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Everything Causes Cancer

It’s likely you know someone who has bought into the notion that nutrition is everything, the source of all health and the cause of all illness. Nutrition is very important, to be sure, but it is only one of many possible causes of disease, and if you live in a Western industrialized nation you probably have adequate nutrition. The notion, however, that food can heal is powerfully alluring, and it makes great headlines. The result is that people who read the headlines for the latest food to avoid, or the latest ingredient that will make them live longer or stave off disease, seem to have an association for everything. Eating around them is to be constantly told that food X is good for you and will prevent Y, or that some other food should be avoided because it causes Z.

Red peppers will help prevent cancer and help you lose weight. Garlic will help prevent heart disease and aids in iron metabolism. Cayenne pepper prevents strokes. Peaches prevent heart disease and cancer. In fact- think of any food at random and type “random food health benefits” into Google and chances are you will be rewarded with a list of the amazing health benefits of whatever food you wish.

My usual response when offered such advice is – you know, food is healthy for you. I recommend you eat food every day. Food is full of nutrition, essential vitamins and minerals, and will give you energy. If you don’t eat food, your health with dramatically suffer. But don’t eat too much food – that’s not healthful.

It is helpful to have published evidence and statistics to back up my casual observation – that nearly all foods are touted as having health benefits or risks. Earlier this year Schoenfeld and Ioannidis did just that. They selected 50 common ingredients at random out of cookbooks, then scoured the literature looking for studies showing an association (positive or negative) with cancer. They found that 80% of the ingredients had such published studies:

Forty ingredients (80%) had articles reporting on their cancer risk. Of 264 single-study assessments, 191 (72%) concluded that the tested food was associated with an increased (n = 103) or a decreased (n = 88) risk; 75% of the risk estimates had weak (0.05 > P ≥ 0.001) or no statistical (P > 0.05) significance. Statistically significant results were more likely than nonsignificant findings to be published in the study abstract than in only the full text (P < 0.0001). Meta-analyses (n = 36) presented more conservative results; only 13 (26%) reported an increased (n = 4) or a decreased (n = 9) risk (6 had more than weak statistical support). The median RRs (IQRs) for studies that concluded an increased or a decreased risk were 2.20 (1.60, 3.44) and 0.52 (0.39, 0.66), respectively. The RRs from the meta-analyses were on average null (median: 0.96; IQR: 0.85, 1.10).

These results mean a few things. First – about 60% of all food ingredients will either increase or decrease your cancer risk, if you believe the studies included in this review. That is a lot of ingredients to keep track of – imagine designing your diet around this information, and this is only for cancer specifically. However, meta-analysis decreased that number by about 2/3, to about 20%. That’s a bit more manageable, but still quite a large number of ingredients.

Fortunately (well, depending on your perspective) you can probably ignore most of this data. Most of the studies were one-off studies, and 2/3 of those that were replicated did not fare well according to the meta-analysis. Further, study replication tended to diminish the magnitude of the relative risk (either increase or decrease).

This is a pattern that has been found generally in the literature, including by Ioannidis himself. Preliminary studies tend to have a large effect size which diminishes throughout replication and with more rigorous studies. Often that effect size declines to zero. This phenomenon is called “the decline effect”, and is at least in part due to publication bias.

Generally speaking, preliminary studies tend to have a positive bias, caused by both a researcher bias and a publication bias. With replication and more rigorous studies, most of these preliminary (and positive) results are discovered to be wrong (Ioannidis again).

Those effects that survive replication tend to diminish in magnitude (the decline effect). The simplest explanation for this is regression to the mean – the tendency for any extreme result (which is likely to get published) to return to a more statistically average result. Further, practitioners are probably adopting interventions too early, before they have finished declining in the research, and are subject to later reversals with more rigorous data.

In this current study on food and cancer, we are seeing all of these same effects, just applied to the relative risk of cancer associated with specific foods and ingredients. There is a large volume of preliminary and low grade evidence, most of it shows a positive result (an association), and most of that does not survive later replication.

Also reassuring is that when you look at the relative risk of various foods and cancer as revealed in the meta-analysis, they all average out. As the authors say – “The RRs from the meta-analyses were on average null.”

This can mean one of two things (or both): either there is some risk or benefit to certain foods, but all these effects average out to zero, or we are just seeing a scatter of random results in the literature that average out to zero – meaning the results themselves may not be real.

Either way it seems to me that these results suggest it is probably a waste of time to obsess over the health risks and benefit of every food and ingredient.

The more research we do on the health effects of food the more the aggregate of this research supports the following simple rule: eat a variety of food, don’t eat anything to excess, and like your mother said, make sure you eat your vegetables.

Posted in: Cancer, Clinical Trials, Nutrition

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134 thoughts on “Everything Causes Cancer

  1. I doubt whether food issues will ever go away. People use food for many things, in this case to imagine that they have control over their health. There are people who obsess over food for any number of reasons, mine being flavor…

  2. angorarabbit says:

    A few brief comments before I leave to teach. When I first started teaching nutritional biochemistry in 1991, we focused two lectures on nutrition-cancer interactions (both positive and negative associations). Over these 22 yrs this has whittled down to one lecture, and that one mostly focuses on mechanism and lifestyle factors; perhaps 15min on actual nutrient interactions. This is because nearly all of them have fallen away, with the exception of exercise, which is still showing a strong, positive protective effect.

    But the reason for this isn’t so much regression to the mean but the same flaw that Ionnadis uses – they are nearly all Associative students. They aren’t interventional. And it is now clear that, great stats not withstanding, association is not causation. Rather, the associations are markers for other traits are do confer protection, such as higher SES, better awareness of protective factors, greater access to health care, preventative screening, reduced alcohol intake, reduced smoking, etc. For me, the story began to unravel with the CARET trials of beta-carotene in lung cancer prevention; I think that was a wake-up call to many that, you can have a great hypothesis that makes mechanistic (science based) sense, but you still have to do the actual intervention trial. And when they did, the whole pretty story fell apart and we found that b-c actually worsened risk. I think it is fair to point to those clinical trials as the beginning of the end of those epi studies.

    There are still interesting compounds being studied in foods, but the serious emphasis is now in translating those into forms with better bioactivity and bioavailability.

    The best advice is still captured in the last paragraph. It is nice that, 30-some years out, the public is finally starting to hear the entirety of the message and not just selected bits.

  3. T says:

    The downside of articles like this one, is that they seem to reinforce the notion that all food is roughly on the same playing field in terms of its ‘healthfulness’ and that it all comes down to “variety” and balancing calories.

    “Food is full of nutrition, essential vitamins and minerals, and will give you energy. If you don’t eat food, your health with dramatically suffer. But don’t eat too much food – that’s not healthful.”

    Except things like Oreos, Cheetos, white bread, chips, soda etc. Are those things really “food”? Are they full of “nutrition”?

    Also,

    “This can mean one of two things (or both): either there is some risk or benefit to certain foods, but all these effects average out to zero, or we are just seeing a scatter of random results in the literature that average out to zero – meaning the results themselves may not be real.”

    To the first point, they might average out to zero if you eat across the spectrum of all foods – but it is quite clear that there are dietary patterns that are more healthful than others (implying that there is benefit that doesn’t average to zero in certain dietary patterns). You are also ignoring the third possibility, which is that different methods come to different conclusions because they are… different. The *results* can then be real for any particular study’s methods. The real-world application of those results of course, are what may not be real.

    1. ‘Except things like Oreos, Cheetos, white bread, chips, soda etc. Are those things really “food”? Are they full of “nutrition”?’

      This is reminiscent of Polan who’s large scale views I like but I think he’s kind of bonkers when he starts with the low-level stuff. I suppose the answer to your question requires an answer to: “What is nutrition?”. Food, even Oreo’s will supply your body with an awful lot of what it needs to do most jobs. That’s certainly one definition.

      “To the first point, they might average out to zero if you eat across the spectrum of all foods”

      Not exactly. These were common items from recipes picked at random from a cookbook. It’s more correct to look at this as the most common ingredients. It would be likely that most people’s diets (who cook their food) contain these items. So it would be likely that people’s overall food RR’s would be close to 1.

      “ou are also ignoring the third possibility, which is that different methods come to different conclusions because they are… different. The *results* can then be real for any particular study’s methods. The real-world application of those results of course, are what may not be real.”

      Come again?

      1. T says:

        “Food, even Oreo’s will supply your body with an awful lot of what it needs to do most jobs. That’s certainly one definition.”

        Sure, “food” will keep you alive, but it won’t necessarily provide optimal (ie. health protecting) levels of micronutrients, fatty acids, proteins, and the whole number of other things we haven’t figured out yet (gut bacteria health, epigenetic effects of different food patterns etc.).

        Regarding my second point, I was trying to point out that this statement: “This can mean one of two things (or both): either there is some risk or benefit to certain foods, but all these effects average out to zero, or we are just seeing a scatter of random results in the literature that average out to zero – meaning the results themselves may not be real.” is a false dichotomy – a pretty basic error in logic that really makes this article grade-school work.

        1. ‘Sure, “food” will keep you alive, but it won’t necessarily provide optimal (ie. health protecting) levels of micronutrients, fatty acids, proteins’

          Are the quotes really necessary?…It’s kind of puerile.

          You have to be more specific (and less circular) with the outcome you are trying to optimize for. Long life? Some aspect of life quality? The ability to see through walls?

          “is a false dichotomy”

          Probably not, I suspect you’re confusing the dependent clause as a criterion and not taking into account the context.

          i) Results represent real effects
          ii) Results do not represent real effects

          Are obviously statements which are collectively exhaustive and mutually exclusive so by extension…

          i) Of the studies we looked at the effects for foods examined are real effects.
          ii) Of the studies we looked at the effects for foods examined are not real effects.

          Are also mutually-exclusive and collectively exhaustive. Considering that the “effects” show an RR of 1 it’s also reasonable to state and that “random results” is a synonym for “not real effects”.

          i) Of the studies we looked at the effects for foods examined are real effects which average out to zero.
          ii) Of the studies we looked at the effects for foods examined are a scatter of random results.

          Are also mutually-exclusive and collectively exhaustive.

          1. ‘Considering that the “effects” show an RR of 1 it’s also reasonable to state and

            Should read: Considering that in this case the “effects” being discussed show an average RR of 1 and that “random results” is a synonym for “not real effects”.

          2. T says:

            “You have to be more specific (and less circular) with the outcome you are trying to optimize for. Long life? Some aspect of life quality? The ability to see through walls?”

            Puerile, eh?

            “i) Of the studies we looked at the effects for foods examined are real effects which average out to zero.
            ii) Of the studies we looked at the effects for foods examined are a scatter of random results.

            Are also mutually-exclusive and collectively exhaustive.”

            Completely ignores the fact that the studies they looked at had different methodologies (and no RCTs btw). Some could be real results (which again, would depend on who/what they are real for… epidemiology is a crapshoot at best for associations) and some could be random results (unless by ‘random results’ the intended meaning is a mix of real and false positive associations – which is not really clear at all).

          3. “Puerile, eh?”

            Yes. You are being so.

            “Completely ignores the fact that the studies they looked at had different methodologies…”

            Because it’s largely irrelevant to your prior argument. A false dichotomy occurs when the **statements** are not collectively exhaustive and mutually exclusive.

            Methodology can impact the accuracy of the outcomes but not the statement made about them. If you want to argue that those statements are not well-supported, that’s not a false-dichotomy. It’s a non-support fallacy.

            It is a good point that of the 13 showing effect, some could be wrong and some could be right. However that has little to do with methodology. That would be true even having identical methodology.

            The problem is that, as an argument it’s not very useful. Sure there will be cases where all the “true” ones are significantly > 1 but most cases will be close to 1.

        2. WilliamLawrenceUtridge says:

          There’s no reason to believe there is an “optimal” diet or food in the first place; optimal in North America will lead to starvation in the Arctic. There’s also no reason to believe that every single thing you put into your mouth needs to be nutrient dense, unprocessed and/or protect you from cancer.

          There’s also no reason to believe that specific food ingredients will magically protect us from cancer or heart disease. Food didn’t evolve to protect us from cancer (and in fact, many foods are sources of carcinogens in sufficient doses or concentrations). Eat your vegetables, sure, but don’t do so under the belief that you will live forever in perfect health because of it.

      2. Dan McPeek says:

        Oreos, cheese and light beer; let’s me do everything I want to do!

        1. 1.) Name calling seems to me a puerile form of argumentation.
          2.) I don’t see how conclusions from different studies using different methodologies can be said without empirical evidence to be collectively exhaustive and mutually exclusive.To make this claim without evidence is the logical error of petitio principii, begging the question.

          -dlj.

          1. “Name calling seems to me a puerile form of argumentation.”

            Let me know when I actually do that to T.

            “I don’t see how conclusions from different studies using different methodologies can be said without empirical evidence to be collectively exhaustive and mutually exclusive.To make this claim without evidence is the logical error of petitio principii, begging the question.”

            What fun!

            Your argument is founded on the statement that you don’t know how A -> B. Which of course is *argumentum ad ignorantiam* an argument from ignorance.

            Boom!

            Your real error is probably deeper than that. Someone asserted that a statement was a false dichotomy. As I explained before a false dichotomy, in fact most of informal and formal logic is about *claims*. A claim is a false dichotomy when two options are given but more than two exist. This isn’t about support for said claims. For example: “You are either for us or against us” is a false dichotomy even if the person it is being spoken to is, does in fact exist in one of those two camps.

            For my counter argument I constructed pairs of options which were mutually exclusive and collectively exhaustive and then used substitution. To show that they were similar enough to the claims made. If the studies don’t actually demonstrate that (which they appear to) then it’s still not a false dichotomy.

            I even acknowledged that there are more options but they are not very likely. Colloquial English tends to allow people to exclude the highly improbable. So while T might be right in a technical sense a) Has zero to do with methodology and b) Isn’t likely.

  4. Jogo Tyree says:

    ….’make sure you eat your vegetables’….Huh? That doesn’t seem a logical way to end this piece. Do vegetables have proven healthful properties that other foods lack? The post seems to say that is not the case.

    1. windriven says:

      You’re taking this sentence too literally. I believe Dr. Novella’s point was to eat a varied diet that includes fruit and vegetables.

  5. Great post. Ioannidis does such interesting and novel work. He should write a book, sort of the “Freakonomics” of medical science.

  6. tgobbi says:

    Dr. Novella’s first two sentences in the above open a floodgate of memories for me. I used to teach cooking classes professionally and I could write a book about all the misinformed comments I got from my students about the purported benefits or harm of this or that foodstuff – whether main ingredient or seasoning adjunct.

    One of my all-time favorites was a woman who belonged to a local food-terrorist organization called NOHA (Nutrition for Optimal Health Association – now renamed American Nutrition Association). http://americannutritionassociation.org/noha My student was concerned about the teaspoon of cornstarch a recipe required to thicken a sauce. Her gripe: cornstarch is “too refined!” I couldn’t figure out whether that meant it wasn’t good for us or if it was actually harmful, so I just laughed and continued with the lesson. As an aside, NOHA was founded by a health food store owner whose sycophants regarded her as some sort of semi-deity. They gave their kids buttons to wear: “If you love me, don’t feed me junk food!” At their meetings, which I occasionally attended for laughs, they served herbal tea (no coffee) with honey instead of sugar, again because the sugar was “too refined.” Go figure THAT one out.

    But my #1 favorite was the student who kept on showing up for all the classes I taught and never tired of telling me that this or that food was very good, or very bad, for us. I argued with her each time, prompting her to preface a testimonial for an ingredient by saying, “I know you don’t believe in nutrition, but…” Right, I don’t believe in gravity either but I still land back on the ground every time I jump!

  7. evilcyber says:

    Hahaha, I liked the slightly sarcastic undertone of this, Steven.

    The whole obsession with what causes cancer to me stems from one idea: if you just behave well enough, you can get around dying. In truth, we will all die and the older we get, the more likely it is to be of cancer. Simply because with advancing age, our cell replication is more prone to commit errors.

    1. windriven says:

      “[B]ecause with advancing age, our cell replication is more prone to commit errors.”

      Not in the land of the wackaloon a. This from ‘holisticprimarycare.net’

      “Dietary Supplements: A number of nutraceuticals are associated with supporting telomere structure and function including, specifically: extracts of Ginkgo biloba, Astragalus, Ginger root, vitamin D, folic acid (and perhaps Vitamin B12), nicotinamide, and omega 3 fatty acids. These are outlined in detail in Table 2. There are studies indicating that taking a basic multivitamin or antioxidant may be associated with enhanced telomere length or prevention of telomere shortening. “

      1. evilcyber says:

        So if I ate 2 lbs of Ginger root each day, I could have my telomeres grow out of my ears? :)

  8. stanmrak says:

    This ignores the simple fact that no food works in isolation. No study can be done that will eliminate ALL variables. Therefore, no food can be scientifically proven to have any specific action on its own. Nothing to learn here, folks.

    1. windriven says:

      ” Nothing to learn here, folks.”

      My you have a tiny mind. Specific foods have specific constituents and those constituents can be scientifically proven to have specific effects. There are vibrant fields of scientific inquiry surrounding foods, food constituents and their biological effects.

      Face it stan, you are just a philistine with a keyboard. You have not once in my memory added a single meaningful thought to a discussion in these pages. You toss what you imagine to be grenades but that everyone else recognizes as water balloons. Tiny water balloons – they gather attention but leave no impact.

      I was going to point out that for an enquiring mind there is something to learn everywhere. The collected wit and wisdom of stanmrak is the exception that underscores that rule.

  9. Alia says:

    Over here we have a running joke that starts with “American scientists found out that…” (and is followed by every conclusion you can imagine), which is a reaction to a multitude of alarmist articles or programmes in the popular media, many of them connected with health benefits or risks of this or that random food product.
    (And then we also have another running joke, “Soviet science has reported such cases”, but that’s a different story.)

    1. @Alia – Here in the U.S. we have the joke “A common everyday household item maybe killing your child! – News at 11:00″ but maybe that’s out of date now with 24 hr news.

      I want to hear the Soviet science story, though.

  10. “…if you live in a Western industrialized nation you probably have adequate nutrition.” Unless you live in the United States. If you do, your diet is probably packed with fat, sugar, and calories, and a dearth of protein and fiber, and you are probably malnourished and obese at the same time.

    1. windriven says:

      And your point?

      Some people make atrocious dietary choices. Shall we force feed them kale and steamed chicken breasts?

    2. calliarcale says:

      Given how popular red meat is in the American diet, I find it difficult to believe the average American doesn’t get enough protein. Not enough fiber, that I can believe.

    3. Young CC Prof says:

      There are a few folks who, out of laziness or extreme poverty, may be eating sweets and french fries to the exclusion of food, but actual nutritional deficiencies are pretty rare. There may be some iron deficiency in women of reproductive age, moderate D deficiency in winter, especially among those with darker skin, but I haven’t seen a case of scurvy, rickets, beriberi, or pellagra in a while.

      1. angorarabbit says:

        Depends on the circles you run in, CC. NHANES puts 22% of child-bearing age US women with iron deficiency,that’s not “some.” Visit (very sadly) a VA hospital to see deficiencies such as pellega or beri-beri in our veterans, usually commensurate with alcoholism. We are seeing rickets in African-American US children in northern latitudes (if you consider Baltimore northern) because the parents are doing such a great job of covering up the kids to reduce skin cancer risk.

        Mind, I don’t see the levels in the US that I recently saw, say, walking the streets of Phenom Phen. But it is sufficiently common that we are training our dietitians to recognize it. Can’t speak to med schools but if it’s like ours, it’s getting missed.

  11. Obviously I oversimplified the advice at the end, but that was on purpose. The point is – obsessing over details of specific foods and ingredients is unlikely to result in a net health benefit. The information is dubious, the ingredients common, and it would be an overwhelming task likely not worth it. You can do just as well, perhaps better, by following simple rules that anyone can understand and easily follow – eat a variety of food, and make sure you include sufficient vegetables. Evidence does consistently show that a diet with sufficient vegetables is more healthful than one with a paucity of vegetables – which could be due to such diets having an excess of things like animal fat.

    Regarding oreos, etc., that is handled by the “eat a variety, nothing to excess”. You don’t have to demonize any particular food, completely avoid “bad” foods – just have a varied diet, nothing to excess. Simple rules that will work as well as the most detailed and obsessive diet plan (this assumes an average person with no specific health needs).

    1. windriven says:

      And balance that diet with a reasonable level of exercise proportionate to age and physical condition.

    2. Dan Hackam says:

      “Regarding oreos, etc., that is handled by the “eat a variety, nothing to excess”. You don’t have to demonize any particular food, completely avoid “bad” foods ”

      Why can’t you completely avoid bad foods? I have dramatically improved my metabolic syndrome by avoiding the standard North American diet, which does occasionally consist of “bad” foods. I don’t see any harm in eliminating refined sugar, trans fats and the like from your diet, and do see (some) potential gain. Happy to share my weight loss, biochemistry, BP, etc.

      1. Chris says:

        “standard North American diet,”

        Define with verifiable references that this thing exists, and the details of the diet. Explain in detail the specific foods with their amount, and not the nebulous references like “trans fat” and “refined sugar.” Because substituting honey can be just as bad as using white sugar.

  12. David Gorski says:

    Heh. Steve is only partially right. Everything we eat causes cancer…sort of.

    I know. I’m a bastard attention whore…but, then, Peter Moran and Dr. Jay already knew that…

    I blame blogging and having to compete for SBM attention with Steve and Harriet. :-)

  13. leeann says:

    And as I head off to my nutrition class (Basic nutrition elective at a business college), I may just start off with this link and it’s title. Lots of intro questions, before we start into the science, are always “which is the BEST food” or “which is the WORST food.” Today I’ll have a student who missed the first two classes b/c he was at a business show, trying to sell his ayurvedic beverage…And he looks forward to talking to me about health and nutrition. I responded by saying I was sorry he missed the lecture on “critical thinking.”

  14. Kismet says:

    Do you really consider the findings of modern food science to be shallow and irrelevant and the official (although sometimes somewhat divergent) recommendations of no value? I must assume this is so, since you did not even mention basic recommendations – several of which are consensus. I hope you can prove me wrong.

    You do not mention the benefits of legumes, nuts, olive oil, fruits, low-fat dairy, whole grains, moderate wine/alcohol consumption; chocolate, coffee or green tea.

    Nor the harms of red meat, high saturated fat and salt intakes or low quality carbohydrate. It is advised to keep intake of these very low.

    You mentioned none of it, but why?

    1. calliarcale says:

      Because the point of the article wasn’t to give a prescription of what to eat and what not to eat but to explain why obsessing over tiny effects on cancer is probably not helpful. That would be my guess, anyway. No article will mention everyone’s cause celebre; it’s just a fact of life, and we shouldn’t try to take it personally or read any motives into it.

    2. Young CC Prof says:

      We do have some basic consensus recommendations, like eating more veggies and less cake, and trying to limit high-calorie foods to prevent obesity. However, the nutritional advice that makes a big difference to health outcomes is stuff that we all know and almost everyone agrees on. investigating whether blackberries are better than blueberries at preventing cancer is kind of silly, since any effect is probably going to be pretty small and difficult to detect.

      1. Kismet says:

        I fear you are wrong. Talking to my friends, university students and German skeptics, I notice that many people are clueless of some basic recommendations.

        I think Dr. Novella wasted an opportunity to educate people on this.

        1. windriven says:

          Novella was writing about the Paleo diet fad.

    3. OlegSh says:

      There are no unhealthy foods – there are unhealthy portions. If you don’t have any specific allergy then you can eat whatever you want and still improve your health just by reducing the total caloric intake.

      For 10 weeks, Mark Haub, a professor of human nutrition at Kansas State University, ate one of these sugary cakelets every three hours, instead of meals. To add variety in his steady stream of Hostess and Little Debbie snacks, Haub munched on Doritos chips, sugary cereals and Oreos, too.

      His body mass index went from 28.8, considered overweight, to 24.9, which is normal. He now weighs 174 pounds. Haub’s “bad” cholesterol, or LDL, dropped 20 percent and his “good” cholesterol, or HDL, increased by 20 percent. He reduced the level of triglycerides, which are a form of fat, by 39 percent.

      http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/index.html

      1. Proplayer44 says:

        Maybe he was eating incredibly badly before. Maybe he exercised and walked and drank lots of water during the same period but doesn’t usually.

        1. WilliamLawrenceUtridge says:

          Maybe he consciously counted, and reduced, his calories – which as the laws of thermodynamics would suggest, would lead to reduced fat stores and thus weight.

  15. hanno says:

    Completely agree with most you wrote, just want to highlight one point: You mention that partly due to publication bias we get preliminary studies with results that tend to have declining effects if repeated.
    But there’s a fix for publication bias, at least a partial one. It’s clinical trials registers. I recently talked to Gerd Antes (head of the german clinical trials register) for an article I wrote about this and he told me, yes, sure you can also pre-register studies on food health effects. But almost nobody does it.

    Simple rule of thumb: If a study on food health effects hasn’t been pre-registered in a public trials register, don’t take it seriously. It’s probably more publication bias than a real result.

  16. WilliamLawrenceUtridge says:

    Unless you live in the United States. If you do, your diet is probably packed with fat, sugar, and calories, and a dearth of protein and fiber, and you are probably malnourished and obese at the same time.

    Unlikely. The signs of protein deficiency are not small, they’re rather blatant. Your comment regarding protein assumes that the majority of the American diet is made up of potato chips and Twinkies, when in reality a common criticism is the large amount of meat in the diet. Further, the signs of nutritional deficiency are also rather stark – it’s hard to miss scurvy, what with the bleeding gums and teeth falling out. Your strongest point migth be fiber – which is mostly about preventing constipation, and perhaps over the span of decades, bowel cancer (perhaps). As far as I’m aware, one can’t be “deficient” in fiber the same way one is “deficient” in vitamin C, or A, or protein.

    I hope Angora Rabbit corrects me. Hint. Hint. Big fan. Huge!

    Much as quacks and loons would love to pretend that North Americans are malnourished, the chronic diseases related to diet are not due to deficiencies. Obesity, hypertension, cancer, diabetes, they don’t go away with vitamin supplements. Only some of them can be addressed (i.e. treated) through diet.

    Food is food. It’s not medicine, and it’s not magic.

    1. calliarcale says:

      Yes. The main problems with the American diet (forgiving for a moment that there isn’t a monolithic “American diet”) tend to be those of excess, not deficiency.

    2. angorarabbit says:

      Oh, you can butter me any time, WLU. :) There are certainly conditions where we worry about micronutrient deficiencies, as I mentioned earlier like alcoholism, rickets in dark pigmented children, digestive disorders, individuals with disordered eating. But for the general US populace, not so much. If anything the general population is over-nourished especially the higher SES and all the supplements they are taking.

      Though one of my favorites was one of those Discovery “mystery illness” shows where the parents let the little boy only eat white food and couldn’t understand why he cried when he tried to walk. Rickets AND scurvy. Made me cry, too.

      Calle will back this up – remember that the DRI is actually set at 2 SDs above the mean requirement for that sex / age group. So even when folks are consuming 70% of reqts, we are unlike to produce overt deficiencies. In other words, a person has to work it. Sadly, there are definitely people out there who manage to do this (the orange-skinned lady who ate pounds of carrots daily), which is why the training is still relevant.

      Not a fiber “requirement” but a definite recommendation! I have to add that some micronutrients also have recommendations rather than requirements, mostly because it’s been too difficult to figure out how much is needed. Vit K is a good example as a lot of it comes from gut microbes.

      1. WilliamLawrenceUtridge says:

        Squee!! It’s like having a rock star throw you their underpants at a concert :)

        Feel free to substitute any word in previous sentence.

        I eat 2-3 carrots five days per week, usually scrupulously with fat. Dear Mrs. Utridge regularly points out how neon the palms of my hands and soles of my feet are. At this point, I do it mostly so I don’t have to think about what to pack in my lunch.

        Next to anatomy, the class that was probably most helpful for day-to-day life was nutrition. It should be required for all adults.

      2. Chris says:

        “Though one of my favorites was one of those Discovery “mystery illness” shows where the parents let the little boy only eat white food and couldn’t understand why he cried when he tried to walk. Rickets AND scurvy. Made me cry, too.”

        This case report is making the rounds: A 3-Year-Old Girl with Eye Pain.

        1. WilliamLawrenceUtridge says:

          That case report is probably the saddest thing I’ve ever read. And for it to have happened twice (her sister had the same problems it sounds like), is unconscionable. What’s the harm? That.

      3. WilliamLawrenceUtridge says:

        Angora Rabbit, I’ve another question for you and I hope you’ll indulge me. I consume an enormous amount of insoluble fiber in the form of raw vegetables, all over the course of several hours in the afternoon of most work days. To balance out the effects on my gut (while insoluble fiber is definitely nature’s steel wool, it doesn’t have that texture coming out…), I’ve taken to consuming about 15g of psyllium fiber at night, taken with about 500-600ml (a big glass) of water. Dear Mrs. Utridge has expressed concern that this might have consequences. I naturally brushed it off, ’cause I be a man and thus indestructible, but I was wondering if you might have any comment? I’ve had much more…solid success…(gross) since doing this, I’m purely doing it for…texture (grosser) and it has been working on drifting things down the Bristol chart, if you know what I mean (grossest). Am I doing something with long-term consequences, for comfort’s sake?

        Many thanks, even more apologies.

  17. Markku says:

    I more sort of tend to believe in your first explanation, i.e. that there is certain risks and benefits associated with certain foods, but they average out to zero. I have this idea for two reasons. Firstly, the risks are measured against a baseline population that has an average diet. To my logic this means that some of the risks have to be positive and some negative. Otherwise the baseline population would not have an average risk.

    Secondly, the statistically significant findings should be real more often than not because of the very definition of statistical significance: Results significant on the 5 % level imply that chance has a 5 % chance of producing this type of spurious correlation. By and large, in 1,000 studies reporting relative risks significant on 5 % level, you would expect 50 false positives and 950 real results!

    However, this notion is subject to one warranty: The statistical significance levels are based on statistical models, i.e. mathematical assumptions about the data (or more precisely, the data generating process). We no that these assumptions are never really fulfilled, and they are only idealizations of the reality. Take for example linear effects – who believes that any effect of anything follows a smooth mathematical relationship, be that linear, log-linear, log-square root linear or whatever?

    On the other hand, there is no a priori reason, why the mathematical idealization should confuse the p values in any one direction. Presumably, in some studies the p value is biased upwards, and in some studies downwards. So I believe that in the big picture, some 900 of the reported results are still real.

    That being said, I definitely agree that food is not magic. The main thing is to eat enough and not too much. All other is small detail. Take for example a case that we know that consumption of food X increases the risk of bowel cancer by 0.5 %, and we know this by 99.99 % confidence. Does that mean that you should stop eating X? Of course not, because you have bigger problems. That does not affect your expected life time very much.

    1. Harriet Hall says:

      “some 900 of the reported results are still real.”

      Not necessarily. Remember, statistical significance is not a measure of whether the results are true or not.

      1. Markku says:

        That’s a very good point indeed. I still confuse p value with probability of null model, even though I have done Bayesian statistics for years!

        Yet you can only talk about the probability of true result in a Bayesian context, and the relationship of the classical p value and the Bayesian posterior probabilities depends on a number of things, among them prior probability of the null model and alternative model. That would be the biological plausibility of the study hypothesis, I believe. Since most of the epidemiological studies are however based on plausible models, I would argue that small p value implies high probability of true effect. My guess is that 95 % is right order of magnitude.

        But of course this is all guessing.

  18. “By and large, in 1,000 studies reporting relative risks significant on 5 % level, you would expect 50 false positives and 950 real results!”

    Not exactly – you would have 950 intervals which capture the population mean. It’s important to note that each one of these intervals would probably not be the same EVEN IF we are performing exactly the same experiment.

    “Take for example linear effects – who believes that any effect of anything follows a smooth mathematical relationship, be that linear, log-linear, log-square root linear or whatever?”

    What if it’s a discrete system? Doesn’t that mean there exists an nth degree polynomial that models it perfectly? Doesn’t that also mean there exists a polynomial with degree < n which models it within a specified error?

    Which is one of the reasons you generally start using linear models is that they are easy to falsify. You can't falsify an nth degree polynomial model derived from n data points.

    1. …and perhaps more clearly this highlights the important thing about models: That they operate within a specified (and arbitrary) error (with certain assumptions). Not that they are point perfect.

      “We no that these assumptions are never really fulfilled, and they are only idealizations of the reality.”

      Yes there are assumptions on statistical models but it’s unclear what “never really fulfilled” means. The way I would put it is that statistical models are to put a probabilistic bound on a statement using information. In other words: “Given information X how likely is Y?”

      True, to do that we have to make some assumptions. The important ones are about the characteristics of that information. i.e. that it’s roughly normally distributed. However when you say that the assumptions underlying a statistical model are “never really fulfilled”. I suspect you’re incorrect. Roll two dice a hundred times. Let me know how often you end up with a distribution that isn’t close to normal.

      1. Markku says:

        I would go as far as to agree that often these assumptions are well justified idealizations of the reality. But completely fulfilled – of course not. Does there exist 200 identical rolls of a die? I doubt. Are the die rolls random in the first place? I doubt. Not being a physicist, I would assume that they are governed by the laws of classical mechanics, and you could in principle calculate the number of the die deterministically from the first principles, if you were given sufficient information. In that sense a uniform distribution on 1,…,6 is a wrong model, because the reality is more complex – but often the uniform distribution is a sufficiently good approximation to yield predictions of the result.

        1. “But completely fulfilled – of course not. Does there exist 200 identical rolls of a die?”

          Why do they have to be identical? The point is, that the assumptions for most statistical analysis you use in medicine don’t require that the the distribution to be exactly normal.

          “Are the die rolls random in the first place? I doubt. Not being a physicist, I would assume that they are governed by the laws of classical mechanics”

          What do you mean by “random”? Unpredictable? Based on what level of information? Are you saying that something can’t be both governed by classical mechanics AND unpredictable? You’re wrong but I’d be interested in hearing your reason for thinking that.

          1. @Markku – Another thing worth thinking about when regarding a mathematical construct as somehow being disconnected with reality (if that is indeed what you think). Is that for any system you are trying to model M by series of values S of the form (x,y) there exists an *algebraic* function which models it perfectly. That is f(x) = y for every x.

            Now if S is not complete, that is there are some aspect of M that is not in S. The behavior of f(x) isn’t going to be anything like M. However it illustrates that the problem isn’t with math being somehow inadequate for perfectly modeling reality but our ability to provide math with data.

            That said, given a couple of reasonable assumptions about the data in S we can model M to a specified probability or measure the probability with which f(x) models S given the carnality (size) of S.

            To me anyway this is reality “completely fulfilling” the assumptions of our model.

            If you really want to think about “Is math real?” consider that a branch of math (complexity theory) routinely demonstrates which kinds of machines can and can not be built and reality has no choice but to obey.

          2. rofl…I typed “carnality” instead of “cardinality”. Autocorrect or Freudian slip?

  19. I tend to think that living causes death. Right now I suspect that peanut butter and jelly sandwiches will be the death of me…I just love peanut butter, jelly and bread, it must be evil because it is so good.

    Besides that I feel like I’m doing really good if I eat for the near future. How should I eat so I feel good this evening, this month or this year. That’s pretty helpful.

    I do think that people could pay more attention to how food affects dental health in kids. Some kids can get by eating a lot of sugar, but other are prone to cavities and dental insurance isn’t always affordable or available.

  20. DavidRLogan says:

    Most of you are so careful and thoughtful in your comments, but…

    One comment brags about laughing at a student’s expression of one of these views. The same comment makes light about ignoring and/or arguing with students. Another comment gloats over a dismissive remark to a student who said they looked forward to the class (because they had pseudo-scientific viewpoints)!

    Newsflash: that’s what college and education are about! People, especially young people (I’m 28), have some crazy views. I know I did and still do. How we treat those views in person is so important, particularly now that it’s so easy to get stuck in echo chambers on the internet. I’m so fortunate my professors approached my stupid questions with so much more care than these comments (granted, I wasn’t smart enough to take cooking or business college nutrition ;)) Do you think SBM is impressed by your treatment of students? I’m not.

    Dr. Novella thanks for the post!

    -David

    1. weing says:

      “How we treat those views in person is so important, particularly now that it’s so easy to get stuck in echo chambers on the internet.”

      You could try rbutr. I’m checking it out now to see how it works.

    2. DavidRLogan – I always hope to get a bright and committed person for an instructor of any class. I accept that many bright and committed people are a bit impatient with thoughtless comments or parroting preconceived notions -particularly when they interrupt the flow of the class*. I enjoy a teacher who will challenge me to rethink my ideas and I don’t really mind* and occassional jab or verbal poke when I deserve it, as long as the teacher isn’t actively hostile or insulting and is willing to point out my successes as well. I take it as a sign of respect that the teacher is treating me as another adult and not hand-holding as they would a child.

      *There is often that ONE student who would consume ALL the classtime with their pet interests and insights if they are allowed. It’s usually the teacher’s job to handle that student and ignoring is often the best way.

      **Actually I mind it, it’s just that I mind it enough to try to do better, which means I learn more, so I like the end result.

      1. WilliamLawrenceUtridge says:

        Heh. I was totally that student. One prof managed this by saying “your questions are too advanced for most of the rest of the class, please write them down and come talk to me afterwards.”

        Is it any wonder I was an insufferable prig for most of my university years? How Mrs. Utridge put up with me until I reached my current state of beatific perfection is an open question. I keep telling her she needs higher standards.

  21. Carl says:

    Yet more stuff to worry about:

    http://i.imgur.com/08qoIHl.jpg

  22. Bubbie says:

    I’ve battled breast and anal cancer (successfully). I don.t know of any food I’ve liked that caused either. I think my immune system is haywire somehow along with something in my family genetics. I read the articles about what food or supplement to keep cancer at bay, but I just don’t trust them anymore. I agree with this article that food in and of itself is not the answer. So docs…..get to work finding me the answer!

    1. windriven says:

      “So docs…..get to work finding me the answer!”

      “I’ve battled breast and anal cancer (successfully)”

      Bubbie, I’d say to some degree they have found the answer! Glad to hear you’ve battled with success.

  23. Dr Novella: I think the last para is spot on, but see 2nd last para as overly simplistic. Blog is enlightening, think reply that makes the most sense is Stanmraks…his brief comment connects directly with the phenomena of hormesis (and most others don’t remotely consider this) , where subtle alterations in concentrations of substances yield very different outcomes…Dr Watson (aka Watson and Crick) and lots of these big thinkers accept and embrace this concept…NCBI/PUBMED has lots on this. Nice overview in article and Blog about challenges with present studies though! We’ve got a long way to go

    1. There’s a marked difference between learning what hormesis is and demonstrating that a particular dose/response model shows evidence of hormesis. I’m willing to bet you can only do the first part.

      While I will not be surprised if some model for toxicity shows hormesis – you need to remember we are talking about freaking FOOD. How are you managing to keep your exposure to the most common cooking ingredients at 50 ng/kg or whatever you think the threshold is.

    2. windriven says:

      @Flaming Rasmussen

      “[I] think reply that makes the most sense is Stanmraks”

      That left me laughing so hard I forgot how crappy the Shiraz I’m drinking is – roughly like prune juice and Everclear. Not much different than your comment, actually.

      Here, as a public service is stanmrak’s flatulence du jour in its entirety:

      “This ignores the simple fact that no food works in isolation. No study can be done that will eliminate ALL variables. Therefore, no food can be scientifically proven to have any specific action on its own. Nothing to learn here, folks.”

      “his brief comment connects directly with the phenomena of hormesis”

      Hormesis is the somewhat controversial notion that some biological stressors provoke a ‘J’ or ‘U’ shaped dose response curve. The Cliffs Notes example would be red wine: a little is thought by some to have salutary cardiovascular effects while alcohol poisoning … not so much. I will just say that controversial or not, hormesis and stanmrak’s comment are as related as string theory and homeopathy.

      “Dr Watson (aka Watson and Crick) and lots of these big thinkers accept and embrace this concept”

      I only give .016 give-a-shits about this assertion and it requires more than .51 give-a-shits for me to chase down a citation that a fool failed to provide. I will simply point out that among the other things that James Watson apparently believes are that those of African descent are dumber than a box of rocks but that they have overcharged libidos and eff like bunnies. Yeah, I’ll be inviting him to my next barbecue.

      Instead of swooping in and dumping a wet load of barely coherent nonsense for us to pick through, how about formulating a nice succinct point relevant to Dr. Novella’s blog and support it with some quality information? Just as a point of order: ‘we’ve got a long way to go’ falls a little short.

    3. WilliamLawrenceUtridge says:

      If the concentrations of substances that yield different outcomes are “subtle”, wouldn’t it be incredibly hard to titrate them to meaningful effects? How does one reach the sweet spot if levels below and above some narrow range are dangerous or ineffective?

      Stan is a notorious troll here, if he’s factually correct in anything it is due to the stopped clock effect.

      1. WL: Yes the sweet spot…for substances like folate deficiencies and thalidomide and their potential horrific impacts during pregnancy, the sweet spot for the first was found out the hard way, and the latter substance am guessing ‘zero’ . Outside of pregnancy we are remarkably less concerned with folate deficiency and thalidomide remains a prescribed drug. I guess one of the readers didn’t appreciate my earlier conclusion, “we’ve still got a long way to go” but think it resonates reasonably well

        1. angorarabbit says:

          Oh, we see hormesis all the time in toxicology and in nutrition. That U-shaped or J-shaped response curve is pretty common. A classic is ethanol, whereas no intake avoids the benefit of moderate intake upon cardiovascular health, but high intakes worsen cardiac function. We found a J-shaped curve with trichloroethylene and birth defects, and our best guess is that a mid-range dose induced hepatic disposal systems that promoted disposal. For micronutrients the U is inverted – too little is deficiency and too much can be toxic. If anything, it’s the linear response that makes me wonder about data integrity.

          But re: food, it’s not the hormesis and the notion that there’s a butterfly effect is naive. The body has amazing homeostatic mechanisms to keep concentrations of many metabolites within a proscribed range. It usually takes a lot of whacking to put the homeostasis out of its self-correcting mechanism, and when it happens it is pretty serious, as in diabetes.

          I’m told that James Watson also paid big $$ to have a tree moved at CSH that blocked the ocean view from his office. Maybe its the Pauling Effect?

          1. “The body has amazing homeostatic mechanisms to keep concentrations of many metabolites within a proscribed range.”

            Excellent point. I mention things like this when people talk about “making your body more alkaline to fight cancer”. Your effective range is pretty small and the consequences of going outside it are pretty dire.

        2. daedalus2u says:

          Vegetables do have, as a class, important nutrients that are pretty much not available from non-vegetables; carbohydrates. Adequate carbohydrate intake is essential for good health. Pregnancy and lactation are not possible without adequate carbohydrate intake. Lactation requires the production of lactose as the major osmolyte in breast milk. That require adequate blood glucose. Glucose comes from gluconeogenesis in the liver, which requires 3-carbon substrates and cannot be made from fat. Some glucose can be make from amino acids, but the liver doesn’t have the urea production capacity for all calories to be derived from amino acids.

          The idea of homeostasis is wrong. It is a completely made-up myth with no data or theory to support it.

          http://daedalus2u.blogspot.com/2008/01/myth-of-homeostasis-implications-for.html

          What is correct is hormesis. All substrates have a hormetic dose-response in the low dose range. If you don’t see a hormetic dose-response, then you are not in the low dose range. This hormetic dose response is a property of the control system of physiology, not a property of the substrate being tested.

          The only reason a substrate has “toxic” (or any) effects, is because that substrate interferes with the control of physiology. If a substance did not interfere with the control of physiology, then it would have no effects, positive or negative.

          The control system of physiology exhibits the most important aspect of “control”; negative feedback within a range so as to result in stability. In other words, as the control system is perturbed, the control system self-modifies so as to counteract the adverse effects of that perturbation. This shows up as hormesis in the low dose range, where the control system has sufficient reserve control capacity to counter the interference with control due to the perturbation from the xenobiotic exposure.

          The problem with the meme of “everything causes cancer”, is that whether a material has positive or negative outcomes depends on the dose, not (so much) on what the material is. You can’t take effects at one dose and extrapolate them to other doses because all dose-responses are non-linear.

          Within a certain dose range, nothing has “toxic” effects. If something interferes with the control system of physiology, then at some dose physiology can compensate for it and hormetic effects will be observed. That is true for something really toxic like cadmium, it is also true for things that are essential such as water, salt, vitamins and other nutrients.

          Physiology is really complicated. It is foolishly naïve to imagine that you can eat a magic diet, one that no human had access to more than 100 years ago, and imagine that will perfectly match our evolved physiology. Human physiology didn’t evolve to produce perfect health. Human physiology evolved to convert substrates into descendants.

          1. WilliamLawrenceUtridge says:

            D2U, have you overseen “fruits” in your discussion, or is there a reason you don’t consider them sources of carbohydrates?

  24. Eating food causes you live longer. The longer you live, the more likely you to get cancer.

  25. JW says:

    Missing point is that the US has a high amount of GMO food. So, article could be correct if you grow your own food….which I enjoy doing thankfully….

    1. Renate says:

      Any reason why GMO food is bad?

      1. windriven says:

        “Any reason why GMO food is bad?”

        Many. Perhaps most important is that it allows agriculture to continue to feed a burgeoning world population that would have been a Malthusian nightmare just 50 years ago. Too damned many people anyhow. Let them eat sand.

        Oh, and Monsanto makes money off it. Reason enough.

        ***

        There are, of course, reasons to be cautious. Genetic diversity in food crops is important, The Monsantos of the world would love for the only soy to be Monsanto soy. Pressure to produce more food on less arable land will only exacerbate the problem. But this is more a public policy problem than a scientific one.

        1. WilliamLawrenceUtridge says:

          Oh, and Monsanto makes money off it. Reason enough.

          It saddens me that you may be trying to exaggerate, but are failing. People genuinely treat corporate profit as if it were not only an inherently bad thing, but enough to invalidate whole fields of research.

          1. windriven says:

            Satire, William. Satire. That some dufi “genuinely treat corporate profit [as only a] bad thing” is the pivot on which the satire rotates. Had I the time I would have included snide remarks about their 401(k) programs.

          2. WilliamLawrenceUtridge says:

            Poe becomes ever more correct the longer the internet exists.

    2. theLaplaceDemon says:

      I suggest you go up to the SBM search box and type “GMO.”

  26. mcrislip says:

    “When you wake up in the morning, Pooh,” said Piglet at last, “what’s the first thing you say to yourself?”

    “What’s for breakfast?” said Pooh. “What do you say, Piglet?”

    “I say, I wonder what’s going to happen exciting today?” said Piglet.

    Pooh nodded thoughtfully. “It’s the same thing,” he said.”

    ― A.A. Milne

    I’m with Pooh.

    1. My first though is “coooooffe”. There are no other thoughts until that task is accomplished.

  27. WilliamLawrenceUtridge says:

    Sure, “food” will keep you alive, but it won’t necessarily provide optimal (ie. health protecting) levels of micronutrients, fatty acids, proteins, and the whole number of other things we haven’t figured out yet (gut bacteria health, epigenetic effects of different food patterns etc.).

    The idea that you can achieve this purely through a manipulation of diet is an assertion. Or, put another way, an untested hypothesis. What is particularly irksome, and galling when compared to how reality appears to work, is the idea that it can be guaranteed through diet – an idea I persist is a belief based on the misfiring of those parts of the human brain that define “clean” and “dirty”, the same area that is responsible for religious ideas of ritual purity (and I would guess, obsessive compulsive disorder).

    The human organism is imperfect. It is not meant to last forever, or maintain perfect health. It is a “good enough” machine. Look no further than the persistence of Huntington’s disease – a dominant gene that has no effect on one’s health until one reaches one’s middle age and has almost certainly bred.

    Nature doesn’t care about you, your health, or your happiness. Only other humans care about these things. One should not descend into the delusion that the world is, or ever was, somehow established purely for our enjoyment but only went awry with the advent of technology.

    The Garden of Eden is a myth, a trope, a fairy tale, and it is to our detriment to pretend we could ever create it in this reality.

    1. TJ says:

      Why quote me, if you are arguing against something else? Nowhere do I suggest diet manipulation offers any kind of guarantee against illness.

      1. WilliamLawrenceUtridge says:

        Think of the implications of the word “optimal”, and consider if there is any diet better than “adequate”.

        1. TJ says:

          “consider if there is any diet better than “adequate”.”

          Really? Define adequate then. From my perspective, adequate might keep you alive, but it might not prevent subclinical deficiencies of nutrients or low-grade inflammation. If you were to achieve “optimal” levels of nutrients (relative to you and your genes/environment/behavior etc.) it is quite plausible that you could tip risk balances of various diseases in your favor over your lifetime. It might appear to come out in a wash on the population level, but the effects of mild micronutrient/protein deficiencies on an individual level over your lifetime are quite possibly real. What is the probability that when you get to age 90 on your adequate diet, that you’ll be fighting infections in a hospital bed vs. playing with your grandkids? Will that probability change if you manage to avoid decades of just a bit too little iron, vitamin D, or the complete amino acid spectrum? If you are getting frequent colds because your body is stressed on a daily basis because you eat an “adequate” diet that is just too pro-inflammatory over decades of a lifetime, will you be able to enjoy old age like somebody who’s lifetime inflammation levels were a tad lower on a better-than-adequate diet? Science doesn’t yet have the answers, but it does have many clues, and IMO, nutrition is unfairly laughed at by skeptics because it is impossible to effectively study dietary patterns in populations and on individual levels over decades.

          The *easy* way out is to just say ‘eat a variety of foods’… but even Novella can’t help but to strangely plug vegetables in at the end of his post without citing any references – and then bashes animal fat despite the fact that of all people, he should be privy to the fact that the anti-animal-fat “nutritionists” are among the worst scientists of all.

          1. WilliamLawrenceUtridge says:

            “Adequate” would be a diet that prevents your body from entering a deficiency state over the long term. The idea that there is a single fixed level, some sort of ideal optimum of nutrient intake, strikes me as spurious. The human body can exist in good health with a range of nutrient intakes, and the idea that all disease, or even most disease, can be prevented through diet, is extremely questionable.

            I think there’s far, far more to playing with your grandkids at 90 than diet. Exercise would be a huge one, and then there’s being lucky enough to have the right genes, and being lucky enough to avoid the random infections, genetic mutations and accidents that can cause poor health.

            And after your criticizing scientists for being “bad” and Dr. Novella for failing to cite references, may I point out your own comments are rather equally speculative? For instance, what if that little bit of inflammation tips you over the edge of being slightly better at fighting off infection? Or being slightly better at rebuilding certain tissue types? You don’t know any more than the “anti-animal fat nutritionists” you appear to dislike so strongly.

  28. Barbara Shalet says:

    I have read this post with great interest even though much of it is beyond my understanding. However, I am able to clearly see that practitioners of epigenetics are treated with scepticism and disdain. Now, I have not yet consulted one but have had my genome analysed and, from the polymorphisms that have shown up, I have been able to improve my health beyond all my expectations. I did this using diet, vitamins, minerals and co-factors in the form that my own system is able to metabolise. I have faulty methylation, transfulfation pathway upregulation and impaired mitrochondrilal function. I learned all I know so far from researching online. Due to my own misinterpretation I have at times taken the wrong supplements and have suffered for it. I now have it almost spot on and I shall never condemn any practitioner who is able to help people with their health in such a simple drug free way.

    1. WilliamLawrenceUtridge says:

      I don’t think one can be a “practitioner” of epigenetics, anymore than one can be a “practitioner” of biology. It’s a domain of knowledge, it’s not a branch of medicine. You might want to consider Dr. Gorski’s post on the matter before putting much faith in it – the field is not yet mature, and hasn’t produced any validated medical interventions just yet. It is at the stage of knowledge that DNA was at shortly after its structure was discovered – we knew something new, but we couldn’t do anything with it.

      You might also want to look into some of the articles on “personalized medicine” for much the same reasons (Dr. Gorski again, Scott Gavura, Dr. Hall though it’s about your biome, and Dr. Hall again this time about blood-based tests).

      The claim that supplements, in the absence of frank deficiency, are a way to improve health, is extraordinarily questionable. Did you get these diagnoses and tests on the advice of perhaps a naturopath? They will often use technical-sounding languages to try to sell themselves as advanced practitioners of medicine knowing more than their MD counterparts (I typed, then deleted both contemporaries and competitors since both are wrong for basically the same reasons). The reality is, they are selling you unvalidated tests, with results that are uninterpretable given current knowledge, that are ultimately attached to no scientific tests that show objective improvements in health. The reason they do this is to, in turn, sell you supplements you almost certainly don’t need, that they happen to stock in their office (all the while accusing Big Pharma and doctors of being greedy).

      Did they describe the mitochondria as “the powerhouse of the cells”? Did they sell you acetyl-CoA, niacin and/or nicotinamide under the guise of “giving you energy”? Technically true, since the mitochondria produces ATP (the fundamental molecule of energy transfer in the cell) using acetyl-CoA and niacin as enzymes and substrates in the reactions, completely ignoring that actual mitochondria dysfunction is quite serious and shows up in objective tests and that Acetyl-CoA and niacin are both readily available in the diet.

      One must question what one reads on the internet unless it comes from high-quality sources of information; sites selling supplements are rarely such sources, as they often wish to justify their trade more than they want to inform you of facts and reality.

      1. weing says:

        @WLU,
        DNA methyltransferase inhibitors and Histone deacetylase inhibitors are already being used in chemotherapy.

  29. Johnathan: Thanks for the thoughtful feedback. Your comments are bang-on regarding the challenge of determining molecule “x” pico/nano gm/kg influence. I am studying cancer from the perspective of how our cellular environments play a governing role in how each cell lives and dies, and how these environments in many ways determine the expression of our genes. Our individual environments are heavily influenced by our lifestyle and surroundings..so we can throw unwanted toxins, excesses and deficiencies into the mix, which includes food. Anyway, there are some interesting NCBI papers on some foods or food molecules that use comments like, “preferentially kills cancer cells”, and “causes massive ROS accumulation” The latter comment is an identical mechanism that many chemo and radiation modalities use. Its a subject area that has the dosing ranges, dosing frequency (1/2 life) and duration (to limit potential for cells to become resistant) as central to any solution yet in an unproven and difficult to fund area. I’ll always take the critical well articulated feedback as it has assisted greatly in my pursuit.

    I attended a recent cancer conference where many of the prominent US universities and cancer centres were represented…and this group was committed to a very different approach…and food was a key (although not sole) area of study http://www.gettingtoknowcancer.org/taskforce_therapeutic.php

    Again, appreciate the blog Dr Novella…I maintain there is a lot more to your title of this article then most think!

    1. WilliamLawrenceUtridge says:

      When you say “toxins”, exactly what do you mean? Would you have to detoxify a person in order to treat the cancer? Do you believe there are widespread deficiencies in North America that cause cancer? Of what substances, specifically?

  30. WL: Toxins – Yes I can see how some clarification might be warranted as most things in excess could be deemed a toxin. Sorry about that. What I meant was a substance like absorbed toxins from working in a chemical factory/dyes, or being exposed to dump sites like “Love Canal”, or some of the types of smoke inhaled by firefighters. The challenge is nothing is an absolute, just that exposure to certain substances shows increased risk.
    Detoxify – Cancer burdens, especially tumour bulk, can (and are) frequently initially targeted successfully without any real changes to the ‘environment’ that seemed supportive of the cancer. So in this scenario, no. As far as long-term remissions/cures and whether toxins need to be removed, I haven’t seen studies on that…but it would seem logical that removing substances in our bodies that played little if any known supportive role in biochemical processes would be better removed or in lesser concentrations.
    Deficiencies – click on my name and will link you to a website my Dad and I have posted. The “Welcome page” and under 2nd tab the “Genes and Environment page” speak to the deficiencies and surpluses aspects.

  31. Iwona Grad says:

    Nice story, though I don’t think complete. One thing is certain, there is a lot of biased, bad data. If you have a lot of bad data and meaningful data and you make a meta, you will get to no effect at the end. Having said that, it is probably too simplistic to say food does not matter. Look at Dean Ornish work (http://www.pmri.org/). Sure, his results come from the complete lifestyle changes and it is also possible to say that it was smoking/exercise/meditation… which was the main factor. However, we cannot exclude food did not play a role. And as far as nutrition goes, it is extremely difficult to design and do a proper experiment. The majority of data for nutrition/health comes from 1.self-surveys or 2.very short metabolic ward studies both of which are imperfect or, if we talk about single isolated component, they come very often form the effect onf this component on rodents and/or cell lines. The conclusion is – it is difficult to conclude yet and more good research is needed. If you are really interested in health and nutrition interaction, look there – http://nusi.org/ . This is a scientific non-profit aimed at improving the science of nutrition to get to a clear conclusion on its role in human health. Also any single food component studies in isolation is not the same as in a context. And I am not only talking about the complexity of the diet, what about human microbiome? And the quantity? Paracelsus said “All things are poisons, for there is nothing without poisonous qualities. It is only the dose which makes a thing poison.”

    1. “One thing is certain, there is a lot of biased, bad data.”

      Can you point out where the data is biased and in what direction?

      ” If you have a lot of bad data and meaningful data and you make a meta, you will get to no effect at the end.”

      This isn’t strictly true biased data will just bias the results of the meta in the direction it is biased (but to a lesser degree). The case where biased data will produce no effect is if you have nearly equal biases in both directions.

      Again this comes back to effect size. If you have a strong effect it takes equally strong bias to create a null result*. Weak effects can be overcome by weak biases (Which is why weak effects should be suspect) but that’s pretty much in line with the thesis that food selection outside some pretty broad and already known parameters isn’t very useful.

      *when looking at averages the “strong effect” could be something as simple as a single outlier as the finite sample breakdown point of the mean is 1. Which is why outliers are of particular interest.

      1. Iwona Grad says:

        “Can you point out where the data is biased and in what direction?”

        well:
        “Generally speaking, preliminary studies tend to have a positive bias, caused by both a researcher bias and a publication bias.”

        what direction?
        depends who wants to prove the point – both directions, perhaps “the good” effect predominating but considering the outcome, probably both – as you pointed out yourself that leads to null effect

        My guess is food matters but the effects are not of a killing magnitude, so difficult to catch.

        1. You’re not very clear about what you’re trying to say…

          Ioannidis selected all the food research for the selected foods which probably represent a significant portion of what most people eat.

          He then analysed evidence which met particular strength criteria and discarded the rest. The analysis of strong evidence produced a result where the mean RR was close to one.

          “Generally speaking, preliminary studies tend to have a positive bias, caused by both a researcher bias and a publication bias.”

          Not sure what group of evidence you’re applying this to. If it’s the evidence Ioannidis ignored you might also find it interesting that he found that effect size goes down as research continues. So if you are applying it to the ignored research then it doesn’t make much sense. As even if the weak effect contained some truth in it, chances are the effect size would go down.

          “My guess is food matters but the effects are not of a killing magnitude, so difficult to catch.”

          Again you’re not being very clear. What SBM seems to be saying is food does matter, however it is highly-unlikely to matter outside of some specific diseases and advice that you’ve been told since you were a kid.

  32. AR: Much appreciate the context, particularly the perspective on the various dose response curves…when I read about them in summary or overview, I had not seen too many individual studies on micronutrients, so missed the connections about many being inverse U. One I do recall, a canine study for selenium, was a ‘normal’ U . tks

  33. WilliamLawrenceUtridge says:

    @Flemming Rasmussen

    Cancer burdens, especially tumour bulk, can (and are) frequently initially targeted successfully without any real changes to the ‘environment’ that seemed supportive of the cancer. So in this scenario, no. As far as long-term remissions/cures and whether toxins need to be removed, I haven’t seen studies on that…but it would seem logical that removing substances in our bodies that played little if any known supportive role in biochemical processes would be better removed or in lesser concentrations.

    Actually, that seems rather illogical. Cancer is a dysfunction of genes, particularly those promoting and restraining growth. While removing the substances that caused the genetic dysfunction makes sense to prevent future cancers, I can’t see that being useful as current treatment (unless I am unaware of some critical aspect of cancer). For that matter, it could even be helpful – my understanding is that radiation is used to cause more mutations (in a targeted fashion) of the genes of cancer cells in the hopes that they will be even more damaging to their ability to continue to grow (also heating the cells to cytotoxic levels). Your analogy seems, to me, akin to buckling a corpse back into the wreck of a car and expecting them to come back to life, or extinguishing a fire and expecting your house to reassemble itself. The cause and treatment of cancer are essentially unconnected in my mind. I don’t believe there are many environmental factors that are supportive of cancer growth, though I believe the situation is quite different for cancer initiation.

    But you did pass the quack test, so that’s good :)

    Deficiencies – click on my name and will link you to a website my Dad and I have posted. The “Welcome page” and under 2nd tab the “Genes and Environment page” speak to the deficiencies and surpluses aspects.

    Are there any specific cancers caused by vitamin deficiency? I’ve never heard of this as a risk factor, usually acute deficiencies cause pretty blatant morbidity and mortality unrelated to cancer. I don’t count the findings that certain vitamins (isn’t it basically down to just vitamin D at this point) can cause general increases in cancer rates, but that might be an idiosyncrasy.

  34. corky says:

    I think the big problem with trying to ascribe a role for any one nutrient or chemical or anything to causing or killing cancer is that cancer develops through a process. Yes, it is often initiated by something that affects gene expression (be that mutations, epigenetic alterations or some viral action), but there are many things that then affect the fate of the cell (or cells) that have acquired those alterations. Many mutations occur each time a cell divides just because of the “slop” in the system. But not all cells that acquire a certain mutation will go on to become cancerous. It generally takes years and multiple changes in gene expression for cells to become cancerous. I think of it as the “wrong time, wrong place” scenario. So at some stages of cancer development, one factor may cause a cell to divide, but at another it might cause the cells to die.

    When people throw some factor at cancer cells growing in dishes this only addresses how the cells respond in that particular circumstance (and usually at doses impossible to obtain in vivo). The same goes for tumor cells transplanted into mice. When we look at diet, it is nigh impossible to isolate when and where any factor might have an effect. Note that while we KNOW that radiation exposure increases your risk of cancer, not everyone who is exposed develops cancer and even if they do, we do not KNOW that it was the radiation that led to the cancer.

    When we add genetic variability into the picture we end up with a very complicated matrix. For the person who claimed that by getting her genome analyzed that she can determine what food will help her, I would only point out that we have NO idea how many of these genetic variants interact. If one variant increases your risk and another decreases your risk (substitute food for variant and you get the same issue) how do you calculate your risk? Now multiply this by your 25K genes and you see the problem. Now add epigenetic alterations onto this and you confuse the picture even more.

    And for how radiation (and most chemotherapy that uses DNA damaging agents) kills tumors cells is that it induces so much RANDOM damage to the DNA that the cells cannot divide and undergo cell death. Other kinds of chemotherapy target specific growth factor receptors or cellular processes and “muck” them up to again cause the cells to cease dividing and die.

    1. WilliamLawrenceUtridge says:

      You might find this post by Dr. Gorski interesting.

  35. AnonRD says:

    As an oncology dietitian, I wish my patients would read – and understand – the points being made here. I get a chuckle out of some of the woo they come up with. It comes from headlines, Google, their spouses, you name it. Even sometimes “doctors”. Their dietary habits run the gammit during treatment, everything from vegan/organic to the alkaline diet and lots of alkaline water (oy!) to Carls Jr. every night for dinner. I want to tell them all that it’s probably too late for their dietary choices to have much influence over their cancer one way or another. My observation is that those people who are able to minimize their weight loss and maintain their hydration tend to have the best (short-term) treatment outcomes. This is probably at least as much a function of their type and stage of cancer as it is what they are or are not eating. It saddens me to see people avoiding foods you know they want to eat during what might be the last weeks or months of their lives simply b/c they think they are “bad” for them or will “feed” their cancer.

  36. Martin says:

    Hi,
    I may be out of topic, but nevertheless…
    Everything who we eat, brief, or absorb are involved in body biochemistry. (metabolism).
    Often food is most important of thees tree factors.
    In cancer cells metabolism is abnormal. (etc. they use more anaerobic respiration. Due to damaged cell DNR or mitochondria they unable initiate apoptosis.)

    Then as follows. By diet and supplements we throw substance which can change or at least make influence at some level to cell metabolic state. If states change, cancer retreats. Sometimes we can change body metabolism only by food. Especially if diet changes significantly.

    I don’t understand, It is unscientific, to believe, that cancer can by cured only by changing diet?
    I understand that everything depends, on very complex biochemical reactions and the states combined with changed materials, and you never can by sure it would work, but it can work,

    1. WilliamLawrenceUtridge says:

      It’s a little hard to understand your comment (English is not your native language, would be my assumption), but you seem to be saying that you think diet can cure cancer.

      This is an unlikely assumption. Cancer cells are human cells, what we need to survive, they need to survive. However, they have a rather large advantage – their undifferentiated division means they are evolutionary. Assuming they somehow become “dependent” on a part of the diet, even if we remove that part of the diet the cells that “need” it may die, but there is a good chance that many of the cells could simply evolve to not “need” it anymore. You would have to eat a lot of whatever this proposed supplement was, for a long time, to drive the cellular evolution to use whatever it was. Assuming it didn’t make you sick, and assuming the cancer cells do evolve in this direction, what prevents them from evolving back?

      Cancer cell metabolism is different from other cells, since they are pretty much geared towards dividing and little else – so they do act differently from the other cells. But they are not a single “disease”, each cancer type is different and I don’t believe all of them are exclusively or increasingly anaerobic. But no matter what, even if this were the case, you couldn’t simply stop eating sugar. Your body makes sugar, and the cancer cells would eat this sugar and/or switch to another fuel source – whatever the rest of you is using to survive. They’re still human cells, and they have all the tricks of human cells to switch fuel sources. And I do mean all – an osteosarcoma could probably draw upon metabolic paths normally only used by the brain, liver or muscles to continue to survive.

      The real problem, always and forever, is that what cancer needs to survive, we need to survive as well.

  37. Shawna says:

    Of course there is going to be varied results as people, diets and research criteria vary. As an example, one study found that natural vitamin E provided a certain benefit while another found that vitamin E didn’t – they were using synthetic vitamin E. That said, are you suggesting that certain foods don’t trigger apoptosis or are not truly anti-angiogenic? Or that other “ingredients” aren’t carcinogenic? That what we put in our mouths doesn’t have a direct impact on our immune system and it’s ability to function?

    I don’t agree with “nutritionism” any more than the next but to suggest that foods can’t have health implications both good an bad is like sticking ones head in the sand and hoping for the best.

    1. Chris says:

      “, one study found that natural vitamin E provided a certain benefit while another found that vitamin E didn’t ”

      Citation needed.

      Please don’t claim that a study said something without providing at a minimum its title, date and journal. Thank you.

      1. Shawna says:

        Seriously? This is one that can be found all over the net.. I find “oral tolerization” to be more fascinating and worthy of a discussion here..

        Using “food” to reverse autoimmune diseases.. Here’s a preview of oral tolerization in the New York Times. http://www.nytimes.com/1994/10/18/science/hair-of-dog-tried-as-cure-for-autoimmune-disease.html?pagewanted=all&src=pm

        And research http://www.ncbi.nlm.nih.gov/pubmed/19353248
        http://www.ncbi.nlm.nih.gov/pubmed/10706554

        My pup born with kd has been given a form of oral tolerization since her diagnosis at her one year check up. She turned seven years old last June, is unmedicated, has never required sub Q fluids, eats a high protein raw diet and is quite healthy using only food and whole food vitamins… I use probiotics and fermentable fiber as a “nitrogen trap” if her blood gets a little toxic and it works like a charm every time. The quality of the diet has a PROFOUND affect on the health of an individual. Will it cure everything – of course not. Will it prevent everything – of course not. But it is the best defense and one we are completely in control of…

        1. WilliamLawrenceUtridge says:

          Dogs aren’t people.

        2. Chris says:

          “Seriously? This is one that can be found all over the net..”

          So what? You made a claim about a study, therefore you need to provide the evidence that the study exists and says what you claim it says. There is lots of stuff on the internet that is pure dreck, but go up and read the title of this blog. It was created because of the stuff “found all over the net.”

          And you don’t get away by changing the subject and posting random studies on mice. Another fun fact: humans are not mice.

        3. Chris says:

          I suggest you actually read more of the articles on this website. You will notice that supplements are not encouraged. Which is evident in the replies to Dr. Hall’s article that was posted today. The comments include food suggestions to get the particular nutrient, though it would have been helpful if they included citations.

    2. WilliamLawrenceUtridge says:

      Are you talking about the source or the molecule?

      Any food that is truly pro-apoptosis or anti-angiogenic is acting as a drug not as food, and is quite likely to have side effects as well.

      Nobody argues food doesn’t have health effects, one needs to eat to live, and one needs to eat a varied diet to meet all nutrient needs. The criticism is that individual ingredients, if treated as medicines and concentrated or eaten in vast quantities, is as likely to cause harm as good. No contributor to this blog would argue against a healthy diet as specified by the USDA is a bad thing – they would just question it being a panacea.

  38. I think you are a fool really to believe in this day and age that there isn’t more to being healthy and fighting disease or fighting the chance of cancer by saying “eat anything but not too much”

    Diets with high fruits and vegetable and less meat and less fast foods are going to fight the onset of cancel vs the opposite. Yes it does matter what you eat and the healthier the better.

    Of course there isn’t a lot of money to be made in this strategy is there. No money being made on pills for cholesteral and blood pressure meds when we are all healthy already right.

    There is your reason it’s hard to find good studies on nutrition. The drug and medical community don’t want the study in their journals. Don’t let the cat out of the bag when there is money to be made.

    1. WilliamLawrenceUtridge says:

      One wouldn’t expect diet to “fight” the onset of cancer; one would at best expect it to have high levels of a rich mixture of antioxidants, which have the potential to disable intracellular oxidants that could damage DNA. It’s unlikely vitamins would do a damned thing for cancer that has already started, since the genes are already disordered. At that point it’s up to the immune system.

      I’m not sure why quacks and loons always bark up the “there’s no money in diet and nutrition” tree. Have they not noticed that the mainstream recommendations for a healthy diet features considerable amounts of fresh fruits, vegetables, and whole grains? Where do they ever get the idea that doctors sit their patients down with a bag of doritos washed down with bacon fat and full-calorie pepsi? And last I checked, the mainstream medical advice is to get lots of sleep and at least moderate intensity exercise most days of the week. Why do people pretend these recommendations are anything but conventional, mainstream advice?

  39. What causes cancer? Cancer is a disease of the cells, which are the body’s basic building blocks. Most cancers do not have known causes from a chemical, environmental, genetic, immunologic, or viral origin. Cancer cells arise when irreparable damage occurs to DNA? According to Cancer Research UK, there is no single cause for any one type of cancer. Medical News Today is a leading resource for the latest news on cancer. Ferromagnetic Cancer Theory (Theory from The OLD TESTAMENT; Iron Conception): any cancer is initiated by accumulation of superparamagnetic, ferrimagnetic and ferromagnetic nanoparticles within pre-tumor cells. Magnetism (a force that attracts or repels intracellular nanoobjects) causes cancer. Intracellular molecules FeO;Fe2O3;Fe3O4 are the main creators of these nanoparticles (any cancer is a subtle iron disease). These nanoparticles chaotically distort DNA and shift chromosomes by local magnetic fields. Thus, DNA and chromosomes get defects and disruptions. Any cancer is intracellular superpara-ferri-ferromagnetic infection. Accurate anti-iron methods of The Old Testament can successfully beat any cancer. Anti-iron intratumoral injections [sulfur (2%) + olive oil (98%); 36.6C - 39.0C] (by ceramic needles) can suppress any tumors and large metastases; can give harmless infiltrations (harmless necroses; deposits of cells that die; benign capsules). Anti-iron slow blood loss (even 75%) [hemoglobin control], anti-iron goat milk diet and anti-iron drinking water containing hydrogen sulfide can neutralize any micrometastases.

    1. Harriet Hall says:

      Perhaps you failed to notice that the mention in Medical News Today was labelled “Opinion” and was talking about a “theory” (hypothesis), not facts. Your claims are ridiculous. Magnetism does not cause cancer. The idea of looking to the Old Testament for modern scientific cancer treatments is ludicrous. If you are going to make claims like this on a science-based blog, you will have to support them with references from the peer-reviewed scientific literature.

      1. Dear Harriet Hall! Vadim Shapoval (born August 11, 1969), also known as the Father of Oncology, as the Father of the Thermonuclear Sun-2018, states that CANCER is MONEY and scientific plans-2013-2030 of onco-scientists.

        1. WilliamLawrenceUtridge says:

          What’s the point of your gibberish comment? That some mutations drive undifferentiated cellular division? We already know this. That doctors, who spend decades studying and learning, are paid for their efforts is also unremarkable.

          Similar gibberish comments appear on other web pages, some signed by Vadim Shapoval. Are you Vadim Shapoval? Can you explain why your name doesn’t appear to exist on pubmed, suggesting a complete lack of substantive scientific publications?

          1. Dear William Lawrence Utridge! Can you explain why your name doesn’t appear to exist on pubmed …? Today, scientists ignore iron-cancer information-1905-2013 and Shapoval’s Ferromagnetic Cancer Theory (Iron Conception). Cancer is ultimately the result of cells that uncontrollably accumulate intracellular superpara-, ferri- and ferromagnetic nanoparticles. In the past? Father of Genetics, an Austrian monk Gregor Mendel discovered and published (in 1865) the fundamental Laws of Inheritance. In 1884, Mendel died. Mendel’s work and his Laws were not appreciated in his time. It wasn’t until 1900, after the rediscovery of his Laws, that his experimental results were understood. In 1905, Albert Einstein, a young clerk at the Swiss patent office, published several ideas that led to a total rethinking of physics and shook the foundation of science. In 1919, 14 years after Einstein published his theory, scientists found the first proof for his theory. Einstein: two things are infinite: the universe and human stupidity; and I’m not sure about the universe.

            1. Chris says:

              You still don’t make any sense.

            2. windriven says:

              Let’s see if I understand your argument:

              1. Mendel’s work was revolutionary but not fully appreciated for 20 years;
              2. Einstein’s work was revolutionary but not experimentally demonstrated for 14 years;

              Therefore every half-assed notion that departs from the current science (which is far advanced from the days of Mendel and Einstein) should be heralded until experimentally disproved. Do I have that about right?

              What difference does it make whether or not WLU or anyone else has been published in the peer reviewed literature? Arguments stand and fall on their merits. If you disagree with his argument you can try to demolish it with superior facts or superior logic.

              (Evening sounds … chirp, chirp …)

            3. WilliamLawrenceUtridge says:

              I’m not asserting Vadin Sharpalova is a genius whose understanding of and treatments for cancer are revolutionary. I don’t have to be a researcher to do so – I merely have to do a quick search on pubmed. Lots of quacks and loons and morons claim to have the cure for cancer, that they will sell you directly or in book form.

              Do you have an peer-reviewed evidence that Mr. Sherpanova’s theories have been tested? Or are even taken seriously? There’s a guy here that comments routinely on SBM that breathing properly can cure cancer, and I ridicule him just as much.

              The thing is, Einstein was a genius – who published his findings, and whose findings when tested passed with flying colours. So before you go invoking his name, maybe you should consider what he actually did to become famous – submitted his ideas to peer review and publication for scrutiny by other scientists. So get off your ass and submit, or shut up. Because your word salad comments here just make you look like a crazy person.

            4. WilliamLawrenceUtridge says:

              Put another way, you must respect science. Asserting revolutionary genius without review by experts is not respecting science, it’s essentially a con job. “Trust me, you can generate electricity with water and a lemon using my proprietary process! I just need $10,000 of your savings to commercialize it! Why no, I can’t show you how it works, it’s a secret!”

              1. Dear Chris, Windriven, William Lawrence Utridge and Harriet Hall! In 1928 Alexander Fleming discovered penicillin. The United States Department of Agriculture first grew large quantities of penicillin in 1941. The Old Testament invented ancient anti-iron miracle cure for AIDS, ALS and Cancer. The U.S. Department of Agriculture must analyze and systematize medical anti-iron information on AIDS, ALS and Cancer. Steve Jobs, Hugo Chavez and James Bond Actor Pierce Brosnan’s Daughter Charlotte ignored clinical aspects of the Ferromagnetic Cancer Theory (Theory from The Old Testament). Father of Oncology (Vadim Shapoval) says: anti-iron intratumoral injections [sulfur (2%) + olive oil (98%); 36.6C - 39.0C] (by ceramic needles) can suppress any tumors and large metastases. Anti-iron slow blood loss (even 75%) [hemoglobin control], anti-iron goat milk diet and anti-iron drinking water containing H2S can neutralize any micro-metastases. Unfortunately, human beings are very stupid beings.

        2. windriven says:

          “Dear Harriet Hall! Vadim Shapoval (born August 11, 1969), also known as the Father of Oncology, as the Father of the Thermonuclear Sun-2018, states that CANCER is MONEY and scientific plans-2013-2030 of onco-scientists.”

          From something called encognitive.com:
          “Vadim Shapoval is a Professor of The Old Testament. According to Shapoval, Varmus and Duesberg ignore Laws of Physics;produce erroneous cancer theories (mutation and chromosomal). Any human cell should be interpreted as a society of dia-, para-, superpara-, ferri- and ferromagnetic nanoparticles.”

          From windriven the all-seeing: Vadim Shapoval is crazier than beagle in a vacuum cleaner factory and you, sir, are crazier than Vadim Shapoval.

    2. WilliamLawrenceUtridge says:

      Oahahaahaha, that’s some fine crazy.

  40. John Smith says:

    Thank you for the auspicious writeup. It in fact was a amusement account it.
    John Smith http://dumm1.co.uk

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