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Epidemiology, Rest in Peace

In the Beginning

Almost two hundred years ago, the methodology for investigating the occurrence and movement of infectious diseases in populations was born. It happened in London during the cholera epidemic of 1836 with the work of the English physician John Snow (1, p.246).   It was an era in which epidemics of infectious diseases caused by yet unidentified “things” were decimating populations throughout Europe.

Dr. Snow studied the eating and living habits of patients who had cholera and neighboring townspeople who did not have cholera for the purpose of identifying the similarities and differences between the groups. It is noteworthy that Dr. Snow examined people who did not get cholera as well as those who did. As a result of the current disregard in medical research of this practice of looking at both sick and non-sick people, important lessons available from subjects who are resistant to disease remain unrecognized.

Dr. Snow ultimately found a strong association between cases of cholera and a public well into which sewage was found to be draining. Dr. Snow requested that the pump handle of the offending well be removed. The immediate cessation of new cases of cholera was his proof that sewage-contaminated water was a cause of cholera.

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Epidemiology: Misunderstood? Misused?

The plethora of The-Only-Diet Book-You-Will-Ever-Need publications widely available in sales outlets, each with its own version of the “correct” nutritional philosophy, is testimony to the confusion suffered by the general public. The reason is elegantly described by Taubes:

…600,000 articles – along with several tens of thousands of diet books are the noise generated by a dysfunctional research establishment. Because the nutrition research community has failed to establish reliable, unambiguous knowledge about the environmental triggers of obesity and diabetes, it has opened the door to a diversity of opinions on the subject, of hypotheses about cause, cure and prevention, many of which cannot be refuted by the existing evidence.

This indictment is harsh, but deserved. Witness to the fact is the massive human feeding experiment foisted on the American public decades ago. It has caused untold suffering and needless deaths from the chronic inflammatory diseases it created. This nutritional debacle was chronicled by Garry Taubes a decade ago and updated more recently by Nina Teicholz.

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The New Epidemiology

Since shortly after World War II, when Ancel Keys and wife Margaret concluded that diets high in animal fat were the cause of cardiovascular diseases, an inestimable number of large, long-term studies have been conducted worldwide to look for proof of a causal relationship between the two. Despite a tremendous expenditure of time and money, all studies have failed to give an answer to the question of whether animal fats (primarily from red meat) and cholesterol cause cardiovascular disease. This failure is blamed on the inadequacies of epidemiology rather than the difficulties of proving a negative. When properly conducted, epidemiology has no inadequacies. Any failure of epidemiology is that of modern epidemiologists who equate association with cause.
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