Great piece, not for pointing out this particular study being trash (cuz obviously), but for using the lens of how taste-makers react to something when it rubs against their bias, in contradistinction to when something strokes their bias. The absence of principles and integrity among the tastemakers is the more important and prevailing story, for me.
Never understood the enthusiasm for intermittent fasting (or for any fad diet). As far as I know, the only diet that makes any iota of difference for CV outcomes is Mediterranean. Anything else is just useless noise. I’ve seen no data showing benefit for IF (beyond reducing total calories consumed) in weight loss. I’ve seen no evidence that sustains the hypothesis of their supposed metabolic and anti-inflammatory benefits. And it appears that any weight loss it achieves is disproportionately of lean muscle mass (isn’t that just great!). Really not sure what the fuss is about.
Of course articles and studies like this are pure nonsense. The data that they purport to analyze is entirely unreliable to begin with. It is logistically impossible to conduct a scientifically valid study correlating disease with self-reported "lifestyle" factors---e.g. diet and/or exercise---in a free-living population. But they are great for promoting or criticizing those that are interested in advocacy . Absent scientific validity, the only thing we have to rely on is the biological plausibility that any of these things could actually cause disease or promote better health.
I don't know if Peter Attia is one of the "Top People" you're talking about, but he dissected the flaws of this study in even more detail than you. (I knew he would). He is not one to only report results where the findings agree with his preconceived notions, but he's human and all humans are biased, including folks here at Sensible Medicine. As Daniel Kahneman argues, we can't totally lose our biases, but we can rely on others to point them out, and that is the purpose of peer review, along with detecting flaws in methodology, statistical analysis, and/or interpretation. So don't pay attention to anything that has not been peer reviewed and even if it has, don't pay attention to those published in journals that have lost their standards of excellence for publication, that is, if there are any left. My humble suggestion is for docs here at Substack to start a list of journals that publish an unacceptable amount of rubbish. (Note: correlational research is not necessarily rubbish so long as confounders have been adjusted for, and IF the purpose is made crystal clear: hypothesis generation ONLY).
"So don't pay attention to anything that has not been peer reviewed and even if it has, don't pay attention to those published in journals that have lost their standards of excellence for publication, that is, if there are any left. My humble suggestion is for docs here at Substack to start a list of journals that publish an unacceptable amount of rubbish."
-- This will only bolster the disgusting elitism that is prevalent in scientific publications.
I am certain that your "solution" will help propagate the elitism in scientific research further. It is not a "maybe, maybe not" for me.
Many journals, even the ones that you might consider as "elite", does not have blinded peer-review. Even those who claim to have double-blinded peer-review, it is not completely effective as at least the editor will remain unblinded. The system has to change although I understand it is probably never going to happen. Even the critique of an already peer-reviewed and published article will suffer from this bias. The least we could do is to stop propagating ideas like yours that will only increase the elitism bias. We need to critique articles on a case-to-case basis regardless of the journal or the author names/affiliations. I understand that 100% objectivity is not attainable. More objectivity and less subjectivity - this is what we need.
Summary of mainstream medical ideologies: STFU and take your pills.
If this was such a problem, we have a huge study group: 1.9 BILLION Muslims during Ramadan. Anyone who buys this result lacks basic observational skills. Again, the medical 'establishment' (whatever cultural power structure that allows something like this to get so much hype) is asking people to throw out their own direct experience and common sense, over and over again. Things like these aren't just "click bait" -- they're a political, ideological weapon meant to keep people in line.
And with a fucking poster? How desperate are these ideologues?
You had me until you said the article was an example of an "ideological weapon meant to keep people in line." Do you honestly think some "deep state" or Big Pharma or "medical establishment" or whatever Bogeyman you fear most is trying to get you to eat more often? How is that going to "keep people in line?" What do you even mean by that? Logical/Analytical critiques: helpful; Paranoia: not helpful. BTW, poster sessions have been in use as a means of presenting information at scientific conferences since the 1960's, and they are not usually the sole means of presenting the information but are adjuncts to less formal oral presentations (link below).
I agree that Mr. Casey was a scary dude! (see p. 8 below). As the author, John Kelly, points out, specific misinformation campaigns serve different purposes. These purposes are political in nature, and meant to maintain power by the promoter of the disinformation. I am perplexed how a flawed study on time-restricted eating or others like it would serve as a useful tool of disinformation for politicians who seek to maintain power. It's amazing to me how even matters of health are now totally polarized along political lines. I understand being skeptical of those who can make money off of certain viewpoints, but time restricted eating just doesn't seem like a huge money maker to me.
I usually like to read the original, as you suggest, but between this article and Attia's, I had enough of the details to know it was garbage. I plead guilty to sometimes being snarky (I'm working on it!) but in this case, I don't see it. Mandrola was the one who used the term "Top People" and I was just responding to that using his words because I really didn't know if he considered Attia as one of those or not. (The term seemed to be used in a derogatory way by Mandrola, and the folks here at Sensible Medicine do not seem to be fans of Attia). Anyway, sorry if it was offensive; it wasn't meant to be.
I didn't use any of those words, and saying "whatever Bogeyman you fear most is trying to get you to eat more often?" is a bad faith characterization, so basically: fuck you. You and your people are so horny to get on anyone or anything that can be characterized as a "conspiracy theory", you miss the point of what people are saying.
Your critique of me is entirely an embodiment of your own inner dialog. You don't need any "deep state" explanations to see the obvious. I have dozens of posters, I know what a poster is. Publishing a news article based on a poster is deeply irresponsible.
Don't school me on what is "helpful" or not. If you don't understand how these issues are essentially part of a big advertising-propaganda complex, you need some basic history lessons.
I get your frustration with much of modern medicine, but let's not forget it's a systems problem, and it appears most medical providers are equally frustrated with it. As for what you said, the words you used that I was responding to were these words (I'll include the entire sentence this time): "Things like these aren't just 'click bait' -- they're a political, ideological weapon meant to keep people in line." If you want to explain more specifically what you meant by that, I'm all ears. I simply don't see how such a silly article as this could ever serve as a "political, ideological weapon" that will "keep people in line." I agree with you that publishing a news article about a non-peer reviewed poster, especially one as deeply flawed as this, is very irresponsible of the publisher.
Although Churnalism is quite maddening, unfortunately CRITICAL Churnalism will not help. My impression is that the vast majority of news consumers don't get past the first few lines of a medical news story. So if the headline is "New study suggests sleep causes cancer", most readers will not get to the critique part of the article. And if they do, it is likely only to increase their mistrust of medical research. We cannot expect news outlets to filter out this stuff...they are basically profit centers. So it is up to Academia and Journals to keep this stuff from being presented at meetings and published in the first place. Otherwise, "peer review" is a sham.
As a health journalist, I deeply appreciate the free education I've gotten on evaluating studies here on Sensible Medicine, though the little I've learned has made it clear how much more I still have to understand. Would you, Dr. Mandrola, or some of your Sensible Medicine colleagues ever consider offering a webinar or short e-course for health journalists (or whoever is interested) on this topic? I'd gladly pony up for such a thing.
It was statistically flawed. Only 400 odd people out of the 20,000 odd fell in the less than 8 hour feeding window. Hence the 91% assumption was based on 2% of the study population, compared to the 98%. Most people who commented never did read the poster.
Thanks for this! It's so true that the bad studies tend to get a pass when prominent people in public health like the result. The good news is that this time, the press got out in front of the clickbait. The first time I heard of this study was in an alert from STATnews, flagging a story debunking it. Then I saw it dissected in the always excellent Unsettled Science substack.
Top people? LMAO. Most studies of this kind and most drug studies are highly flawed and always geared toward some ulterior motive, not towards proving honest and sincere truth and facts. I will never blindly trust the "top people" anywhere. Nor most medical studies.
A similar criticism can be made for a recent meta-analysis that found more than one hour a week of resistance training to be correlated with worse overall mortality.
Again, longitudinal studies mostly based on self-reporting that didn't take into account possible confounding factors, not even the use of performance enhancing drugs. That was enough for me to dismiss the whole thing.
Not hard to imagine I'm one of those people who train a lot. 😂
The study is flawed if the Top People doesn't like it. The study is not flawed if the Top People like it.
But I’d argue *you* are top people! Who to trust…
Very interesting piece as always.
Great piece, not for pointing out this particular study being trash (cuz obviously), but for using the lens of how taste-makers react to something when it rubs against their bias, in contradistinction to when something strokes their bias. The absence of principles and integrity among the tastemakers is the more important and prevailing story, for me.
Never understood the enthusiasm for intermittent fasting (or for any fad diet). As far as I know, the only diet that makes any iota of difference for CV outcomes is Mediterranean. Anything else is just useless noise. I’ve seen no data showing benefit for IF (beyond reducing total calories consumed) in weight loss. I’ve seen no evidence that sustains the hypothesis of their supposed metabolic and anti-inflammatory benefits. And it appears that any weight loss it achieves is disproportionately of lean muscle mass (isn’t that just great!). Really not sure what the fuss is about.
Of course articles and studies like this are pure nonsense. The data that they purport to analyze is entirely unreliable to begin with. It is logistically impossible to conduct a scientifically valid study correlating disease with self-reported "lifestyle" factors---e.g. diet and/or exercise---in a free-living population. But they are great for promoting or criticizing those that are interested in advocacy . Absent scientific validity, the only thing we have to rely on is the biological plausibility that any of these things could actually cause disease or promote better health.
Saw this reporting in regard to the abstract. Not even the full article. All I can say is thank you for going over it.
I don't know if Peter Attia is one of the "Top People" you're talking about, but he dissected the flaws of this study in even more detail than you. (I knew he would). He is not one to only report results where the findings agree with his preconceived notions, but he's human and all humans are biased, including folks here at Sensible Medicine. As Daniel Kahneman argues, we can't totally lose our biases, but we can rely on others to point them out, and that is the purpose of peer review, along with detecting flaws in methodology, statistical analysis, and/or interpretation. So don't pay attention to anything that has not been peer reviewed and even if it has, don't pay attention to those published in journals that have lost their standards of excellence for publication, that is, if there are any left. My humble suggestion is for docs here at Substack to start a list of journals that publish an unacceptable amount of rubbish. (Note: correlational research is not necessarily rubbish so long as confounders have been adjusted for, and IF the purpose is made crystal clear: hypothesis generation ONLY).
"So don't pay attention to anything that has not been peer reviewed and even if it has, don't pay attention to those published in journals that have lost their standards of excellence for publication, that is, if there are any left. My humble suggestion is for docs here at Substack to start a list of journals that publish an unacceptable amount of rubbish."
-- This will only bolster the disgusting elitism that is prevalent in scientific publications.
Maybe, maybe not. So what should we do? Just give up on journals and science altogether? I'm all ears to hear your solution.
I am certain that your "solution" will help propagate the elitism in scientific research further. It is not a "maybe, maybe not" for me.
Many journals, even the ones that you might consider as "elite", does not have blinded peer-review. Even those who claim to have double-blinded peer-review, it is not completely effective as at least the editor will remain unblinded. The system has to change although I understand it is probably never going to happen. Even the critique of an already peer-reviewed and published article will suffer from this bias. The least we could do is to stop propagating ideas like yours that will only increase the elitism bias. We need to critique articles on a case-to-case basis regardless of the journal or the author names/affiliations. I understand that 100% objectivity is not attainable. More objectivity and less subjectivity - this is what we need.
Summary of mainstream medical ideologies: STFU and take your pills.
If this was such a problem, we have a huge study group: 1.9 BILLION Muslims during Ramadan. Anyone who buys this result lacks basic observational skills. Again, the medical 'establishment' (whatever cultural power structure that allows something like this to get so much hype) is asking people to throw out their own direct experience and common sense, over and over again. Things like these aren't just "click bait" -- they're a political, ideological weapon meant to keep people in line.
And with a fucking poster? How desperate are these ideologues?
You had me until you said the article was an example of an "ideological weapon meant to keep people in line." Do you honestly think some "deep state" or Big Pharma or "medical establishment" or whatever Bogeyman you fear most is trying to get you to eat more often? How is that going to "keep people in line?" What do you even mean by that? Logical/Analytical critiques: helpful; Paranoia: not helpful. BTW, poster sessions have been in use as a means of presenting information at scientific conferences since the 1960's, and they are not usually the sole means of presenting the information but are adjuncts to less formal oral presentations (link below).
https://fourwaves.com/blog/poster-session-explained/
https://fourwaves.com/blog/poster-session-explained/
CIA Director William Casey, 1981: "We'll know our disinformation program is complete when everything the American public believes is false"?
I agree that Mr. Casey was a scary dude! (see p. 8 below). As the author, John Kelly, points out, specific misinformation campaigns serve different purposes. These purposes are political in nature, and meant to maintain power by the promoter of the disinformation. I am perplexed how a flawed study on time-restricted eating or others like it would serve as a useful tool of disinformation for politicians who seek to maintain power. It's amazing to me how even matters of health are now totally polarized along political lines. I understand being skeptical of those who can make money off of certain viewpoints, but time restricted eating just doesn't seem like a huge money maker to me.
https://www.cia.gov/readingroom/docs/CIA-RDP90-00845R000100130006-7.pdf
Including a link to the poster or abstract would be helpful. Your comments appreciated but a little snarky towards the Big People!
I usually like to read the original, as you suggest, but between this article and Attia's, I had enough of the details to know it was garbage. I plead guilty to sometimes being snarky (I'm working on it!) but in this case, I don't see it. Mandrola was the one who used the term "Top People" and I was just responding to that using his words because I really didn't know if he considered Attia as one of those or not. (The term seemed to be used in a derogatory way by Mandrola, and the folks here at Sensible Medicine do not seem to be fans of Attia). Anyway, sorry if it was offensive; it wasn't meant to be.
I like snarky! No apology needed 🤣 Love Attia but hate him as well… Snarky comes up a lot with him, both by him and me towards him…
Good to know! 😜
I didn't use any of those words, and saying "whatever Bogeyman you fear most is trying to get you to eat more often?" is a bad faith characterization, so basically: fuck you. You and your people are so horny to get on anyone or anything that can be characterized as a "conspiracy theory", you miss the point of what people are saying.
Your critique of me is entirely an embodiment of your own inner dialog. You don't need any "deep state" explanations to see the obvious. I have dozens of posters, I know what a poster is. Publishing a news article based on a poster is deeply irresponsible.
Don't school me on what is "helpful" or not. If you don't understand how these issues are essentially part of a big advertising-propaganda complex, you need some basic history lessons.
I get your frustration with much of modern medicine, but let's not forget it's a systems problem, and it appears most medical providers are equally frustrated with it. As for what you said, the words you used that I was responding to were these words (I'll include the entire sentence this time): "Things like these aren't just 'click bait' -- they're a political, ideological weapon meant to keep people in line." If you want to explain more specifically what you meant by that, I'm all ears. I simply don't see how such a silly article as this could ever serve as a "political, ideological weapon" that will "keep people in line." I agree with you that publishing a news article about a non-peer reviewed poster, especially one as deeply flawed as this, is very irresponsible of the publisher.
Although Churnalism is quite maddening, unfortunately CRITICAL Churnalism will not help. My impression is that the vast majority of news consumers don't get past the first few lines of a medical news story. So if the headline is "New study suggests sleep causes cancer", most readers will not get to the critique part of the article. And if they do, it is likely only to increase their mistrust of medical research. We cannot expect news outlets to filter out this stuff...they are basically profit centers. So it is up to Academia and Journals to keep this stuff from being presented at meetings and published in the first place. Otherwise, "peer review" is a sham.
Nutritional science is less scientific than political science.
As a health journalist, I deeply appreciate the free education I've gotten on evaluating studies here on Sensible Medicine, though the little I've learned has made it clear how much more I still have to understand. Would you, Dr. Mandrola, or some of your Sensible Medicine colleagues ever consider offering a webinar or short e-course for health journalists (or whoever is interested) on this topic? I'd gladly pony up for such a thing.
It was statistically flawed. Only 400 odd people out of the 20,000 odd fell in the less than 8 hour feeding window. Hence the 91% assumption was based on 2% of the study population, compared to the 98%. Most people who commented never did read the poster.
Good Business doesn't necessarily equate to Good Medicine.
Thanks for this! It's so true that the bad studies tend to get a pass when prominent people in public health like the result. The good news is that this time, the press got out in front of the clickbait. The first time I heard of this study was in an alert from STATnews, flagging a story debunking it. Then I saw it dissected in the always excellent Unsettled Science substack.
Top people? LMAO. Most studies of this kind and most drug studies are highly flawed and always geared toward some ulterior motive, not towards proving honest and sincere truth and facts. I will never blindly trust the "top people" anywhere. Nor most medical studies.
A similar criticism can be made for a recent meta-analysis that found more than one hour a week of resistance training to be correlated with worse overall mortality.
Again, longitudinal studies mostly based on self-reporting that didn't take into account possible confounding factors, not even the use of performance enhancing drugs. That was enough for me to dismiss the whole thing.
Not hard to imagine I'm one of those people who train a lot. 😂