The Importance of Evidence

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Re: The Importance of Evidence

Postby Katydid » Thu Feb 23, 2012 10:07 am

JeffN wrote:

So, there is no "novickian" plan and I ask no one to blindly follow my recommendations nor can you find any specific detailed recommendations of mine, but instead, help them to understand the process of finding the truth for themselves.

In Health
Jeff


And we appreciate that, Jeff. You've given me an excellent education over the past few years. Even more than Dr. McDougall telling me what to do to lose weight, I appreciate your teaching me how to make that knowledge applicable specifically to me.

Here are a few more links for people interested in digging deeper into actual clinical research. If its one thing I've learned, it's never get your nutritional information through the media :nod:

The NCBI PubMed searchable database at:
http://www.ncbi.nlm.nih.gov/pubmed/

Google Scholar (to help sort out the chaff when doing a search):
http://scholar.google.com/

The Lancet website. There are a surprising number of full articles available online for free. They recently had a whole issue on obesity research:
http://www.thelancet.com/
This diet can save your life - it saved mine! Read my story at:
http://www.drmcdougall.com/stars/cathy_stewart.htm
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Re: The Importance of Evidence

Postby patty » Fri Feb 24, 2012 12:28 am

JeffN wrote:One of the comments I make when discussing the above, is that of course any system will have its limitations and many people like to point out the limitations with the above system.

So, if for some reason you disagree with the above system of evidence, then what system do you use? And, if you choose to use a different system, then shouldn't it be a better system?

Many people who say the system is flawed then make their decisions based on a lesser system (ie, youtube video, neighbors comments, commercial on TV, etc etc) which makes absolutely no sense.

In Health
Jeff


I feel Jeff you very clearly state the facts, untangling the entanglement is then up to the receiver. If I had any advice to give to a ten year old, it would be about the man who said he was a liar, and if he is telling us he is a liar, how can that be because he is telling the truth? It is always to look beyond where the finger is pointing. Our body is our best ally, just as you clearly explain in your calorie density dvd, we are programed to eat the same amount of weight of food daily.

In reflection the evidence is a womb experience. And if that is true I can eat my starch and relax and be here as I now know because of your research, it is easy to overeat the higher density foods and just eating the lower calorie dense foods I am still hungry. Once I get it, my children who I gave birth too many, many years ago get it too, because we are all a species of amnesia. We live in a culture that separates church and science. Who put milk in the breast of the mother to feed her young, and who usurped the woman? Hmmm I think you are a light bringer:) however it appears.

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Re: The Importance of Evidence

Postby didi » Fri Feb 24, 2012 6:58 pm

re, becoming your own guru. Jeff, did you just talk yourself out of a job?

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Re: The Importance of Evidence

Postby landog » Sat Feb 25, 2012 12:12 am

JeffN wrote:we then have to learn how to evaluate evidence at each level and as not all RCT's are the same....

So yes, we have to learn to evaluate studies also, for power, strength, significance, methodology etc.

I am not asking anyone to have a guru but to become their own guru...

Apparently, everyone who is here has taken the time and effort to figure out how to successfully navigate the world of the internet, and computers. The process, or the ability to learn it, is no different for anything else, we just have to apply it.

Fair enough, but I have apparently learned a bit more about computers than the average bear - enough so that I make a comfortable living at it. I could say that I don't have any 'special' knowledge that anyone else that puts forth the effort can't learn. Yet, aside from the professional services I am compensated for, frequently friends and acquaintances seek my advice.

While I have concentrated on computer stuff over the past few decades, it is obvious that you have mastered the art of evaluating scientific evidence, especially when it comes to health and nutrition. I can't master computers and also do a good job at weeding my way through all the evidence about nutrition anymore than you could master what you have learned while learning how to keep essential computer systems available, scalable and reliable.

So, we leave it to you (and Campbell, McDougall, Esselstyn) to weigh the evidence for us and thank you very much for doing so.

(Also, we're just lazy and we trust you.)

JeffN wrote:So, there is no "novickian" plan...
Please reconsider! :-D

Be well,
-dog
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Re: The Importance of Evidence

Postby JeffN » Sat Feb 25, 2012 8:05 am

landog wrote: Fair enough, but I have apparently learned a bit more about computers than the average bear - enough so that I make a comfortable living at it. I could say that I don't have any 'special' knowledge that anyone else that puts forth the effort can't learn. Yet, aside from the professional services I am compensated for, frequently friends and acquaintances seek my advice.

While I have concentrated on computer stuff over the past few decades, it is obvious that you have mastered the art of evaluating scientific evidence, especially when it comes to health and nutrition. I can't master computers and also do a good job at weeding my way through all the evidence about nutrition anymore than you could master what you have learned while learning how to keep essential computer systems available, scalable and reliable.


I agree.

I am not an "expert" on everything and there are areas in my life where I consult other experts. But, I still have to learn a set of basic skills. So, I am not asking everyone to become a statistician or an epidemiologist, but to learn some basic skills or to at least ask some basic questions about the information they are getting.

I can't fix many things on my car, but I do know how to keep it up with basic maintenance and care. And, I don't need to know how a combustion engine works to keep a car running in excellent condition for many many years.

It's tax time. I don't do my taxes and have an accountant who does them. However, I still understand as much of the process as possible and what I don't, I try to understand with his help, and review what he has done. I got rid of my last accountant because I was having to tell him things he should have been telling me.

And, that is also why I included this in the initial comment...

JeffN wrote: I would add in another comment, blind trust of authorities, who sound like they are coming with solid evidence, is not better. We really must learn not only how to evaluate evidence but those who deliver it.


So, even if we are not going to become an expert in an area, we still need to use some logic, reasoning and critical thinking in how we pick our experts.

I think we can do a much better job in this area.

landog wrote:
JeffN wrote: So, there is no "novickian" plan..


Please reconsider! :-D

Thanks!! :)

In Health
Jeff
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Re: The Importance of Evidence

Postby patty » Sat Feb 25, 2012 8:53 am

I have been listening to Elizabet Sahtouris and she shares about a new scientist vs. Western. I feel you are like her, you have a gift of clarifying what works because you are able communicate to the trillions cells of the recipient's body. You have taken something very complex and made it very simple. I feel it is because you practice holon vs. hierarchy.

When the cycle of addiction ends, the hippocampus thrives. The organ that makes the unknown known. We are free to weigh and measure the new thoughts rising. I feel the addiction of food and money go hand in hand. If you are not familiar with Elisabet Sahtouris check her out: http://www.youtube.com/watch?v=j_immL2m1tg

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Re: The Importance of Evidence

Postby r-marie » Sat Feb 25, 2012 9:08 am

JeffN wrote:As I said above

"That even once we establish the pyramid, we then have to learn how to evaluate evidence at each level and as not all RCT's are the same. And, there are standards of how to evaluate within and between the two (ie, are 8 very well done population studies worth more than one short term, small RCT?)"

So yes, we have to learn to evaluate studies also, for power, strength, significance, methodology etc.

In Health
Jeff


And therein lies the rub for me: After all the scientific evidence is gathered and laid out - some Human still has to, as you said, "evaluate" it. Being human, that 'evaluator' will with or without conscious intend tend to bend the "proof of evidence" in favor of his own beliefs and/or expectations. The result is that most people remain confused and uncertain which side is right - no matter how much evidence is presented.

Thanks for posting this article, Jeff, it was a wonderful read and I agree with most of it.
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Re: The Importance of Evidence

Postby JeffN » Sat Feb 25, 2012 9:21 am

r-marie wrote: And therein lies the rub for me: After all the scientific evidence is gathered and laid out - some Human still has to, as you said, "evaluate" it. Being human, that 'evaluator' will with or without conscious intend tend to bend the "proof of evidence" in favor of his own beliefs and/or expectations. The result is that most people remain confused and uncertain which side is right - no matter how much evidence is presented.


No doubt. But, there are again, logical and reasonable ways to deal with all of this. This is why we have meta-analysis, reviews studies, and consensus opinions, all of which are still part of the process.

We also have to understand how science works...

I posted this a while back..

viewtopic.php?f=22&t=7925&p=57004

JeffN wrote:Just some general comments...

Eventually you begin to realize that they are making the same mistakes and/or assumptions in the way these studies are either done, and/or reported, and you learn what to look for. We all know that most "low fat" diets are not low fat, nor are they anything like the diet recommended here.

If you do listen to them, one day fat is good, one day fat is bad.

But realize that real science doesn't "work the way", and/or change its mind every day, though the media wants us to think that. One day coffee is good & one day coffee is bad. One day Atkins is good, one day Atkins is bad. This week in the NY Times, eggs are now good. What's a person to do? :)

This kind of information just keeps the public dazed and confused. But, outside of the media hoopla on these topics through its various outlets, the real scientific community, is not swayed but the results of any one study.

All true science is a slow moving development and unfolding of information that build on what is known & adds to it & also looks for & acknowledges its own flaws & weaknesses. It makes conclusions based on methods and levels of significance. It doesn't suddenly jump from one place to another every time a new study comes out. Eggs didn't go from bad to good this week either.

But the mass media, like the NY Times, and other media outlets, (NOTE: And many health "experts") thrive on this kind of (mis)information, and in presenting it in such a way, just as it did a few weeks ago with the Atkins study which was supposed to have vindicated Atkins, and is doing this week with eggs, which are supposed to be good for you again. There was no Atkins diet, there was no low fat diet in the so called Atkins study. This type of reporting of information is very good for readership and advertisers. It's very bad for real science.

However, because of human nature and the way the mind works, people are drawn to these types of "reports" and the faulty conclusions the media presents.

Unfortunately, these reports and the confusion created by them, rarely if ever, address the primary problems. They act as little more than distractions because as long as people continue to argue over, or focus their energies on these side issues, they miss putting their real time, energy and efforts into doing what really works and matters.

I base my decisions on a careful study of the literature including the entire body of evidence and all the work, on both sides. My decisions are based on the overwhelming majority of the evidence as evaluated a supported by the majority of the work and not any one single study, especially when it has just come out & especially if all I have read (or know) is a mass media account of the new study. Sure, you can always find a study that appears to say the opposite or support a contrarian view, but we have to look closely at it, how it was done, what was the methods, who funded it, and the totality of the evidence to date. And, of course, our own biases, which we all have.

And, while some may think the conclusions I draw, (which you are welcome to disagree with), are alternative, holistic, complimentary, hygienic, natural, vegan, etc etc, to me, they are just simple, conservative, basic guidelines and principles of good science for good health.


We can understand and apply this perspective, without even having to understand statistics and epidemiology.

And, this is why I have "general guidelines and recommendations" and not black and white rules, as they do not accurately represent what we know. If you were my patient, and I knew all the specifics about you, that together, we may come up with some more detailed specifics for you, that we would monitor over time and adjust accordingly.

We do use these same skills every day. It's how (hopefully) most all of us choose a car, or computer, etc etc.

r-marie wrote: Thanks for posting this article, Jeff, it was a wonderful read and I agree with most of it.


Thanks

In Health
Jeff
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Re: The Importance of Evidence

Postby greentea » Sat Feb 25, 2012 6:05 pm

Great letter Jeff, thanks for posting that.

Katydid wrote:Great post, Jeff! Whenever I come across the latest 'miracle cure' I like to apply Carl Sagan's Baloney Dectection Kit from 'The Demon Haunted World' (one of my favorite books of all time). For those not familiar, here is a link:

http://www.xenu.net/archive/baloney_detection.html

I just wish I could get my friend at work to think logically. He saw a YouTube video the other day, and is now convinced that the government and medical establishment are in cohoots to surpress hemp oil because it is a miracle cure for cancer. Sigh.

Kate

And Kate, thanks for the link to that video, it is excellent. I need to dig out the book "Crimes against logic" again. It is about critical thinking and it is a great read. It is something I struggle with, and this book has really helped me see more clearly flaws in logic & misinformation.
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Re: The Importance of Evidence

Postby Mike Crosby » Tue Feb 28, 2012 11:28 am

I love this article and I will spend more time to understand the pyramid that Jeff posted.

It is all so thought provoking.

If I could tell you about my experience, I've become a healthy person following Dr McDougall, Fuhrman, Esselstyn, Campbell, Lisle and Jeff. I know their teachings are backed by science. Sometimes I try and read the studies, but most often not, I rely on what they say the studies say (even though Jeff says repeatedly, "here's the website, go look for yourself").

In life we use shortcuts all the time to navigate through life. I don't have to think of manipulating my right leg to move in front of my left when I walk. Same way, I rely on people I trust on health info.

I wish when I hear these lectures, I could actually go to a microscope and see things with my own eyes.
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Re: The Importance of Evidence

Postby LauraW » Wed Feb 29, 2012 11:52 am

Mike Crosby wrote:If I could tell you about my experience, I've become a healthy person following Dr McDougall, Fuhrman, Esselstyn, Campbell, Lisle and Jeff.


Please do. I love reading people's success stories. It helps strengthen my own resolve.
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Re: The Importance of Evidence

Postby JeffN » Sun Mar 04, 2012 1:15 pm

This free book is an incredible resource and not only expands on the above, and also teaches you all the basics you need to know to learn how to understand the health information you hear and to evaluate the evidence.

I would consider this required reading. :)

http://www.ncbi.nlm.nih.gov/books/NBK63638/

And thanks for the forum member who first posted the link here

viewtopic.php?f=1&t=28057

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Re: The Importance of Evidence

Postby geo » Sun Mar 04, 2012 2:13 pm

Thanks Jeff! It was this thread that got me thinking and researching about the subject...you tend to have that effect on people :D
geo

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Re: The Importance of Evidence

Postby JeffN » Thu Mar 08, 2012 10:38 am

On a similar note...

http://www.huffingtonpost.com/ron-ashke ... 26442.html

From the article...

"all the available information means people have to work harder to consume it: categorizing information, sorting facts from opinions, & putting everything in context. Unless we take the time to do that, & have the skills to do it well, we could actually be less knowledgeable"

IMH(P&P)O increased access to something does not equate to increased advantage. Simply having access to this large flow of information has little advantage to people if they have no clue how to use it. In addition, an increased rate of flow could easily overwhelm a system that may have been able to handle a slower flow. So its a disadvantage on two accounts, rate of flow and amount of flow.

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Re: The Importance of Evidence

Postby geo » Thu Mar 08, 2012 12:06 pm

Hi Jeff,

Again with the thought provoking questions :)

Rate and flow may be a temporary disadvantage but time is the great equalizer here. And while an increased flow and rate may not equate to an increased advantage, it does equate to an increased potential for advantage and that makes all the difference :)

The solution is simple. We create more/better filters for the flow. And I believe thats why we are all here. To teach and to learn. One step at a time.

Time is on our side.
geo

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