Tuesday, March 04, 2008

Brother Can You Paradigm?

In today's NY Times there's a wonderful article on the resignation from the presidency of the Obesity Society by Dr. David Allison, a leading specialist on the subject. The piece underscores just how much the public health debate has become permeated by ideological presumptions that corrupt any effort at fair scientific inquiry: "Dr. Allison drew criticism from some members after he wrote an affidavit as a paid consultant on behalf of the restaurant industry, which is trying to block new rules in New York City that at the end of March will require fast-food and other restaurant chains to list the calories of menu items."

Now, as we understand them, the rules for scientific inquiry demand that all research be peer reviewed and, where possible replicable by others using similar data. In truth, it really shouldn't matter from any scientific vantage point, who's paying for the research. If one suspects that the research results are being driven by a pay check than the door is open to demonstrate that the conclusions are not supported by the facts.

That is no longer the case with public health-where certain shibboleths are sacrosanct and cannot be challenged if one wants to remain in good standing with the bien pensants of the profession: "Because the position of Dr. Allison ran counter to the conventional thinking in his field, some critics contended that it illustrated the way industry money influences scientific and medical debate." (watch out for the "some critics" usage at the Times; it portends bias).

The reality here, one that the Times steers clear of, is that researchers in public health are aware of what avenues of inquiry that should be avoided-because contrary data would be the real inconvenient truth. Here's what Allison's research showed: "In the affidavit, Dr. Allison said that there was not sufficient evidence to show the effect of calorie labeling on people who eat in restaurants, and that while it was possible such labels on menus could be helpful, it was equally possible that they could have no effect — or that they might increase obesity, in part by casting high-calorie foods as forbidden fruit."

Which is exactly the truth because there is no evidence of efficacy-as we've pointed out in the past. There is also no evidence that the current labels on manufactured food products does any good; since that FDA requirement is more or less coterminous with the current obesity epidemic.

Which doesn't stop the ideologues from wanting to shut the Allisons of the world up: "Dr. Allison’s affidavit had ignited a flurry of e-mail messages among obesity experts who questioned both Dr. Allison’s position and his industry ties. It also led the Obesity Society to issue its own separate statement in supporting calorie labeling on menus. “The Obesity Society believes that more information on the caloric content of restaurant servings, not less, is in the interests of consumers,” said the statement by the group, which is based in Silver Spring, Md."

But belief doesn't equal scientific evidence; and it more often than not equates to faith-based reasoning that is inimical to science-and more research is driven by ax-to-grind advocates than by industry. This research is never challenged for the corruption it might represent because of its provenance-only the industry is tainted, which leaves us with a one-sided debate driven by the loudest political voices convinced of their own rectitude; in this case the righteous fight against the evil fast food empire.