Science, it’s a Gas

Money, it’s a gas
Grab that cash with both hands
And make a stash
(Pink Floyd – Money)

“Money (that’s what I want)”
(Beatles –Money)

Money is a gas and that gas seems to be a dissociative anesthetic, like laughing gas (nitrous oxide), that makes everything, right or wrong, seem righteous and an end to itself, and perhaps capable of relieving existential angst as long as it’s inhaled.

Money and ego are what makes this world go round. And in our society the two are inexorably bound together. A discussion of which comes first can be compared to the philosophical nuances of existence versus essence.

We can argue that with money come feelings of importance and power, which in turn feed the ego. Or that the ego exists first and as it emerges confidence, determination and vision ensue and that money naturally follows to one extent or another.

Money and ego infect almost everyone in our postmodern (or should that be post postmodern) society to the extent that no one or nothing seems immune to the two siren calls. Not even Science or Scientists, which have as goals the finding of truth, at least in so far as matters that can be observed and measured. Unfortunately science is often done in the name of the evil twins. And other partners in crime, such as entertainment industry, which promotes scientific sensationalism for economic gain, and social interaction, join in on the fray.

The results of one or even a number of studies, especially if done by a single person or the same team, results in a theory about the meaning of these results and should only be the beginning of a search for truth. The process is a cumulative one, alternating between theory and empirical testing until a consensus is reached. This consensus is merely an agreement that the theory is likely true at least under the conditions that it has been tested, and that the theory is truth only so long as it’s not disproven by further empirical testing.

This process provides us with information by which we can make reasonable decisions. Unfortunately this cumulative process is only as good as the research that supports it. Questionable methodology and bias lead to findings that seriously undermine this process leading to misinformation that has little validity and does a disservice to us all.

While the aim of the scientific method is to be completely objective, this is rarely the case. Since we’re human, science has objective and subjective elements and remaining completely objective is impossible due to our nature.

There are many stated objectives regarding research and financial conflicts of interest. An example is the National Institute of Health’s Financial Conflict of Interest statement on their web site:

The NIH is committed to preserving the public’s trust that the research supported by us is conducted without bias and with the highest scientific and ethical standards. We believe that strengthening the existing regulations on managing financial conflicts of interest is key to assuring the public that NIH and the institutions we support are taking a rigorous approach to managing the essential relationships between the government, federally-funded research institutions, and the private sector.

“The public trust in what we do is just essential, and we cannot afford to take any chances with the integrity of the research process.” — Dr. Francis Collins, Director, NIH

Laudable though they may seem, these statements do not reflect the real world. Even if the scientific measurements are objective and as truthful as can be, the people who interpret these measurements always have cognitive and social biases that lead them, in either a conscious or unconscious way, to introduce their own interpretations into their description of what they are ‘seeing’.

These interpretations are further polarized by the Hollywood style news media and internet sites whose only interest is sensationalizing the implications of the study, without looking at its validity – all done of course for humanitarian reasons. Jumping from a tenuous theory to sensationalized facts that many people take to heart does a disservice to us all.

While there are countless examples of how research has been turned into exploited consumable goods, the most recent example involving bacteria in our gastrointestinal tract warns about the cardiovascular risk of consuming red meat, L-carnitine and choline, has made more of an impact than most, and in fact has gone viral.

All you need to do is search the internet using tmao, red meat and choline as search parameters and you’ll see hundreds of sites parroting the misinformation from a number of studies led by Dr. Stanley Hazen. You’ll also see a small number of well thought out criticisms of Hazen’s research which implicates red meat, L-carnitine and choline in cardiovascular disease. One of the better ones is the blog by Chris Masterjohn of the Weston Price Foundation.

All the fuss is because of three papers published this year, and one published in 2011 by the Hazen group.

Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk.
Tang WH, Wang Z, Levison BS, Koeth RA, Britt EB, Fu X, Wu Y, Hazen SL.
N Engl J Med. 2013 Apr 25;368(17):1575-84.

Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis.
Koeth RA, Wang Z, Levison BS, Buffa JA, Org E, Sheehy BT, Britt EB, Fu X, Wu Y, Li L, Smith JD, Didonato JA, Chen J, Li H, Wu GD, Lewis JD, Warrier M, Brown JM, Krauss RM, Tang WH, Bushman FD, Lusis AJ, Hazen SL.
Nat Med. 2013 May;19(5):576-85.

Trimethylamine-N-oxide, a metabolite associated with atherosclerosis, exhibits complex genetic and dietary regulation.
Bennett BJ, de Aguiar Vallim TQ, Wang Z, Shih DM, Meng Y, Gregory J, Allayee H, Lee R, Graham M, Crooke R, Edwards PA, Hazen SL, Lusis AJ.
Cell Metab. 2013 Jan 8;17(1):49-60.

Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.
Wang Z, Klipfell E, Bennett BJ, Koeth R, Levison BS, Dugar B, Feldstein AE, Britt EB, Fu X, Chung YM, Wu Y, Schauer P, Smith JD, Allayee H, Tang WH, DiDonato JA, Lusis AJ, Hazen SL.
Nature. 2011 Apr 7;472(7341):57-63.

I’m not going to go into the details as to why this research needs to be taken with a grain of salt. Others have dissected these papers and found the pathology, including the blog by Chris Masterjohn.

I’m not going to criticize the implications of the studies towards endogenous and exogenous L-carnitine, or even mention the many studies that show the health and performance benefits of L-carnitine, which in a study published this year was found to be cardioprotective. I’m not going to go into the documented benefits of choline/phosphatidylcholine.

I’m not going to go into any details about why the studies and the conclusions were inconclusive and lacking in so many ways. Nor the fact that the connection between TMAO and cardiovascular disease is tenuous at best and lacks a cause and effect relationship. I’m not going to go into any of that as it’s been done elsewhere if you care to look.

And I’m not even going to congratulate the National Institutes of Health who helped fund this study for putting the following on their site regarding Hazen’s research on carnitine.

Some research indicates that intestinal bacteria metabolize carnitine to form a substance called TMAO that might increase the risk of cardiovascular disease. This effect appears to be more pronounced in people who consume meat than in vegans or vegetarians. The implications of these findings are not well understood and require more research.

Damn Straight! A hell of a lot more research if they’re to put things in perspective as far as the effects of other foods, including heart healthy fish, that increase TMAO, and definitely more as far as the evidence on if and how TMAO and cardiovascular disease are linked. And we need to be much more objective so we don’t blindly repeat the cholesterol/saturated fat fiasco that’s been raging the last several decades.

The nail in the coffin here is that it’s not about science it’s about money as you can see by the following disclosure.

This research was supported by grants from the National Institutes of Health and the Office of Dietary Supplements, Grant Numbers (R01HL103866, 1P20HL113452, P01HL098055, P01HL076491, R01HL103931, and R01DK080732). Cleveland Clinic has a licensing agreement with a diagnostic company to develop and commercialize a blood test for cardiovascular disease based upon the gut flora metabolite, TMAO. Dr. Hazen is listed as a co-investigator on pending and issued patents held by the Cleveland Clinic relating to cardiovascular diagnostics. He also is a paid consultant to the company and has received royalty payments for technology that he developed.

That’s not to say that Hazen doesn’t have some valid points that need to be researched further, just that he and his team seem to have enough financial incentive to slant their findings.

But I get it! It’s just part of the human condition.

Money, it’s a hit
Don’t give me that
Do goody good bullshit
(Pink Floyd – Money)

A human being is part of the whole, called by us “universe,” a part limited in time and space. He experiences himself, his thoughts and feelings, as something separate from the rest — a kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty.
(Albert Einstein)

Mauro Di Pasquale, B.Sc. (Hon), M.D.
May 16, 2013

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