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The War Over Ultraprocessed Foods
Recently the city of San Francisco sued several food giants (Kraft Heinz, Mondelez and Coca-Cola) for deceptively marketing “ultraprocessed foods” and then externalizing the resulting health care costs onto the public. They cite a recent Lancet review which concludes: “The totality of the evidence supports the thesis that displacement of long-established dietary patterns by ultra-processed foods is a key driver of the...
A New Test for Chronic Fatigue Syndrome?
The headline reads, “Breakthrough blood test finally confirms Chronic Fatigue Syndrome.” As you might imagine, the story is far more complicated than that. Let’s start with some background of chronic fatigue syndrome, also called myalgic encephalomyelitis (ME/CFS). As the name implies, it is a syndrome, meaning a collection of symptoms with a typical natural history – CFS is characterized by severe debilitating...
Creatine Supplements for Brain Function
There is a long history of supplements marketed to enhance memory, focus, overall cognitive function, and brain health. None of them are backed by quality scientific evidence, and they seem to go through the typical conveyor belt of claims – by the time one claim is collapsing, such as ginkgo biloba, the industry is happy to move on to the next. The...
Systematic Review of Homeopathy for Rheumatological Disease
It really makes our job more challenging when otherwise reasonable medical journals publish pseudoscientific nonsense. The European Journal of Rheumatology is considered a respected peer-reviewed journal in the field. I have to wonder if the editors were completely asleep at the switch with this one, or if they may be harboring one or more true-believers (homeopathy remains popular in some corners of...
Are Cardiac Calcium CT Scans Useful?
My doctor recently recommended that I get a cardiac CT calcium scan to help stratify my risk of cardiovascular disease (CVD). So of course I was interested in how good this scan is, because diagnostic tests to assess risk, especially in those who are asymptomatic, can be tricky. I was happy to discover that the short answer is – yes. These tests...
The Effectiveness of COVID Vaccines
One of the common themes of SBM is that medical evidence can be very complex. In order to come to any robust conclusion about what the science says on any question you need to do a careful and thorough evaluation of all the relevant evidence, including plausibility as well as observational and experimental clinical evidence. Essentially we want to look at the...
Is (Conversion) Therapy Speech?
The US Supreme Court recently heard a case that could have devastating effects on the standard of care in medicine, and the indicators of where the justices fall are not good. The case is Chiles v Salazar, in which a licensed therapist is arguing that a Colorado law banning conversion therapy for gay and trans clients violates her free speech. So the...
Nobel Prize in Medicine: Peripheral Immune Tolerance
Each year I like to write a post about the Nobel Prize in Physiology or Medicine. While advocating for higher standards of science in medicine we tend to spend much of our time criticizing pseudoscience, so I like to balance that by occasionally just celebrating great medical science, and the Nobel Prize is a great opportunity. The 2025 award for physiology or...
The Cholesterol Wars Continue
As a first approximation it seems that the purpose of social media is to misrepresent medical information and to promote wellness gurus who basically have no idea what they are talking about. Part of the problem is that medical science is often complex, and the short attention-span format of social media often favors simple clean narratives. So “wellness influencers” dominate while genuine...
Rejecting The Null Hypothesis
In various contexts, for practical, philosophical, and logical reasons, there is a default assumption. In the criminal justice system, for example, someone is presumed innocent until proven guilty. Therefore we must act “as if” someone is innocent until the burden of proof is met that they are indeed guilty of the specific crime of which they are accused. In medicine, if someone...