The stakes are high. The adversaries (conventional wisdom and conventional commodities) well-funded and more or less articulate. The doctors in the trenches are gun shy but pressured to adhere to "evidence-based medicine." And by pressured, I mean, will be sued or not meet some evidenced-based "standard care marker" (such as a certain percentage of folks with high cholesterol taking statins) and will make less $$ if they don't adhere to "standard of care." By gun-shy, I mean they were excited by vitamin E. They were excited by B vitamins lowering homocysteine. Then it turns out that vitamin E made everything worse. Lowering homocysteine didn't prevent heart problems. Chromium maybe hurts the liver. The glorious Stumptuous put it best in her blog post - "F%^$ supplements."
If you think you will make your primary care physician happy by showing up with a list of non-standard labs to be checked and some half-baked theories as to why they are important, you are going to be disappointed.
Music: Never Miss A Beat by the Kaiser Chiefs (right click in new tab, sorry about the ads!)
Doctors are conservative because we have to be conservative. We are the last bastion of sense against shark cartilage injections and calcium as the cure for everything. If you want to shoot across the bow of conventional wisdom, you need some hard core rigorous evidence and medicine.
Gary Taubes sent me (and many, many others) an email for a petition in support of insulin and hormonal fat regulation at the level of the adipocyte being the cause of obesity. He wrote the petition in repsonse to Tara Pope's article about the difficulties maintaining fat loss after an initial bout of obesity.
Gary, I'm all for eating well as a long-term cure for obesity, but I'm not going to sign something blaming insulin alone. I can't do it. There's too much evidence against it. And I'm not sure I buy the "lean mass protection" gig Paul Jaminet endorses. Why so many thin people with vitamin deficiencies, after all? And I'm not going to sign up for the Harvard School of Public Health omega 6 fest of a food plate, either. Epidemiology be dammed. Show me the coronary arteries. Hard evidence for such a departure from the ancestral norms of low omega 6.
And yes, I removed Perfect Health Diet from the "Of Like Minds" list at the right (probably temporarily - depends on my mood) after one too many posts praising Dr. Mercola.
I can't do it. I can't have my blog linking to direct endorsements of frauds. Paul isn't an MD and is not in clinical practice. He can give clinical advice on his blog whereas I, as an MD, cannot due to ethical and legal obligations. He can feel free to consider the fringe of alternative medicine "on the same team" whereas I cannot. I can't be on the same time as quackery because I am one phone call away from the front lines of the gun-shy primary care doctors. I think Paul and Shou-Ching are amazing and thoughtful, but they never went through the humbling experience of clinical medicine training. As many times as we are right, we are wrong.
So when Mat Lalonde gives a talk endorsing real science and hard evidence as a basis for Ancestral Health, I am in complete agreement (more or less). I understand Andrew's reticence for the general population of folks and bloggers, but those who find "paleo" and have improvement will build it and spread the word on their own amongst their friends. The real inertia to be lifted is with the primary care doctors and the incentives to keep pumping our processed food and vegetable oils. No amount of enthusiasm and crappy anti-wheat polemics will change that. Primary care doctors aren't stupid. They need good evidence to turn the tide.
Here is the sordid truth - conventional wisdom is not wrong. It is only skewed in favor of the vested interests. Cardiovascular disease has been dropping with the advent of the vegetable oil. We have to get people caring about obesity, autoimmune disease, and mental health but the funding is problematic, to say the least.
Once doctors such as myself are linked with the lunatic fringe, we are done for. Credibility, critical thinking, and scientific evidence are harsh mistresses. I can have my little mistakes, but if I post anything showing major fallacies of critical thinking, I'm done for. As it should be. I'm a Harvard-trained physician, after all. There are certain expectations, even in my hobby of a blog.
I'll try not to be blinded by science. I'm not going to praise paleo for the sake of paleo (eat a g$$d%#@^ed banana already, and I don't have time to hunt and kill a boar).
Let's not throw the baby out with the bathwater. Life is good and only getting better without the processed food, without the seed oils. Let's protect it, nurture it, and not shove it out into the rocky shoals of the lunatic fringe too soon.
* The Glorious Cause is an excellent history of the American Revolution. I highly recommend it.
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