I continue to read your posts because I'm hoping they will sharpen my own critical thinking about health research. However, especially in light of some of the comments from other readers, I'm becoming concerned that your writing is also contributing to a kind of nihilism regarding health and medical research. That would not be good. Every teacher knows that they must offer examples of good work as well as bad. Are you going to give us some examples of solid research that have contributed to the prevention or treatment of disease (or solid journalism reporting on health research, good or bad)?
Best comment, from Alicia Ceccarelli: "Ok so let’s see who the researchers are connected to…and where their funding comes from….
It’s getting very difficult to trust science at all, since as you both point out, it can be manipulated any way it needs to be based on the goal of the researchers."
This is very instructive. For the record, I know of not so well off truck drivers who have enjoyed playing tennis (indoors) for years. I played tennis at a nearby high school after hours. There are even tennis courts in the small park in my small town. Further, tennis works your upper and lower body, takes concentration, some quick running...Maybe there is something to tennis...But I get the point.
Diversification is widely viewed as one of the very few free lunches out there.
This article misses that the public, and the authors, may benefit from diversifying their exercise mix to include a combination of cardio/endurance activities and strength training. The latter will help with bone density, injury prevention associated with e.g. running, and so on.
My rule of thumb for exercise: If you're going to exercise, go with whatever activity you actually enjoy doing, and have fun with it. The satisfaction and pleasure you derive - I think that's what gives longevity. My spouse's grandfather, for example, did nothing but sit and watch the world go by while enjoying the company of others who did the same. This was his 'exercise' from the time he retired at 65 to the time he died in his mid-90s.
Aug 30, 2022·edited Aug 30, 2022Liked by Adam Cifu, MD
Much grief and wasted expense could be avoided by simply understanding the basics of experimental design and critically, the problems with being able to conclude that the differences observed between 2+ groups (to which individuals were NOT randomly assigned) are due to treatment X. I doubt that one in 1000 journalism majors took (& passed with a "B" or better) any statistics class that included hypothesis testing.
I certainly did not meet any in that statistics classes I took.
This includes a lot of the important ingredients for a great article: tennis, exercise, stats, medicine, with a little depression thrown in for good measure. Thanks for writing it!
Small correction: "...we, both upper middle-class doctors who love tennis, do not get to play more than a few times a year..." You both choose to not play more than a few times a year.
Perhaps exercise and metabolic syndrome are somehow linked? How could you show causation?
Does diet play a part? Do glyphosates in food or subclinical micronutrient deficiencies reduce energy for exercise? Maybe there is some linkage to industrialized agricultural methods to reduce time to harvest, which might result in micronutrient deficiencies. Maybe GMO foods play a part.
Is there linkage when family gardening has a major impact on a family's diet? Maybe some fasting improves health leading to more activity--especially if autophagy results.
And what about vitamin D insufficiency or deficiency? Does this play a role in available energy? Or perhaps musculo-skeletal pain increases with osteoporosis due to vitamin D deficiency, resulting in less activity?
Thank you for this article. I’m currently searching for literature that will safeguard me as (a clinical trial journalist) from writing an article that leaves out an important element.
I do always reach out to experts to gain their insight but don’t always get a response. Yet the story must eventually get published, and I have to do my best to present the results of the trial as fairly and as transparently as possible.
When the trials are politically motivated, that makes things even more difficult. For instance, COVID-related trials that say the vaccinated or the boosted “had more antibodies than unvaccinated.” Okay, but was that just SPIKE PROTEIN antibodies or all immune antibodies? And was it an intentional move to write that vaguely or research that incompletely?
Another ex: Conducting a trial to disprove an early treatment medication and giving it too late from onset of infection or too little.
Ok so let’s see who the researchers are connected to…and where their funding comes from….
It’s getting very difficult to trust science at all, since as you both point out, it can be manipulated any way it needs to be based on the goal of the researchers.
Doctors tell people, “eat less, move more” but like social distancing and mask wearing, it is a concept that lacks any real basis, and is probably the opposite of what people should do.
I don’t agree with you at all that there is any real evidence that structured exercise is beneficial to lifespan.
The problem is the types of studies that say exercise lengthens life — they have too many confounders.
Healthy people are active people,. That’s about all you can really say.
That doesn’t mean that unhealthy people will become healthy when they exercise. Quite the opposite in fact. Unhealthy people who exercise are less healthy than they were before.
Most people today as they age are better off not pushing themselves in exercise at all. They should walk and be active — that’s about all you can say.
Because unhealthy people — including most middle aged and older people who exercise — have high stress hormones and low thyroid function.
They spill free fatty acids into their bloodstream that damage their delicate cells. These fats contain high PUFA content, a source of systemic inflammation.
Their high cortisol eats their lean mass and brain mass and thymus mass. Exercise makes it worse, not better.
Nobody ever wants to hear this.
There is such a strong “no pain no gain” belief that is utterly and completely false.
Sadly, you miss the mark here, as you did in your last “churnalism” article, due to your own prejudices, making you Exhibit A in the exercise churnalism exhibition…except at least you are bringing up the subject!
I continue to read your posts because I'm hoping they will sharpen my own critical thinking about health research. However, especially in light of some of the comments from other readers, I'm becoming concerned that your writing is also contributing to a kind of nihilism regarding health and medical research. That would not be good. Every teacher knows that they must offer examples of good work as well as bad. Are you going to give us some examples of solid research that have contributed to the prevention or treatment of disease (or solid journalism reporting on health research, good or bad)?
Love the article and the comments about it. I am not alone in this.
I really like the information you share to us
Best comment, from Alicia Ceccarelli: "Ok so let’s see who the researchers are connected to…and where their funding comes from….
It’s getting very difficult to trust science at all, since as you both point out, it can be manipulated any way it needs to be based on the goal of the researchers."
Chill... it's health, not medicine!
This is very instructive. For the record, I know of not so well off truck drivers who have enjoyed playing tennis (indoors) for years. I played tennis at a nearby high school after hours. There are even tennis courts in the small park in my small town. Further, tennis works your upper and lower body, takes concentration, some quick running...Maybe there is something to tennis...But I get the point.
Great points, big problem, not just in journalism but the constant onslaught of social media and advertising "information." Prevagen anyone?
Like Vinay, I'm a dedicated cyclist, definitely lifts my spirits except when I crash. Pretty sure that's generalizable data.
I just included your Nutrition churnalism PT. 2 article in a course discussion for my nursing students. I look forward to their responses.
Diversification is widely viewed as one of the very few free lunches out there.
This article misses that the public, and the authors, may benefit from diversifying their exercise mix to include a combination of cardio/endurance activities and strength training. The latter will help with bone density, injury prevention associated with e.g. running, and so on.
My rule of thumb for exercise: If you're going to exercise, go with whatever activity you actually enjoy doing, and have fun with it. The satisfaction and pleasure you derive - I think that's what gives longevity. My spouse's grandfather, for example, did nothing but sit and watch the world go by while enjoying the company of others who did the same. This was his 'exercise' from the time he retired at 65 to the time he died in his mid-90s.
Much grief and wasted expense could be avoided by simply understanding the basics of experimental design and critically, the problems with being able to conclude that the differences observed between 2+ groups (to which individuals were NOT randomly assigned) are due to treatment X. I doubt that one in 1000 journalism majors took (& passed with a "B" or better) any statistics class that included hypothesis testing.
I certainly did not meet any in that statistics classes I took.
This includes a lot of the important ingredients for a great article: tennis, exercise, stats, medicine, with a little depression thrown in for good measure. Thanks for writing it!
Small correction: "...we, both upper middle-class doctors who love tennis, do not get to play more than a few times a year..." You both choose to not play more than a few times a year.
Perhaps exercise and metabolic syndrome are somehow linked? How could you show causation?
Does diet play a part? Do glyphosates in food or subclinical micronutrient deficiencies reduce energy for exercise? Maybe there is some linkage to industrialized agricultural methods to reduce time to harvest, which might result in micronutrient deficiencies. Maybe GMO foods play a part.
Is there linkage when family gardening has a major impact on a family's diet? Maybe some fasting improves health leading to more activity--especially if autophagy results.
And what about vitamin D insufficiency or deficiency? Does this play a role in available energy? Or perhaps musculo-skeletal pain increases with osteoporosis due to vitamin D deficiency, resulting in less activity?
Hypotheses. I got a million of 'em.
Thank you for this article. I’m currently searching for literature that will safeguard me as (a clinical trial journalist) from writing an article that leaves out an important element.
I do always reach out to experts to gain their insight but don’t always get a response. Yet the story must eventually get published, and I have to do my best to present the results of the trial as fairly and as transparently as possible.
When the trials are politically motivated, that makes things even more difficult. For instance, COVID-related trials that say the vaccinated or the boosted “had more antibodies than unvaccinated.” Okay, but was that just SPIKE PROTEIN antibodies or all immune antibodies? And was it an intentional move to write that vaguely or research that incompletely?
Another ex: Conducting a trial to disprove an early treatment medication and giving it too late from onset of infection or too little.
Ok so let’s see who the researchers are connected to…and where their funding comes from….
It’s getting very difficult to trust science at all, since as you both point out, it can be manipulated any way it needs to be based on the goal of the researchers.
I’m glad to see you are addressing this.
Doctors tell people, “eat less, move more” but like social distancing and mask wearing, it is a concept that lacks any real basis, and is probably the opposite of what people should do.
I don’t agree with you at all that there is any real evidence that structured exercise is beneficial to lifespan.
The problem is the types of studies that say exercise lengthens life — they have too many confounders.
Healthy people are active people,. That’s about all you can really say.
That doesn’t mean that unhealthy people will become healthy when they exercise. Quite the opposite in fact. Unhealthy people who exercise are less healthy than they were before.
Most people today as they age are better off not pushing themselves in exercise at all. They should walk and be active — that’s about all you can say.
Because unhealthy people — including most middle aged and older people who exercise — have high stress hormones and low thyroid function.
They spill free fatty acids into their bloodstream that damage their delicate cells. These fats contain high PUFA content, a source of systemic inflammation.
Their high cortisol eats their lean mass and brain mass and thymus mass. Exercise makes it worse, not better.
Nobody ever wants to hear this.
There is such a strong “no pain no gain” belief that is utterly and completely false.
Sadly, you miss the mark here, as you did in your last “churnalism” article, due to your own prejudices, making you Exhibit A in the exercise churnalism exhibition…except at least you are bringing up the subject!
The best exercise for longevity is the one that the person will do (n = 1; me).