US government to withdraw longstanding warnings about cholesterol (2015) • Hacker News Board

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#111

Post by baddox » Fri, Dec 30, 2016, 4:33 AM UTC

badsock wrote: post #54

clarkmoody wrote: post #17

Wouldn't it be nice if there were more government warnings and less restrictions / regulations? Imagine if the FDA, instead of blocking new drugs for 10 years and $1B, it simply withheld its endorsement until satisfied by the clinical trials. Consumers could then take the government's recommendations into consideration when making a decision and drugs could get to market much faster. The history of medical reversals…

Just as an example: 9% of the cases of Idiosyncratic Drug-induced Liver Injury is self-harm caused by people taking non-regulated dietary supplements: https://www.ncbi.nlm.nih.gov/pubmed/18955056 You have a theory that the average person will wisely assume the responsibility to vet the health effects of what they consume, but empirical reality disagrees with your theory. Right now people are injuring themselves with…

You didn't show any evidence of the FDA being a net benefit. You only showed that the FDA probably could have reduced that specific type of liver injury by regulating those specific supplements. But the government is not magic, and the FDA almost certainly has also caused injuries by overly or erroneously regulating other things. I have no idea what the net effect is, but you certainly haven't shown it to be positive.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#112

Post by baddox » Fri, Dec 30, 2016, 4:35 AM UTC

azinman2 wrote: post #73

badsock wrote: post #54

Earlier quoted context omitted.

Just as an example: 9% of the cases of Idiosyncratic Drug-induced Liver Injury is self-harm caused by people taking non-regulated dietary supplements: https://www.ncbi.nlm.nih.gov/pubmed/18955056 You have a theory that the average person will wisely assume the responsibility to vet the health effects of what they consume, but empirical reality disagrees with your theory. Right now people are injuring themselves with…

Don't forget that marketing budgets for pharmaceuticals are also huge. The average person has no chance. The constant bombardment already means people go to their doctor asking for Rx by name even without understanding the medical need or if they're right for it. Now remove regulation... the warnings basically just blur into the background. Already we get so many warnings on prescriptions that they just turn into not…

Don't forget that lobbying budgets for pharmaceuticals are also huge. I'd rather pharmaceuticals spend money to show me ads while I still get to make my own choices than spend money to buy laws that restrict my choices.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#113

Post by oh_sigh » Fri, Dec 30, 2016, 4:36 AM UTC

badsock wrote: post #54

clarkmoody wrote: post #17

Wouldn't it be nice if there were more government warnings and less restrictions / regulations? Imagine if the FDA, instead of blocking new drugs for 10 years and $1B, it simply withheld its endorsement until satisfied by the clinical trials. Consumers could then take the government's recommendations into consideration when making a decision and drugs could get to market much faster. The history of medical reversals…

Just as an example: 9% of the cases of Idiosyncratic Drug-induced Liver Injury is self-harm caused by people taking non-regulated dietary supplements: https://www.ncbi.nlm.nih.gov/pubmed/18955056 You have a theory that the average person will wisely assume the responsibility to vet the health effects of what they consume, but empirical reality disagrees with your theory. Right now people are injuring themselves with…

What dietary supplements can cause liver injury?

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#114

Post by ubercore » Fri, Dec 30, 2016, 4:37 AM UTC

sandGorgon wrote: post #48

ubercore wrote: post #18

Earlier quoted context omitted.

Even in that article, they say it's just associated with reduced obesity, and saturated fats in dairy are still associated with heart disease.

This is inaccurate. Pubmed studies show that butter is not related to heart disease https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines...

I'm just relating what's in the article. Thanks for sharing that, though.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#115

Post by epmaybe » Fri, Dec 30, 2016, 4:37 AM UTC

credit_guy wrote: post #78

andy_ppp wrote: post #38

Earlier quoted context omitted.

"Eat food. Not too much. Mostly plants." - Michael Pollan

Right. And what do you do if you are hungry after you eat "not too much" ?

You do something to satiate yourself. Foods high in fiber help with that, to some extent.

It's really a matter of how long we've been overeating. Over time, our body adjusts to accept that as the new norm, or set point for food intake. It just takes more time to sensitize yourself again to less food making you feel "full".

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#116

Post by mastazi » Fri, Dec 30, 2016, 4:38 AM UTC

kuschku wrote: post #94

pdq wrote: post #36

Earlier quoted context omitted.

I'm referring to the original 1992 food pyramid: https://en.wikipedia.org/wiki/Food_pyramid_(nutrition)#/medi... > Fats, oils, sweets: sparingly > Bread, cereal, rice & pasta: 6-11 servings Yes I am in the camp that believe fats and proteins are both much healthier than carbs, and especially refined sugars. The latest nutrition supports low carb diets, as can be seen with Atkins and Keto diets.

> The latest nutrition supports low carb diets, as can be seen with Atkins and Keto diets. That statement is not supported by any reliable studies. The latest nutrition supports a healthy mix of carbs and fats, specifically whole grain and unsaturated fats. Not a monodiet of fat, nor a monodiet of carbs, nor processed carbs, nor saturated fats. Focusing too much on a fat-based diet causes massive kidney issues, just…

I recently have had to conclude that HN is not the right audience to express this kind of ideas and not be downvoted.

I am fine with people taking "religious" positions when it comes to a text editor or the latest web framework, the problem is that nutritional choices have environmental and health-related consequences, so I would rather them be fact-based.

Also, I wonder what we're going to see next on HN, flat earth? Chemtrails? After a recent submission which was also related to nutritional topics, I have been considering leaving HN altogether.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#117

Post by baddox » Fri, Dec 30, 2016, 4:39 AM UTC

BurningFrog wrote: post #52

mkautzm wrote: post #27

Earlier quoted context omitted.

The science behind nutrition health is extremely complicated and expecting it to remain constant represent a total misunderstanding of how nutrition research is done and how results are determined. > The history of medical reversals -- and in this case, nutrition reversal -- shows that the government isn't magic. What it shows is that nutrition science is hardly 'solved' and you'd be hard pressed to find a researcher…

> The problem with this is that the average consumer is both A) dumb, and B) doesn't know what they need Note that the customer for prescription drugs is a licensed doctor.

Also note that the proposed (and current) alternative is for these consumers to vote for politicians who will make these scientific decisions for them.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#118

Post by generj » Fri, Dec 30, 2016, 4:39 AM UTC

BurningFrog wrote: post #68

greglindahl wrote: post #26

Earlier quoted context omitted.

Drug approvals are currently much better than nutrition studies. Your suggestion of allowing not-known-to-work "medicine" to be sold would return us to the era of patent medicines, which killed a lot of people. You can look at the supplements market to see people dying from a similar policy right now.

Like anything else, you have to look at both costs and benefits of the alternatives. The current extremely tough FDA approval process has the benefit you mention: Fewer people are injured by unsafe drugs. But it also has a big (but harder to observe) cost: If disease X kills 1000 people/year, then each year a cure is delayed kills 1000 people. The main argument against the current system is that it weighs the deaths…

The problem is that we also don't know how many people might be killed by an unsafe drug. It's impossible to know in advance what could fail with a drug - hence the testing. We have no concept of the upper bound of possible deaths. If a major drug is released without enough drug trials and widely prescribed we could lose thousands. See Voixx for an example. Almost 40,000 people died [0]. This was with a comprehensive drug trial under the FDA process. We would have many more incidents like this if not for drug trials required by regulatory agencies.

On the other hand national statistics on deaths caused by various diseases have been compiled for decades. We can know with certainty the upper bound of people killed per year (which in your example isn't 1000 but some fraction of that - no drug is 100% effective). Also, many drugs don't prevent deaths but merely comfort the patient or remove some symptoms. Many drugs have alternates which could be taken. Many drugs have an upper bound of deaths prevented of 0. Why should we risk any lives for a drug which cannot save any additional lives?

In general humans prefer taking a known risk with known odds rather than an unknown risk with unknown odds.

If an informed consumer wants to make a different choice than the FDA, nobody is stopping them from traveling to a country where the drug is already available.

[0] http://www.npr.org/templates/story/story.php?storyId=5470430

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#119

Post by FrancoDiaz » Fri, Dec 30, 2016, 4:39 AM UTC

mkautzm wrote: post #27

clarkmoody wrote: post #17

Wouldn't it be nice if there were more government warnings and less restrictions / regulations? Imagine if the FDA, instead of blocking new drugs for 10 years and $1B, it simply withheld its endorsement until satisfied by the clinical trials. Consumers could then take the government's recommendations into consideration when making a decision and drugs could get to market much faster. The history of medical reversals…

The science behind nutrition health is extremely complicated and expecting it to remain constant represent a total misunderstanding of how nutrition research is done and how results are determined. > The history of medical reversals -- and in this case, nutrition reversal -- shows that the government isn't magic. What it shows is that nutrition science is hardly 'solved' and you'd be hard pressed to find a researcher…

The problem with this is that the average consumer is both A) dumb, and B) doesn't know what they need.

Unfortunately, a significant number of bureaucrats and statists would prefer consumers to be dumb (or at least say that they are) in order to maintain power.

Oh and let me guess, you're not one of the dumb ones....it's the other guys right? ;)

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#120

Post by alistairSH » Fri, Dec 30, 2016, 4:40 AM UTC

throwaway2016a wrote: post #61

alistairSH wrote: post #34

Earlier quoted context omitted.

That worked out really well for the banking industry. You really want a similar scheme for medical care?

That's a false analogy. I was not proposing self-regulation. I was proposing something like UL which is independent from the companies being overseen.

How is it independent? UL is for-profit and relies on revenue from the companies seeking certidication. That's the same, or similar, conflict that exists with the credit agencies and the finance industry.