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Monday, September 17, 2007

On this date in 1787 The U.S. Constitution was completed and signed by a majority of delegates attending the constitutional convention in Philadelphia.

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Buyer beware! Medicine is today very much marketing in search of molacules and machines that will produce a steady stream of revenue for the manufacturer and the physician. This excellent warning shot was fired in yesterday's New York Times:

Do We Really Know What Makes Us Healthy?By GARY TAUBES
New York Times, Sept 16, 2007

What to believe. (edited for clarity)

So how should we respond the next time we’re asked to believe that some medication or some facet of our diet or lifestyle is either killing us or making us healthier? We can fall back on several guiding principles:

1. Assume that the first report of an association is incorrect or meaningless, no matter how big that association might be. Be skeptical.

2. If the association appears consistently in study after study, population after population, but is small — in the range of tens of percent — then doubt it.

3. If the association involves some aspect of human behavior, which is, of course, the case with the great majority of the epidemiology that attracts our attention, then question its validity.

3a. The exception to this rule is unexpected harm. If the subjects are exposing themselves to a particular pill or a vitamin or eating a diet with the goal of promoting health, and, lo and behold, it has no effect or a negative effect — it’s associated with an increased risk of some disorder, rather than a decreased risk — then that’s a bad sign

4. All of this suggests that the best advice is to keep in mind the law of unintended consequences.

The point of this article is that much of what we've been told about what is or isn't good for us is based on guesswork. Taubes talks with Madeleine Brand about his article.

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