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Big Placebo says Medicine never cures anything

Kudos to Lindsay Beyerstein of Majikthise for coining a new appellation “Big Placebo.” Big Placebo is the alternative health counterpart to Big Pharma. Both are special interest groups designed to promote their products, whether they are worthy of promotion or not. There is one big difference between them: Big Pharma makes products that usually work (though not always, and sometimes not safely). Big Placebo hawks books and products that never work.

Big Placebo is unsatisfied with the $40 billion it takes in every year on treatments that don’t even work. They’re aiming for a much larger piece of the healthcare pie and to do so they are criticizing modern medicine.

To hear Big Placebo tell it, virtually all illness can be prevented and anyone who gets sick deserves it because of poor lifestyle choices. If only that were so. Unfortunately, most illness and disease is caused by factors beyond people’s control, including infectious agents, genetic defects and inherited predispositions.

Another axiom in the Big Placebo armamentarium is the notion that contemporary American Medicine cures nothing and merely “manages” diseases. According to “Dr.” John Neustadt (naturopathic doctor) writing in the Huffington Post:

The current system teaches disease management and symptom suppression, which is insufficient to meet our healthcare needs. A reformed system needs a new paradigm that stresses health promotion and treatments that attempt to correct the underlying causes of disease.

Dr. Andrew Weill, of Weil Lifestyles LLC, licensing Weil Nutritional Supplements (vitamins and supplements), Dr. Andrew Weil for Origins (skin-care products), Pet Promise (premium pet food), Dr. Andrew Weil for Tea (premium teas), Lucini Italia Organics(organic extra virgin olive oil and whole, peeled tomatoes), Weil by Nature’s Path (organic cereals and nutrition bars), Weil for Vital Choice, Weil Baby™ (baby feeding systems), Weil by Vita Foods, and Orthaheel™, claims:

By no stretch of the imagination does mainstream American “health care” move us closer to this vision of robust, resilient health. It is a fiscally unsustainable, technology-centric, symptom-focused disease-management system.

To hear them tell it, American medicine cures nothing. It simply manages disease and suppresses symptoms. It is a measure of the astounding success of the American medical system that anyone could seriously contemplate such nonsense. American medicine cures so much disease, involving so many people, so reliably and so often that everyone takes it for granted.

Evidently American Medicine doesn’t cure anything except … tuberculosis, pneumonia, bacterial meningitis, gonorrhea, any bacterial illness you care to name. American medicine routinely cures previously deadly conditions like appendicitis, ectopic pregnancies and obstetric hemorrhage. Better yet, it can completely prevent many viral and bacterial scourges through vaccination. It’s not a coincidence that American lifespan has increased from 48 years to 77.7 years in slightly more than a century. Much of what routinely killed Americans is now routinely cured.

In fact, cure is so routine that these illnesses rarely enter American consciousness. No one worries about dying from tertiary syphilis, diphtheria or rheumatic heart disease. Those diseases are routinely prevented or cured in their early stages.

And “disease management” is hardly a deficiency, either. Some diseases cannot yet be cured. Until the day that a cure is discovered, we manage those diseases. Juvenile (type I) diabetes was uniformly fatal until the discovery of insulin. Insulin doesn’t cure diabetics; it merely allows them to live an addition 50 years or more. Instead of dying in childhood, type I diabetics routinely live to have and enjoy grandchildren. Such “disease management” is worthy of praise, not the contempt that Big Placebo attempts to heap on it.

Can we do better? Of course we can, particularly in the areas of chronic diseases caused by smoking and alcohol abuse. However, that’s a far cry from claiming that American Medicine doesn’t cure disease. That cynical and disingenuous claim should be understood for what it is, Big Placebo’s attempt to line its own pockets. Alternative health purveyors and practitioners are charlatans and quacks … and dishonest.

Posted in: Science and Medicine

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240 thoughts on “Big Placebo says Medicine never cures anything

  1. provaxmom says:

    Sadly, not only do some of them think modern medicine does nothing, in fact they think it actually does more harm. And yet they don’t see themselves as becoming complacent and taking things for granted, they are renegades and mavericks who are challenging the current medical system. Because of course, today’s doctors do nothing to try to further advance medicince by challenging the system. They’re just sheep doing what big pharma tells them.

  2. provaxmom says:

    Sadly, not only do some of them think modern medicine does nothing, in fact they think it actually does more harm. And yet they don’t see themselves as becoming complacent and taking things for granted, they are renegades and mavericks who are challenging the current medical system. Because of course, today’s doctors do nothing to try to further advance medicince by challenging the system. They’re just sheep doing what big pharma tells them.

  3. Brian says:

    In the mind of the general public it seems very easy to conflate the system of delivering medicine (with all of its failings and real-world challenges) with the actual discipline of medicne as a scientific human endeavor. I think that the healtch care debates our American friends are having now may only add to the problem.

  4. mlegower says:

    If only Atlas could shrug and not kill thousands (if not millions) of people. That would seem to be the only way to shut these people up.

  5. DevoutCatalyst says:

    And these are the folks who want to integrate a complementary and alternative sloppy wet French kiss with real medicine — on the house. Your house.

  6. a says:

    I’m pretty sure modern medicine does promote health and treatments to address the underlying cause for disease. Don’t I see news reports and hear my doctor telling me to exercise more, eat less, and not smoke, so as to reduce my chances for stroke, heart attack, and type II diabetes? Big Placebo should be harassing the American public for not listening to their doctors, and for waiting for a pill or surgery to cure illnesses that could have been prevented.

  7. windriven says:

    “Evidently American Medicine doesn’t cure anything except … tuberculosis, pneumonia, bacterial meningitis, gonorrhea, any bacterial illness you care to name. American medicine routinely cures previously deadly conditions like appendicitis, ectopic pregnancies and obstetric hemorrhage.”

    Ah, but Dr. Amy, in the fabulous world of Big Placebo (I personally prefer Big Herba) these diseases don’t exist because a special combination of 27 herbs and spices (first discovered by Colonel Sanders in the 1950s) taken daily prevents most diseases instead of simply managing them as so-called “modern” medicine does. And on the rare occasion that one finds oneself coughing up blood or suffering burning sensations during urination, 3 drops of tincture of newt diluted in Lake Erie will set things right.

    Now see? All those years you spent in medical school were wasted. You should have been something useful like an E-Lit major.

  8. DevoutCatalyst says:

    Don’t get me started on the medical school aspect. That is, alternative medical schooling. With our newfound knowledge regarding sham acupuncture, you could teach the real thing in about an hour, saving much human misery and dollars. As it stands, you could almost get your Airline Transport Pilot License in the same amount of time as the quack, and get paid to fly passengers for less income than an acupuncturist, but at least you’d have your dignity, and a skill that is utterly unforgiving of stupidity.

  9. lizkat says:

    “To hear Big Placebo tell it, virtually all illness can be prevented and anyone who gets sick deserves it because of poor lifestyle choices. If only that were so. Unfortunately, most illness and disease is caused by factors beyond people’s control, including infectious agents, genetic defects and inherited predispositions.”

    Of course we can’t prevent all illness by having a healthy lifestyle! I doubt that anyone makes such an absolute claim. On the other hand, you’re saying that most illness today is unrelated to lifestyle, and that just doesn’t seem right. We know, for example, that the obesity epidemic has resulted in a type 2 diabetes epidemic, which contributes directly to heart disease (and various other diseases). That is just one example of a serious and very common disease that has a strong link to lifestyle.

    Of course genetics and luck are involved in any disease, but for modern Americans, lifestyle is often an extremely important factor. Cancer is probably also related to lifestyle, sometimes, since it can be related to obesity.

    Some of the most common diseases of middle-aged and older Americans are lifestyle-related. And this is very well known and easy to verify. There have been enough studies showing this fact, so that it is hard to understand why you deny it.

    No, an unnatural and unhealthy lifestyle is not the cause of all diseases. Of course not! Things are not so absolute and simple. But unhealthy lifestyles are extremely common today, since physical activity is not a necessary part of everyday life for most of us, and since processed food is easily available and cheap.

    A healthy lifestyle requires conscious decisions now days, and the average American doesn’t have the time or inclination to think much about it. And MDs like yourself, who assure your patients their chronic conditions are all because of genetics, etc., just make things even worse.

  10. lizkat says:

    And I forgot to mention smoking! Don’t tell me that doesn’t contribute to cancer!!

  11. bonedoc says:

    What else can moderate medicine do? Forgive me please for belaboring the point. Even this long reply only illustrates a fraction of advances due to science based medicine.

    Vaccination
    Tens of thousands of people now avoid smallpox annually because it was eradicated by vaccination. In America we avoid tens of thousands of polio cases, diphtheria cases, pertussis cases and 100s of thousands of measles cases. We have vaccines that treat or prevent rabies, typhoid, cholera, plague, tetanus, pertussis, influenza, varicella, rotavirus, mumps, rubella, hepatitis A. and B., Haemophilus, cervical cancer, pneumococcus, meningococcus, parainfluenza, respiratory syncytial virus, and more. This has resulted in a dramatic decline in morbidity and mortality.

    Nutrition
    The mortality during childbirth is 100 times lower than it was 100 years ago. Much of this change is due to vitamin D supplementation of dairy products preventing pelvic deformity due to rickets. There has been a dramatic diminution in birth defects due to folate supplementation of bread. Food fortification has nearly eliminated major nutritional deficiency diseases such as rickets, goiter, and pellagra.

    Surgery and Anesthesia
    Surgical anesthesia and antiseptic surgery allows life-saving and life improving treatment. Hip fractures remain a common injury in the elderly although there has been some success with osteoporosis treatment and prevention. A hip fracture treated in traction resulted in an approximately 80% death rate within the first three months, now 10 or 20% within one year with modern surgical care. Appendicitis without surgery was a near certain death sentence. Many traumatic injuries or serious illnesses such as cancer are now survivable. Heart bypass machines and valve replacement surgery prolongs of the lives of thousands. Ruptured aortic aneurysm is cured by surgical graft replacement of the damaged artery. Some brain aneurysms can be treated before rupture preventing brain damage and death. Heart bypass or angioplasty can limit the extent of heart muscle death after heart attack and diminish the likelihood of future injury the pain. Severe crippling arthritis can now be treated with joint replacement that has a high success rate, literally allowing the lame to walk again. Amputated digits, arms, legs, and feet have been successfully reattached with techniques that are now routine, and also used to repair serious nerve and artery injuries preventing substantial disability and suffering.

    Antibiotics
    Infections that are now curable routinely led to death, disability, and great suffering before the antibiotic era.

    Immune System Diseases
    The survival rate from autoimmune disease has dramatically improved, and the morbidity diminished due to disease modifying medications. Protease inhibitors prolonged the survival of AIDS patients.

    Cancer
    Many cancers can be treated with chemotherapy resulting in long remission or prolonged survival, especially when combined with modern surgical techniques when indicated. Surgical removal of a single metastatic cancer mass has resulted in the prolonged survival in some diseases.

    Blood Clotting
    The early use of thrombolytic agents has prevented permanent heart damage and heart attack and permanent brain damage in the stroke. Cases of fatal pulmonary embolism and embolic stroke have been reduced with prophylactic use of anticoagulation, and the treatment of phlebitis. Hemophilia is survivable and treatable.

    Genetics
    Genetics screening and knowledge has allowed families to avoid some of the risks of passing on genetically based diseases to their offspring. PKU, now usually detected at birth with mandatory screening tests, is cured with a special diet

    Fractures
    Surgical fracture treatment has improved diminishing the burden of suffering, posttraumatic arthritis, deformity, and disability. Fracture nonunion (lack of healing) and, which can lead to pain, deformity, and disability, can now be successfully treated with surgical techniques including bone grafting, transplant, bone transport, and improved surgical hardware. People at risk for fracture can sometimes be identified and treated with effective medications that reduce there risk for future fractures, avoiding the associated morbidity and mortality.

    Transplant
    Patients with otherwise fatal conditions have survived many years after transplant of heart, liver, lung, kidney, or bone marrow.

    Poison
    Narcotic, Valium, and other overdoses can be treated with specific antagonist drugs that save lives. There are antitoxins that can be used to treat those envenomed by poisonous animals and insects.

    Mental Illness
    Much of the profound suffering and disability due to severe mental illness can be ameliorated with medication and modern psychiatric treatment.

    Public-health and medical research
    The importance of clean water, preventing diseases such as cholera and typhoid, water fluoridation, the role of scurvy prevention with diet, the importance of hand washing, the role of smoking in lung cancer, treatment of hypertension, advances of family planning, and a myriad of other advances that now improve and save 100s of thousands of lives are the result of science based medicine.

    Steven Zeitzew
    Orthopaedic surgeon, Los Angeles, California
    - This document has been prepared with voice recognition software. Please excuse unusual errors. -

  12. bluedevilRA says:

    “And MDs like yourself, who assure your patients their chronic conditions are all because of genetics, etc., just make things even worse.”

    Lizkat, this is a huge mischaracterization of what Dr. Tuteur said.
    Her words:

    “Unfortunately, most illness and disease is caused by factors beyond people’s control, including infectious agents, genetic defects and inherited predispositions.”

    She very clearly says most, not all disease.

    Doctors routinely recommend lifestyle changes (within the patient’s physical limits) to people with heart disease, obesity, diabetes, etc. That is part of the standard of care for these patients. Have you not seen the massive campaigns against smoking? We know smoking is a poor lifestyle choice. Hence, why doctors encourage their patients to quit.

    You single out the most visible diseases. You’re right that obesity is an epidemic right now and a large part of that is due to lifestyle (excessive calories, poor exercise, etc.). However, there are literally thousands of diseases known to medicine and the great majority of them have little to do with lifestlye choices, as Dr. Tuteur points out. I encourage you to try to list off more of your so-called “lifestyle diseases” and I will respond with a list of every infectious disease (numbering in the 1000′s alone), autoimmune disease, neurological disease, psychiatric disease, and so on. I’m pretty sure I will win.

  13. lizditz says:

    I prefer “Biq Quacka”

    For push-back on health-insurance coverage of unproven, unscientific “treatments” see the Homeopathy 10^23 campaign in the UK “Homeopathy: There’s Nothing In It.

  14. “On the other hand, you’re saying that most illness today is unrelated to lifestyle”

    I’m saying that most illness today is what’s left after modern medicine has treated, cured or prevented the diseases that were responsible for the vast majority of deaths of children and adults.

    The fact that chronic diseases of the elderly are now the leading causes of death is a sign of the tremendous success of modern medicine, not a sign of its inadequacy.

  15. EricG says:

    @ lizditz

    i think you fall short on a few points here.

    “Of course genetics and luck are involved in any disease, but for modern Americans, lifestyle is often an extremely important fasd as actor. Cancer is probably also related to lifestyle, sometimes, since it can be related to obesity.”

    True – However…if you lump everything “lifestyle” into a group – all things related to smoking, obesity, sunbathing…extreme sports…you name it – you might have a list of 100 (maybe 500?) conditions and ancillary conditions as a factor there of.

    There are (anyone care to provide an estimate?) literally THOUSANDS of things that can go wrong with you, many of which sbm can address, cure, manage, ameliorate or suppress. I think HH is correct in her use of “most.” You could start counting here:

    http://en.wikipedia.org/wiki/Lists_of_diseases

    “And MDs like yourself, who assure your patients their chronic conditions are all because of genetics, etc., just make things even worse.”

    Do you, HH, recommend that patients make no lifestyle changes in the event such changes could have a positive impact? And, further, assert that all of your patients suffer some genetic condition? Come on! That is patently absurd generalization.

    I am not coming to HH’s rescue (I’m sure she’ll address these points if they sufficiently arouse her arguing muscles) but rather, pointing out where you have used a broad brush to paint a necessarily complicated portrait of health and wellness (and of the Drs. who participate). I suspect that it might be fueled by your own displeasure at seeing lazy americans pop pills and contribute to skyrocketing health care by failing to be proactive in their own health outcomes.

  16. EricG says:

    whoops, Dr. T wrote this post…not HH. sub where necessary

  17. lizkat says:

    “The fact that chronic diseases of the elderly are now the leading causes of death is a sign of the tremendous success of modern medicine, not a sign of its inadequacy.”

    I think this is partly true, but partly a myth. Infant and child mortality have decreased dramatically. In nature, a high percentage of offspring do not survive. It is nature’s efficient, but cruel, method of keeping species healthy overall. So yes, modern medicine has dramatically increased our lifespans, largely because babies and young children seldom die, while in the past they very often died.

    But the average person who survives childhood does not come down with a lot of diseases that are unrelated to lifestyle, and which require medical attention. Yes, of course, some do, but very large numbers do not.

    I am not bashing modern medicine — it does save people who would have died from serious injuries, or from bacterial infections, and it does prevent certain viral infections.

    But it is misleading to say that we are only surviving to middle age only thanks to medical interventions. Yes, many of us would have died in childhood. But most adults do not depend on modern medicine to keep them alive.

    Unless they have one of the very common chronic diseases that are caused by our the very unhealthy lifestyle of the average American.

    Let’s say you went to a society that did not practice the unhealthy modern lifestyle. If you decreased infant and child mortality in that society, do you think you would see an enormous increase in chronic disease in the middle-aged?

    I really do not think so. But that seems to be what you are claiming.

  18. Calli Arcale says:

    The on that always really gets me is the accusation that “Western medicine” doesn’t treat the cause of diseases — it just treats the symptoms. Given how many diseases have a symptom unrelated to the cause which gets treated, this seems an absurd thing to say. It’s as if they want us to believe people who go into an ER with a gangrenous leg will be treated with pain killers, not antibiotics. Doctors do treat symptoms; it’s so you can function while waiting for the condition to improve. I take phenazopyridine when I have a urinary tract infection. Doesn’t cure it. Great symptom relief until the ciprofloxacin my doctor prescribed does its job.

    It gets especially funny, though, when the argument is made by a homeopath, and I have seen that more than once before. “You don’t treat the cause, you treat the symptom,” says the homeopath, right before going off an preparing a remedy explicitly designed to treat the patient’s symptoms with no regard to the cause.

  19. lizkat says:

    “There are (anyone care to provide an estimate?) literally THOUSANDS of things that can go wrong with you,”

    Most of us, in my estimation anyway, have never been cured of a life-threatening disease. Most of the non-lifestyle diseases are relatively rare. And there are only a relatively small number of serious diseases that smb is able to cure reliably.

    How many of us are always rushing to the doctor to be cured of one of those thousands of diseases?

  20. Uncle Glenny says:

    Most of us, in my estimation anyway, have never been cured of a life-threatening disease.

    Maybe because you didn’t get one in the first place?

  21. tahoe69 says:

    speaking of “big placebo”, i came upon this a few months ago on medicalnewstoday.com, Pain Related Placebo Effect Detected in Spinal Cord. “Direct Evidence for Spinal Cord Involvement in Placebo Analgesia” Science, 2009, Vol. 326 no. 5951 p. 404

    Researchers in Germany(University Medical Center Hamburg) found that when they treated volunteers with a placebo that they believed to be a painkiller, scans (fMRI) showed reduced signs of pain-related activity in their(dorsal horn) spinal cords. The author concluded, “these results provide direct evidence for spinal inhibition as one mechanism of placebo analgesia and highlight that psychological factors can act on the earliest stages of pain processing in the CNS”.

  22. Zoe237 says:

    I would also love to know if one of LizKat’s assertions is true or not, because I’ve read it many places. The increase in lifespan is due most significantly to less children and infants dying, (from age 48 to 70 something I believe), and not from people being saved at age 30 (or pick an age past 18). That if a person survived childhood, they were very likely to make it to 50+, and that even hundreds of years ago people routinely lived into their 70s. And that it was primarily vaccinations, germ theory, nutrition, indoor plumbing, sanitation, antibiotics that leads to this decrease in child mortality.

    Theories about the chronic diseases we know have would be interesting too, since we know vaccinations didn’t cause them. I have no idea if it’s really mostly genetic, “out of our control” factors or not. ;-)

  23. lizkat says:

    Zoe237,

    In addition to infant mortality, ancient and primitive people were likely to die from violence or accidents. Traumatic injuries were often fatal, without modern surgery or antibiotics. So if you combine infant mortality with traumatic injuries, that may account for a great deal of the difference in lifespan. We often assume that in previous eras, people were dying from old age in their 30s, but that is not true. And if they were fortunate enough to survive into middle age, they might have been healthier than we are, since they had no soft drinks and they had to walk a lot.

    And yes, I have also read that the great modern advances in health were mostly due to improved nutrition, sanitation, surgical technology, antibiotics and vaccines. It was even stated here at this blog (I don’t remember the exact post though).

  24. micheleinmichigan says:

    # lizkaton 21 Jan 2010 at 2:30 pm

    “There are (anyone care to provide an estimate?) literally THOUSANDS of things that can go wrong with you,”

    Most of us, in my estimation anyway, have never been cured of a life-threatening disease.”

    Well. I’ve had pneumonia once. Like a lot of people I have asthma. Had strep throat twice and another serious throat infection once as a child. My daughter had pneumonia once, had to have a finger reattached once (I know not generally life threatening, unless it became infected) I am hypothyroid, which generally isn’t fatal, short term, but is very common and not fun when untreated. My close friend just recovered from thyroid cancer (not really uncommon). My mom had a serious allergic reaction to shellfish and beestings, epipen probably saved her life. I know three people who have had serious bacterial staph infections that would have resulted in death if left untreated. Five people treated for serious heart disease that would have been fatal. Various children treated for congenital heart conditions. (international adoption group) and since my son was born with severe cleft lip and palate that would have made infant starvation a serious risk, I’ll include him in the group of people I know who’s life probably has been saved by sbm.

    Oh sorry, three people in serious accidents that would have been fatal without ER, hospital care.

    I’m not a medical person either, these are just friends and family.

    When you say most of us can you give me a percentage?

  25. EricG says:

    @ lizkat (lizditz as well?)

    “Most of us, in my estimation anyway, have never been cured of a life-threatening disease. Most of the non-lifestyle diseases are relatively rare. And there are only a relatively small number of serious diseases that smb is able to cure reliably.

    How many of us are always rushing to the doctor to be cured of one of those thousands of diseases?”

    so now its about frequency of particular disease occurence? not exactly sure how that proves your point that lifestyle changes prevent some inordinately large number of diseases and MDs contribute to this problem by denoting all diseases as genetic…

    Likewise, to play on micheleinnmich’s point, my closest people have encountered: occurlar melanoma, cysts, ashma, type 1 diabetes, broken leg, rib, arm, wrist, collar bone, SVT, car accidents, athritis, bee stings, various lascerations…all of which were undoubtedly addressed by sbm. your “most” could use some qualification.

  26. SF Mom and Scientist says:

    Excellent post! This is a topic that really gets my blood boiling. I can’t stand it when I hear someone say our medical system only treats symptoms, and then talks about how they love their chiropractor, who they have to go to for the rest of their life. If the chiropractor actually cured the “root cause”, why can’t you stop going after a while?

    @a – “Big Placebo should be harassing the American public for not listening to their doctors, and for waiting for a pill or surgery to cure illnesses that could have been prevented.”

    That’s the thing. Big Placebo is the one who is selling the pill that will save everyone. People don’t get the answer they want from their doctor, and they find someone who sells them false hope instead. I never understood why these people think that taking some unregulated concoction is more “natural” than taking real medicine.

  27. SF Mom and Scientist says:

    btw, has anybody seen this.

    Future doctors support integrated therapies

    http://latimesblogs.latimes.com/booster_shots/2010/01/alternative-medicine-doctors.html

    I think the title is a bit misleading, because (thankfully) the students are saying that they need more scientific evidence. But still.

  28. lizkat says:

    micheleinmichigan,

    ” three people in serious accidents that would have been fatal without ER, hospital care.”

    I said that modern medicine can save people with traumatic injuries.

    “Five people treated for serious heart disease that would have been fatal.”

    Very often, heart disease that requires surgery is lifestyle-related. No, not always, but often.

    “My close friend just recovered from thyroid cancer”

    Cancer is not one of modern medicine’s triumphs. There are differing opinions, but many believe the attempt to cure cancer has been largely a failure.

    “My daughter had pneumonia”

    And I specifically said that children were very likely to die before modern medicine. That was the point.

    “my son was born with severe cleft lip and palate that would have made infant starvation a serious risk”

    Another childhood example.

    So at least half of your examples were irrelevant to my comment. And I doubt the average adult has quite so many serious health problems as you, that are not lifestyle related. Actually, asthma sometimes is lifestyle related.

    And, as I said, I am not bashing modern medicine. That was not my point.

  29. trrll says:

    “A healthy lifestyle requires conscious decisions now days, and the average American doesn’t have the time or inclination to think much about it. And MDs like yourself, who assure your patients their chronic conditions are all because of genetics, etc., just make things even worse.”

    Yet MDs have been in the forefront of supporting healthy lifestyles–stopping smoking, limiting alcohol intake, losing weight, healthful diet, exercise. I don’t know of any lifestyle modification that has been established to improve health or lifespan that is not energetically promoted by MDs.

    It is Big Placebo that is most guilty of promoting the notion that one can offset the risk of an unhealthy lifestyle by taking vitamins or herbs, eating “organic” foods, and avoiding “unnatural” chemicals. I knew a great guy who thought that he didn’t have to worry about his smoking, because he exercised, and smoked only natural tobacco, without all of those pesticides and synthetic additives of commercial cigarettes. Dead now, of lung cancer.

  30. “But the average person who survives childhood does not come down with a lot of diseases that are unrelated to lifestyle, and which require medical attention.”

    That’s flat out false.

    In 2006, a total of 2,426,264 resident deaths were registered in the United States (Deaths: Final Data for 2006).

    Life expectancy at birth was 77.7 years.

    The 15 leading causes of death in 2006 were:
    1. Heart disease 26%
    2. Cancer 23.1%
    3. Stroke 5.7%
    4. Chronic lower respiratory diseases 5.1%
    5. Accidents 5.0%
    6. Diabetes mellitus 3.0%
    7. Alzheimer’s disease 3.0%
    8. Influenza and pneumonia 2.3%
    9. Kidney disease 1.9%
    10. Septicemia 1.4%
    11. Suicide 1.4%
    12. Chronic liver disease and cirrhosis 1.1%
    13. Hypertension and hypertensive renal disease 1.0%
    14. Parkinson’s disease 0.8%
    15. Homicide 0.8%
    Other 18.5%

    So almost 40% of patients died of disease that have no lifestyle component. (I am assuming that everyone who died from stroke, chronic respiratory disease and chronic liver disease died from lifestyle factors although the percentage in reality is not 100%)

    Now let’s look at the diseases that do have a lifestyle component:

    There were 559,558 deaths from cancer, but most were from cancers that are not associated with lifestyle choices. Approximately 31% of cancer deaths were due to cancers associated with smoking, which represents 7.1% of total deaths.

    There were 631,636 deaths from heart disease. Approximately 67% died from heart problems that may be associated with smoking. That represents 17.4% of total deaths.

    So by my informal back of the envelope calculations, more than 63% of deaths annually are due to diseases that are not related to lifestyle.

  31. lizkat says:

    Heart disease and cancer have by far the largest percentages and both are likely to be influenced by lifestyle. Cancer is sometimes related to obesity, so smoking is not the only lifestyle factor that can lead to cancer. Heart disease, as I said, is related to type 2 diabetes as well as to smoking.

  32. trrll says:

    “Most of us, in my estimation anyway, have never been cured of a life-threatening disease.”

    Really? Ask around. Find out how many people you know have never received an antibiotic for a lung infection (bacterial lung infections were once a common cause of death among otherwise healthy adults). Find out how many have never required antibiotic treatment for an infected cut. And of course, that doesn’t even begin to take into account those who would have died of tetanus–once a lifelong risk of almost any injury, but for their vaccination.

  33. Geekoid says:

    lizkat – “Most of us, in my estimation anyway, have never been cured of a life-threatening disease. Most of the non-lifestyle diseases are relatively rare. And there are only a relatively small number of serious diseases that smb is able to cure reliably.”

    there was a time when you would know at least one person that died from polio. Do to modern medicine, it’s almost eliminated.

    Very few people die of measles or chicken pox, thanks to modern medicine. In fact there are a whole long list of things you probably wont’even get anymore, thanks to modern medicine.

    There are a variety of internal issue that would kill people, but no longer due, thanks to modern medicine.

    pneumonia doesn’t kill as many people as it used to.

    Bones are set properly thanks to modern medicine.

    Infections don’t kill nearly as many people thanks to modern medicine.

    Statistically YOU are alive due to modern medicine.
    You are provably wrong. Go troll elseware.

  34. lizkat says:

    Often related to lifestyle, through type 2 diabetes, related to obesity:

    1. Heart disease 26%
    2. Cancer 23.1%
    3. Stroke 5.7%
    9. Kidney disease 1.9%
    13. Hypertension and hypertensive renal disease 1.0%

    Often related to alcohol overuse:

    12. Chronic liver disease and cirrhosis 1.1%

    Not diseases:

    5. Accidents 5.0%
    11. Suicide 1.4%
    15. Homicide 0.8%

    Lifestyle related, if type 2:

    6. Diabetes mellitus 3.0%

    These should be separated:

    8. Influenza and pneumonia 2.3%

    Pneumonia is often secondary to other problems, which may be lifestyle related.

    So this is all that’s left. And we don’t know to what extent they may be related to environmental factors:

    7. Alzheimer’s disease 3.0%
    10. Septicemia 1.4%
    14. Parkinson’s disease 0.8%

  35. lizkat says:

    Geekoid,

    I very carefully stated the benefits of modern medicine. It is possible for something to have benefits and yet not be wonderful in all respects.

  36. pmoran says:

    Steve:”Cancer
    Many cancers can be treated with chemotherapy resulting in long remission or prolonged survival, especially when combined with modern surgical techniques when indicated.”

    Did you mean to support some highly misleading alt.med rhetoric with this warped characterization of mainstream cancer treatment?

    Of the 50% plus of all invasive cancers that are now permanently cured, the vast majority are cured by surgery. Radiotherapy is the next most common curative agent.

    A small but important group of cancers can be cured by chemotherapy alone, or by combinations of the above, or with the aid of other adjuvants such as immunotherapy or hormonal interventions.

    Even in the palliation of cancer chemotherapy has a less dominant role than many think.

    Chemotherapy was already a soft enough target for quack cancer propaganda. Nearly everyone will know of someone who received it but who still died of their cancer.

  37. “Often related to lifestyle, through type 2 diabetes, related to obesity:

    1. Heart disease 26%
    2. Cancer 23.1%
    3. Stroke 5.7%
    9. Kidney disease 1.9%
    13. Hypertension and hypertensive renal disease 1.0%”

    Yes, but as I just explained above, only a subset of those deaths are related to lifestyle factors.

    It is axiomatic among purveyors of “alternative” health that most disease and death is attributable to lifestyle choices. Not only is that claim factually false, it is symptomatic of the wishful thinking that characterizes “alternative” health. At it’s heart “alternative” health is about pretending that good health is entirely within your control, that people who follow the guidelines are guaranteed to be healthy and that people who are sick brought it on themselves.

    It would be very nice if that were true, but it’s not.

  38. EricG says:

    lizkat

    I am interested in recapturing your point, if you don’t mind sharing. I think you tread on some valid points, but have basically lost what you are asserting.

  39. micheleinmichigan says:

    #
    # lizkaton 21 Jan 2010 at 4:38 pm

    “I very carefully stated the benefits of modern medicine. It is possible for something to have benefits and yet not be wonderful in all respects.”

    Oy, let me introduce you to my husband. :)

    and I would agree, in modern medicine there is room for improvement. But I like to focus on specific issues that could generate reform ideas rather than broad generalizations.

  40. SimonH says:

    Some medical schools in Australia where I’m from, have teaching sessions on “integrative medicine” ie integration of mainstream and alternative medicine. Most of the medical students and junior doctors I teach think alternative medicine has some basis. Of course they can’t quote any actual papers and say things like “well I tried acupuncture and it helped” or “my sisters best friend swears by homeopathy and it seems to have helped her”.

    Note that alternative medicine is big on anything that is nebulous or benigh, it is not so hot on things that are less so ie bone fractures, leukemia, heart attacks, etc.

    For a bit of fun see the brilliant UK sketch on You Tube: That Mitchell and Web Look: Homeopathic A&E. Surely the best spoof on alternative medicine ever!

  41. Circe of the Godless says:

    lizkat my whole family all lived pretty healthily. All reasonably slim and fit. My father had 2 heart attacks but died of stomach cancer, all his 11 other siblings died of heart attacks or cancer, my grandparents on both sides both died of cancer (bowel), my mother had a stroke a while ago, age 77.
    Honestly it is offensive of you to suggest that these bung genetics are all due simply to lifestyle choices.
    I live healthily, eat reasonably well, am active and reasonably fit. I find it very unlikely that I will die of anything else other than heart attack or cancer.
    Also, you may not be aware that slim, fit & currently HEALTHY PEOPLE DIE TOO at some stage.

  42. Enkidu says:

    “Most of us, in my estimation anyway, have never been cured of a life-threatening disease”

    My sister had the measles. A good friend of mine ovarian cancer. My mother-in-law had a heart attack and a stent put in. I had a rotavirus infection while an infant and spent a week in the hospital. My daughter had a group B strep infection in utero… to save her I had to undergo an emergency c-section and she was born 3 months premature. Surfactant works wonders.

    Thank you modern medicine.

  43. tmac57 says:

    Somewhere in all of this give and take, the basic idea of this article may have been lost: “Western” (science based) medicine=effective. Cam=ineffective (as far as current evidence shows). Do any of the commenters here really dispute this?

  44. lizkat says:

    Enkidu,

    I explained that I was talking about non-lifestyle related diseases, and that I was not talking about childhood diseases. Most of your examples are irrelevant to what I was saying.

  45. lizkat says:

    [“alternative” health is about pretending that good health is entirely within your control, that people who follow the guidelines are guaranteed to be healthy and that people who are sick brought it on themselves.]

    I am not an “alternative” health advocate. I am a skeptic. I was trying to show that some of what you are saying is misleading. Hardly anyone believes that good health is entirely under our control. But saying almost the opposite — that lifestyle is not an extremely important factor now days is not at all accurate. Lifestyle-related diseases are extremely common, and it is not just because people are living longer thanks to modern medicine.

    LIfestyle factors are extremely important. You try to make it sound like we are fortunate to live long enough to get these chronic diseases that we have no control over. That is just not true.

    Even with an ideal lifestyle people will still get old and die. But they probably won’t start getting type 2 diabetes and artery disease in their 40s, or even younger.

  46. lizkat says:

    “I am interested in recapturing your point, if you don’t mind sharing. I think you tread on some valid points, but have basically lost what you are asserting.”

    Dr. Tuteur said that most disease is unrelated to lifestyle, and is caused by genetic factors and other things outside the patient’s control. That is simply not true. We have epidemics of serious diseases now that are very much related to lifestyle. There are even teenagers who are starting to get type 2 diabetes and artery disease — she really thinks this is mostly because of genetics??

  47. Davdoodles says:

    “There are even teenagers who are starting to get type 2 diabetes and artery disease — she really thinks this is mostly because of genetics??”

    This is really a red herring. Dr T’s post is not about whether people’s “lifestyle” does or does not affect their health.

    It is about Big Placebo’s claim that modern medicine is not effective, and that CAM, in contrast, is effective.

    Rather than continuing to claim that unhealthy lifestyle is evidence of the ineffectiveness of modern medicine, you should be instead be prepared to show how Big Placebo does (or would do) better.

    Not theoretically, mind you, but in reality. Not enough to simply assert that if-people-change-their-lifestyles-they-will-be-healthier. How, specifically, would Big Placebo achieve this change, where current methods do not? Which specific homeopathic tincture in fact reduces laziness, gluttony, and addictive cravings? And which sage advice or naturopathic concoction makes unfit, overweight smokers want to take that tincture in the first place?

    And, where is the evidence that they do (or would do) it better in fact than the current regime of doctors’ health advice, advertising campaigns, employer and insurance incentives etc?

  48. bluedevilRA says:

    We are all in agreement that lifestyle is important. No one has said otherwise. Doctors routinely recommend that their patients eat right and exercise. There is no way of enforcing this. If people want to eat poorly and smoke, then that is their right.

    We know type II diabetes is linked to obesity and we know obesity is on the rise. There is no denying this. The genetics of a population have not changed in 20 years, yet their diet and activity levels have. What else can you point to as a life-style disease other than this (and other obesity related diseases)? You are not pointing out anything that science based medicine doesn’t already know.

    I think, from a public health perspective, that we should have a strong campaign against obesity, like the aggressive anti-smoking ads of the last 20 years. New York City has already fired the first salvo and hopefully other cities/countries will follow suit. Of course, it is also a much more sensitive issue. This is not just criticizing a bad lifestyle choice, but condeming the way a person looks.

  49. lillym says:

    “There are (anyone care to provide an estimate?) literally THOUSANDS of things that can go wrong with you,”
    Most of us, in my estimation anyway, have never been cured of a life-threatening disease.”

    Non life style diseases that people I know survived:

    Breast Cancer
    Meningitis (although the people I knew lost their hearing as children)
    strep throat
    asthma
    pneumonia
    bronchitis
    polio
    kidney infections (required IV antibiotics)
    diabetes – type 1 and Gestational diabetes
    Non Hodgkin’s Lymphoma
    measles
    scarlet fever
    strep throat
    recurrent ear infections
    heart disease (in this case it is genetic and not lifestyle related)
    prostate cancer
    tetanus
    rabies

    In fact if I stop to think about it I know more people who have survived non lifestyle disease than they have disease caused by their lifestyle.

  50. Zoe237 says:

    “If only that were so. Unfortunately, most illness and disease is caused by factors beyond people’s control, including infectious agents, genetic defects and inherited predispositions.”

    “It is axiomatic among purveyors of “alternative” health that most disease and death is attributable to lifestyle choices. Not only is that claim factually false, it is symptomatic of the wishful thinking that characterizes “alternative” health. At it’s heart “alternative” health is about pretending that good health is entirely within your control, that people who follow the guidelines are guaranteed to be healthy and that people who are sick brought it on themselves.”

    Okay, so I haven’t a clue what percentage is lifestyle related, and what is beyond our control. I do doubt that “most illness and disease” is beyond our control, as quoted above, once you dramatically reduce vaccine and antibiotic preventable disease. However, I am completely annoyed by my recent forced switch as of Jan. 1 to an HMO who “cares” about my lifestyle factors. Anyway, just wanted to note that this has been discussed before (probably several places):

    http://www.sciencebasedmedicine.org/?p=2625#more-2625

    “Dr. Val: We have to recognize that 75% of our healthcare dollars are spent on the treatment and management of chronic disease, and that those diseases are 80% preventable with diet and lifestyle interventions. Of course, the other 20% are NOT preventable. There will always be people who are injured at random – perhaps by gene mutations (such as cancer), genetic diseases (like Cystic Fibrosis), or even car accidents (spinal cord injuries). “

  51. Hugh7 says:

    One of the biggest cons of Big Placebo is passing off their vitamin pills as “nutrition” and the hucksters of them as “nutritionists”. If you eat a good variety of foods, including plenty of different vegetables, you’ll get all the vitamins you need. The body excretes the rest. I suspect that this is true even for the US’s Big Agriculture vegetables, but fortunately I live where I don’t have to put that to the test.

  52. Citizen Deux says:

    A related great article about the challenges of getting out the message from the evidence / science based side of the house!

    Pseudoscience in the Ascendency”

    For me this is the winning line;

    “I’m allergic to willful ignorance, but I’m in desperate need of an open exchange of ideas. I never won a debate using make-believe facts, but neither did I ever win one by calling my opponent stupid.”

  53. lizkat says:

    [Dr T’s post is not about whether people’s “lifestyle” does or does not affect their health.
    It is about Big Placebo’s claim that modern medicine is not effective, and that CAM, in contrast, is effective.]

    I am not someone who would try to advocate alternative medicine. I don’t use it myself and I don’t promote it. The point of my comments was to show that Dr. T. had made some misleading and inaccurate statements. I do not think anyone, even if they are a CAM advocate or practitioner, would ever claim that all disease results from lifestyle. And I do not think anyone would claim that modern medicine is worthless. Modern medicine has many extremely valuable treatments and technologies. How many of us would like to have a tooth pulled without anesthesia, for example? All of us, mainstream or not, are in favor for anesthesia, antibiotics, vaccines and surgery, when used appropriately.

    So Dr. T. misrepresented her opponents’ claims and is debating a straw man.

    She also stated that most disease is unrelated to lifestyle and results from factors outside patients’ control. But we know that is probably completely untrue. We don’t know what percentage of heart disease, kidney disease, liver disease and cancer are lifestyle related, but we can estimate that it’s pretty high. We know that the modern lifestyle, on average, is unhealthy.

    She stated that the main reason people are dying of heart disease, cancer, etc., is because modern medicine has cured so many other diseases, and people have to die from something. That is untrue or greatly exaggerated.

    The entire post comes across like propaganda, without much concern for accuracy. I am not defending alternative medicine; I am defending accuracy.

  54. squirrelelite says:

    Amy,

    Do you have a link/reference for Lindsay Beyerstein’s “Big Placebo” comment.

    I tried your link and it took me to her most current blog and it took me to her most current post.

    I checked back through the last few weeks and her “medicine” posts and didn’t find it.

    Thanks.

  55. lizkat says:

    ‘I never won a debate using make-believe facts, but neither did I ever win one by calling my opponent stupid.”

    Very true.

    Yes I think this makes a sane and fair-minded statement: http://www.bioworld.com/servlet/com.accumedia.web.Dispatcher?next=bioWorldHeadlines_article&forceid=53348

  56. weing says:

    “How many of us would like to have a tooth pulled without anesthesia, for example? ”

    Had a root canal done without it. Didn’t like it one bit. Would not recommend it.

  57. weing says:

    “We know that the modern lifestyle, on average, is unhealthy.”

    We do? Unhealthy compared to what? Borneo?

  58. lizkat says:

    “Unhealthy compared to what? Borneo?”

    I should have said, more specifically, the modern American lifestyle, where everyone goes from bed to car to office desk, back to car, to couch, to bed. Other modern cultures probably are better. But it is known that type 2 diabetes and heart disease, for example, are rare in more traditional cultures.

    Sure there are over-crowded, unsanitary, miserably poor, traditional cultures, and I am not referring to them.

    Our knowledge of how pre-modern people lived is of course very limited. Yes, infant mortality was high (nature’s not very nice way of keeping species healthy). And people often died from traumatic injuries, since they had no antibiotics or surgery.

  59. EricG says:

    lizkat

    ok, i think i got you, but i think this might be where the discrepancy comes in:

    “She also stated that most disease is unrelated to lifestyle and results from factors outside patients’ control. But we know that is probably completely untrue. ”

    most diseases (all diseases) or most disease (all occurence of disease)?

    sure, there are way more type II diabetics than there are lepors. however, there are way more diseases (overall) that are more effectively addressed with sbm than with lifestyle. obviously, two different things.

    “So Dr. T. misrepresented her opponents’ claims and is debating a straw man.”

    obviously you haven’t trounced around the alt med spheres every much, here are some great quacks to check out. try and find where they fail to advocate a cure all or natural trick…no matter the cause. likewise, try and find a shred of evidence to support their claims or even reasonable temper as to the effectiveness of their own treatments.

    http://www.blaylockreport.com/

    http://www.mercola.com/

    to them EVERY maladay is lifestyle and every cure is cheap, plentiful and “natural.”

  60. lizkat says:

    “obviously you haven’t trounced around the alt med spheres every much, here are some great quacks to check out.”

    Yes there are quacks everywhere you look. But an intelligent discussion should not even bother with them. People go to wacky extremes and we all know that, and we ignore them. It’s misleading to set them up as typical.

    “sure, there are way more type II diabetics than there are lepors. however, there are way more diseases (overall) that are more effectively addressed with sbm than with lifestyle. obviously, two different things.”

    Yes there are a large number of ailments that are very rare and maybe some of them can be cured with antibiotics or surgery. But the most common disabling and killing diseases today are lifestyle-related. And if alternative medicine practitioners are emphasizing lifestyle over drugs and surgery for these diseases, then they are to some extent correct.

  61. weing says:

    “But the most common disabling and killing diseases today are lifestyle-related.”
    Are you sure? Please define your terms. A soldier has one lifestyle and ends up with disabilities, a pro athlete also frequently ends up with disabilities. A truck driver has a more sedentary lifestyle, a single mother’s lifestyle depends on the work she does or doesn’t do. Do you have an ideal “lifestyle” here? What’s the life expectancy of these people compared to say someone living the “natural” paleolithic lifestyle in the jungles of Borneo?

    Are you saying SBM hasn’t played a role in improving their lives? Isn’t SBM part of the modern lifestyle?

    Not everyone in the world has the upper middle class lifestyle that gives him or her ample rest, exercise, and ability to follow a healthy diet.

    “And if alternative medicine practitioners are emphasizing lifestyle over drugs and surgery for these diseases, then they are to some extent correct.”

    That is such a crock. Your going to take someone with unstable angina and tell them not to take medications, have a stent placed, or CABG done and tell them to change their lifestyle instead? As has been pointed out multiple times, therapeutic lifestyle changes for prevention are and always have been a part of SBM.

  62. Ken Hamer says:

    @lizkat
    “Dr. Tuteur said that most disease is unrelated to lifestyle, and is caused by genetic factors and other things outside the patient’s control. That is simply not true. We have epidemics of serious diseases now that are very much related to lifestyle. There are even teenagers who are starting to get type 2 diabetes and artery disease — she really thinks this is mostly because of genetics??”

    This is a bogus argument. Just because “We have epidemics of serious diseases now that are very much related to lifestyle” does NOT mean that lifestyle is not the cause of most disease.

    “The point of my comments was to show that Dr. T. had made some misleading and inaccurate statements. I do not think anyone, even if they are a CAM advocate or practitioner, would ever claim that all disease results from lifestyle.”

    But you are doing the same sort of thing. You claim her statements are untrue (implying that most disease is NOT unrelated to lifestyle), but provide nothing more than a very general observation as proof.

    “She also stated that most disease is unrelated to lifestyle and results from factors outside patients’ control. But we know that is probably completely untrue. ”

    Oh, give me a break… “we know that is probably completely untrue?” In that case, you/we don’t know anything. If something is only probably true, then it’s also possibly false, including your denial that most disease results from factors outside the patients’ control.

    “We don’t know what percentage of heart disease, kidney disease, liver disease and cancer are lifestyle related, but we can estimate that it’s pretty high. We know that the modern lifestyle, on average, is unhealthy.”

    You claim we don’t know the percentages, then go on to use those “estimates” as proof. More bogusity.

    “She stated that the main reason people are dying of heart disease, cancer, etc., is because modern medicine has cured so many other diseases, and people have to die from something. That is untrue or greatly exaggerated.”

    Well, is it true, or untrue? The alternative to “untrue *or*” is true. You seem to be suggesting that a claim is exaggerating the truth. Does that mean it’s, like, very very very very true?

    All you’ve done is claim that lots of people suffer conditions due an unhealthy lifestyle, which I think is generally understood and agreed. But that’s a far, far cry from proof that most disease is caused by lifestyle (or the alternative, that the claim that most disease is unrelated to lifestyle is false.)

  63. lizkat says:

    [Well, is it true, or untrue? The alternative to “untrue *or*” is true.]

    You may feel a need for clear and certain answers Ken, but you won’t always find them in medical science.

  64. weing says:

    That’s right. Only sCAM has clear and certain answers. With SBM you get answers of a certain probability of being correct.

  65. lizkat says:

    “That’s right. Only sCAM has clear and certain answers. With SBM you get answers of a certain probability of being correct.”

    You don’t get clear and certain answers with either, and that was my point. Diseases result from lifestyle, and from factors outside our control. Exactly what percentage is lifestyle or not varies and depends on many factors. The original post said it’s mostly NOT lifestyle, and that is an overly general and overly certain, and inaccurate, statement.

  66. weing says:

    lizkat,

    There are no clear answers. SBM admits it up front. Regarding your lifestyle fixation. I am not sure about that either. As I said before, you have to define your terms. Everyone has a certain lifestyle. I think disease result from life, period.

  67. lizkat says:

    weing,

    Yes everyone has their own lifestyle. But there is a general tendency as societies become westernized. There is less need for walking as people start to drive their cars everywhere. There is less need for physical labor, because of all the labor-saving machinery. Food is more likely to be processed and refined, and to contain substances our bodies did not evolve with. White sugar and flour are known to be especially damaging.

    I think we all know all of this very well. I think most MDs know this very well, and see the results in many of their patients. Most of the people I know do not get regular exercise. It’s hard to find the time when they are so busy driving around, working, and watching TV.

    And it’s harder to eat food that is natural and didn’t have all its nutrition removed by processing, because it takes more time. It’s easier to get some processed junk food.

    This is not true of everyone, but we are not talking about absolutes. We are talking about statistical tendencies. That should be obvious.

    You seem to resist the idea that lifestyle is a big problem currently. I don’t know why you resist it, since mainstream medicine is very much in agreement that we have a health crisis, and it is largely because of lifestyle.

  68. weing says:

    “This is not true of everyone, but we are not talking about absolutes. We are talking about statistical tendencies. That should be obvious.”

    Take a look at cultures that eat “natural” foods have more “natural” lifestyles as hunters and gatherers and tell me what statistical tendencies you detect.

    “You seem to resist the idea that lifestyle is a big problem currently.”

    I don’t believe in panaceas. Do I think overeating is a problem? Yes. Do I think we have a health crisis on our hands? That’s another story. SBM has come a long way. Just because we still have problems doesn’t mean it’s a crisis. We still have a long way to go.

  69. Mark P says:

    But most adults do not depend on modern medicine to keep them alive.

    But I would bet that most use modern medicine at least once a year to keep them more healthy.

    I am blessed with good health. But a slightly long colon. So I take Buscopan from time to time when the spasms get too painful. Tonsilectomy was also a god-send when I needed it.

    My wife is blessed with good health. And hayfever. Summer can be miserable for her without the drugs.

    Medicine is far more than keeping people alive. Even healthy people benefit.

    In any case, the original statement is misleading. My wife is not in any way being kept alive by modern medicine now. But her experience of child-birth made us very happy we live in modern times.

  70. Mark P says:

    we have a health crisis

    No we don’t. Most people are healthy in a way that previous times could only have dreamed of. We live longer, and live better.

    Sure, not all of us are at our peak of potential health.

    You seem to be the society equivalent of the “worried well”.

  71. lizkat says:

    “Take a look at cultures that eat “natural” foods have more “natural” lifestyles as hunters and gatherers and tell me what statistical tendencies you detect.”

    Yes that argument is always used, and I think I have already responded to it. Primitive people do not have antibiotics or surgery so they are likely to die from traumatic injuries resulting from violence or accidents. Since many members of a tribe are involved in dangerous activities such as hunting and warfare, these injuries may be common.

    I also mentioned that high rates of infant mortality — nature’s not so nice way of keeping a species healthy — skewed the average lifespan for non-modern people. If the average lifespan was 30, or example, that does NOT mean people were decrepit at 30. They may have been extremely healthy, compared to us, but got in the way of an arrow.

    All that has nothing to do with general health. We know very little about the general health of prehistoric or primitive people.

  72. lizkat says:

    “We live longer, and live better.”

    We live longer, mostly because of decreased infant mortality, improved sanitation, antibiotics and surgery. Whether or not we live “better” in all respects is a subjective opinion. The people I know with type 2 diabetes, arthritis or dementia are not living so wonderfully, in my opinion. Many of their troubles were caused by lifestyle factors.

  73. “arthritis or dementia are not living so wonderfully, in my opinion. Many of their troubles were caused by lifestyle factors.”

    Lizkat,

    You are basically proving my point for me. The claim that “most disease” is caused by lifestyle factors is fabricated. I’ve already showed you that it is factually false, and you’ve simply ignored the proof.

    Now you are making up new absurd claims. Where is the evidence that arthritis or dementia are caused by lifestyle?

    It is far more comforting to pretend that you can control your own health by living a “healthy lifestyle” but that’s merely pretending. Most people die of factors that have nothing to do with lifestyle; in many cases, it’s simply bad luck, and no amount of wishful thinking can protect your from that.

  74. squirrelelite says:

    Lizkat,

    You state that “We live longer, mostly because of decreased infant mortality, improved sanitation, antibiotics and surgery.”

    Three of those four causes are directly the result of modern medicine. Only improved sanitation is partly a lifestyle choice. Even that is largely a result of government projects to build city-wide clean water supply and enclosed sewer systems which were largely the result of scientific studies in the 19th century. Personal improved sanitation such as hand washing is a random factor. Compliance depends a lot on our knowledge of the scientific basis of sanitation or the lack thereof as an influence on our health.

    “Whether or not we live “better” in all respects is a subjective opinion”

    Unfortunately, science and science based medicine can not as yet tell us anything useful about our subjective opinions. If your opinion is different from mine, we can only agree to disagree.

    Perhaps, like Citizen Kane, we were all happier when we were little kids playing with our sleds in the snow. I still have fond memories of those days.

    But, to cite an anecdote as a counter illustration, I also remember my grandfather. For most of his life, he suffered from rheumatoid arthritis (which as my sister the doctor points out is different from plain old osteoarthritis). In the mid 1950′s he was confined to bed for over a year. Then, with the help of modern medicine, he was able to get out of bed and go back to work. (I think it was steroids. At least I know it wasn’t because he took more vitamin pills or stopped smoking.) He was also able to go fishing, buy a boat, and teach his kids and grandkids to water ski.

    I believe that I have objective, not just subjective, evidence that he lived better as a result of modern medicine.

  75. lizkat says:

    I specifically gave credit, repeatedly, for the improvements that resulted from modern medicine. However, it is also very well known that the modern lifestyle, which includes automobiles, Coca-Cola and TV, can be extremely damaging to health.

    “The claim that “most disease” is caused by lifestyle factors is fabricated. I’ve already showed you that it is factually false, and you’ve simply ignored the proof.”

    You showed that “most” diseases are not caused by lifestyle, but you’re just being tricky. I showed how your list was misleading, and that some of the most common diseases today are lifestyle-related.

  76. Fifi says:

    I still prefer Big sCAM to Big Placebo – it’s more to the point and Big Placebo sounds very benign. It’s not like the placebo effect (or the role belief plays in modulating subject experience) is a bad thing when understood and used ethically, nor is it woo. In certain areas of medicine where the placebo effect is most noticeable – like mental health and chronic pain treatment, which are both very much about subjective experience and often best approached in a multidisciplinary fashion that considers both mind and body – harnessing the placebo effect can be very useful (it’s entirely unnecessary to lie to patients to do this). The placebo effect is part of SBM and not woo (even if much woo harnesses the placebo effect), forsaking or attributing it to CAM is forsaking important knowledge about health, cognition and biology that is actually part of SBM. It’s not like Big sCAM does research into the placebo effect, it’s SBM that does this!

  77. trrll says:

    “I showed how your list was misleading, and that some of the most common diseases today are lifestyle-related”

    “Lifestyle-related” is a weasel word. Scientists refer to a disease as “lifestyle related” if lifestyle has any statistically significant effect, no matter how small, on the risk of a disease. Yet you seem to take this as an excuse to claim that all cases of that disease are a consequence of lifestyle choices. You have to consider how strong the relationship is. For example let’s suppose that “bad” lifestyle choices results in a relative risk of 1.99 compared to people who make “good” lifestyle choices. Now this is a big effect, nearly a doubling of the risk of the disease. Very few lifestyle choices have been actually found to produce such a large increase in the risk of any disease. Yet a risk ratio of 1.99 would still mean that most of that disease is not due to lifestyle choice.

  78. shelcobsohn says:

    recently, while in Bioethics class, one of the students was presenting a powerpoint on acupuncture. at the end of his presentation he said something very similar to what John Neustadt said. the student said that conventional medicine doesn’t directly treat diseases, and that “western medicine” only deals with pain. i tried to explain to my fellow pupil that it was the other way around. i find that kids take for granted the marvels of modern science and focus on the diseases that haven’t been cured yet. all was not lost, later i presented my presentation on homeopathy and revealed it to be one of the biggest scams of our time. afterward, most of my peers where convinced that modern medicine isn’t evil, and that people should be careful when accepting an alternative medication. I apologize for any spelling or grammar mistakes, i have dyslexia.

  79. lizkat says:

    “Yet you seem to take this as an excuse to claim that all cases of that disease are a consequence of lifestyle choices.”

    I repeatedly said some, not all. I repeatedly said we should not speak about this in terms of absolutes. But it is very well known that certain diseases very rarely occur in non-western, traditional types of cultures. It is also very well known, and there is plenty of scientific evidence, that physical inactivity and processed food contribute greatly to some of the most common, and most deadly, diseases. It is also extremely well known that cigarettes contribute greatly to cancer and heart disease.

    There is nothing controversial in what I am saying.

  80. Zoe237 says:

    There was an article in the paper yesterday that radon was the second leading cause of lung cancer. Any truth to that?

    While I am not convinced that most diseases are unrelated to lifestyle (at least in the U.S.), I’m enjoying the debate.

  81. squirrelelite says:

    Zoe237,

    The EPA radon website says there are about 20,000 lung cancer deaths each year due to radon exposure. Practically all of that is in enclosed areas like homes, especially in basements. Those are places where the radon gas, which is chemically inert although it is radioactive, can build up to dangerous levels.

    http://www.epa.gov/radon/index.html

    According to the NCI website:

    “Estimated new cases and deaths from lung cancer (non-small cell and small cell combined) in the United States in 2009:

    New cases: 219,440
    Deaths: 159,390

    So, radon related lung cancer deaths are about 12.5% of the total.

    The American Cancer Society estimates that 85-90% of all lung cancer deaths are due to tobacco smoking.

    http://www.cancer.org/docroot/CRI/content/CRI_2_4_2x_What_Are_the_Risk_Factors_for_Small_Cell_Lung_Cancer.asp?sitearea

    So, tobacco and radon are clearly the two biggest factors.

    Other, less common risk factors include airborne asbestos fibers and exposure to uranium, beryllium, arsenic and other metals.

  82. alibim says:

    lizkat: it is very well known that certain diseases very rarely occur in non-western, traditional types of cultures
    and I’m guessing you’re including cancers of various types? But many cancers don’t appear until relatively late in life; the reason they are rare in the cultures you mention may have little to do with lifestyle & everything to do with the fact that people simply die before the cancer develops to the point where it’s noticed.

  83. weing says:

    “It is also very well known, and there is plenty of scientific evidence, that physical inactivity and processed food contribute greatly to some of the most common, and most deadly, diseases. It is also extremely well known that cigarettes contribute greatly to cancer and heart disease.”

    I’d like to agree with you but find it difficult. What is your evidence for processed foods contributing to the most common and most deadly diseases? I was under the impression it was the overconsumption of food that was the problem. Feel free to correct me.

  84. “I showed how your list was misleading”

    No, you didn’t. You just chose to ignore the fact that more than 2/3 of cancer deaths and 1/3 of heart disease deaths are due to factors other than lifestyle.

  85. lizkat says:

    “What is your evidence for processed foods contributing to the most common and most deadly diseases? I was under the impression it was the overconsumption of food that was the problem. Feel free to correct me.”

    Type 2 diabetes is, to some extent, caused by physical inactivity and by consumption of refined carbohydrates. (Of course there is a genetic component, as there is with any disease.) Simply eating too much is probably not the main cause of obesity. It would be hard to become obese by eating too much unprocessed food. Of course it might be possible. But it is pretty well known that white sugar and white flour are major culprits in obesity and type 2 diabetes.

    I don’t think all MDs would agree, but some believe that refined carbohydrates can lead to carbohydrate addiction. For example, you drink a Coke and your blood sugar shoots up, which causes a spike in insulin, which eventually makes you crash. This leads to a craving for more sugar.

    The cycle of carbohydrate addiction is thought, by some, to lead to hypoglycemia, which can progress to insulin resistance and hyperglycemia (diabetes).

    Type 2 diabetes is a major cause of artery disease, and other disabling and life-threatening illnesses.

    A person who is physically active and eats unprocessed natural food could be obese, I guess, but it’s probably rare.

  86. weing says:

    I don’t buy that at all. Diabetes was described in ancient Rome and China. They were eating refined carbohydrates?

  87. Harriet Hall says:

    Weing is right. Diabetes was commonly recognized in the ancient world as sweet urine disease, dating back to ancient Egypt. We don’t have incidence figures. The prevalence of the disease was low, because there was no treatment and patients died quickly.

  88. StatlerWaldorf says:

    I’m not buying it that lifestyle plays only a minor role in disease. If you want to talk about ancient civilizations, what were their eating habits and activity levels? How about drinking lots of alcohol, feasting frequently, and having all of your household chores done by servants? Was the prevalence of diabetes lower or higher in certain levels of society? I think there are many questions to be asked an no way of finding answers from those times.

    Governments all over the world are spending tons of money on health programmes to influence citizens’ lifestyles to help lower risk of diseases, feel healthier, and live better for longer. Have they planned their health initiatives based on bad science?

  89. “If you want to talk about ancient civilizations, what were their eating habits and activity levels? How about drinking lots of alcohol, feasting frequently, and having all of your household chores done by servants? Was the prevalence of diabetes lower or higher in certain levels of society? I think there are many questions to be asked an no way of finding answers from those times.”

    You mean societies in which the average expectancy was 35 years?

  90. lizkat says:

    “You mean societies in which the average expectancy was 35 years?”

    You didn’t bother to read what I explained, repeatedly, about the distribution being skewed by infant mortality. And that people often died from traumatic injuries. And I also said we don’t know much about health and lifestyle in ancient civilizations.

    But if you want evidence about the damaging effects of the typical modern lifestyle, it is not hard to find scientific evidence.

  91. lizkat says:

    “Diabetes was described in ancient Rome and China. They were eating refined carbohydrates?”

    Type 1 diabetes has completely different causes than type 2, for one thing, and you don’t know which type they were describing. Type 2 diabetes is currently an epidemic in America. Everyone knows this, or should know it. And you do not see that in societies that do not have a similar lifestyle.

  92. weing says:

    You are assuming it was all Type 1. Is that a safe assumption?

  93. windriven says:

    @lizkat, StatlerWladorf, et al

    “It would be hard to become obese by eating too much unprocessed food. Of course it might be possible.”

    Rubens painted at the dawn of the 17th century and is celebrated for his depictions of plump women. Paintings of Henry VIII and many others whose lives antedated modern food processing show ample girth. In the 17th and 18th centuries plus sizes suggested financial wealth. It was the poor who were thin.

    It isn’t that it is difficult becoming obese eating unprocessed food just that it is has, historically speaking, been expensive.

    Also:
    “But it is pretty well known that white sugar and white flour are major culprits in obesity and type 2 diabetes.”

    I’m not going to quibble about white sugar though I question whether replacing it with raw sugar would make any difference. But you’re going to have to show some proof that white flour is linked to type 2 diabetes.

  94. lizkat says:

    “Rubens painted at the dawn of the 17th century and is celebrated for his depictions of plump women. Paintings of Henry VIII and many others whose lives antedated modern food processing show ample girth. In the 17th and 18th centuries plus sizes suggested financial wealth. It was the poor who were thin.”

    Rich people didn’t have to walk.

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