The People's Perspective on Medicine

Show 1141: Which Health Risks Should You Worry About?

Common sense and paying attention to the way studies are conducted and interpreted can tell you which health risks are a real menace. Listen on November 3, 2018
Dr. Aaron Carroll, author of The Bad Food Bible: How and Why to Eat Sinfully
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Which Health Risks Should You Worry About?

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Do you enjoy a glass of wine from time to time? If so, were you alarmed to read headlines last fall announcing that ANY amount of alcohol is problematic? Here’s how those headlines came about. The researchers wrote in The Lancet (Sept. 22, 2018), in their interpretation of their meta-analysis of the health risks, world-wide, of alcohol consumption:

“the level of consumption that minimises health loss is zero.”

How Do You Evaluate Health Risks?

Obviously, people who consume excessive amounts of alcohol are putting their health at risk. But maybe those who drink only occasionally don’t need to freak out. Dr. Aaron Carroll, pediatrician and research mentor, explains just why. You can read his article in The New York Times Upshot, but you should also listen to our interview. In it, he explains the basic statistics you need in order to understand this and similar research and make choices about which health risks you should worry about.

Part of the problem is due to the study methodology. Observational studies may find associations that don’t have a causal connection. But part of the problem may also be due to how studies are presented in the media. Exciting findings make good headlines. Negative results may be good science, but they don’t attract attention.

Nutritional studies have been especially prone to flip-flops. One month you may read that coffee is bad for your heart; the next month you might read that it will protect you from heart failure and help you live longer. At one time, Americans were advised to avoid eggs if they wanted to be healthy, but more recent data have exonerated eggs, even for people with diabetes.

How Does the Cookie Crumble? Studying Nutritional Health Risks:

Dr. Carroll has pointed out the weaknesses of research design in a study that claimed kids eat more fruit if the apples are decorated with cartoon characters. Why was this study retracted? And how, really, can you get kids to make healthier food choices?

How Safe and Effective Are Medications?

All drugs are supposed to be safe and effective, but how exactly do we define safe and effective? Research design also has an impact on the medications that FDA approves for use, such as antidepressants. What do you need to know about the benefits and harms of the drugs you take? How can you figure out if an article is describing absolute risk or relative risk–and relative to what? This is crucial in evaluating which health risks you should worry about.

Why Unlearning Is a Problem:

You can teach old dogs new tricks; the trouble is in teaching them to give up their previous tricks. The same is true for all of us, including doctors. As a result, the doctor may recommend a treatment that is no longer state-of-the-art. It may even have been shown to be inappropriate in most cases. However, if ear tubes, for example, are what a pediatrician has been recommending for decades, he or she may continue to recommend them. How does this impact you and your children?

This Week’s Guest:

Dr. Aaron Carroll is a Professor of Pediatrics and Associate Dean for Research Mentoring at Indiana University’s School of Medicine, and Director of the Center for Pediatric and Adolescent Comparative Effectiveness Research. His research focuses on the study of information technology to improve pediatric care, health care policy, and health care reform. In addition to his scholarly activities, he has written about health, research, and policy for CNN, Bloomberg News, the JAMA Forum, and the Wall Street Journal.

He has co-authored three popular books debunking medical myths, has a popular YouTube show called Healthcare Triage, and is a regular contributor to the New York Times’ The Upshot. Dr. Carroll’s most recent book is The Bad Food Bible: How and Why to Eat Sinfully. The photograph of Dr. Carroll is copyrighted by Marina Waters.

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    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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    Does anyone have an opinion on Arthrozene ?
    It is advertised along side your site.

    I listened to this show. I do not agree with the good doctor’s claim that eating 3 slices of bacon every day has tiny effect on health, which is offset by the pleasure of eating it. Even a one-tenth percent absolute reduction in cancer cases (1 person in a thousand) at the population level is a large number of people and a large societal cost. On the personal level, I prefer to avoid foods that merely taste good that contribute to cancer, which is a consequential outcome, which could impact my quality and duration of life. There are plenty of nutritious foods that taste good. I do not feel deprived.

    Observational studies have real problems but can sometimes be definitive. When only a few hundred people had been on Redux during clinical trials but represented almost half of reports of “Primary” Pulmonary Hypertension – we should have taken notice. When Diet Coke was introduced, and cans were exploding if stored warm, we should have asked what chemical reaction was taking place. When nutrition experts don’t prominently discuss the role of frankenfats and plastics in the insulin resistance crisis, we should look into how their institution is funded. Would make a good study.

    I feel sorry for the medical profession trying to treat all of these overweight people. So many of their problems would disappear if they would only lose weight. Our nation has a health crisis.

    I always cringe when someone talks about “all those overweight people” and how much better everyone would be if only they would lose weight. Doctors themselves really don’t know that much about nutrition, they push pills and surgeries and most times don’t know how to help. It’s a lot more than pushing yourself away from the table. I say if you haven’t ever had a weight problem or walked in “their” shoes it’s best not to judge.

    I am so sick of those studies that blare: “X” is shown to have no benefits for the heart! (or for cancer! etc. etc.) Makes it sound like “X” is worthless — when in fact, “X” may absolutely contribute in many small, subtle ways to general holistic resiliency, power and longevity. It’s just that “general holistic resiliency” is very hard to study. Too many variables, and too hard to keep the study controlled. So they just pick heart attack or cancer statistics and link “x” to that. This is fine, but it’s misleading!!! It takes a lot of reading and observing to get to the real truth of the matter and place things in the correct context.

    83 year old aunt recently hospitalized, it was discovered she was on 23 prescription drugs, including a fentanyl patch. She was so weak that she could not lift her hand to her mouth. She had always been very active in gardening, taking care of her home, walking, and so forth. Taken off the drugs, she is slowly recovering. When I questioned her about the drugs, she said she went to the doctors, and they prescribed them. She thought they knew what they were doing! All of her prescriptions were filled by one pharmacy. How does this happen? I know some of the drugs have awful side effects : PPI, 3 ACi, Statin etc. She has heart failure, bone loss, cough, pulminary hypertension.

    I’ve taken statins for 10+ years. I’ve been reading that there is a risk taking them. Because of this and muscle cramps, I quit the statins. My parents never took them and died with unrelated illness. They both had strong hearts. I take natural supplements that are supposed to help with cholesterol. Am I ok with doing this?

    * Be nice, and don't over share. View comment policy^