a visit from a rather distressed postdoc (not in my area of work) who felt pressurised by her boss into putting an interpretation on her work that she did not agree with. In the end, the bit of work in question was left out of the paper. That could be held to be dishonest, in that the omission wasn’t mentioned, but it could also be held that the omitted result was too ambiguous to contribute much to the paper. It was just short of the point where I’d have felt compelled to do something about it. But only just. That is about the worst thing I’ve encountered in a lifetime.
There is, of course, an enormous difference between being wrong and being dishonest. Any research that is worth doing has an outcome that can’t be predicted before the work is done. At best, one can hope for an approximation to the truth. Mistakes in observations, analysis or interpretation will sometimmes mean the announced result is completely wrong, with no trace of dishonesty being involved. But when that happens, others soon fiind the mistake. It is that self-correcting characteristic of science that keeps it honest in the long run.
Of course there have been occasional cases of outright fraud, simple
falsification or fabrication of data. How often it occurs is not really known. There is a recent analysis in PLoS One, about verified cases of misconduct in the USA suggested that 1 in 100,000 scientists per year are to blame, but other ways of counting give larger numbers. For example, if asked around 2 in 100 scientists claim to be aware of misconduct by someone else., The numbers aren’t huge but they are much bigger than they should be.
It isn’t perhaps surprising that the Fanelli study found misconduct was most on in clinical pharmacological studies, which are often funded by the pharmaceutical industry, Basic biomedical research and other subjects were better, though sadly that could be only because they are less often offered money.
What gives rise to dishonesty?
It seems obvious that one motive is money, as suggested by the worst rates of misconduct being found in the clinical pharmacological studies, It is well known that studies funded by industry are more likely to produce results that favour the product than those funded in other ways.
The other reason is presumably the human desire to win fame, promotion and to get grants.
It is no excuse, but it is perhaps a reason for misconduct that the pressure to publish and produce results is now enormous in academia. Even in good universities people are judged by the numbers (rather than the quality) of papers they produce and by what journal they happen to be published in. Contrary to public perception, even quite senior people have no guarantee that they can’t be fired, and life for postdoctoral fellows, who do a large fraction of experimental research, is harsh to the point of cruelty. They exist on a series of short term contracts, they work exceedigly hard and have poor prospects of getting a secure job. In conditions like that, the only surprising thing is that there is so little dishonesty.
The pressure to publish in particular journals is particularly invidious because it is known that the number of citations that a paper gets (itself a fallible measure of quality) is independent of the journal in which it appears. Bibliometrists are the curse of our age. (See, for example Challenging the tyranny of impact factors, 2003; and How to get good science, 2007 or its web version; and Peter Lawrence’s article, The mismeasurement of science)
The enormous competitive pressure under which academics work is imposed by vice-chancellors, research councils and other senior people who should know better, It is a self-inflicted wound.
In other words, the authorities provide a strong incentive to do poor, over-hurried and occasionally dishonest science. Perhaps the surprising thing in the circumstances is that there is so little outright fabrication. The very measures that have the aim of improving science actually have just the opposite effect. That is what happens when science is run by people who don’t do it.
For an idea of what life is like in science now, try Peter Lawrence’s Real Lives and White Lies in the Funding of Scientific Research. Or, for someone at the other end of their career, Jennifer Rohn’s account on Nature blogs.
Given the high degree of insecurity for young researchers, compounded by well-intentioned but vacuous “training” from daft Robert’s’ "training courses", or the dismaly ineffective Concordat, the only surprise is that so many people remain honest and devoted to good science. Nothing raises the ire of hard-pressed scientists more than the constant emails form HR trying to force people to go to gobbledygook courses on "wellbeing". Times Higher Education recently did a piece on "Get happy", The comments are worth reading.
So what about climate change?
Out of thousands of pages in the IPCC reports, a single mistake was found, On page 493 of the IPCC’s second 1000-page Working Group report on “Impacts, Adaptation and Vulnerability” (WGII) it was said that Himalayan glaciers were “very likely” to disappear by 2035. Glaciers are melting but that date can’t be justified. This single mistake has been blown out of all proportion. Furthermore it is important to notice that the mistake was found by scientists, not by ’sceptics’. It is a good example of the self-correcting nature of science. Nevertheless this single mistake has provoked something close to hysteria among those who want to deny that something needs to be done.
On the other hand, the hacked emails from the University of East Anglia (UEA) look bad. It simply isn’t possible at the moment to say whether they are as bad as they seem at first sight, We just don’t know whether anything of importance was concealed, but we should know.
One thing can be said with certainty, and that is that the reaction to their revelation by Dr Phil Jones, and by the vice-chancellor of the University of East Anglia, was nothing short of disastrous. Fred Pearce put it very well in Climate emails cannot destroy proof that humans are warming the planet
Most unforgivably of all, UEA refused to comply with requests under the Freedom of Information Act, and there is some reason to think that relevant material was deleted. The deputy information commissioner, Graham Smith, said: in a statement that
“The emails which are now public reveal that Mr Holland’s requests under the Freedom of Information Act were not dealt with as they should have been under the legislation. Section 77 of the Freedom of Information Act makes it an offence for public authorities to act so as to prevent intentionally the disclosure of requested information.”.
That seems to me to be a matter that requires the resignation of the vice-chancellor. On this matter, I think George Monbiot is spot on in his article “Climate change email scandal shames the university and requires resignations“.
There was a big feature about academic freedom in Times Higher Education recently. One of the problems was what happens to someone who brings their own university into disrepute. But when that term is used, it is always used about junior partners in the organisation (you know, professors and the like). It should apply equally to heads of communications and vice-chancellors who bring their own university into disrepute, whether the disrepute is brought about by failing to comply with the Freedom of Information Act, or by promoting courses in junk medicine.
In general, conspiracy theories are wrong. I’m not sure how much of the distortion of climate data results from surreptitious funding of opposition to doing anything by the fossil fuel industry. The Royal Society is an organisation that is not usually prone to conspiritorialist views. That means one must take it seriously the fact that in 2006, the Royal Society wrote to ExxonnMobil to ask them to stop funding climate denialist organisations. This is a bit like the way Big Pharma has been caught funding “user groups” that endorse their products. Some newspapers like to stir up controversies about things that aren’t very controversial. For example there is a good analysis of a recent Sunday Times piece here.
Of course it is often alleged that "quackbusters" are funded by Big Pharma, though in fact the amounts of money involved are far too small for Big Pharma to bother. Climate deniers too like to suggest that there is some sort of conspiracy, arranged between hundreds of labs in the world to conceal the fact that there is no such thing as warming. I guess that shows only that deniers know little about how science works. it is an exceedingly competitive business, and getting hundreds of labs to say the same thing would be like trying to herd cats.
If there is a problem, it is the other way round. Labs are in such intense competition with each other, that it lcan lead to undesirable levels of secrecy.
Blogs in which researches have a direct dialogue with the public are a big help. As always in the blogosphere, the problem is to find the reliable sources. Two excellent sites, in which scientists (not journalists or lobbyists) talk directly with the public are realclimate.org and Andrew Russell’s blog. The post on RealClimate, IPCC errors: facts and spin, is especially worth reading.
Total openness is the only cure
All the raw data and all emails have to be disclosed openly. Everything should be put on the web as soon as possible. By appearing to go to ground, UEA has made enormous problems for itself and for the rest of the world. Some people object to total openness on the grounds that the other side tells lies. In the case of climate change (and in the case of junk medicine too) that is undoubtedly true. The opponents are ruthlessly dishonest about facts. The only way to counter that is by being ruthlessly and visibly honest about what you know, and why.
The UK’s Meteorological Office has, to its great credit, put raw data on line. That policy has already paid off, because a science blogger found a mistake in the way that some Australian data had been incorporated into forecasts. The Met Office thanked him and corrected the mistake. In fact the error makes no substantial difference to the warming trend, but the principle is just great. The more people who can check analyses and eliminate slip-ups the better.
Putting raw data on the web is an idea that has been gathering force for a while, in all areas of work, not just climate change. In my own are (stochastic properties of single ion channel molecules) our analysis programs have always been available on the web, free to anyone who wants them, despite the large amount of work that has gone into them. And we run a course. almost free, on the theory that underlies our analyses. Within the last couple of months we have been discussion ways of making public all our raw data (in any case, we would always have sent it to anyone who asked). Digitised single channel records are big files (around 100 Mb) and it is only recently that the web has been able to deal with such large amounts of raw data. There are also problems of how to format data so other people can read it, The way we are all heading is clear, and the fact that some people in climate science appeared to be hiding raw data is a disgrace.
Public relations is not the cure
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It is not uncommon to read that science needs better PR. That is precisely what is not needed. PR exists to put only one side of the story. That makes it an essentially dishonest occupation. Its aims are the very opposite of those of science. The public aren’t stupid: often they recognise when they are getting half the story.
It is particularly unfortunate that many universities have developed departments with names like "corporate communications". Externally they are seen as giving information about science, and indeed some of the things they do are successful public engagement in science. Only too often, though, it is made clear internally that an important aim of these departments is to improve the image of the university.
But you have to choose. You can engage the public in science or you can be a PR image-builder. You can’t be both.
The matter came to a head in 2008 when, according to a report in Times Higher Education, the University of Nottingham issued a memo that defined public engagement as: “The range of activities of which the primary functions are to raise awareness of the university’s capabilities, expertise and profile to those not already engaged with the institution”.
The mainstream media and political blogs
The biggest problem of all with climate change is that it has become more about politics than about facts. It has become an essential credential for any conservative to deny that climate is changing. It is part of their public image, and most conservatives neither know nor care about evidence. Like Sarah Palin, they just know. In the USA especially, the argument is not really about climate at all. It is really about discrediting Barack Obama -a sort of swift-boat treatment that uses whatever lies are needed.
Just as with the great MMR fiasco and the promotion of its false link to autism, reports in newspapers and blogs must bear much of the blame for failing to inform readers of the actual underlying facts and, just as important, the uncertainties. Of course some papers have done a pretty good job, particularly the Guardian and the Independent in the UK, and the New York Times.. The political blogs, by and large, haven’t. The Huffington Post has made little effort (and publishes some appalling nonsense about medicine too).
The problem with political blogs and tabloid newspapers is that they are much more interested in sensation and circulation than they are in giving accurate news and information. Take, for example, the Guido Fawkes blog. To be fair, the blog itself says "The primary motivation for the creation of the blog was purely to make mischief at the expense of politicians and for the author’s own self-gratification. Its writer", so you know not to expect much, Paul Staines, was at the Westminster Skeptics event, Does Political Blogging Make a Difference? He makes no pretence of taking the news seriously, which, I guess, is why I don’t read his blog. After the talks I asked why his blog did little about climate change. His answer was "where are your sandals?". On the way home I tweeted, from a very overcrowded train (most trains from Euston being cancelled that night),
"On way home from #sitp political blogging. Learned that Guido serious about nothing but Guido. Narcissist not journalist."
At least one other person there agreed (thanks, Dave Cole).
It was good to hear Sunny Hundall of Liberal Conspiracy (the only one I read), but I found myself agreeing mostly with the chair, Nick Cohen. It would be a tragedy if the great national and local papers were to vanish. Guido Fawkes and Huffington Post are not remotely like proper newspapers.
Specialist blogs like this one are fine if you are interested in the topics we write about, but we don’t begin to supplant proper newspapers. Bloggers can and do occasionally get good stories. Those that are written by scientists can analyse more critically than most journalists have either the knowledge or the time to do. Bur they don’t come close to supplanting the detailed reporting in good newspapers of local events, what happens in law courts or in parliament. That’s why it is vital to buy newspapers, not just read them free on the web.
Follow-up
Posted on February 12, 2010 04:59:15 AM
Every single request for information about course materials in quack medicine that I have ever sent has been turned down by universities,
It is hardly as important as as refusal of FoI requests to see climate change documents, but it does indicate that some vice-chancellors are not very interested in openness. This secretiveness is exactly the sort of thing that leads to lack of trust in universities and in science as a whole.
The one case that I have won took over three years and an Information Tribunal decision against the University of Central Lancashire (UCLAN) before I got anything.
UCLAN spent £80,307.95.(inc VAT) in legal expenses alone (plus heaven knows how much in staff time) to prevent us from seeing what was taught on their now defunct “BSc (Hons) homeopathy”. This does not seem to me to be good use of taxpayers’ money. A small sample of what was taught has already been posted (more to come). It is very obvious why the university wanted to keep it secret, and equally obvious that it is in the public interest that it should be seen.
UCLAN had dropped not only its homeopathy "degree" before the information was revealed, They also set up an internal inquiry into all the rest of their courses in magic medicine which ended with the dumping of all of them.
Well, not quite all, There was one left. An “MSc” in homeopathy by e-learning. Why this was allowed to continue after the findings of UCLAN’s internal review, heaven only knows. It is run by the same Kate Chatfield who ran the now defunct BSc. Having started to defend the reputation against the harm done to it by offering this sort of rubbish, I thought I should finish. So I asked for the contents of this course too. It is, after all, much the same title as the course that UCLAN had just been ordered to release. But no, this request too was met with a refusal
Worse still, the refusal was claimed under section 43(2) if the Freedom of Information Act 2000. That is the public interest defence, The very defence that was dismissed in scathing terms by the Information Tribunal less than two months ago,
To add insult to injury, UCLAN said that it would make available the contents of the 86 modules in the course under its publication scheme, at a cost of £20 per module, That comes to £1,720 for the course, Some freedom of information.
Because this was a new request, it now has to go through the process of an internal reviw of the decision before it can ne referred to the Information Commissioner. That will be requested, and since internal reviews have, so far, never changed the initial judgment. the appeal to the Information Commissioner should be submitted within the month. I have been promised that the Information Commissioner will deal with it much faster this time than the two years it took last time.
And a bit more unfreedom
Middlesex University
I first asked Middlesex for materials from their homeopathy course on 1 Oct 2008. These courses are validated by Middlesex university (MU) but actually run by the Centre for Homeopathic Education. Thw MU site barely mentions homeopathy and all I got was the usual excuse that the uninsersity did not possess the teaching materials. As usual, the validation had been done without without looking at what was actually being taught. The did send me the validation document though [download it] As usual, the validation document shows no sign at all of the fact that the usbject of the "BSc" is utter nonsense. One wonderful passage says
“. . . the Panel were assured that the Team are clearly producing practitioners but wanted to explore what makes these students graduates? The Team stated that the training reflects the professional standards that govern the programme and the graduateness is achieved through developing knowledge by being able to access sources and critically analyse these sources . . . “
Given that the most prominent characteristic of homeopaths (and other advocates of magic medicine) is total lack of critical ability, this is hilarious. If they had critical ability they wouldn’t be homeopaths. Hilarious is not quite the right word, It is tragic that nonsense like this can be found in an official university document.
Middlesex, though it doesn’t advertise homeopathy, does advertise degrees in Traditional
Chinese Medicine, Herbal Medicine and Ayurveda. On 2nd February 2010 I asked for teaching materials from these courses. Guess what? The request was refused. In this case the exemptions under FOIA were not even invoked but I was told that "All these materials are presently available only in one format at the University – via a student-only accessed virtual learning environment. ". Seems that they can’t print out the bits that I asked for, The internal review has been requested, then we shall see what the Information Commissioner has to say.
Two other cases are at present being considered by the Information Commissioner (Scotland), after requests under the Scottish FoIA were refused. They are interesting cases because they bear on the decision, currently being considered by the government, about whether they should implement the recommendations of the execrable Pittilo report.
Napier University Edinburgh. The first was for teaching material form the herbal medicine course at Napier University Edinburgh. I notice that this course no longer appears in UCAS or on Napier’s own web site, so maybe the idea that its contents might be disclosed has been sufficient to make the university do the sensible thing.
Robert Gordon University Aberdeen The second request was for teaching material from the “Introduction to Homeopathy” course at the Robert Gordon University Aberdeen. The particular interest that attaches to this is that the vice-chancellor of Robert Gordon university is Michael Pittilo. The fact that he is willing to tolerate such a course in his own university seems to me to disqualify him from expressing any view on medical subjects.
Michael Pittilo, Crohn’s disease and Andrew Wakefield
Michael Pittilo has not been active in science for some time now, but Medline does show scientiifc publications for Pittilo RM, between 1979 anf 1998. Between 1989 and 1995 there are five papers published jointly with one Andrew Wakefield. These papers alleged a relationship between measles virus and Crohn’s disease. The papers were published before tha infamous 1998 paper by Wakefield in the Lancet (now retracted) that brought disgrace on Wakefield and probably caused unnecessary deaths.. The link between measles and Crohn’s disease is now equally disproved.
The subject has been reviewed by Korzenik (2005) in Past and Current Theories of Etiology of IBD. Toothpaste, Worms, and Refrigerators
“Wakefield et al proposed that Crohn’s results from a chronic infection of submucosal endothelium of the intestines with the measles virus [Crohn's disease: pathogenesis and persistent measles virus infection. Wakefield AJ, Ekbom A, Dhillon AP, Pittilo RM, Pounder RE., Gastroenterology, 1995, 108(3):911-6]“
"This led to considerable media interest and< public concern over use of live measles vaccine as well as other vaccines. A number of researchers countered these claims, with other studies finding that titers to measles were not increased in Crohn’s patients, granulomas were not associated with endothelium 49 , measles were not in granulomas50 and the measles vaccine is not associated with an increased risk of Crohn’s disease51–55 "
This bit of history is not strictly relevant to the Pittilo report, but I do find quite puzzling how the government chooses people from whom it wishes to get advice about medical problems.
Posted on January 6, 2010 10:56:33 AM
Jump to follow-up
The purpose of this post is to reveal a few samples of things that are taught on a homeopathy ‘degree’ course. The course in question was the "BSc Hons homeopathy course at the University of Central Lancashire (UCLAN). Entry to this course was closed in 2008 and, after an internal review, UCLAN closed almost all of the rest of its courses in alternative medicine too. The university is to be commended for this .
The purpose of making public some of what used to be taught is not to embarrass UCLAN, which has already done the sensible thing, but to make it clear that the sort of thing taught on such courses is both absurd and dangerous, in the hope of discouraging other courses
.Three years after I first asked for teaching materials, the Information Commisioner ruled that all the reasons given for refusal were invalid, and they must be handed over. However UCLAN then appealed against the decision, so the appeal went to an Information Tribunal. That appeal was lost decisively and UCLAN was.obliged to provide the whole of the course material.
On Christmas Eve I got five large box files, 13.7 kg of documents, or 30 pounds, in old money.
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Because these documents are copyright, I rely on the twin defences of fair quotation (only a tiny proportion is being quoted) and public interest. The Information Tribunal decided very firmly that it was in the public interest that it should be known what is taught on such courses, and that can be achieved if some of it is made public. Here are a few extracts.
Code of ethics
The students are given a copy of the code of ethics of the Society of Homeopaths. This is 25 pages long, but paragraph 48 is especially interesting.
48 Advertisements, stationery and name plates maintain a high standard of propriety and
integrity to enhance the reputation of homeopathy.
- Advertising shall not contain claims of superiority.
- No advertising may be used which expressly or implicitly claims to cure named diseases.
- Advertising shall not be false, fraudulent, misleading, deceptive, extravagant or sensational.
No mention though, of the fact that this code of ethics has been repeatedly breached by the Society of Homeopaths itself, on its own website. See, for example, here in 2007 and again in 2009. as well as Ernst’s article on this topic.
Anyone who has followed dialogues among homeopaths knows that "claims to cure named diseases" is the norm not the exception. The code of ethics is just a bad joke. And the (late) course at UCLAN was no exception. Take, for example, course HP3002, Therapeutic Homeopathy, module leader Jean Duckworth.
Homeopathic treatment of cancer
There was a lecture on HP3002 called "A Homeopathic Approach to Cancer (Ramakrishnan methodology [sic])".. Here are 10 slides from that lecture. It is illegal to claim to be able to cure cancer under the Cancer Act 1939. If a homeopath were to make claims like these in public they’d be open to prosecution, not to mention in breach of the SoH’s code of ethics. If cancer is not a "named disease", what is?
Aha so it is better if the water is diluted in some more water.
Specific treatments for a named disease are recommended.
What happened to treating the whole person? Now specific organs are being treated. The term "affinity", as used here, is of course sheer hocus pocus.
It is easy to forget when reading this that none of the “medicines” contain any medicine whatsoeever.
Notice that the term "remedy" is used throughout. Any reasonable person would interpret "remedy" to imply "cure", though no doubt a homeopath, if challenged, would claim that "remedy" carried no such implication. The last slide is typical of junk medicine: the personal testimonial, supplied with no detail whatsoever. Just an anecdote which is useless as evidence.
This lecture alone strikes me as a cruel (and possibly illegal) hoax perpetrated on desperate patients. Of course a true believer might get some solace from taking the sugar pills, but that is not sufficient justification.
The same course dealt with quite a lot of other "named diseases", autism, ADHD and coping with a heart attack. And, you are asked, did you think arnica is just a first aid remedy?
If that isn’t a list of "named diseases", what is? The code of ethics appears to be a total sham.
And of course never forget that the “arnica” doesn’t contain any arnica anyway. And if you don’t believe that you can read the words of Kate Chatfield, module leader on thie very course, as recorded in the minutes of evidence to the Select Committee on Science and Technology .
Q538 Lord Broers: I have a simple, technical question about homeopathy and drugs. Is it possible to distinguish between homeopathic drugs after they have been diluted? Is there any means of distinguishing one from the other?
Ms Chatfield: Only by the label.
You can read a lovely analysis of the views of Kate Chatfield by physicist A.P. Gaylard here.
Follow-up
The Daily Telegraph. January 8th 2009 Ian Douglas reported on this post: The workings of a BSc in homeopathy
The Lancashire Evening Post carried a big spread on January 15th, Professor seeks out the truth about ‘quackery’.
River’s Edge. News and thoughts from Preston, Lancashire reviewed the Lancashire Evening Post article on Saturday January 16th: Homeopathy at UCLAN, a degree in quackery.
The cost of trying to stop this material being revealed. UCLAN told me on 5 February 2010 that the legal costs alone were £80,307.94 (inc. VAT). That doesn’t include staff time and photocopying. I’m not convinced that this was a good way to spend taxpayers’ money.
Posted on December 28, 2009 06:10:39 AM
There is no topic more widely discussed than what one should eat in order to stay healthy. And there are few topics where there evidence is so lacking in quality. This post isn’t about quackery, but about something much more important. it is about the real science (if it merits that description) behind dietary advice. I’m not an expert in nutrition, but I do know a bit about the nature of evidence. I’m continually astonished by the weakness of the evidence for some things that have become received truths, and nowhere is that more true than in nutrition.
The BMJ used my review of Gary Taube’s book, The Diet Delusion, to start off their new Round Table feature [full text link to BMJ].
The published version had some big cuts so I publish the original version here. Taubes was kind enough to send me a copy of the book after I’d mentioned his wonderful New York Times piece in my previous excursion into the murky world of diet and health, Diet and health. What can you believe: or does bacon kill you?
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The biggest omission in the BMJ version was Taubes’ own ten point summary of his conclusions (on page 454).
"“As I emerge from this research, though, certain conclusions seem inescapable to me, based on existing knowledge
- Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization
- The problem is the carbohydrates in the diet, their effect on insulin secretion, and thus the hormonal regulation of homeostasis – the entire harmonic ensemble of the human body. The more easily digestible and refined the carbohydrates, the greater the effect on our health, weight, and well-being.
- Sugars – sucrose and high-fructose corn syrup specifically – are particularly harmful, probably because the combination of fructose and glucose simultaneously elevates insulin levels while overloading the liver with carbohydrates.
- Through their direct effect on insulin and blood sugar, refined carbohydrates, starches, and sugars are the dietary cause of coronary heart disease and diabetes. They are the most likely dietary causes of cancer, Alzheimer’s disease, and the other chronic diseases of civilization.
- Obesity is a disorder of excess fat accumulation, not overeating, and not sedentary behaviour.
- Consuming excess calories does not cause us to grow fatter, any more than it causes a child to grow taller. Expending more energy than we consume does not lead to long-term weight loss; it leads to hunger.
- Fattening and obesity are caused by an imbalance – a disequilibrium – in the hormonal regulation of adipose tissue and fat metabolism. Fat synthesis and storage exceed the mobilization of fat from the adipose tissue and its subsequent oxidation. We become leaner when the hormonal regulation of the fat tissue reverses this balance.
- Insulin is the primary regulator of fat storage. When insulin levels are elevated – either chronically or after a meal – we accumulate fat in our fat tissue. When insulin levels fall, we release fat from our fat tissue and use it for fuel.
- By stimulating insulin secretion, carbohydrates make us fat and ultimately cause obesity. The fewer carbohydrates we consume, the leaner we will be.
- By driving fat accumulation, carbohydrates also increase hunger and decrease the amount of energy we expend in metabolism and physical activity.”
It is on these bases that Taubes suggests that the increase in obesity is, in part, a consequence of the recommendation of a low fat, and hence high sugar diet.
The Diet Delusion [ pp 601]
(published in the USA as Good Calories, Bad Calories)
Gary Taubes 2008
There is no topic more widely discussed than what one should eat in order to stay healthy. And there are few topics where the evidence is so lacking in quality. It is also a topic that is besieged by gurus, cranks and supplement hucksters.
You need to beware of misleading titles. Dietitians are good. Nutritionists are sometimes good. But titles like ‘nutritional therapist’ and ‘nutritional medicine’ are usually warning signs of alternative therapists and/or pill salespeople.
Gary Taubes is a journalist, but he is quite an exceptional journalist. His account of the importance of randomisation for the establishment of causality is one of the best ever and it was published not in an academic journal, but in the New York Times [1]. His book, The Diet Delusion, is in the same mould. It is more complete and more scholarly than most professional scientists could manage. Not only does it cover the literature right back to Samuel Johnson, but it is also particularly good at unravelling what one might call the politics of science. And by politics I don’t mean the vast lobbying industry that has built up with the aim of selling you unnecessary supplements, but the politics of academia.
Obesity sounds simple. If you are fat it is because you eat too much or exercise too little, right? Well no, it’s not as simple as that. For a start, it has been shown time and time again that low fat diets, and exercise, have small and temporary effects on weight. The problem with diet and health revolves round causality. The law of conservation of energy is an inevitable truth, but says nothing about causality. It could imply that you get fat because you eat too much, or equally the causal arrow could point the other way and “we eat more, move less and have less energy to expend because we are metabolically or hormonally driven to get fat”. The assumption that positive caloric balance is the cause of weight gain has predominated since the 1970s and “this simple misconception has led to a century of misguided obesity research”.
At the heart of the problem is the paucity of randomised trials, which are the only way to establish causality. Those that there are have usually shown that diet does not matter as much as we are told. Taubes concludes
“It does little good to continue basing public health recommendations and dietary advice on association studies (the Framingham Heart study and the Nurses Health Study are prominent examples) that are incapable of reliably establishing cause and effect.”
I think it can certainly be argued that the problem of causality has been greatly underestimated. We are warned constantly of the dangers of processed meat, on the basis of very unconvincing evidence [2].
This is one reason why we still know so little about the causes of obesity, diabetes and heart disease. For Taubes, a major villain was the US nutritionist Ancel Keys (1904 – 2004). His
forceful advocacy of the low-fat hypothesis in the early 1970s, was, says Taubes, based on ignoring the many studies that did not agree with the idea. It seems that the sort of citation
bias, recently described systematically by Greenberg [3], resulted in great exaggeration of the strength of the evidence.
It is quite possible that there was rather more to be said for the Atkins diet than was apparent at the time. The fact that Atkins was not a university scientist, that his views were extreme and that he was so obviously out to make a lot of money from it, gave him all the appearance of being yet another profiteering diet guru. He was dismissed by the medical establishment as a quack. Taubes points out that conflict of interest cuts both ways. Atkins’ sternest critics at Harvard were funded by General Foods, Coca-Cola and the sugar industry. It adds up to a sorry story of a conflict of vested interests and scientific vanity.
Taubes’ final judgement is harsh. He quotes Robert Merton’s description [4] of what science is, or should be.
“The organization of science operates as a system of institutionalized vigilance, involving competitive cooperation”
In such a system, scientists are at the ready to pick apart .and assess each new claim to knowledge. This unending exchange of critical appraisal, of praise and punishment, is developed in science to a degree that makes the monitoring of children’s behavior by their parents seem little more than child’s play".
He then comments
“The institutionalized vigilance, “this unending exchange of critical judgment”, is nowhere to be found in the study of nutrition, chronic disease, and obesity, and it hasn’t been for decades.”
It took Taubes five years to write this book, and he has nothing to sell apart from his ideas. No wonder it is so much better than a scientist can produce. Such is the corruption of science by the cult of managerialism that no university would allow you to spend five years on a book [5]. I find all ten points in his summary convincing. But his most important conclusion is that you cannot have any certainty without randomised trials.
The business of nutrition is greatly at fault for not having put more effort into organising randomised trials. Until they are done, we’ll never really know, and we shouldn’t pretend that we do.
1. Taubes G. Do we really know what makes us healthy? New York Times 2007 Sep 16.[full text link] [pdf file]
2. Colquhoun, D. (3 May 2009) Diet and health. What can you believe: or does bacon kill you?.
3. Greenberg, S.A.. 2009 How citation distortions create unfounded authority: analysis of a citation network. BMJ ;339:b2680 [pdf file].
4. Merton, R. K. Behavior Patterns of Scientists . Leonardo, Vol.3 1970; 3(2):213-220. From Jstor [or pdf file]
5. Lawrence PA. The mismeasurement of science. Curr Biol 2007; 17(15):R583-R585.PM:17686424 [pdf file] [commentary]
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If length had allowed, there should certainly have been a reference here to Robert Lustig of UCSF. He is an academic nutritionist who supports the main thesis of Taubes’ book. See, for example, his 2005 review, Childhood obesity: behavioral aberration or biochemical drive? Reinterpreting the First Law of Thermodynamics [full
text link]. Lustig’s slide show, The Trouble with Fructose is available in the NIH web site.
There are a couple of other articles by Taubes that are well worth reading. The Scientist and the Stairmaster Why most of us believe that exercise makes us thinner—and why we’re wrong. Gary Taubes, in New York Magazine, and We can’t work it out, in the Guardian.
You can see Taubes in action on YouTube, for example in “on Cholesterol and Science Practices“, and “on Carbohydrates and Degenerative Diseases“. There is also a video of Taubes on medical grand rounds at Dartmouth-Hitchcock Medical Center in June 2009. You can see Robert Lustig on YouTube too: “Sugar: The Bitter Truth“.
Follow-up
22 December.2009, Unlike the serious questions dealt with in the Diet Delusion, this concerns merely another bit of the ubiquitous nutribollocks that crops up in the media, While writing this I was listening to the excellent early evening news programme, PM, run by Eddie Mair, when a diet-related topic came up, it was nonsense about how a cocktail made with vodka, cointreau, acai juice and pomegranate juice would not give you a hangover. I suppose it was meant as christmas fun but whenever I hear the words ‘antioxidant‘ or ’superfood; I feel an email coming on. It seems that Eddie Mair liked the fact that the email contained the words ‘quack’ and ‘codswallop’ because the next thing I knew I was asked to give an interview on next day’s programme. The mp3 is here.
