Saturday, December 3, 2011

Science? What Science?

"The Diaphanous Frippery of Science" Part 1 of 3
The river of thought flows from reality to fiction depositing sediment as it moves along. Thoughts become confluent with assumptions, weighted down with rewrite for purposing a change to the past so as to comfort the present and sometime by the expediency of ignorance, ignominy or incompetence.

We live in a society, which ventures only to the far reaches of its nose tip. The absolute certainty that exists in medicine is only in our mind. Thus this potpourri unfolds:


Chocolate the great panacea against cardio-metabolic diseases?

What have we here? A piece on how chocolate can fix your heart and with its cadre of bioflavonoid protect against metabolic disorders in a single daily bite. No seriously any article that imposes such odds-defying statistics about the benefits of chocolate consumption and health benefits is on my table for review and acceptance. They don’t disappoint either. The industry is hard at work to find links and nuances that will shelve any doubt or disdain. Really. Consider this: A piece of dark chocolate is heart healthy and some will go so far as to say it prevents heart damage (attacks). Now that one ticks me off in the wrong places, because I love the milk chocolate variety. So there I go rummaging through the reams of papers and the ethereal pages of digital text till I am red in the eye, to find the answer. And lo and behold, “there it is!” Yes! Milk chocolate helps too, but maybe not as much. But help it does! That, is the answer, I am looking for. I find it. I am satisfied. Lets move on. Might one not be a little curious here? Ok maybe not. I love chocolate, so we will let it pass. That is my “albatrossy-cross” to bear. "Seek and Ye shall Find."
And you cannot have forgotten this!

Alcohol and its many ills?

Then comes the value of alcohol. It is great for you. Uh huh. The study says, “A drink a day will most certainly keep the cancer doctor away!” Yep! But then recently there has been a carving out against the fairer sex. Or as I’d like to call it, “The scientifically corrected gender version of the truth.” No the previously mentioned half a glass of daily wine which was good as purported by the liquor industry is now considered somewhat “tongue-in-cheek” dangerous and potentially deadly. It can increase the risk of lobular carcinoma of the breast in women. But that kind of cancer is only found in about 10% of total breast cancer cases, you see, so we shall leave it to your imagination of potential harm in such low numbers and thus their implied meaning. Meanwhile the same people who popularized the initial beneficial version of alcohol against breast cancer now say that 1-3 glasses of wine are helpful against prostate cancer, They may end up losing the smart female consumer target and now wish to make it up in the other 50% of the population with a higher consumption rate. This one has to do with the suppression of the androgen receptor, as I recall. No` I certainly don’t wish to be a party-pooper. I don’t, really. Just want to know the real truth. Not someone else’s version of it. So the question is. Is alcohol good or bad? That depends on which side of the fence you are on.
Even without drinking alcohol about 3g of it is produced in the gut via fermentation. So it is a retained byproduct of normal digestions and metabolism. A word about Alcohol Metabolism: Ethanol-> Acetaldehyde ->Acetic Acid -> AcetylCoA for an exothermic release of 1325kj/mol energy (that is why brandy in winter keeps you warm and stupid to walk outside without a jacket) Too much of this inebriating liquid is known to damage the liver (cirrhosis) also. A little makes you light on your feet, a little more makes you giddy and stupid and more of it puts your head in the toilet bowl. But you see the horns of dilemma in the declarations made before which, impale you when you start believing the half-bottomed manipulated data for a “reason.”

Lies, Damn Lies and Statistics! ~Mark Twain

You see most of the “scientists” nowadays are in the form of statisticians, or at least have access to these wonderful brains that can sift through tons of data and find the proverbial “needle” in this burgeoning data haystack. They can manipulate the numbers until they fit the premise. So the question arises, are we testing a premise or creating one?  (Please also see my previous (rant) Blog on “Hypothesis and Evidence” if so inclined: It is here: http://bit.ly/ojPK8L ) The answer lies in the shades of gray, in the depths of the ocean or the starlit skies of the night. If you can create, the magic of graphing, plots out of the “forests” and give your premise the unquestioned fairy-dust of “p-value” lesser then 0.05, then you have achieved a “publishable game changer.” 
(By the way, the p-value refers to “probabilistic value and a 0.05 means that the observed data will fall within the known range 95% of the time, period). Nothing more or less! No Magic! Even though this information is for a 15 minute of fame it is milked as "gospel" for all its worth. It remains the unholy grail in medicine. Or until they (the real thinkers) find out the corrupted methodology that went into it and dash it to pieces! Or maybe, until you have the courage to write something contrary with hard evidence against the floating nebulous concept, then, my friend all bets are off. You will be one lonely dude for a while tossing about in the sea of anger.

Be faithful in small things because it is in them that your strength lies. ~Mother Teresa

Next up: Part 2: Epidemiology, Sclerotic thinking and the Ivory Towers





References:

Adriana Buitrago-Lopez. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ 2011; 343 doi: 10.1136/bmj.d4488 (Published 29 August 2011

Steven A. Narod. Alcohol and Risk of Breast Cancer. JAMA. 2011;306(17):1920-1921.
doi:10.1001/jama.2011.1589

Christopher I. Li, Rowan T. Chlebowski, Matthew Freiberg, et.al, Alcohol Consumption and Risk of Postmenopausal Breast Cancer by Subtype: the Women’s Health Initiative Observational Study. Journal of the National Cancer Institute, 2010;

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