David L. Katz, MD, MPH, FACPM, FACP, FACLM, is the Founding Director (1998) of Yale University’s Yale-Griffin Prevention Research Center, and former President of the American College of Lifestyle Medicine. He has published roughly 200 scientific articles and textbook chapters, and 15 books to date, including multiple editions of leading textbooks in both preventive medicine, and nutrition. He has made important contributions in the areas of lifestyle interventions for health promotion; nutrient profiling; behavior modification; holistic care; and evidence-based medicine. David earned his BA degree from Dartmouth College (1984); his MD from the Albert Einstein College of Medicine (1988); and his MPH from the Yale University School of Public Health (1993). He completed sequential residency training in Internal Medicine, and Preventive Medicine/Public Health. He is a two-time diplomate of the American Board of Internal Medicine, and a board-certified specialist in Preventive Medicine/Public Health. He has received two Honorary Doctorates.
A report in JAMA Internal Medicine highlights prevailing medical practices that should be “reconsidered” in 2018 based on the weight of evidence. The paper, appropriately, is written in the matter-of-fact style customary for the peer-reviewed literature. To some extent, that semblance of analytical calm belies the storm swirling between the lines of the report, and the mess it has long been making in the House of Medicine.
Amazingly, Thanksgiving Day has already come and gone. As I write this, then, the somewhat euphemistic “holiday season” has begun. In a bizarre testament to the priorities of our culture, many are spending Black Friday - rather than in cozy, familial repose - in full-contact, retail roller derby. We have convinced ourselves that the right digestif for our signature annual indulgence is combat with other shoppers to purchase things friends and relatives likely don’t need and often don’t want, obligating them to reciprocate in kind if only out of remorse. The Got Junk guys are presumably looking on with anticipatory glee, knowing their payday reliably follows.
Industry funding of research has always been a rather fraught topic. In the immediate aftermath of what we might reasonably call the “Coca-Cola calorie debacle,” or perhaps “GEBNgate,” it is all the more so. But in this domain, as in so many, the rush to summary judgment (in either direction) obliterates nuance fundamental to real understanding, and obscures a middle path conducive to important and even crucial advances.
We have all heard that eating fish is good for us, and the proposition is valid both empirically, and epidemiologically. But it begs a vital question just the same: good for us, compared to what?
A high profile paper previously published in the highly prestigious journal, Nature, suggests that overwhelmingly, cancer results from “extrinsic factors,” namely behaviors and exposures, rather than the “intrinsic” transgressions of our chromosomes. The media response is a proclamation that no, cancer is not just about “bad luck.” So august a platform for so salient a proposition seems to demand a highly erudite response, and I’ve got just the one: duh.
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