Reversals of Fortune

From Menletter May 2005

By Tim Baehr

It seems that much of our lives are spent reacting to things - often things that are in the popular culture. And those things tend to reverse themselves periodically.

Hormone replacement therapy for menopausal women? Good. No, bad. No, maybe good for some.

Universal prostate cancer screening for men over 50? Good. No, bad. No, probably good for most.

Vitamin E for heart disease prevention? Good. No, bad.

Cox-2 inhibitors like Vioxx and Celebrex? Good. No, bad.

Massive hydration for athletes? Good. No, bad.

Margarine as a butter substitute? Good. No, bad.

High-fat diets? Bad. No, good. No, bad.

Low-fat diets? Good. No, bad. No, good, sorta.

Body mass index (BMI)? 25 or under, or you're fat. No, a few extra pounds and you live longer. Yeah, but you could be sick during those extra years.

Preemptive war-making? Bad. Still bad, no matter what popular culture says. Just making sure you're paying attention.

Feminism? Bad. No, good. Well, sometimes toxic.

Women's place in business? Bad. No, good.

Men's place in the universe? Good. No, bad. Well, maybe a mixed review.

And these are just a few examples. What's a poor person to do? Scientific and social certainties seem to go in and out of fashion like bell-bottom pants and wide ties. And we run the danger of living lives in fearful reaction to the latest reversal in trends. It seems as though we're caught in an ever-changing tapestry of life, woven one day and ripped out the next by a sadistic weaver.

Let's try to tease apart just a few of the threads in the tapestry.

Research showed that Vitamin E, a powerful anti-oxidant, should be helpful in preventing heart disease. Than another study showed that people taking over 400 IU of E every day had a statistically higher chance of dying from - you guessed it - heart disease. But consider this: the death rate did not plummet or rise in dramatic numbers when people started scarfing down Vitamin E. If that had been the case, public reaction would have been equally dramatic. No, it took relatively sophisticated research to figure out. In other words, the numerical trends were pretty subtle. Yes, we should probably stop taking extra Vitamin E. But we're not all doomed if we were taking it.

Margarine was assumed for many years to be safer than butter in not promoting rises in cholesterol. Funny thing, though: To make margarine hard enough to act like butter, manufacturers had to pump hydrogen through it. That created trans-fats, and the trans-fats in margarine are worse than the saturated fats in butter. Once we were afraid of butter. Now we can be afraid of margarine, too. Or maybe we just eat butter (it does taste better), but in moderation. And use more olive oil or canola oil (mono-unsaturated and not bad in the cholesterol department), but also in moderation.

Dieting of all kinds: probably bad. For years, diets have made many of us miserably unhappy and afraid of what we put into our mouths. We might be prolonging our lives a bit, but at what cost? And serial dieting and weight gain (often called yo-yo dieting) can be quite bad for our health. Frankly, I'd rather not be afraid of my food (I'm a Weight Watchers alum, by the way) or guilty about every other spoonful. I'm still working on trying to figure out a plan of moderation in what I eat, but I'm done counting things and turning my food into a chemistry experiment.

The reversals about what is good about men and women seem to have a longer cycle. What I find interesting about the latest installment is that both sides seem to think that the advantage is on the other side, and each side has its own cadre of experts and statistics to back it up. Wage discrepancy? As bad as ever. No, a fiction created with cooked data. Domestic violence? Yes, still bad, and women are the only victims. No, wait - violence of women against men is way under-reported. Etcetera, ad nauseam.

All these things - food, drugs, health, social issues - are researched and commented on, often by "experts" with impressive degrees and piles of data. And then reversed. And then often reversed again.

How do we respond to all this?

I think in many cases we know what's good for us, but we have handed over the power to the "experts." Maybe all we need is to make some simple observations, apply a little common sense, and relegate many of the expert opinions to the background.

Here's my (definitely non-expert) take on some of the issues.

Don't overdo. Use moderation. The 400 IU of Vitamin E I took for several years did not do me any harm. More, like 1200 IU, might have. Also, I didn't have a heart condition to begin with (the problem with overdosing was with people who had heart trouble already). Red meat or butter is bad if you eat lots of it every day. Same with sweets and oils and salt.

Eat the real thing, not Frankenfoods. The more processing, the more likely the food contains noxious stuff not meant for humans. For prepared foods (even bread), read the ingredients. Generally, the shorter the list, the better. Save the really evil stuff for occasional treats. But don't get obsessive - we can make ourselves sick with worry, too. (This just in: a study has shown [yeah, I know . . . ] that not all low-fat diets are equal. A low-fat diet with lots of fruit and veggies lowers LDL cholesterol more than a low-fat diet based on processed foods. In both cases, the test subjects ate the same number of calories and had the same amount of exercise. Yes, it may be yet another study, but it does pass the "real thing" test.)

Don't be seduced by the new. Wait. Unless you have a compelling reason to switch, don't try that new pill or potion; keep eating that food newly designated as "bad". If you're taking a medication that works, stick with it. Producers of foods and drugs (as with many other products) are under constant pressure to make more money. One way to do this is to introduce new products at higher prices and profits.

Forget the orthodox cants and rants. All women are this? All men are that? All anybodies are those? You are an unworthy person unless you believe in this or that? We don't need to adopt a moral or ethical relativism in which nothing is ever right or wrong. But I think we owe it to ourselves to make our own observations. Having convictions and acting on them is not a bad thing. But it's a good idea to ponder from time to time where those convictions have come from and test them for reasonableness.

When we get new information from the experts, it seems we have three possible reactions: nervously change our behavior based on the new information, nervously ignore the new information, or just get nervous and depressed that it's all so confusing. Here's a fourth option: instead of reacting, we can in many cases apply a reasonableness test, gather some corroborating or contradicting information, use some common sense, and then make up our minds.

But don't take my word for it - I'm no expert.