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.
The events culminating in our election outcome were characterized as the advent of a “post truth era.” We have since devolved from post-truth, to “alternative facts:” essentially, a choice between bald-faced lies about verified reality- or delusion, calling out for medical care. Either way, we are being fed a daily diet of unpalatable (to most of us), insalubrious (for all of us) deceit.
I keep wondering, in what seems the new, emperor’s-new-clothes-like surreality: where have all the grown-ups gone? Where are the parents, and grandparents? Are we, somehow, in a post-parent as well as post-truth dystopia now?
The volume of bad answers, bad questions, noise and nonsense conspiring to hide the simple, fundamental truths about diet and health seems to swell daily. The task of generating a signal to be heard over this din grows more challenging in tandem. Among the cries populating the cacophony of misinformation is the contention that we know nothing not directly demonstrated in a randomized controlled trial. Much as I like RCTs, having run and published the results of dozens over my career, I consider this view misguided surrender to the tyranny of trial design.
I have yet to see any installments of the long-running Fast and Furious movie franchise, although my son and I recently agreed we probably should. There is, however, a much longer franchise that I’ve been watching closely throughout my career: the fad and folly franchise, devoted not to fast cars, but fast weight loss and promises of high-octane health, achieved magically and without effort.
Cancer has been much in the medical news over recent months, and with both good and diverse reasons. The good reasons all relate to genuine and important advances in medical knowledge, and options for patients. These range from immunotherapy for lung cancer, to the recently revealed insights, informed by genetic markers, about when breast cancer does not require chemotherapy.
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