04/26/2012 07:56 am ET Updated Jun 26, 2012

Toil, or Tirade? Hard Truths About Hype

Here's a dual-choice question about making a fortune in a relative hurry -- which do you think works better?

A) A hard toil with the truth
B) A well-timed tirade?

Here's another related question: Which is more likely to put you on the fast track to fame?

A) Dispensing a genuine dose of useful information
B) Hard-boiled hype

I'll go with tirade and hype for a quick million and national TV coverage, Bob...

Too often, I think, even here on The Huffington Post, that's the answer people choose.

The temptations of hype and tirade are obvious, but ultimately you are victimized by them. Distortions and exaggerations can mutate even genuinely useful information into nonsense. In the aggregate, the propagation of hype and propaganda dilutes "information" in such a vast sea of misinformation, it becomes nearly impossible for anyone to find the reliably true.

The flu vaccine is certainly not an attempt by the CDC to carry out genocidal population control -- but make the unfounded assertion that it is, and it's apt to go viral. So is the claim that sugar (or at least fructose) is a poison; in fact, it has. So has the contention that statin drugs represent a pharmaceutical industry conspiracy, intended to bilk the public of both money and health.

Tirades are, by their very nature, apt to gain a lot of attention and "go viral." They are dramatic. They are extreme, provocative, and full of intrigue. Hype sells. Unfortunately, much of the time -- it is wrong.

The allure of the counter-culture tirade is not new. Just look at what it did for Dr. Robert Atkins, for example, in the mid-90s -- despite the fact that at that time, any nutrition professional with half a wit was already advising against excesses of refined starch and added sugar as well as harmful varieties of fat. And despite the fact that both lentils and lollipops are sources of "carbs," and lumping them together is a classic case of baby and bathwater for anyone who bothered to think about it. Others have caught the same wave since, including Gary Taubes, Arthur Agatston, and most recently the increasingly scandalous Dr. Pierre Dukan.

The issue here was never whether it made sense to cut back on refined starches and added sugars in the diet. As noted, that was a well-established truth and remains so today. The issue was that this tried-and-true advice is moderate, and thus dull. The wild exaggeration that distorts truth into falsehood -- that takes "cut back on starches and simple sugars" into the realm of "don't eat fruit" -- is the attention-grabber.

There are many such waves -- and the temptation to surf hyperbole and iconoclastic conjecture to fortune and glory is very widespread. It's all for you, of course. You are on the beach, picking your favorites. Enjoy the show -- but caveat emptor!

Those inclined to stoke the flames of conspiracy theory outrage as a matter of routine will tell you, for instance, that Big Pharma is evil. That docs are always on the take, and out to make a buck -- and if at the expense of their patients, no problem. That the leading causes of death are unknown, ignored, neglected, or denied by we ordinary mortals -- and are addressed correctly only by the rare, renegade geniuses who grace these and like pages -- and the morning news shows- with their insights.

In this world of righteous indignation, evidence that statin drugs can increase diabetes risk in women is not a mere proviso about their use -- it is an indictment of the whole medical system. It's evidence that statin drugs should be abandoned -- and Big Pharma indicted yet again. The possibility of side effects from vaccines is not a reminder that everything in medicine is about risk/benefit ratios, or that everything in life involves trade-offs -- it's an indication of some nefarious cover-up.

But before you buy in to the next great conspiracy theory, and even as you read this -- pause for a moment, and take a deep breath. You live in the real world. Do you know a lot of people who are purely good, all the time, or purely evil? Is every situation perfectly divided into right/wrong, bad/good -- or do you encounter some shades of gray from time to time?

The easiest kind of opinion to make famous is an extreme opinion. By their very nature, the most outlandish claims are the ones people are most likely to remember, and pass along. Combine dramatic content with repeated exposure, and you have a potent formula for widespread conviction. But remember that at one time, everyone believed the sun revolved around a flat earth.

During the Spanish Inquisition, any wild claim of heresy quickly spread -- and became conviction. During the McCarthy era, any wild claim of communist sympathy did likewise. And let's recall but not dwell on the wild and extreme claims about groups of people that have justified every imaginable horror from slavery to the Holocaust.

Extreme positions are rarely right, and can be extremely dangerous. Repeating something often and loud does not make it true.

Perhaps it's the dualism imparted to us by our religions -- good and evil, god and devil, heaven and hell -- that make us look for such extremes in the world around us. Maybe you'll find one if you look hard enough -- but they are rare. The best of people can be bad at times, the worst of people may have some redeeming trait. And the notion that science is evil and nature benevolent is utterly benighted nonsense.

The particular inspirations for this column are many and varied and span years. Recently, I have been goaded to passion by excessively extreme positions about sugar, statin drugs, and vaccines -- to name a few. In general, over my 12 years directing an integrative medicine center, I have witnessed up close and personally the danger of unfurling the conspiracy theory flag too readily. Many of the patients who come to our center have a strong, intrinsic distrust of drugs -- yet will readily take a "natural" supplement cocktail without even knowing what's in it.

I suspect, as I write this, that I am quickly turning myself into a human punching bag. With some vague hope of avoiding that fate, I would like to establish my personal position and bona fides. Maybe this will dissuade some few of you from calling me names that would make my mother's hair fall out.

I do, indeed, direct an integrative medicine center -- working side by side with naturopathic physicians. We like to avoid drugs, and help our patients do so as a matter of routine. One of the more common reasons people come to us is to learn how to use lifestyle as medicine, and stop relying on pharmaceuticals.

But we also acknowledge that drugs may at times be needed, and that "natural" doesn't mean safe. Botulinum toxin is natural. Rattlesnake venom is natural. Smallpox is natural; and the vaccine that eradicated it represents science at its best.

Our attitude at the clinic is: We don't care if a product comes from a test tube, or a tree leaf. We care if it works. We care if it's safe. We care if it's the best thing for a given job in a given patient. And we encourage our patients -- sometimes, but not always with success -- to believe the same.

I am, as well, the president-elect of the American College of Lifestyle Medicine. For me, the name says it all: Lifestyle IS the best medicine. I have espoused that for two decades, and do all I can, every day, to help people make better use of feet and forks, and less use of medications.

But until better use of feet and forks prevails, a whole lot of people do have use of medication -- and often, it is life-saving use. The statin drugs are a case in point. True, they have been associated with an increased risk of diabetes in women. That's important, and deserves attention. But when the attention is distorted, it becomes the tail that wags the dog.

What's the dog? For starters, a recent meta-analysis that included data for 40,000 women showing a decisive reduction in all-cause mortality with statin use compared to placebo. Other such reviews in tens of thousands show mortality reductions in both women and men.

And no, by the way: I don't have stock in any pharmaceutical company. I don't take or routinely prescribe statins -- although I do prescribe them occasionally. I am NOT on the payroll of any pharmaceutical company.

Such knee-jerk criticisms populate HuffPost commentary routinely. My skin is thick and my mission is clear, so they don't bother me- but I bet they dissuade a lot of others from risking the truth. The truth can be rather thankless toil. And all such rush-to-judgment diatribe serves as positive reinforcement for the distortions that foster fame, fortune, and folly.

There are, from time to time, genuine conspiracies -- it is naïve and perilous to think otherwise. But it is also naïve and foolish to think that those with a chip on their shoulder, an axe to grind, a fortune to make, or fame to grab will reliably provide a balanced perspective and look at issues from both sides. Generally, they avoid the middle path like the plague -- because the truth that walks there is not nearly as sexy, or as virally infectious, as the exaggerations off to other side.

Which is probably why this piece will evoke some combination of opposition, shoulder-shrugging, and yawns. Perhaps I should have said, "News flash: Buying into conspiracy theory and hyperbole will cause brain tumors and your eyeballs to catch fire!"

Tempting. Just not true.


Dr. David L. Katz;

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