Chemicals in My Food

Informed Consent and a Korean Field Trip

The BBC filmed a documentary in North Korea.  To get access they posed as members of a London School of Economics student trip to the country.  LSE is furious and demands the programme be withdrawn but the BBC argues the students were informed of the risk and gave their consent (although some students deny this). The reporter justified his actions in terms of the evil of the North Korean regime.

Even accepting the BBC’s story, this is a mockery of “informed consent”.  The BBC staff that stood to benefit the most from the trip going ahead were the ones who had to assess and explain the risk.  The university itself was not consulted, although any future programs they may run are put in jeopardy. Other academic visitors to the country must now be under greater scrutiny – they were also not consulted.

There are clearly risks and benefits associated with any action but the process for weighing them here was very wrong.

Edit: Comments from the director of the LSE.
Edit: Apparently this wasn’t an “official” LSE trip. That certainly reduces but doesn’t eliminate the university’s interest in the subterfuge.  I wonder how clear it was to the students or the North Koreans that this was a private group?

Nutrition, health and evidence

These radio programs by Ben Goldacre on evidence and nutrition are well worth a listen. I particularly like the way he describes:

• The differences between observational and intervention studies and how you weigh evidence from scientific evidence.  Doing good interventional trials in nutrition is hard or even impossible and the results we do have are often less convincing than predicted from observational studies.
• The media’s (and our) love for detailed prescriptive advice about food and health (“X causes/cures cancer”). 
• It is easy to do harm while genuinely believing you are doing good, particularly when you are giving advice to a whole population.  Dr. Spock recommended babies be put to sleep on their stomachs. We now know, by doing scientific studies, that that is a risk factor for cot death.  Gary Taubes has made a similar argument that the drive in the 1970’s to lower fat intake (“what harm could that possibly do?”) could plausibly be related to a rise in carbohydrate consumption and obesity.
• The tendency to cherry pick scientific data to support a strongly held belief. The interview with the representative from the British Association of Nutritional Therapists towards the end of the second episode on how she uses science is very telling. 

There are clearly relationships between the environment and health and we instinctively want to believe that specific foods will either do us great good or great harm.  We use science methods to start to investigate the relationships between food and disease but the experiments are hard and the data is limited.  Despite this, our “need to believe” allows food and supplement companies, therapists and the media to make very concrete recommendations wrapped in a veil of sciencyness. The people making the recommendations often passionately believe they are doing good and through the power of placebo they actually can. Their recommendations aren’t scientifically based though, and the series of fads undermines the rather bland nutritional advice given by governments and experts.

“The nutritional therapists are feeding on the detritus that comes from the scientific community” – Tom Sanders, King’s College London.

[Image from flicker user Stephen Burch]