Prospective randomized controlled trials on diet — why are they so rare?

I came across this study recently and it got me making 😛 TAGEND

A criticism of RCTs in nutrition

The author’s criticisms are laughter in comparison to the profound and unavoidable Type 1 and Type 2 corrects that fill the majority of members of epidemiological based research, which is the majority of food science. They are interesting points in and of themselves and certainly should be taken into consideration anytime one is doing good research, but no similarity. Like criticizing the cupholders in a Tesla while epidemiology is akin to a Ford Pinto that can’t even start on a cold day.

As an example, look at this study of intragastric balloons for weight loss, a horribly invasive procedure that is often done as a last resort for those who have almost no other option 😛 TAGEND

Intra gastric bags – RCT

Does this have the same issues as a dietary study would? Yes. Did the authors still are to be able to do an effective study? Yes. With things that don’t lead to profit, it’s almost as if we’re not even trying.

Take keto for example — to date, there are only a few dozen RCTs of its impact 😛 TAGEND

32 RCTs of keto

In the context of food science as a whole, this is a paltry sum.

Also — the idea that dietary studies are unethical is one of the best smokescreens the meat and agricultural industries have put out there — ended misinformation and propaganda.

If we objectively knew that something was the best treatment — like antibiotics for an infection or positioning a disintegrate bone — then yes, to do something that we were sure was less effective would be unethical. Again think to the gastric balloon study above. Tell me, that’s ethical while menu termination nutritions are not? And rendering someone’s diet during a study would be far less costly than a surgical procedure any day of the week.

We truly has got no idea with diet. Keto, Paleo, Atkins, Vegan, Carnivore, Fruitarian, any one of these could be the best. Epidemiology has only baffled developments in the situation further. Can you imagine a field of research stagnating over a half century? At this level, it’s not menu discipline, it’s food philosophy. Trying to do the same thing again and again without result.

In situations of misgiving, the only way forward is prospective randomized doubled blinded multi center tribulations. Otherwise you’re stuck with a priori reasoning and resemblance. Inductive reasoning. A genuinely inadequate road to develop theories. This is where superstition and religious fundamentalism is born. That’s why it’s such a knot to try and debate approaches.

Prospective studies are how we figured out retroviral combinations for AIDS or chemotherapy combinings for cancer. We didn’t exactly refuse to experiment because we had a treatment that “kind of” ran. And as it stands, current dietary recommendations “kind of” don’t work at all.

The ethics assertion is meant to obscure the real reason these studies haven’t been done: the food and agriculture industry. Their hallways and capital affect are big, and they strongly persuade the NIH to not apportion gifts to study that indicates their food is bad for you. Proponents of each say, “Well why is the meat industry stronger than the fruit industry? Shouldn’t these conflict interests cancel out? ” It doesn’t relatively direct like this. Instead of cancelling out, they both suppress. The investigate doesn’t get done. A scientist doesn’t want to hamstring his busines coming in between these titans.

This becomes for both sides of the tent — the dairy, egg, agricultural, meat industries. Got Milk, Beef it’s What’s for Dinner, etc. If you had a multibillion dollar industry and you were a producer, wouldn’t you pool with your competitors to fund a business expedition and vestibule? Why wouldn’t you? In the capitalistic system, the goal is to win.

All of them do the same dirty underhanded nonsense. They learned from the best — Big Tobacco did this to devastating effects for most of the 20 th century. Big Food is filled with the same yanks. It is impossible to convince a humanity of a reality if his billfold depends on him conceiving the opposite.

As an example of a food science impression that I have: I don’t suppose the genetic carbohydrate filled monstrosities that we announce fruit are not good for almost anyone other than those who have issues metabolizing fat( PEMT discrepancies not taking choline etc .) But this is inductive reasoning based on a handful of my patients that were willing to get genetic testing and carefully move their nutritions — even then when you have a specific genetic even out, it doesn’t mean your genes are definitely “turned on”. We know so, so few without randomized prospective studies.

I remember trying to get nutritional experiment funded for fatty liver with fund introduced for their food and obtains tracked via their smartphones; both publication editors and my lab administrator time chuckled in my face when I referred research proposals.

“Interesting idea. Who’s gonna pay for this? ” with a knowing smirk. No one would.

“Sure if you’ll work for free.”

“How are you going to stop people from cheating? “( literally a appraisal that can be applied to any stimulant, diet or behavioral revision study in existence ).

It takes about a billion dollars to raise anti-retroviral drugs from terrace to bedside when you tally up the tabs, research and trial penalties. Approximately a few hundred billion dollars to do an efficient diet study on a large scale( you would save a portion of the benchside costs ).

The thing we know definitively works for longevity and general state in the average person is caloric restriction. But we don’t know how much and how you get now. It’s really anecdotes — “I received this works” and “I perceived this doesn’t work.”

I think we’re going to look back on this time in food discipline as part of its dark ages. I hope we can change this.

submitted by / u/ toafobark [ connection ] [ mentions ]

Read more: reddit.com