"Reactionary." That's the word that best captures the loud defense of the status quo in science. And, as the old saw goes about courtroom strategy for lawyers: If you have the law, argue the law; if you have the facts, argue the facts; if you have neither the law nor the facts argue at the top of your lungs. Perhaps the humor offers an insight into why institutional defenders of the status quo in medical science have turned up the volume in condemning high quality new science that challenges the conclusions of their earlier, often lower quality conclusions.

One of the best new blogs I've read in months examines this phenomenon in two posts this weekend. Junkfoodscience.com , in "Say it isn't so - Part 1 " looks at the Women's Antioxidant Cardiovascular Study (WACS), noting:

It is predictable. A flurry of press releases and articles appear everytime a major study is released that debunks "pop science" - what everyone "knows" to be true - and threatens the research or agendas of special interests. These stories attempt to confuse us, spin the science, or restate the beliefs more emphatically. Many times, they even claim to have new research supporting their position, when they don't!

Registered Nurse Sandy Szwarc, RN, BSN, CCP, pointed out that WACS

followed nearly 16 other major clinical trials released earlier - including the Heart Outcomes Prevention Evaluation (HOPE), Atherosclerosis Folic Acid Supplementation Trial (ASFAST), and the Norwegian Vitamin Trial (NORVIT) - all firmly demonstrating no benefit of folic acid or vitamin supplementation in heart disease, and that lowering homocysteine levels does not translate to real-life reductions in heart disease. And more importantly, has no effect on the most important end point of all: death.

As a Medscape review noted, the clinically measureable evidence is overwhelmingly consistent.

Immediately, the institutional status quo leaped into action, papering the media with the contrary story, to wit (from Reuters):

Folic acid can cut heart attack risk: experts

Can taking folic acid supplements reduce the risk of heart disease and stroke? British researchers believe it can. After analyzing evidence from earlier studies, a team of scientists in Britain said on Friday there is enough research that shows folic acid lowers levels of the amino acid homocysteine and reduces the odds of cardiovacular [sic] disease.

Now, I"m not going to wander from the confines of salt and health to comment on the benefits of folic acid supplementation; there are plenty of experts to thrash that out. What seems worth mentioning, however, is the tactic of the defenders to deflect serious consideration of the WACS and the other 16 studies. And you can read in more detail on Junkfoodscience.com. Szwarc describes how David Wald, a colleague of Malcolm Law, well known for his low-quality "meta-analyses" of the blood pressure effects of salt restriction, for context, launched a high-volume attack on the mounting number of clinical trials using older, lower-order observational studies he had done reaching the contrary conclusion (his news release implied the studies were new and of superior quality).

In today's "Part two ," Szwarc turns her attention to the same phenomenon in the current debate over obesity. Anyone who challenges the orthodoxy that obesity is the root cause for virtually all nutrition related medical conditions has a hard time having their voice heard. Again, it's not a primary issue for our focus, but the process of defending the status quo is frighteningly consistent. As she explains:

Nothing compares to the all-out, massive, well-organized efforts to preserve the "obesity crisis" that began last year after senior research scientists inside the CDC's National Center for Health Statistics exposed the war on obesity - begun by their own director of the CDC, Julie Gerberding, and Secretary of Health and Human Services, Tommy Thompson - as a grossly exaggerated and fabricated scare campaign.

She continues:

the study, looking for correlations between weight and premature death that had been created to lay the foundation for billions of dollars in government and industry "obesity" initiatives, and popular with an enormous throng of marketing and political interests all using the "obesity crisis," had been derived from poor data and had flagrant methodological flaws. How bad was it? It didn't even account for aging, the single biggest risk factor for death, in its computer model!

But, back to the story of tactics used to defend the status quo. Szwarc explains:

Within hours of the release of this potentially devastating study in the Journal of the American Medical Association, special interests - notably, doctors from Harvard School of Public Health, along with the American Cancer Society, American Heart Association and the CDC - quickly rallied press conferences and media releases to deny and spin the findings and attempt to discredit them in the minds of the credulous public. They made noises about it failing to consider smoking, of reversing causality and attributing higher deaths among thin due to the fact they are sick or old, and of not considering the long-term effects of obesity. These spin doctors assumed, correctly, that the media would simply repeat their assertions and not a single reporter would go to the actual study to realize they were nonsense.

Flegal and her associates had analyzed the data in a myriad of ways and had accounted for smoking, chronic diseases and preexisting health problems, involuntary weight loss, and long-term obesity ... and each time the results were the same.

Reporters who'd read the journals where this controversy had been raging could have learned that the "obesity is deadly" studies done by researchers from Harvard, the American Cancer Society and CDC that were being so vehemently defended, had looked at self-reported data from select groups of people that weren't representative of the population and had excluded nearly 90 percent of the deaths in their analyses to get the results they wanted. Among other such studies, you'll find all sorts of other shenanigans.

Let's not blame the media entirely. As much as we should hope reporters would ask the tough questions and look critically at the evidence itself and not just accept what one side of an issue says it means, the real -- and largely hidden -- story here is the enormous lengths that defenders of the status quo have gone to dredge up lower quality studies or those focused on only one portion of a broad problem to emphasize their argument. And the volume! Turn down the hyperbole. Let's discuss science and get that right; then we can turn our attention to getting the policy right to build on that science.

The same process has been playing out in the salt and health issue. Investigative journalist Gary Taubes won the top award from the National Association of Science Writers for his article "The (Political) Science of Salt " appearing in the prestigious magazine Science.

We all need to pay attention to these tactics. Thanks, Ms. Szwarc.