The most fundamental problem in the U.S. is this: Infinite Growth Capitalism
The VAST majority of what is wrong with our society (political and obviously economic) can be traced to this. It's the expectation that every economic endeavor must show a return on investment - forever. That every entity must strive to optimize the bottom line every day of its existence. Optimizing for growth above all else crushes and consumes everything.
Increasing local manufacturing will only create more opportunities for people to be indentured to a company that literally hates their existence.
A company is forced to build here in the U.S. and people are supposed to rejoice they now have another option for their lives to simply be tolerated and disposable?
It was probably always a game. Explaining the difference between downloading the weights and using the website hosted in china is beyond our collective scope of interest/attention, and that's probably a bit worrying. The Crown would call Franklin intellectually bankrupt but here we are.
So... is the existence, or non-existence, of a certain bacteria why some people never get cavities? I'm sure there can be multiple factors, but I'm 51 and never had a cavity, but don't really know the specifics of what might be different about the environment of my mouth that seems to discourage, or not encourage, the formation of cavities.
I grew up without fluoridated water and have no cavities (I am over 40). I have gum disease, though, so apparently I am still susceptible to the bacteria that causes it.
While evidence for temporary benefit from fluoride in toothpaste is somewhat positive, evidence for similar benefit from fluoridated water is mixed and has not been isolated from numerous confounding factors. Ingested fluoride at has some small potential for mildly adverse health effects. Whether common levels in municipal water supplier are a net benefit, harm, or neither remains debatable.
However, there is significant variation of thickness of tooth enamel, seemingly due to genetics.
Not OP but I'm a similar age and never had a cavity either. I grew up in a rural area and drank well water as a kid. They did occasionally provide topical flouride in the schools.
I stopped going to dentists in my mid 20s. Routine cleanings are not actually shown to improve outcomes, and the lack of cavities leaves me no other reason to go.
I couldn't say why I'm so lucky in this respect, but the bacterial explanation seems plausible.
You don’t know if you have cavities. I was similar. No issues so I stopped going for 15 years. Needed multiple fillings when I finally got a checkup, one of which was quite deep and has caused tonnes of issues since. If I’d gone regularly it would have been caught early. I wish I’d kept going when I had no issues so things would have been caught earlier. Cavity != pain a lot of the time. Typically when you get pain it’s a bad cavity which could have been caught sooner and treated more easily.
I got busy, then pandemic, next thing I know it's been like 7 years since I've seen a dentist. No problems or discomfort whatsoever. It occurred to me that bi annual cleanings are the SaaSification of dentistry, but I've never seen any real evidence.
I'm happy to go for regular cleanings, but I don't know how you could construct a well designed study to get data showing objectively what interval of cleanings results in better outcomes over many years. There's just too many uncontrolled variables. And, I don't think you can glean it from population studies either, because again, there are too many variables.
Routine dental visits are essentially cargo culted.
There is some robust evidence indicating that routine plaque removal does not improve outcomes for cavity prevention or gingivitis [0].
Routine consultation with dentists otherwise may be beneficial, maybe not, but it hasn't really been studied much yet. The studies that exist are insufficient to form any conclusions. [1]
My post was downvoted by those who feel going to the dentist is important. I should state clearly avoiding the dentist should not be considered medical advice from me, and YMMV. I did the research myself and determined that routine dentistry was unlikely to improve my health outcomes, this is a personal decision that people should make on their own.
The fact that these were published in 2018, implying before then it was never really studied, is sort of crazy.
The cost of biannual dentist visits for life is huge across the entire population. I would have thought there was strong evidence for this a long time ago. If nothing else, I would have thought insurance companies would stop paying for the bi-annual visits if there wasn't good evidence it works.
Then again, maybe I'm giving insurance companies to much credit since they've been paying for acupuncture for decades.
for many years, i went for cleanings every 6 months. zero problems, usually in and out without any pain.
i didn't go for a couple years and just had one of the worst experiences at a cleaning in quite some time. super painful, a lot of build up.
i haven't changed my brushing/flosing habits at all, but i did switch toothpastes to non-flouride.
now, i'm back on the 6 month schedule and back to flouride. i also switched to a tablet based toothpaste (tidalove). you chew it (don't swallow) and then brush. the pill has a bunch of other good stuff in it too. kind of neat cause it is also zero waste packaging.
I’ve never had a cavity. Still like to go to the dentist and get the plaque scraped off. I also cracked a tooth from grinding my teeth at night and he fixed that up for me.
The primary purpose of cleanings is not to prevent cavities. It's to remove the biofilm that exists at and below the gumline containing facultative anaerobes which cause periodontal disease. You can have gorgeous, cavity-free teeth that fall out because the supporting structures have been resorbed and destroyed by these anaerobes.
And yet it garnered millions of users within days. It has inspired people who don't do computers to feel like they can actually get amazing things done with computers. The pace of creative use cases discovered by non-tech types, with such a lazy interface, is nearly impossible to keep up with.
It has democratized what is possible with technology, when that technology was programmable with natural language, i.e., by just asking questions, or asking it to do things, in every day language. It meant people who didn't know how to build software could get software to do their bidding regardless.
This likely depends on the degree and the purpose for which you tried to obtain it.
Some online Masters degree programs are just scams preying on people's desire to improve their careers. They are successful because so many employer's won't pay or promote to certain positions without advanced degrees. So there is a real demand for degrees like MBAs.
For some degrees, the real value is the additional education you receive because of the increased complexity of the subject. Not everyone goes after these degrees for the same reason. For me, I went to grad school in physics not because I thought it would help my career, but because I wanted to learn more physics. I don't think this is the typical reason for which advanced degrees are sought anymore, but at least in some cases, like mine, master's degrees aren't scams, but a necessary part of deeper education into a specific area.
So I studied as a scientist (physicist) and have a high bar for what constitutes a meaningful scientific study and scientific result. A food frequency questionnaire, of the sort this study's results are based on, means very little scientifically. No meaningful result can be drawn, and I consider it borderline immoral, given the type of affect this could have on people's behaviors, to assert a conclusion based on such poorly conducted research.
Asking people to quantify their eating habits over the previous several years and expect to have meaningful quantitative results is impossible. I can barely quantify my eating habits over the last few months. There are just far too many variables that cannot be controlled for in such research as to render any conclusion impossible.
We need meaningful nutritional research, desperately, and this just isn't it. It angers me deeply that this passes as science that will get reported on, used as "proof" in justifying recommendations, etc.
I'm also a physicist and I would first say that generally (except for some specific sub-fields) we are actually not well trained on experiments (like this) that require significant statistics.
In particular the law of large numbers applies (which you should know about as a physicist). I would argue that despite the noise in the reporting the conclusions from this study are likely much more significant than a tightly controlled randomized trial with a small group (~100 people).
Self reported questionnaires are certainly a well established method in these sort of studies and the short-comings are well understood, that does not mean their results are meaningless.
In particular, I would argue that many (most) people can give meaningful quantitative answers to their eating habits over several years as their habits rarely change. Certainly most people here would be able to answer approximately with how many meals per week they eat meat, how much vegetables they eat on average, how often they drink alcohol etc.. We are only interested in rough averages.
Regarding your argument that there are too many variables that can't be controlled for, ok lets hear them name at least 10 and make a valid statistical argument why they need to be controlled for in a sample size of ~80 000.
In this case, a "well established method" simply means common-place methodology, not necessarily a robust scientific protocol.
The problem is the humans. We are not reliable witnesses, even of our own pasts, and unless we are following very strict diets, most of us essentially follow a mostly random walk with our food intake across a narrow range of food groups (even caloric intake can be wildly inconsistent over time). I've met enough people who completely underestimate their consumption of desserts, e.g., that they mentally reduce the occurrence of such events in their personal historical narratives. That alone could put many from both low-carb vegans and low-carb meat eaters into the high-carb category.
Which is the point, the worst failure of this methodology is that there is no evidence that human memory, regarding food consumption, provides an accurate measure over long periods of time. If you cannot establish the trustworthiness of the most basic tool of your methodology, then almost by definition it's meaningless. The error in self reporting could be high enough such that the true classification of 80% of the low carb group is actually high carb. Or the vegan group could be nearly half high-carb, etc.
Without a thorough vetting of the accuracy of the instrumentation used in the research (FFQ in this case), we cannot know the margins of error. But we have apriori reasons for believing the accuracy to be significantly high. Adding more people to the group doesn't increase the accuracy in this case, it only increases the volume of the noise. Is the True Low Carb ratio of each group 10% or 90%? Who knows.
If we can't validate the accuracy of the tools, it makes the results essentially a random choice between the possible conclusions. It means they haven't disproven the null hypothesis.
Which is why I favor some form of sequestration of smaller populations of similar genetic makeup (multiple groups for each type of diet), etc. But that is mostly impractical.
I agree with your ethos; too often poor science, regardless of kind, is being passed as "soft" or "applied" scientific research.
That said, I do think even noisy studies (noisy as in inaccurate measurements) like this at least show that there is no glaring big correlation between, say, low-carb diet and mortality. If low-carb diet people started to die decades younger than average, then even noisy studies would show. In this sense, studies like this have some value, albeit little.
I just think there is far too much noise in this sort of study to draw any sort of conclusion. An effect has to be very strong to manifest in such noise. Yeah, if the difference in life expectancy was 3 decades, say, then perhaps it would show in such noise.
> We need meaningful nutritional research, desperately,
I am now wearing a constant glucose monitor and tried half a cup red lentil - semolina flour pasta. Should be OK, shouldn't it? My blood sugar jumped from below to 100 to above 140. My target is 120 and I am almost always below. Most often, well below. 140 is bad. I tried a "keto burrito". 135. I simply cut all starches and now I am good.
All in all, ever since I am wearing my CGM I can attest almost all nutritional advice given to diabetic people at least does not apply to me and I suspect I am not alone.
I am not surprised. At all. First of all, the entire science reeks because it's not genetics based. We know (although, do we? I no longer trust anything) at least lactose intolerance is caused by a gene. Is it too far fetched to say reaction to other foods could also be varied based on genetics? Second, there is a huge problem with scientific research itself. There are books and how to say, counter-research done on this. Basically, you take a grant, run a study and then produce some result, if your end result is nothing which is ought to be default, well that doesn't look good. So you produce some result... even if it's cherry picked data. And then some statisticians a decade later get hold of the raw data and prove you have found nothing. It happens all the time. Third, this is especially a problem with drugs but can happen with nutrition research too. Surely you have seen the ads where they are looking for volunteers? Well, who do you think they are going to get? No one produces a study with the title "our study among people experiencing homelessness and abject poverty"...
Anyways, I am vaccinated against covid. I hope this one is not botched. But nutritional advice? Nah. I refuse to talk to a nutritionist, I refuse to accept any advice, all of them are invalid -- for me.
Kind of questionable perhaps, but a good place to do these studies would be on prisoners. You could potentially do it by simply monitoring their intake and not actually changing anything in the offering. It should be fairly reasonable to get a reliable intake report.
Proposal and other issues aside, I’m not sure you rely on food served to be food consumed. Prisons in most places still buy food at commissary.
But I’ll agree that you might be able to quantitative compare prison A vs prison B if you can get a control prison and account for differences. Just a diet of 20% more carbs between A/B would be interesting.
I imagine someone has “done science” on prisons in other areas already. Way more ethical than the typical proposals I see for prisoners/prisons on the internet.
Every time I've considered how to really do nutrition research, it essentially amounts to a prison, even if voluntary. You would need to be able to lock different populations away from any source of food than what you provide, and control their daily activities, etc, for at least 2 years, though you could likely get some results after only 6 months.
Yeah, the ethics would be tough, but essentially to really do nutrition research, you MUST control the food intake. Control for age, weight, calories and activity, and vary only the dietary makeup to varying degrees, etc.
What sort of ethical issues are you thinking? I would have thought higher grade meals than you'd find in a standard prison would entice all the volunteers you could want. There's probably other groups were some good quality meals would be just as enticing, like college students.
A bigger practical issue in prisons would be things like the high prevalence of hepatitis and drug use along with all the confounding factors (like poverty) that lead them to end up in prison.
In the US, federally funded research institutions have to follow certain rules when doing human subjects research. When I was a researcher the training I took said prisoners generally could not be used as subjects just because they were convenient, and that the two situations where they could typically be studied were cases where prisons, crime, or something else that was inherently specific to prisoners was being studied and cases where some condition very highly over represented among prisoners was what was being studied (the example given was HIV).
I just don't know how ethical it would be to force a particular diet that might affect someone's life expectancy without their consent. I mean, I suppose you could get volunteers...
Why not self-imposed prisoners... like at a rehab-type facility. You can leave whenever you want but you don't get paid...then pay them like $5k for 1 month, or 5k/month for however long the study goes... Then it's not prison -- it's controlled but "at will"
> Previous validation studies revealed reasonably good correlations between energy-adjusted nutrients assessed by the FFQ and multiple food records completed over the preceding year in both NHS(21) and HPFS(20).
> I consider it borderline immoral, given the type of affect this could have on people's behaviors, to assert a conclusion based on such poorly conducted research.
Based on the massive amount of evidence linking 'chemicals from plants' (polyphenols, glycosinolates and others) with (in the main) markedly positive effects on human biochemistry & physiology, this appears to be a very good idea.
It's noteworthy that the 'five (vegetables/fruit) a day' mantra is a familiar one in the UK and I guess elsewhere. But rarely does anyone explain precisely why this is a recommendation given that it's quite possible to supply the required fat, protein, carbohydrate, vitamins and minerals without consuming significant amounts of fresh fruit and vegetables (using supplements).
That particular behavioral change likely wouldn't be bad itself, but that was more a rant on these sorts of studies overall. Poor research has real world consequences in this case (nutrition research), and we really need sound insight into what diet works best for the individual.
Even after you control for all the things you propose controlling for, you still have a huge confounding factor in genetic makeup. So then you need prisons with thousands of identical twins, each pair living out the same life in all ways but diet (which is meticulously recorded).
You're just not going to get an experiment like you can lay out in physics.
I think the point of the author mentioning major limitations in the paper is to acknowledge that this is sadly the best we've got to work with
Oh, yeah, the biochemistry of individuals is what makes so especially challenging, but not insurmountable. Maybe we are in a simulation to find out whether eating fish is good for you...
> Poor research has real world consequences in this case (nutrition research), and we really need sound insight into what diet works best for the individual
I think your claim is unsubstantiated. You're for some reason under the belief that nutrition has a large impact on people's life expectancy and health, but I don't know what accurate experiment or data you're basing this off, while also pointing out that this research was not good enough.
All the nutrition studies are like this, and so if you disregard them, you're left with no reason to believe nutrition even affect health or life expectancy for the average person in the first place.
It seems you want science. Sorry, the world seems to want headlines and diet fad debate.
We do desperately need actual research. I think the obesity crisis is far worse than most anyone realizes. I can think of a dozen reasons for people to actively ignore it.
Yeah, it bugs me deeply that this passes as science (and other such "research"). I realize it's difficult to conduct meaningful science in this area, given how different the biochemistry of every person is, but it's something I believe we can do. Given how important our health is, it's something I feel we really need to do.
I was contacted by their recruiters recently and started getting warmed up on their interviewing, etc. However, this was back in December when they put out ads against Apple's choice to allow users to opt out of tracking. It kind of made it difficult to want to follow through on the interview process after that... so I didn't.
So much nutrition research is all correlation and no causation. Statements like this, which over-infer, kill me:
"There is little doubt that people with high cholesterol have an increased risk of disease."
It's just as valid to say that people with heart disease are more likely to have high cholesterol. When all you have is correlation, there is a heart disease group, and a high cholesterol group, and all you shown with correlation is that there is a third overlapping group of people with both. With only correlation, you don't know how/why, or even if, members of one group transform into the other. Which is partly the underpinning of the article.
It's possible that high cholesterol is a result of underlying heart disease (which the article says is possible), rather than a cause. But what shocks me is that people, even researchers, seem surprised to realize such possibilities.
We know that high cholesterol is a cause of heart disease rather than a mere correlation because people with genetic Hypercholesterolemia have a rate of heart disease 10-20x that of the general population, independent of other risk factors: https://www.acc.org/latest-in-cardiology/articles/2020/06/01...
By definition, Familial Hypercholesterolemia is a genetic defect of the receptor responsible for clearing cholesterol-containing droplets from the blood.
I understand that, but my point was that it's in principle possible that the exact effects of a particular genetic disease are hard to discover. Serum cholesterol is easy to measure, so it could be just the easiest to notice sign of a more complex metabolic modification induced by the specific genes. I doubt we are at a point where we can look at a gene and say exactly what it affects in the entire body.
That doesn't rebut my assertion or complaint at all, since you are referring to a specific type of genetic disorder.
The research in general on nutrition and hearth health is still mostly correlation. Definitely someone with a specific disorder could have a more obvious causal link with cholesterol and cardiac events, but I've read a bunch of different papers, many from respected institutions, and the conclusions usually are, IMHO (I studied physics), garbage.
No we actually understand the underlying mechanisms here, to a decent extent.
In case of people who have a high level LDL cholesterol, the phagocytes - the scavenger cells in blood consume more cholesterol particles in general. The result is cholesterol is more likely to stick to the walls of affected blood vessels.
This is one of the most thoroughly researched topics in medicine.
Does it mean high LDL will always result in a heart attack? No! Just like not every cigarette smoker dies of lung cancer.
The "thoroughness" of the research doesn't matter much when it's based upon a false assumption or two.
You describe one mechanism by which cholesterol could cause heart disease. As you say, there is lots of evidence that it happens -- in an unknown subset of the population, with defining characteristics that nobody's managed to figure out.
The science just isn't there. And the financial success of statins seems to really get in the way of people wanting to work it all out.
The molecular mechanism by which cholesterol causes heart disease is well understood, and atherosclerosis has been experimentally induced in every species of mammal ever studied by either feeding the animals a high cholesterol diet or knocking out genes related to LDL metabolism, and these results are consistent between hundreds of studies performed over the past 100 years. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/
The VAST majority of what is wrong with our society (political and obviously economic) can be traced to this. It's the expectation that every economic endeavor must show a return on investment - forever. That every entity must strive to optimize the bottom line every day of its existence. Optimizing for growth above all else crushes and consumes everything.
Increasing local manufacturing will only create more opportunities for people to be indentured to a company that literally hates their existence.
A company is forced to build here in the U.S. and people are supposed to rejoice they now have another option for their lives to simply be tolerated and disposable?