Medical Controversy: When is a Controversy Over?

Quick... what change of diet is the best way to reduce your blood pressure? What has been shown to cause headaches and other problems and should be removed from processed foods? What common seasoning is bad for you?

Did all your answers involve salt? Simple ordinary table salt? It's common knowledge that salt isn't good for us. Since it's common knowledge it must be true right?

Right?

What if the science isn't so clear cut? What happens when the vast research includes studies and calculations that support both sides? What happens when researchers want to find out more about the risks and the benefits while anxious public health officials want to make decisions right now?

In 1999 Gary Taubes won a Science in Society Journalism Award from the National Association of Science Writers for his article The (Political) Science of Salt.

Maybe the link between salt and hypertension isn't as strong as we think. Maybe, as the article states over a decade ago, as research continues the benefits of salt reduction are seen to be smaller and smaller. This is a good example of how complicated issues are and how difficult it is to even agree which studies are good and useful and which aren't. To quote the article:

One-sided interpretations of the data have always been endemic to the controversy. As early as 1979, for instance, Olaf Simpson, a clinician at New Zealand’s University of Otago Medical School, described it as "a situation where the most slender piece of evidence in favor of [a salt-blood pressure link] is welcomed as further proof of the link, while failure to find such evidence is explained away by one means or another." University of Glasgow clinician Graham Watt calls it the "Bing Crosby approach to epidemiological reasoning" — in other words, "accentuate the positive, eliminate the negative." Bing Crosby epidemiology allows researchers to find the effect they’re looking for in a swamp of contradictory data but does little to establish whether it is real.

Even if the studies and the data have become clearer in the last decade there are important underlying questions brought to light in the article.

• What happens when one piece of the puzzle (let's say salt) is only part of a much more complicated mechanism (for instance how the body maintains blood pressure)? Maybe it isn't always possible to reach simple conclusions in all cases.
• Who gets to decide which studies are good and which are bad? The concept "it doesn't support my view so it must be wrong" works to explain every point of view.
• When should incomplete or unfinished science be used to form public policy? Should public health officials change official policy after each new discovery or wait for long term results? What happens when science gets applied to whole populations of people?
• Who can act as arbiter and interpreter in the middle of scientific controversies? Who can explain what is going on to the rest of us? I don't want to hear from someone who's attached to one side of each controversy.
• If enough people think that reducing salt reduces blood pressure then is the controversy over before the science has been made clear? Could we end up with a massive public re-education campaign explaining that salt reduction isn't necessarily good in some cases?

I could go on. It's a fascinating read and well worth your time. Gary Taubes' article gives some insight into the human nature of science. All while still leaving me unsure whether I'm allowed to add salt to my food.

Time for Another Scene

I've written about the birth of punk and the birth of jazz. Both represent music I understand and enjoy. I will admit that I enjoy jazz more than punk but I do listen to both. There are a number of genres I'm not so enamoured with. I never did get caught up in House music for instance.

Even so I find it fascinating to read a detailed history of how a single model of synthesizer had such a profound affect on House and Acid House. Don't believe me? Just read The Silver Dream Machine: The synthesizer that accidentally changed the world.

Counterintuitive Thinking at Its Best - Traffic

How would you control traffic and drivers? How would you make roads safer? How would you lower the number of accidents and control speeding? How would you make drivers act like responsible adults instead of selfish children?

If you ignore the last question the answer would seem to be: more signs, more intersections, more speed bumps, and more ways to restrict and control traffic. All that seems the right thing to do. Treat drivers like moronic children who don't know what to do and force them to follow the rules.

What if the answer is completely the opposite. What if fewer signs are used? What if roads are changed to alter behaviour? What if we treat drivers like responsible adults?

The Traffic Guru gives an overview of the ideas of Hans Monderman. He thought that the best way to influence traffic was not to try and impose crushing control. Quite the opposite. I have no idea if we'll ever get ideas like those put in place on a large scale but it would be an interesting experiment.

Who knows, it's so crazy it just might work.

Medical Controversy: Cigarettes and Cancer

So now it's no longer controversial - smoking is closely linked to cancer. Not every smoker will get lung cancer but their chances are much higher than they are for non-smokers. And it's easy to tell why smoking is bad for you right? All those chemicals, all that tar, and the noxious fumes and gases right?

The question of the day sounds simple. How does smoking cigarettes cause cancer?

Well one theory making the rounds is that it's because of radioactivity. You heard me right - radioactivity in cigarettes. The non-scientific group that seems to push this theory the most is the pro-cannabis lobby. They like to show that smoking cannabis is less dangerous than smoking cigarettes. Any time there is a theory that shows that smoking tobacco is bad for you in a way that smoking cannabis may not be they jump on it.

Sol Lightman, in UMASS CANNABIS wrote how the hidden danger in cigarettes is radioactive material in cigarettes. The article pushes the idea that most cancers due to smoking are caused by radioactivity.

This view is disputed. Certainly the number of chemical carcinogens seems to make it hard to reach a hypothesis that only the radioactivity is bad for you. I don't think many researchers in the field would say that smoking would be safe if you could remove the radioactive compounds.

Still... did you even know there are radioactive compounds in cigarettes?

Radioactivity is a scary word for many people. Which is odd since we live in a radioactive world. Not just since the atomic age opened. Our world is slightly radioactive. It's all around us. In fact there may be more of it around you than you ever thought.

Obvious Sources (Canadian Edition): The National Film Board

Today is Canada day. July 1st 1867 the British North America act was enacted and Canada was created. So to celebrate, and realizing it's a holiday and no one wants to work too hard, here's a bit of Canadian history as presented by the National Film Board of Canada.

• The Romance of Transportation in Canada
• The Voyageurs
• The Fate of America (The title refers to French North America becoming British North America. Not to the United States of America.)

The Fate of America is an amazing documentary to watch. For two reasons. First, about an hour in Laurier LaPierre will give you an interpretation of the battle of Abraham which will change the way you look at Canadian history. Secondly I don't think any documentary has had me laughing out loud for a long time. The last 20 minutes or so are not to be missed.

The NFB is a national treasure. It has an interesting history in its own right. So many of it's most famous films are on the website and freely available to watch that you could get lost for hours. If you are Canadian you'll find every favourite you remember. And no matter what your background this is an invaluable collection of films.

On the more personal side I reminisced by watching "I don't know. Looks pretty tricky" aka Path of the Paddle: Doubles Whitewater. 

Happy Canada Day!