TROUBADOURS OF TRAGEDY: THE LOSS OF TRUST
IN EPIDEMIOLOGISTS
Epidemiologists are bureaucrats of Western
Medicine. They are usually male, middle aged; White and lack people skill or
communications skills but brilliantly hide behind numbers, which they crunch,
using tools they or their colleagues invent. They do not do field studies, nor
are they clinicians who have to take care of sick people. Epidemiologists not
only are ignorant of sicknesses affecting the individuals but are experts in
creating sicknesses by manipulating numbers, one such thing being,
Pre-Hypertension, Metabolic syndrome etc.
They can predict and given the
responsibility to do so by the governmental agencies so that health policies
for the societies could be drawn up. What a pity!
During my career I have seen them come up
with “patch work” causes of one single physical manifestation, Obesity, which
was recently got into the hall of fame as a Disease. One would study would show
that single mothers were overweight, as if it is the fact that they are single
mothers is the primary cause or association.
(a very successful north american export)
Having now seen 97 causes or associations
why a person becomes OBESE, I am convinced that further epidemiological studies
are not to be trusted. Lately studies are emerging to say that what they said
earlier is not true. Such is life.
On the other hand, scientifically oriented,
clinically minded researchers are coming up some good answers or solutions. An
excellent paper from Finland on twins could show that there are metabolically
healthy and metabolically unhealthy overweight and obese people. Fatty liver
was the distinguishing feature there.
Of course we all know what causes NAFLD, non-alcoholic
fatty liver disease. The epidemiologists will tell you that it is associated
with Type 2 Diabetes but more and more scientific research is pointing the
other way, it is the fatty liver that may be causing the type 2 Diabetes.
So we now have metabolically healthy
overweight and metabolically unhealthy overweight categories (MHO vs. MUO?). It is also an explanation of
why only a very small percentage of Overweight or Obese people ever get Type 2
Diabetes.
Of course no one wants to take on the food
industry (McDo is a sponsor at International Diabetes Federation meetings and
how many of these mavens who would be speaking at IDF in Melbourne in December
2013 are on speaking trips for food industry or drug companies, I would guess
upwards of 59%)(I have become so sensitive to this issue that if ever I see the
name Fonseca or Groop on a panel or an article, I don't read it or listen to
them)
There is no doubt that the so-called
nouveau western diet: high is processed food is the cause of Fatty Liver, not
the carbohydrate or protein or fat but the quality of these ingredients. If
ever you saw what they do to cattle in the “farms” in the state of Nebraska you
may never want to eat meal again, because of the high infiltration of
antibiotics, growth hormones and other plastic in the cattle feed.
So the recent issue of JAMA Surgery journal
had the news that BMI (the measure of obesity or overweight) had the least
predictive risk factor for mortality rate over 10 years in obese patients.
First of all, I looked up the original
article, not “readers digest” kind of free medical literature sent to the
doctors on a daily basis by the drug company supported journalists.
Before reading the article, I checked out
the lead author, Dr Padwal. He is a practising physician, not an office-based
epidemiologist without any contact with patients and this doctor actually looks
after the illness in obese people.
Next to see their affiliations. The authors
are university-affiliated people but the main support for their research comes
from the State Government and the University. They do have some commercial ties
but it does not seem to be with any of the heavy weights (sorry for the pun).
Conclusion was simple and straightforward:
In patients who are obese, all cause 10 year mortality can be estimated using a
simple 4 variable prediction based on age, sex, smoking and diabetes mellitus.
BODY MASS INDEX WAS NOT AN IMORTANT MORTALITY PREDICTOR.
Ah, well. Another one of the trumpets of
the troubadours of tragedy, the Epidemiologists, is silenced.
One of the axioms I have learned from the
Oppressed First Nation/Aboriginal/Native people
Try to be Healthy in the Body you have..