“Medical Reversals?”

An interesting NYT blog piece on medical reversals

The consequences of medical reversal are complicated. For starters, reversal challenges the notion that medicine is scientific — the premise that a century ago helped doctors to exorcise images of snake oil and hucksterism. But despite impressive progress, faith in medical leadership is currently at its lowest point in 50 years, a decline likely accelerated by a widespread sense that medical dogma often flip-flops.

On a practical level, reversals also mean accomplishing the near impossible: convincing people to abandon strongly-held convictions. Antibiotics have been used for ear infections for so long, and so pervasively, that years after studies showed they do more harm than good, parents and doctors continue to believe.

Anybody who is currently following a low carb high fat diet and has made the mistake of mentioning this salient fact to their physician is all too familiar with this phenomenon. How resistant to new facts M.D.’s can be.

The reasons treatments like antibiotics for ear infections persist are complicated. Patient expectation, patient-doctor communication, cultural norms, time pressures and financial factors all contribute, making solutions fraught. Meanwhile, scientifically-debunked practices remain common, and troubling.

Shall we add ‘lipiphobia‘ to that list? (related)

So how does this happen?

The pattern repeats: A promising new therapy or technology is introduced based on weak data and later, more rigorous studies discredit the practice. When I spoke with Dr. Prasad, he suggested a more staid, scientific approach. “The adoption of practices based on little or no good evidence is our biggest problem,” he said. “If we decide to use new technologies while waiting for definitive studies, they should be labeled ‘experimental,’ and patients should be counseled appropriately.”

Kinda like this?

The great, flaming irony here is that lipophobia is arguably the biggest and most damaging experiment ever conducted on a human population in the history of the world. And though the data is in, unbelievably it is still ongoing

We spend more time sick now than a decade ago
Despite longer life spans, fewer years are disease-free

Original paper: Mortality and Morbidity Trends: Is There Compression of Morbidity? Eileen M. Crimmins and Hiram Beltrán-Sánchez. J Gerontol B Psychol Sci Soc Sci (2010)

A 20-year-old today can expect to live one less healthy year over his or her lifespan than a 20-year-old a decade ago, even though life expectancy has grown. (snip)

The average number of healthy years has decreased since 1998. We spend fewer years of our lives without disease, even though we live longer. (snip)

Functional mobility was defined as the ability to walk up ten steps, walk a quarter mile, stand or sit for 2 hours, and stand, bend or kneel without using special equipment. (snip)

A male 20-year-old today can expect to spend 5.8 years over the rest of his life without basic mobility, compared to 3.8 years a decade ago — an additional two years unable to walk up ten steps or sit for two hours. A female 20-year-old can expect 9.8 years without mobility, compared to 7.3 years a decade ago.

And among serious medical folk the subject of nutrition, other than scolding patients to do low fat/high carb harder, is simply not on their radar in any appreciable way. In fact to bring it up will get you a condescending sneer and a lecture about the dangers of animal fat. We know, when we were improving our health massively by doing the exact opposite of what modern medical science recommends Michelle was seeing multiple Doctors, everyone of whom was running full panel tests on her.

To a one they would enter the examination room marveling at Michelle’s improvement and wonder what she was doing. When we informed them that it was simply LCHF (blank look) Atkins, they would recoil in horror and insist we stop immediately as Atkins was dangerous, everybody knows that!

With the exception of the nephrologist, he was interested until he learned it was a dietary intervention and said “Boy, I wish we could make a Pharma for that.”

To which we replied, “there is a Pharma Doc, food.” As this flew in the face of his received religion he just tuned us out. Here’s what we think, if the average American reversed their diet, eating large amounts of saturated fat preferably from animals and eliminating processed carbs most hospitals could eliminate eighty percent of their current volume.

And perhaps that is why the medical profession always reacts with hostility to this simple idea?

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