The Wall Street Journal yesterday had a story with a sad and pathetic undertone.
They were talking about another in the rash of recent announcements that stuff isn’t as good for you as once thought. In this case, it was a pair of studies checking to see whether calcium supplements protected older women against hip fractures. You might have seen the headlines saying that calcium just didn’t do the trick. This article mentioned that only about half of the women in the studies actually took the supplements regularly — 57% in one study and, I believe, 54% in the other. If only the women who said they took the supplements were considered, then the results showed a statistically significant improvement.
This mirrors recent announcements that low-fat, high-fiber diets don’t reduce heart disease and cancer (among women who don’t actually make those changes in their diets), and that mental training doesn’t reduce loss of mental acuity (among old folks who don’t actually maintain mental activity).
The sad part is this sentence: “The researchers were disappointed that the results were so dependent on compliance.”
Now, you and I might think it pretty obvious that you can’t test the results of a treatment without factoring in whether people were really following the treatment or not, but apparently (and according to The WSJ) this is customary. The medical community, which cannot after all force anybody to eat whole grains or drink their milk, wants to be able to find significant results merely from telling people to do stuff. They can control what they tell people to do, so it is a terrible disappointment to find that telling people to do stuff doesn’t cause them to have a healthier old age.
Isn’t that sad?
Perhaps the medical community needs to be more persuasive. They could take a leaf from my pharmacist’s book and be more empathetic.
I had some trouble getting my prescription filled this month — I won’t tell the whole boring story. Just suffice it to say that I had to talk to three people in the doctor’s office and go to the pharmacy twice. So it was actually a day late by the time I got it. I expressed concern about this. “These are my birth control pills, ” I said, as though the pharmacist might not know that, “I can’t just skip a day.”
The pharmacist, who looks about 24, told me I could just take two right away and return to the usual schedule without any loss of effectiveness.
“So I can take two and not worry about it?”
“I would,” he said firmly. “I wouldn’t bat an eye.”
Knowing that a boy would skip a day of my birth control pills without batting an eye might not be completely reassuring, but I did what he said. I’m pretty compliant.
But even I have not followed my doctor’s orders to the letter. I think that I would if I were in a study, just for the integrity of the data. Fortunately, I am not in a study, so I just feel sympathy for the researchers in The WSJ story, and go ahead and eat the occasional piece of key lime pie.
But I think Chanthaboune hit the nail on the head back when they designed the new Food Pyramid. They did this, you may recall, because the old one wasn’t working. People just kept on eating cheeseburgers and fries. And key lime pie. They thought this new design might do the trick, but Chanthaboune said no. “It’s just a piece of paper. Now, if it had electrodes…”