RFK Jr’s ‘Maha’ report found to contain citations to nonexistent studies

[Hans Blaster]

If you recall, it wasn't the alternative medicine quacks who told people to replace their morning eggs & coffee with a bowl of refined grains & a side of toast with artificial trans-fat margarine spread all over it (washed down with a glass of orange juice).

Nor was it the alternative medicine people who pushed the misguided war on salt.


If the mainstream medical community had a 1.000 batting average, then the decision would be a lot more straight-forward.

Alternative "medicine" is mostly cons and frauds. Why are you talking about "alternative medicine" in reference to basic nutrition?

 

[Desk trauma]

Alternative "medicine" is mostly cons and frauds. Why are you talking about "alternative medicine" in reference to basic nutrition?

Mandatory:

 

[ThatRobGuy]

Alternative "medicine" is mostly cons and frauds. Why are you talking about "alternative medicine" in reference to basic nutrition?

Because (whether through luck or being a broken clock that's right twice a day), it just so happens to shake out that in many cases, the nutritional/dietary advice they give happens to be better than that of most GPs -- even if it's outside of what their supposed "expertise" is supposed to be.

I've shared before that I grew up in a family that was into all that stuff... I'm the outlier in that I'm one of the few in the family that doesn't go to those sorts of "practitioners"

But for example:

Chiropractors believe that all disease its caused by neurological interference cause by "subluxation" and the the removal the "subluxation" will unlock some sort of magical ability for the body to heal itself. -- and they believe that's true for everything from ear infections, to digestive disorders...up to more serious things like cancer. And the whole homeopathy thing is even more laughable.

We know that's hogwash... a "chiropractic adjustment" isn't going to heal an ear infection, and it's downright dangerous to trust that over real oncology care for cancer.


However, on the flip side.

When my uncle was dealing with work-related knee pain, the GP wanted to put him on a regular regiment of high dose Naproxen, and then potentially stronger stuff... whereas, his Chiropractor gave him exercises and stretches to do at home, and put together a little diet plan to help him drop some lbs. (which obviously losing weight can alleviate some knee pain for people)

When my mom found out her cholesterol was high when she was in her early 50's, her doctor wanted to get her on statins ASAP. When she went to a Naturopathic/Homeopathic person, they saw the numbers and said "yeah, it's a little high, but at your age, for women there's not a huge benefit to rushing to get on statins", and then gave a list of certain foods to cut out, and other foods to add, and it ended up helping. She's still in the normal reference range a decade later.


That doesn't change the fact that Chiropractic and Homeopathy are nonsense (in terms of their primary philosophies and what they claim to specialize in), but it just demonstrates that they can be right about a few indirectly related things in areas where actual doctors may have some blind spots.

Which, those blind spots are somewhat predictable when you consider that your average MD only got 15-20 hours of nutrition training across that whole time they spend in med school.

 

[ThatRobGuy]

There's a pretty obvious difference in scale that makes your comparison kinda silly. Chipotle serves about 275 million meals per year, or about 20x the number of people consuming raw milk. And raw milk illnesses are generally linked to "outbreaks" as well - a dairy doesn't sanitize its equipment well enough or there's an outbreak of brucellosis in a farmer's herd, so a batch of milk gets contaminated and people get sick. The difference between that and, say, an outbreak of e. coli linked to lettuce at Chipotle is that the Chipotle outbreak represents a failure of established safety and testing standards, while the raw milk outbreak would have been prevented by simply pasteurizing the milk.

The dynamic you describe between raw and pasteurized would also exist with regards to beef and cooking temperature as well, would it not?

We're already talking about a quite low relative risk in either case.


A similar risk is being taken when someone opts to get a burger cooked with pink in the middle instead of well-done

Both would be a case where it's a not failure of inspection or testing, but rather of procedure, correct? (as the illness could've been prevented by simply cooking the burger to 160 degrees -- or as I would call it, shoe leather, I don't know how Canadians live with that well-done only rule for burgers in their restaurants when I go up there)


Yet, people don't seem to have the same aversion to the concept of eating a burger with pink in the middle, in fact, a lot of people prefer it that way.

Is there even the slightest possibility that a big media outlet like CBS is putting a spotlight on a story about a single negative outcome from raw milk, less because of the aversion to the practice itself, and more because of the particular health official it involved and the state it occurred in?

Point of reference, Cali is actually one of the states that allows raw milk consumption and has for quite some time. They've have numerous issues with it.

Outbreak of Salmonella Typhimurium Infections Linked ...

This report describes a Salmonella outbreak linked to ...

www.cdc.gov

(of which, 70% were children)

Why weren't the pitchforks coming out for that situation?

I think the "raw milk aversion" recently taken up by some people can be explained by this politico piece

https://www.politico.com/news/magazine/2024/03/10/the-alt-right-rebrand-of-raw-milk-00145625

Politico even notes that as recently as the mid-late 2000's, raw milk was a "left wing hippie organic" thing, and got favorable write-ups in the New York Times, the Washington Post and the New Yorker defending it.

It wasn't until some right-wingers started making it "a symbol of distrust in mainstream health institutions" that people started turning on it.

 

[Hans Blaster]

Because (whether through luck or being a broken clock that's right twice a day), it just so happens to shake out that in many cases, the nutritional/dietary advice they give happens to be better than that of most GPs -- even if it's outside of what their supposed "expertise" is supposed to be.

I've shared before that I grew up in a family that was into all that stuff... I'm the outlier in that I'm one of the few in the family that doesn't go to those sorts of "practitioners"

Mine was just the opposite, no quack practitioners, no psychics, we were just simple rationalistic rural folk.

But for example:

Chiropractors believe that all disease its caused by neurological interference cause by "subluxation" and the the removal the "subluxation" will unlock some sort of magical ability for the body to heal itself. -- and they believe that's true for everything from ear infections, to digestive disorders...up to more serious things like cancer. And the whole homeopathy thing is even more laughable.

We know that's hogwash... a "chiropractic adjustment" isn't going to heal an ear infection, and it's downright dangerous to trust that over real oncology care for cancer.

Frankly it should be illegal because it is fraudulent. (There seems to be some use of chiropractory for what it actual does, manipulating joints, as a form of physical therapy, but any other claims are clearly garbage.)

However, on the flip side.

When my uncle was dealing with work-related knee pain, the GP wanted to put him on a regular regiment of high dose Naproxen, and then potentially stronger stuff... whereas, his Chiropractor gave him exercises and stretches to do at home, and put together a little diet plan to help him drop some lbs. (which obviously losing weight can alleviate some knee pain for people)

When my mom found out her cholesterol was high when she was in her early 50's, her doctor wanted to get her on statins ASAP. When she went to a Naturopathic/Homeopathic person, they saw the numbers and said "yeah, it's a little high, but at your age, for women there's not a huge benefit to rushing to get on statins", and then gave a list of certain foods to cut out, and other foods to add, and it ended up helping. She's still in the normal reference range a decade later.

Which is just commonly available nutrition advice. They would have been better of just going to a nutritionist.

That doesn't change the fact that Chiropractic and Homeopathy are nonsense (in terms of their primary philosophies and what they claim to specialize in), but it just demonstrates that they can be right about a few indirectly related things in areas where actual doctors may have some blind spots.

The problem with this is that "better nutrition" isn't part of the chiropractic or homeopathic fraud. It's just something that individual "practitioners" are adding common knowledge nutrition advice to their clients. It's not like real physicians don't make this kind of advice to their patients.

Which, those blind spots are somewhat predictable when you consider that your average MD only got 15-20 hours of nutrition training across that whole time they spend in med school.

Like anything, nutrition is a specialty.

Back to this MAHA menace...

If they were talking about "Making America Eat Better" and were not dragging along the quackery of things like chiropractry and naturopathy and homeopathy and the anti-vax nonsense there wouldn't be the resistance you see here.

If it comes down to real, science based medicine and ignoring bad nutrition practices or quackery and anti-vax with a focus on better nutrition, I will take the bad nutrition practices every time. (It's not like real medicine and good nutrition can't go together. Nothing, I repeat, nothing can make the quakery and anti vax palatable.)

 

[durangodawood]

I don't consume milk as a beverage, I'll use it in recipes that call for it --primarily just because I don't like the taste all that much, but it's fine for people who like it (I do eat cheese though)


But the thing I have noticed is there is some "selective shock" when it comes to the foods that some of the "alternative medicine" types consume/promote, and the negative potential effects and risks.


What I mean by that, stories like the one that was linked earlier.
"Woman has this really bad thing happen after consuming raw milk... hey, RFK and that MAGA surgeon general in Florida have both advocated for raw milk, this is just more proof that they're bonkers"

However, when you look at the actual numbers:
10-15 million people consume raw milk every year

Over a 20 year period: approximately 2,645 illnesses, 228 hospitalizations, 3 deaths have been reported (Per the CDC)

A single Chipotle outbreak (of which, they've had 5 big ones over an 8 year period) can exceed an entire year's worth of illnesses attributable to raw milk consumption.

However, nobody would refer to someone as "cooky" if they said "Hey, I think the grilled chicken fajita bowl from Chipotle with brown rice is a pretty healthy option"

When comparing raw milk to Chipotle we should ask: what are the alternatives?

With raw milk problems the alternative is pasteurized milk.

With Chipotle problems the alternative is stronger food safety enforcement and penalties. (Assuming we're not going to shut down the restaurant industry generally.)

 

[RocksInMyHead]

The dynamic you describe between raw and pasteurized would also exist with regards to beef and cooking temperature as well, would it not?

We're already talking about a quite low relative risk in either case.

A similar risk is being taken when someone opts to get a burger cooked with pink in the middle instead of well-done

That is a better example, yes. That said, I don't think you'll find any government representatives extolling the health benefits of eating undercooked hamburger.

Is there even the slightest possibility that a big media outlet like CBS is putting a spotlight on a story about a single negative outcome from raw milk, less because of the aversion to the practice itself, and more because of the particular health official it involved and the state it occurred in?

Point of reference, Cali is actually one of the states that allows raw milk consumption and has for quite some time. They've have numerous issues with it.

Outbreak of Salmonella Typhimurium Infections Linked ...

This report describes a Salmonella outbreak linked to ...

www.cdc.gov

(of which, 70% were children)

Why weren't the pitchforks coming out for that situation?

I think the "raw milk aversion" recently taken up by some people can be explained by this politico piece

https://www.politico.com/news/magazine/2024/03/10/the-alt-right-rebrand-of-raw-milk-00145625

Politico even notes that as recently as the mid-late 2000's, raw milk was a "left wing hippie organic" thing, and got favorable write-ups in the New York Times, the Washington Post and the New Yorker defending it.

It wasn't until some right-wingers started making it "a symbol of distrust in mainstream health institutions" that people started turning on it.

I would argue that it was government officials pushing it as "beneficial and healthy" that led to the backlash. Generally speaking, I don't really have any problems with people choosing to drink raw milk (or order their burger medium rare). The problem comes when those in positions of supposed authority (e.g. government health officials) start promoting things that are objectively unsafe as "healthy."

Side note - while I wasn't able to read the WaPo article since I don't have a subscription, the NY Times article wasn't really favorable aside from pointing out the economic benefits for small dairy farms, and the New Yorker article was more about "single-origin" milk (e.g. milk from a single cow) than raw milk specifically.

 

[ThatRobGuy]

If they were talking about "Making America Eat Better" and were not dragging along the quackery of things like chiropractry and naturopathy and homeopathy and the anti-vax nonsense there wouldn't be the resistance you see here.

If it comes down to real, science based medicine and ignoring bad nutrition practices or quackery and anti-vax with a focus on better nutrition, I will take the bad nutrition practices every time. (It's not like real medicine and good nutrition can't go together. Nothing, I repeat, nothing can make the quakery and anti vax palatable.)

It's everyone's prerogative as to which thing they'd prefer in terms of the trade-off.

However, there's two ways to look at it.

Anti-vaxx sentiments (but sounder nutrition advice) can leave people woefully unprepared and in a bad place when the next pandemic comes along.


The other vantage point...

Things like measles, even at their peak in the pre-vaccine era, weren't causing a fraction of the deaths and hospitalizations that are caused by metabolic health issues today.

around 18,000 hospitalizations and 500 deaths a year were from measles pre-vaccine.

Meanwhile, cardiovascular disease and diabetes is racking up more than that every day.

 

[ThatRobGuy]

I would argue that it was government officials pushing it as "beneficial and healthy" that led to the backlash. Generally speaking, I don't really have any problems with people choosing to drink raw milk (or order their burger medium rare). The problem comes when those in positions of supposed authority (e.g. government health officials) start promoting things that are objectively unsafe as "healthy."

California used to check that box as well (and still does on some of it)

California expands access to traditional healing for substance use treatment | Governor of California

www.gov.ca.gov

LA County Department of Public Health

publichealth.lacounty.gov

The LA County public health department is not only giving people resources to to help them locate whatever their preferred form of quackery is, they're encouraging people to "do their own research" (which from my understanding was supposed to be a real sticking point)


And UC is advertising quack services through multiple campus locations at their university medical centers

Clinical Specialties

Our practitioners are trained in both conventional and complementary therapies. We assess your individual needs and listen to your concerns and goals for well-being in order to offer a professionally guided, whole-person approach to your health care.

osher.ucsf.edu

Integrative Medicine Patient Education Videos

Explore our collection of on-demand integrative medicine videos on acupuncture (including a general overview and acupuncture for back and neck pain) and chiropractic topics (including care and management, as well as conditions such as chiropractic adjustment, care for pain and athletic injuries...

www.uclahealth.org

UC touting benefits to things things like Ayurvedic "medicine"

And listing the following as things it's supposedly good for:

I know that people have a certain gut reaction to anything RFK says because he's aligned with a polarizing figure...

But if we take just a step back and think about it objectively....
is RFK saying "I think raw milk is healthy" or "Vitamin A is a great way to boost your immune system" really any more or less "quacky" than the LA public health department touting Chiropractic care (who are and were the main purveyors of the anti-vaxx movement dating back to the smallpox vaccine), the state of California touting that they're now going to license "traditional healers", or UCLA/UCSF saying that there's benefits for Depression, Asthma, and Arthritis from magic herbs and healing gems?

 

[Hans Blaster]

It's everyone's prerogative as to which thing they'd prefer in terms of the trade-off.

However, there's two ways to look at it.

Anti-vaxx sentiments (but sounder nutrition advice) can leave people woefully unprepared and in a bad place when the next pandemic comes along.

And it isn't a place I would like to go to. (I fear I have no choice. Dumb is going to take me there anyway.)

The other vantage point...

Things like measles, even at their peak in the pre-vaccine era, weren't causing a fraction of the deaths and hospitalizations that are caused by metabolic health issues today.

around 18,000 hospitalizations and 500 deaths a year were from measles pre-vaccine.

All of which are completely unnecessary. Not to mention the time lost to work and education by the disruption of millions of sick kids every year. The chicken pox causes even less death and injury, but does cause economic lossses. In both cases the economic cost of the vaccine is easily covered by the economic savings from disease that doesn't happen.

Then there is the HPV vaccine which has wiped out cervical cancer in vaccinated women in places where it has been near universal for a while.

And COVID killed *ONE MILLION* over two years and would have been much worse without a vaccine.

Meanwhile, cardiovascular disease and diabetes is racking up more than that every day.

The amount that it could be reduced by this land where everyone practices the "MAHA" nutritional practices are not quantified and I doubt they could be.

The bottom line is that we have discussed three areas of health:

Vaccines/no-vaccines
Good nutrition/bad nutrition
Scientific medicine/quackery

Two of those we are in a pretty OK position on, the first not so much.

Your proposal/position is fix the worst performing one by allowing the repairman to trash the other two. There is absolutely no need to do that. There is no reason that better nutrition can't be sought without trashing all of medicine. None at all.

But "RFKJr" is *the* prime anti-vax force in this country. He was not the guy to "fix food" nor was his perch at the top of the US government health apparatus the place to make this fix. Appoint him (or one of his MAHA accolytes more known on nutrition) as "Food Führer" (it just works better as an autocratic title on food than the all to common "Tsars".) or a couple food related posts in USDA or HHS and I don't think anyone would care that much if they were anti-vaxxers. But instead Trump puts the biggest and worst anti-vaxxer in the whole country to supervise the CDC and NIH.