Monday, June 21, 2010

Starry eyed at Starbucks! Bulletin from the Doublethink Department

Here is more of the java jazz we blogged about a while back. It's the ultimate sin in western life: something fun that may also be good for you. Tea and coffee are good for your heart! And we mean lots of tea and coffee. Of course, there have been countless studies of the caffeine hits that one can pick and choose from to find one's preferred results, and habits have changed a lot over that time, so confounding variables may also have changed but not have been measured. The rise of the coffee house culture, change in other components of diets (having berries with your tea, say), drop in smoking, all may be correlated.

Here comes the next ad jingle: "4+ cups of tea or 2-4 cups of coffee a day keep the cardiologist away."

Now let's take this nonsensical doublethink logic a step or two forward. First, If 4 cups reduces heart attack risk by 1/3, then the simple response is to drink 12 cups and be totally immune! That means you can hog up on Twinkies and BigMacs with double-sized fries, and if you eat all that along with a coupla cuppas, you can stride healthfully through life. Or sit at Starbucks and slug away, also eating hyper-fat, hyper-sugared muffins with abandon.

But wait! What if you drink 16 or more cups a day?? That means you'll have less than one heart attack. It's not the same as being immortal, but it may mean you'll grow a second heart so that if you stop honoring TeaTime you could have a heart attack in one of those hearts but live on your spare. How about that! Isn't epidemiology great?

But, comes the party-spoiler. The same Big Study found that if you take any milk with your coffee and tea, this negates the entire protective effect. Now all this titration makes a chem lab seem like amateur city, and how it works only a chemist would know. Of course, another response is to ask how such nonsense can make it into the journals, much less the news. Well, it's easy to see how science reporters might pick this stuff up, given the nature of their profession. But epidemiologists should know better.

Anyway, all such musings aside, this little celebratory note about something you enjoy being good for you--a rare enough finding--is to point this out, to reassure you, and who knows, maybe it'll lead on to bigger and better things? If caffeine hits the spot, maybe nicotine is next? Or a few stiff drinks a day to keep the doctor away?  Remember when eggs were poison?  Too full of cholesterol to be part of any thinking person's diet?  What happened to that?

OK, there's a serious message here. 30 years ago the Big Story was that coffee, even a small amount, caused pancreatic cancer.  So how do we know when we should believe a study that comes along and is reported as the Big Story? Is there any reason whatever to believe this one, or should we wait until tomorrow's contradiction?

This is a very serious issue of widespread import for science and the society that supports it and depends on its results. There is no easy answer, and accountability is difficult to impose for many reasons. But the problem is real, especially in our era in which science is not just what a few idle rich do, but is an institutionalized part of our national 'system.'

The nature of the science involved makes these results problematic. Why don't we tell epidemiologists that if they want funds to do something, that it should actually answer a question definitively. If they protest that this is hard to do, then let's say that if they want funds they have to suggest a better way? Otherwise, the same money could pay for exercise centers (with coffee bars) to reduce disease much more effectively than the results of these studies generally do.

Finally, why not ignore most of these Big Stories, and just go go and eat what you want--just do it in moderation. You'll do better by far than you can by attempting to follow every bit of New Advice that comes along.


Texbrit said...

Bigger question is, "why" are scientists forever interested in looking to find harm (or benefit) in our daily mundane habits? Don't they have better things to be doing? Like finding the meaning of life, rather than the meaning of coffee?

Ken Weiss said...

An absolutely cogent question! There are lots of reasons: western puritanism, the view that pleasure is sin; careerism in what was allowed to grow into a large epidemiological-research 'establishment'; the unwillingness to accept that we'll get sick and die some day; the reductionism of modern science by which everything must have identifiable cause(s); the fact that you can always score political points in elections by saying you're going to support medical research; the false promise that is no different from what preachers promise heavenly immortality in pulpits and continue to get away with it (then pass the plate, of course).

Two deeper truths are that a researcher who actually solves a problem is put out of work by doing so, and, more importantly, if we 'cure' one disease we let people live longer and that means they're sure to get something slower, more costly, more complicated, and probably worse.

Anne Buchanan said...

So the meaning of your life is looking for disease causation. There are basically two approaches an epidemiologist can take -- pick a disease and try to tease out what causes it, or pick an environmental factor and try to determine whether it causes a disease.

The pick a disease first approach works best with infectious diseases, though when the non-infectious risk factor has a large effect, like cigarettes, it can work then too.

It's harder with chronic 'complex' diseases which may have multiple small effect causes, or many different causes, so that not everyone with the disease has the same cause. There, epidemiological methods aren't well-equipped to find causation.

So, go the other way around -- pick a 'cause' and see if you can find an effect. The major problem here is of confounding, our theme of the week last week; we don't only drink tea or coffee. In fact, tea or coffee are small parts of our diets. So, these kinds of studies are usually inconclusive, as reductionist studies in complex situations tend to be.

But they do tend to be revealing of a Puritan mindset -- who ever studied the negative health effects of string beans?

Anne Buchanan said...

And what Ken said!

Texbrit said...

Indeed, if every day I had to eat all the portions of oat bran, vegetables, blueberries, red wine, coffee, oily fish, olive oil, chocolate, whole grain rice and marula fruit that I am supposed to in order to be healthy, I'd die of obesity!

Anne Buchanan said...

If obesity really is lethal. Jury's still out on that one, too!

Ken Weiss said...

And you'd have at least 2 hears, probably several extra lungs, etc. (since you'd reduce your risk of disease in those organs by more than 100%!)

Jennifer said...

ok, so we can take what we want from your writings, out of context of course, and use what you say to make a point in anything we want to "prove". You know that if it's written down, especially on the internet, it must be true, right?

Texbrit said...

Speaking of...of all of the insane studies, this one takes the cake:

Ken Weiss said...

We decided to make a new post of this, for MTers who didn't see this comment of yours...

Texbrit said...

Yes, but do bear in mind it was a 2005/2006 study, so it may have since been refuted with a new story that says that it is, in fact, not housework but rather mastery of cooking and sexual activity that are the keys to a woman's longevity!