Systemic review of antidepressants vs placebo commentary
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/pdf/zfp_222_3_128.pdf
The background on this story is a community of science people found a bunch of unpublished studies that, when weighed with the studies which supported antidepressant approval, showed they were no more effective than placebo in mild-moderate cases.
Except unlike placebo, antidepressants express a wider range of severe side effects, like worsening depression and suicide.
Isn't this a scandal? How do psychiatrists still prescribe these en masse?
LW's take on nutrition?
There's a book called The China Study. It's written by the "Professor Emeritus of Nutritional Biochemistry at Cornell University, and his son Thomas M. Campbell II, a physician". Based on what I know about the words "professor" and "emeritus" and "cornell", I assume this is written by an authority in the field of nutrition.
When it was published in 2005 it recommended clearly crazy stuff: by minimizing or eliminating the consumption of animal based foods as well as refined/processed foods (e.g. adopt a "whole food plant-based diet"), you could greatly reduce your risk of diseases of affluence like heart disease, diabetes, some cancers, etc. The book follows his 60+ year career through cancer experiments on animals, conducting a pretty large epidemiological study (the China-Cornell-Oxford study), and then discusses some important clinical trials that support his recommendations. He also surveys some nutrition literature that corroborates his research.
Some other experts vocally support him; further, his recommendations don't seem to be a radical departure from either public health recommendations or prior research in the field. The FDA MyPlate, and also the UK's health initiatives ("5 fruits/vegetables a day"), as well as the Harvard School of Public Health's recommendations and others all seem to be moving in his general direction, although seemingly filtered by politics (e.g. telling Americans to stop eating meat entirely seems like political suicide, so baby steps in the direction seem more expedient; but I'm conjecturing this).
The book is widely dismissed as vegan propaganda, but the author says he's not advocating a vegan diet and in fact criticizes vegan diets as only minimally healthier than the "standard American diet". He also conducted experiments which subjected animals to carcinogens, which is not a very vegan thing to do. He does not admit to being vegan. He even observes that the evidence says restricting animal based calories to under 10% of total calories offers almost all of the health benefits as restricting them to 0%, but says as a practical matter this is much harder to stick to (e.g. you may only eat a 3mm slice of chocolate cake is much harder than simply saying no to chocolate cake). He also admits he had a bias when he entered the field of nutrition, but a bias in favor of attempting to justify the use of dairy to cure malnutrition (he came from a family of dairy farmers). He said when he discovered that his research did not support his dairy bias he abandoned his dairy bias (and would later shut down his diary farm).
Anyway, the China Study is widely criticized, but not by people in his field? I've been watching for several years now (I adopted the diet myself in 2010), and all of the negative critiques tend to fall into (a) critiques from non-experts, (b) critiques from experts in unrelated fields, (c) health experts who agree that his recommendations have merit, but that they're impractical for the general public to follow.
(C is worthwhile, but this is a problem for public health authorities to worry about. I'm much more interested in what any sufficiently motivated individual can elect to do to maximize their health)
So, this is the part that I find most surprising. There are lots of people who are PhDs of exercise, anthropology, or economics who criticize his recommendations, but I have a hard time finding a mass gathering of nutrition scientists coming out of the woodwork to shoot down his recommendations.
What should I believe? Here are things I've considered.
1. Science is crap. Don't believe expert predictions about the natural world.
2. No no, just nutrition science is crap. Don't believe any expert predictions about nutrition.
3. Nutrition science isn't crap, but the Campbells are rogue and the community of nutrition scientists have better things to do than debunk pop culture books.
4. Nutrition scientists **are** criticizing him in droves, I just don't come across them because I have confirmation bias blinders on.
5. "Nutrition scientist" is a made up discipline, and I've been tricked!
I'm more or less at a loss on how to make progress on these points. Am I missing something crucial?
What's the LW take on this? Why isn't this good enough to inform your dietary choices? Assuming you don't plan to become an expert in the field of nutrition yourself, what's a better way to inform your dietary choices?
EDIT: I would just like to thank everyone who responded. I've tried to discuss this in many forums, both IRL and on the internet and it's almost always a disaster unlike here on LW. Your measured, insightful responses are an enormous relief. You've given me a lot of food (ha!) for thought.
Plane crashes
So. Inevitably after a plane crash a discussion comes up where someone may say that they're worried about flying now, and someone else pulls out the statistic that driving to the airport is more dangerous than flying. I think this reasoning is basically correct on the long-term, but not appropriate in the short-term.
Suppose it's the day after flight MH370 mysteriously disappeared. Information is extremely sketchy. You're about to get on a similar plane, operated by the same airliner, taking off from the same airport flying the same route. Should you get on the plane? That is, are you wrong to worry more than usual when we have no idea what happened to MH370? I would say no. The complete disappearance of flight MH370 without warning and without a trace the day before says **update your priors** at least for the short-term.
Deconstructing the riddle of experience vs. memory
I don't think I understand the riddle of experience vs. memory. I would daresay that means the concept is half-baked.
Within the TED talk, Daniel Kahneman poses the probably familiar philosophical quandary: if you could take a beautiful vacation and afterwards your memory and photo album was completely erased, would you still do it? Whether you would still do it illustrates whether you live in service of the experiencing self instead of the remembering self.
Part of what prevents me from understanding the riddle is that I believe vacations are worth more than the memories and photos: vacations change you.
Maybe you could argue that this change is also a form of memory in service to the remembering self, but I'm not sure that's what he meant. In his thought experiment on vacations he asks if you would still take a vacation if, at the end of it, you forgot the whole thing and all of your photos were deleted.
- a chance to unwind from not having to work
- a chance to heal, because you break normal patterns of repetitive stress (e.g. not sitting at a desk all day for a week or two)
- a chance to work out every day in a different way
- developing your "worldliness"; e.g. opening your mind a bit, because you've likely met new and different people
- come back with a sweet tan
- come back with more Facebook friends
- come back with extra dives in your SCUBA log book
- new delicious condiments in your kitchen
- flashes of insight you get from having some time to consider a 30,000 foot view of your life
- surprisingly large dip in your bank account balance (so much personal development awaits)
- if you're lucky (or maybe unlucky), you discover new modalities of being and abandon your current way of life
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