Wednesday, May 11, 2011

Dr. Cinque's "Diet Doctor" Challenge

I've been enjoying Dr. Cinque's blog since I discovered it a few months ago. He's a tidy thinker, very dry. In his last post (A Tale Of Two Doctors), he contrasted Dr. Mehmet Oz, who he says is mostly vegan, with Dr. Michael Eades whose diet advice emphasizes meat and other animal foods. He wrapped up with a challenge:
"But, allow me to finish with a suggestion. All of these diet doctors- including McDougall, Barnard, and Esselstyn from the veggie side, and Eades, Cordain, and Mercola from the paleo side- they should all agree to undergo a carotid artery ultrasound at the same time so that we can find out the condition of their carotid arteries and compare. The test is harmless, and it’s not that expensive. And it tells a lot about a person's real internal health. The only caveat is that age is a factor as arteries tend to worsen with age. So, an adjustment would have to be made for that. However, some of the above-named doctors are close in age (60-ish), so a straight-up comparison would be fine. I am 60, so let me be the first to volunteer. I’ll do it; I’ll pay for it: and I’ll share the results with the world. Doctors, are you willing?"
Wouldn't I savor the results of that comparison. You could say it isn't valid, that n is too small, that their results are testimonials and not statistically relevant. Certainly every body is unique. I think you'd have to account for non-dietary factors like physical activity and environmental pollutants ... and age as Dr. Cinque pointed out.

There is something else ... the aspect of generalizability. That is, if you find that one diet is better than another, can you apply those results to a population that differs from your test population. In this case, can you apply that diet to a person who is not male, not (mostly) Caucasian, and who does not possess an income and support network which fosters the diet. I'm not poo-pooing the idea. I'm just thinking out loud. It would be a provocative little data point, one I would relish.
Photo from SFWeekly.


Bix said...

I don't know where the comments went. I think Blogger had a data corruption issue. I hope they reappear, I had a reply.

Binko said...

I've been paleo and I've been vegan. Vegan sometimes leaves me feeling deprived but paleo always ends up making me feel ill.

Paleo aristocrats like the wealthy Dr. Eades can afford to have special hogs raised on private farms and fed the choicest of natural feed.

But the average Joe who embraces the Paleo lifestyle will be buying packaged meat at the supermarket that has been gassed to stay red even when old and half putrid and is full of hormones, antibiotics and the residue of thousands of industrial chemicals from the nasty concoctions fed to feedlot animals.

This is something that is rarely discussed in Paleo circles.

Charles R. said...

That would only be interesting, but not very informative. Far too few data points.

If you did the same thing with a cross-section of their patients, that might tell you more. But it will still only tell you the kind of patients that seek them out, not the results of following their advice.

Bix said...

Binko is on to something. That is ... what foods do you actually eat in a particular diet? And how realistic is it for average people to eat those foods?

I think it's hard to eat lots of plant-based unprocessed foods. I spend a lot of time buying, cleaning, storing, preparing, cooking. And cost ... one big onion cost me $1.50 last week, 50% more than anything on McDonald's Dollar menu.

I also think it's hard to eat a lot of animal foods in a healthy way for the reasons Binko stated.

And there's the person-centered issue ... Does Dr. Eades advise eating meat 2 or 3 times a day if, say, you have colon cancer? Colon resection? Microalbumnuria or other kidney problem? I don't know, maybe he does. I think it's difficult to apply one diet to all conditions and all circumstances.

On the other side of the coin, telling someone with diabetes to eat a high-carb diet often translates into them eating a lot of refined breads, biscuits, cereals, chips, cheap oils, packaged and prepared foods, which, as I've seen, makes managing their blood glucose difficult.