Epidemiological Studies

I spend hours every day reading studies, articles, and researching health-related matters. When I find a new publication or exploration of a topic, I get excited to dive in. That being said, some studies and articles are more useful than others.

One type of study that is used frequently to make health claims and guide public policy is an “epidemiological study”. Epidemiology is the study of a set population, or group of people, to develop correlations or inferences.

The problem is that these do not prove anything. When we find a strong correlation between factors, we should use that as a starting point to conduct further research. An epidemiological study, by itself, should never be the basis for making health policies.

Let me give some examples.

Epidemiology suggests that soy is a healthy incorporation in a diet. This is due to the fact that Asian countries consume high amounts of soy on a regular basis and don’t experience the same health problems as Western nations.

However, no other factors are taken into account.

The soy that Asians consume has not been genetically modified to the same extent as ours, nor has it been grown in soils depleted of minerals. Also, most Asian dishes use fermented soy or the bean in its natural state.

Asian cultures consume more wild-caught fish (high in anti-inflammatory omega-3s), sea vegetables (loaded with vitamins and minerals), and opt for white rice, with less anti-nutrients and gut-damaging proteins than typical “heart-healthy” whole grains such as wheat and oatmeal.

Historically, Asians don’t consume as much processed food as Americans. They don’t cook in corn or canola oil, they don’t have packaged foods at every meal, and they don’t go out to eat as often.

And finally, they are far more active – walking, biking, and taking the stairs as part of daily life.

Because of these factors, we cannot confidently say that the consumption of soy in Asian countries is the cause of their better health.

When we look at soy mechanistically, we find phytoestrogens that have the potential to skew hormone levels, leading to fat-storage and growth of cancer cells. It is extremely high in inflammatory omega-6s. Take into consideration our growing practices, extensive refinement process, and consumption of soy byproducts, and soy consumption in the US no longer seems as safe.

Another example of epidemiology lacking substance:

In March of this year, there was a headline stating: “Animal protein-rich diets could be as harmful to health as smoking”. These news reports were based upon two studies: one epidemiological study of over 6000 adults and one study of mice in a laboratory.

The results of these studies suggested that a high protein diet (over 20% of calories) was “positively associated with diabetes-related mortality”. When you look at the numbers, one person in the “high-protein” group (consisting of over 1000 individuals) died from diabetes.

The lead researcher running this study owns a plant-derived protein supplement company…explaining the claim that only animal-protein is dangerous.

Some other issues:

There was no way to control for protein quality. There has never been a study showing negative outcomes from consumption of wild-caught fish, grass-fed beef, or eggs from pasture-raised chickens.

The mice that experienced growth of cancer tumors were implanted with melanoma cells before the study began. Plus, the study found that high protein consumption was “not associated with all-cause, CVD, or cancer mortality”. Therefore, the protein-cancer correlation was in fact disproved.

Finally, diet was self-reported. The average participant reported consuming 1,800 calories a day…30% lower than the national average. This suggests major under-reporting.

So, even though the study was riddled with flaws, and actually found no increased risk from animal-protein consumption, the results were phrased to dissuade individuals from consuming meat.

To get back to my original point – epidemiology is used too often to prove a pre-existing belief, promote a political agenda, or increase profits.

By itself, epidemiology is no different than trying to claim that the number of birds flying over a particular region somehow determines cancer rates in that area.

Certainly we should use any research tactic available to ask questions and form a hypothesis…but ultimately, we need to examine issues in every way possible.

Once we’ve investigated mechanisms, done cohort studies and some “food-diary” studies with pictures, it’s time to form a hypothesis and conduct a blinded, crossover, metabolic ward trial to draw some real conclusions!
correlation

Gluten

At this moment, there appears to be a “gluten-free” craze or fad.

By now, you all know that I recommend a gluten-free lifestyle. But, I advocate learning the reasons behind elimination first.

Imagine if, in 1949, when doctors were recommending cigarettes, that I came out of nowhere and just said “stop doing what your doctor tells you – it’s bad for you!”

Instead of just hoping that people will go against “conventional wisdom” to improve their health, I’d rather provide some facts about gluten.

First, let’s look at the actual plant that has the most gluten – wheat. The plant in the bottom of the picture is wild-grown wheat, while the top plant is commercially grown wheat.
Wheat
This picture is slightly deceiving because the “ancient einkorn wheat” is actually a modern day variation of wheat grown in the wild. Originally, the stem would continue even further and there would be far less seeds. But, even in this picture, you can see that the output (the size and amount of protective “hairs”) of the plant has changed.

While scientists tinkered with the genetics of the plant to increase profits, they also increased the protein content immensely. This was considered an added benefit but, unfortunately, no testing was done on human tolerance.

As acetaminophen (Tylonel) was developed, it had to be researched mechanistically, tested on animals, and finally on humans, before each generation of the product could be sold in stores. This was never done with wheat.

Next, let’s consider the role wheat played historically. For the last 10,000 years, grains helped humans develop villages, cities, and countries, allowing us to leave behind 2.6 million years of hunting and gathering.

Imagine life as a hunter-gatherer – traveling around in groups, moving your “home”, and collecting food.

Would it make sense to spend hours every day picking tiny seeds off a plant, that would then have to be soaked, sprouted, and ground to make one thin cracker? Or would it make sense to throw a spear into a herd of antelope and provide enough food for weeks?

Would you rather search for days to find a few grasses of wheat? Or would time be better spent picking berries and plucking leaves (requiring no preparation) as you travel?

Wheat, and other grains and seeds, would be stored for a time of famine…when a hunt was unsuccessful or in winter when plants were scarce.

Now we know the role wheat played historically and how the plant changed through recent genetic hybridization. But, what about the actual affects gluten has on humans?

It is predicted that 1% of the world population has celiac disease, an overt allergy to gluten, while about 10% report having “non-celiac gluten sensitivity”.

Gluten sensitivity can result in over 250 symptoms, including joint pain, dry skin, or indigestion.

There is no test for “gluten sensitivity”, as there is with celiac disease. The only way to discover sensitivity is to completely remove gluten from the diet and reintroduce after a few months. Finally, one microgram of gluten can change the gut chemistry for up to 6 months – therefore, an accidental exposure, or short-term elimination, may provide invalid results.

I don’t want to bore you by exploring every issue involved with gluten, so I’ll just mention the two most compelling facts:

Gliadin, one of two proteins that make up gluten, breaks down to polypeptides. These are small enough to travel through the gut lining, into the blood, and cross the blood-brain barrier. At this point, they bind to opiate-receptor sites, producing euphoria, similar to a tiny dose of morphine or heroin. Studies show that gluten stimulates appetite so much, through the reward/pleasure centers of the brain, that individuals eating gluten consume an extra 400 calories a day.

Finally, transglutaminase is the enzyme in that breaks down gluten. The more gluten one eats, the more transglutaminase their body must produce. The issue here is that transglutaminase has the ability to affect every cell in the body. This is one reason gluten sensitivity can manifest in hundreds of different symptoms. The literature shows that high levels of transglutaminase are present in individuals with neurological diseases such as Huntington’s, Parkinson’s, and dementia.

I could continue but I don’t want to make this post too dry or sound like I’m trying to make gluten into some boogey-man.

The takeaway points are:

We have genetically-altered the wheat plant to contain far more gluten than it should.

Humans are not meant to consume as much gluten as we have in the last 50 years.

Gluten has the potential to affect nearly every function within the body.

Considering these facts, it is no surprise that there is a “gluten-free” craze at this moment. As more people eliminate gluten from their diets, they discover that it was the cause of many different health issues, ranging from fat-gain to Type II diabetes to anxiety.

And with that, you know the risks of over-consuming gluten, and the benefits of opting for more nutritional foods.

The science is out there – why not give it a try and see if removing gluten from your diet for a few months improves your life in any way? What will you have to lose (besides a few pizza nights or conveniently packaged snack bars)?