Well, it’s official. We are in the age of cutting-edge medicine. We have now discovered that nuts, seeds, and popcorn do not cause diverticulitis, or cause it to flare. Shout it from the rooftops! In fact, it has an inverse relationship with diverticulitis meaning, the more you eat, the fewer issues you will have with this painful and sometimes life-threatening infection of your colon. Cutting edge stuff right? This study was published 10 years ago, so why are we still telling people to avoid these foods?
Like so many things in medicine, it doesn’t have to be right, but rather it should be what everybody else is saying. Standard of care, often means doing what our peers are doing. This means we do not have to be right, but legally we are covered if we fall in line and do what everybody else is doing.
What else is the literature telling us that is against the common wisdom, but we continue to propagate because that is what we were taught or was considered conventional wisdom? One of my favorite studies showed that women who drank 2 glasses of milk a day, had a 47% increased risk of fracture! That’s right. In 1997 they did this study at Harvard (I hear they have a reputation for academic excellence.) In other words, perhaps Harvard words: “The more milk one drinks, the higher one’s inflammatory markers”, and that is what drives osteoporosis. We have known this for over 20 years, yet I continue to hear the “wisdom” of milk and bone strength touted.
My final example of false advertising centers on hormone replacement therapy, especially bio-identical estrogen for women. This hormone has been vilified with no proof that it actually causes cancer. In fact, 35 years ago it was used to treat breast cancer with good results. The data from the WHI study, which vilified estrogen and progesterone, 10 years later re-examined the data and saw that Premarin, oral pills made of horse urine, actually prevented the incidence of breast cancer! This is a non-bio-identical, by mouth (Makes more metabolites that are not good for us) and from another species and it still beat out not taking it for breast cancer prevention. The problem, it seems, was the constant dosing of non-bioidentical (man invented, progestin(not bioidentical progesterone-big difference). I have yet to find a smoking gun study connecting bio-identical hormones (much better than horse urine estrogen) with breast cancer. Without estrogen, women become insulin resistant (estrogen helps prevent blood sugar elevation) so there is much more likely a connection with menopause, lack of estrogen, more insulin resistance and increased incidence of breast cancer. There are whole books written on this connection. I have just such a book of all the studies that support the estrogen/breast cancer prevention connection.
I am not sure why we, as a medical community, hold up the need for peer-reviewed published literature for medical decision making, and then ignore it. This is baffling to me, but I think Dr. Google (Google Scholar is a great resource for medical studies) and Pubmed can change a lot as patients become empowered and start looking up their own answers from reliable resources.
Common wisdom is not always so wise, it seems…
Dr. Morris, MD