Talk about misbranding! In 1997, the federal National Heart, Lung and Blood Institute (NHLBI)-sponsored Dietary Approaches to Stop Hypertension (DASH) study found that -- holding salt intake at a constant level -- blood pressure could be improved significantly by adding fruit, vegetables and dairy products to the American diet. Hypertensives subjects dropped their systolic BP by 11.4 mmHg -- impressive.
Those interested in improving dietary quality and lowering cardiovascular risk -- including the Salt Institute -- rejoiced and called for the DASH Diet to be the guiding principle for the new year 2000 Dietary Guidelines for Americans. It took a bit longer, but the 2005 edition of the Guidelines, in fact, explicitly endorsed the "DASH Diet." So far, so good.
But in the last nine years, those with their own nutrition agendas have tried to hijack the "DASH Diet" by asserting that the DASH Diet is now fruits, vegetables and dairy products AND salt-restricted or, in current headlines, fruits, vegetables and dairy products AND carbohydrate-restricted and protein-enhanced. Well, folks, there is no such thing as a South Beach DASH Diet.
The DASH Diet offers an exciting possibility that correcting nutritional (mineral) deficiencies in the American diet can confer health benefits, but it has nothing to do with dietary salt, dietary carbs or dietary protein.
Unfortunately, NHLBI, rather than defend its original findings, has been playing along with the misbranding of these later studies. FDA should call "halt" on its sister agency; this misbranding is akin to "bait-and-switch."
Reasononline's science correspondent Ronald Bailey's Jan. 6 post revisits the issue of objectivity/politicization in science, asking: "Has science become politicized? A better question might be: When has it ever not been?" He sees no way out of the current situation where funding sources - both industry and government - seem to bias "scientific" conclusions. He continues:
"Surveys of studies show that scientific reports sponsored by drug companies generally find the supporting company's drugs to be safe and efficacious, whereas independent studies often do not. Interestingly, studies supported by the $132 billion in federal research and development expenditures rarely occasion such scrutiny. Perhaps that's because they are generally above reproach. But it is also true that most academic research is funded by government agencies and it will not help a scientist's career to bite the federal hand that feeds him and his postdocs. I also suspect that most agency funded research generally finds that what the agency guesses is a problem turns out to be a problem.
"In a liberal secular society in which traditional sources of authority-the Church and the State-have eroded, science stands the ultimate arbiter of truth. So, both the right and the left loudly seek to claim that scientific findings justify their political goals.
"Not surprisingly, when a scientific finding doesn't support their policies or programs, both sides suspect that it has been "politicized." In this case, "politicized" meansdisagrees with what we good people want. Naturally to prevent politicization,both Republicans and Democrats have sought to legislate scientific objectivity."
Bailey then concludes.
"What these efforts to legislate scientific objectivity really point up is that science, as the chief arbiter of truth in our society, will remain unavoidably enmeshed in politics. The government official who ordered the ban on DDT despite the scientific evidence for its safety, William Ruckelshaus, the first administrator of the EPA, brought admirable clarity to the issue. In 1979, Ruckelshaus wrote to Allan Grant, president of American Farm Bureau Federation president, stating , "Decisions by the government involving the use of toxic substances are political with a small 'p.' The ultimate judgment remains political." What was true for the EPA in 1972, is even more true for federal agencies today. The science wars are here to stay."
Who's to say Bailey's wrong? I hope we never entirely replace our healthy skepticism with a crusty cynicism that forecloses a healthier outcome for our polity. As I blogged earlier , the objective criteria of good science termed "evidence-based medicine" by scientists united in the Cochrane Collaboration seem, to me at least, to offer hope. The concept is that the rules of the game are set out before the evidence itself is assessed - sort of like an election where we agree to accept the outcome because we know the process itself has integrity (or at least it does in Baghdad if not Broward).
Still catching up from the holidays. A Dec. 30 commentary in the Wall Street Journal made much the same point in the Vioxx debate as raised earlier in this blog : even our most prestigious medical journals are "mere magazines."
Thomas Stossel, the American Cancer Society Professor at Harvard Medical School, decried MSM coverage of Merck's Vioxx situation, stating the media conclusion: "Medical academics are saints -- devoted selflessly to patient care -- and corporate people are sinners, morally blinded by greed." Stossel obviously disagrees: "But having worked in academic medicine for over 35 years and consulted for companies, this Manichean duality is inconsistent with my experience and a woeful distortion of reality. In a Sept. 8 article in the New England Journal of Medicine, I reported that no systematic evidence exists that corporate sponsorship of academic research contributes to misconduct, bias, public mistrust or poor research quality." Stossel urges medical journals to "stick to their core business of facilitating imperfect communication between researchers. Leave drug and device monitoring to the FDA -- and theology to theologians."
Picking up on the last point, it is disturbing how anti-scientific (theological) have become the calls to restrict dietary salt against accumulating evidence that the intervention just doesn't deliver health benefits for the general population. The anti-science has a theological tenor -- faith in the absence of evidence. In this case, it's worse -- faith in the face of evidence to the contrary . As in the case of the all-knowing Wizard of Oz, we're advised: "Pay no attention to the man behind the curtain."
We need truth-tellers like Dr. Stossel...and Dorothy.