Occam’s razor is an important tool for critical thinking, and it is employed constantly in science. Nevertheless, it is often misunderstood and is frequently (and erroneously) stated as, “the simplest solution is usually the correct one.” This is an unfortunate and misleading way to phrase the razor, because it leads people to conclude that conceptually simpler hypotheses are more likely to be correct, and that isn’t actually true. I have, for example, shared images like the one above multiple times on my blog’s Facebook page, and almost without fail, someone responds to them with something to the effect of, “Occam would have something to say about this.” The reality is, however, that Occam’s razor is actually about making assumptions, not conceptual simplicity. In other words, a “simple” hypothesis is one that doesn’t make unnecessary assumptions, not one that is conceptually simple.
I will elaborate on what I mean by unnecessary assumptions in a moment, but first I want to talk a bit more about conceptual simplicity. If you have ever really studied science, then it should be obvious to you that reality isn’t simple. Indeed, the history of science is largely the history of replacing a conceptually simple understanding of nature with an increasingly complicated understanding. In the pre-science era, many people had a very simple understanding of nature. There were only four elements, the earth was the center of the universe, etc. Those ideas were all replaced with far more complex scientific explanations, but those complex explanations are correct.
This accumulation of complexity happens constantly within science. Gravity provides a good example of this. Newton’s understanding of gravity was far simpler than the more complicated general relativity model proposed by Einstein, but that doesn’t make Einstein wrong nor does it mean that he violated any guidelines of logical thought by proposing it. Indeed, science has repeatedly confirmed that Einstein was right, and we need his conceptually complex model to account for how nature works. Biology has gone through similar revisions. Our modern understanding of evolution, for example, is far more complicated and nuanced than what Darwin proposed. There are many additional (and very correct) layers of complexity that have been added to our understanding over the years (e.g., neutral evolution, punctuated equilibrium, etc.). Indeed, most, if not all, branches of science have experienced similar increases in complexity, and that’s fine. It doesn’t violate Occam’s razor.
Note: In the examples above (and many examples for core scientific topics), the original idea was not wrong so much as incomplete. Darwin and Newton were mostly right, there were just some special circumstances that they weren’t aware of.
Having said that, you should never make a model, hypothesis, etc. more complicated than it needs to be, but simply saying, “hypothesis X is complex and hypothesis Y is simple” doesn’t really tell you much about which one is more likely to be correct. Assumptions, in contrast, tell you a great deal about which hypothesis is more likely to be correct.
Assumptions are the heart of what Occam’s razor is actually about, and the correct way to state the razor is that you should never make more assumptions than are strictly necessary. This concept, sometimes referred to as parsimony, is a guiding principle of science. Everything should be based on evidence and known facts, and the further outside of the known you have to step, the more likely you are to be wrong.
If you think about this for a second, it should make good, intuitive sense. Assumptions are, by definition, things that may or may not be true. Thus, the more potentially untrue components your hypothesis has, the higher the probability that it will be wrong. We can describe this mathematically. Let’s say, for sake of example, that you have a hypothesis that makes one assumption and there is a 90% chance that your assumption is correct (pretend we know that somehow). Watson also has a hypothesis, but his hypothesis makes three assumptions, each of which has a 90% chance of being correct. Your hypothesis only has a 10% chance that its assumption is wrong; whereas for Watson’s hypothesis, there is a 27% chance that at least one of the assumptions is wrong. Thus, it is obvious that his hypothesis is less likely to be correct (see this post for probability calculations).
In case math isn’t your thing, we can use some every-day examples to illustrate this as well. Imagine that you get in your car and try to start it, but when you turn the key, the engine won’t start. It won’t even turn over. Now, there are several possible hypotheses. The most obvious three are that it is the battery, starter, or alternator, but let’s say that you have an additional piece of information. Let’s say that yesterday you had your alternator and battery tested, and they both checked out as fine. Now, which of those three hypotheses is more likely to be correct based on the information you have? It’s obviously the starter, right? You just had the other two tested, so it’s reasonable to conclude that they likely aren’t the problem. This is a perfectly rational and intuitive conclusion, but when we break it down, it’s really just an application of Occam’s razor. Consider, the starter hypothesis proposes only one unknown: there is something wrong with the starter. In contrast, both the battery and alternator hypotheses require additional assumptions, because not only must there be something wrong with one of those car parts, but you also have to assume that the test equipment you used yesterday was faulty, or that a problem happened to develop right after being tested, etc. You have to make an assumption that is not required for the starter hypothesis.
To further illustrate this, we can construct hypotheses with additional assumptions. I could, for example, propose that the starter, battery, and alternator all died simultaneously. Now I have multiple assumptions running, and I trust that it is clear that it is unlikely for all of those things to have gone bad at the same time. We can make it even more ridiculous though by also assuming that in addition to those three parts, the ignition coil, spark plugs, and spark plug wires are also dead (see note). Do you see my point? Every time that we add another unnecessary assumption, the odds of the hypothesis being correct go down. We don’t need to be making assumptions about spark plugs, ignition coils, etc., and therefore we shouldn’t. We should work with what we know and add other assumptions only if they become strictly necessary.
Note: Yes, I know that bad spark plugs, spark plug wires, and the ignition coil(s) would not prevent the engine from turning over, but that only further illustrates the absurdity of assuming that they also stopped working.
I want to segue here briefly into a related topic: ad hoc fallacies. These fallacies are prevalent in anti-science arguments, and they are fundamentally failures to apply Occam’s razor. They occur when, after being faced with evidence that defeats your position, you invent a solution (i.e., make an assumption) that serves no function other than attempting to patch the hole in your argument.
Let me give an example. Suppose that a friend is with you when your car won’t start, and suppose that you have bragged to him repeatedly about how your car is impervious to faults and can’t break-down. Thus, upon seeing your car’s failure to start, he snidely says, “so much for your car never breaking down.” You are, however, unwilling to acknowledge that your car is capable of having flaws, so instead, you claim that someone must have sabotaged it. That is an ad hoc fallacy. You arbitrarily assumed that someone sabotaged your car even though you have no evidence to support that claim and even though it breaks Occam’s razor by making unnecessary assumptions.
That example may seem absurd and obviously silly, but people do this all the time. For example, anytime that you see someone in an internet debate blindly accuse their opponent of being a “shill,” they are committing this fallacy. Rather than accepting contrary evidence, they are blindly assuming that their opponent has a conflict of interest. Similarly, when people blindly reject scientific studies based on assumptions that the studies were funded by major companies, they are committing this fallacy. Indeed, anytime that someone resorts to a conspiracy theory to dismiss a contrary piece of evidence, they are committing this fallacy and are being irrational.
This brings me to my final point. Namely, the quality of the assumptions matters as well as the quantity. In other words, some assumptions are more justified than others. Someone could, for example be pedantic about my car example and argue that saying that the starter died and saying that the starter and spark plugs died both make the same number of assumptions because the first one implicitly assumes that the spark plugs did not die. It should be obvious, however, that (unless you have been having perpetual problems with your car) the default position should be to assume that things work. Every time that you get in your car, you’re implicitly assuming that all of its necessary parts work. Technically, you could argue that the opposite hypothesis (i.e., that none of the parts work) makes the same number of assumptions, but one set of assumptions is clearly more justified than the other (the reasons behind that get into inductive logic and the burden of proof and other concepts that I don’t have time to go into here). The same is true in science and debates. It is not valid to, for example, assume that the entire scientific community is involved in a massive conspiracy, and you can’t try to validate that assumption by saying that everyone else is assuming that the conspiracy doesn’t exist. Those two assumptions are not equal, and you need some concrete evidence before you can claim that there is a conspiracy.
In short, Occam’s razor does not state that the simplest solution is more likely to be correct. Rather, it says that the solution that makes the fewest assumptions is more likely to be correct; therefore, you should restrict your assumptions to only the ones that are absolutely necessary to explain the phenomena in question. A solution can be very complicated and still likely be correct if it is based on facts, not assumptions. Indeed, the answers science produces tend to be conceptually complex, and the history of science is a graveyard of simple ideas that were replaced with more complex ones.
One correction, It’s the General Theory of Relativity that deals with gravity, not the Special Theory.
oops. fixed it. thanks
Propaganda tells us that the federal income tax law is too complex for even experts to understand. The law, like every other body of knowledge, must follow logic principles such as the law of noncontradiction. If the logic rules and legal definitions of specific words are ignored, then the law cannot be understood correctly.
Most of the words of the law mean what they do in everyday English. But different than the scientific method, the reader must NEVER make any assumptions about what the law means; the law must tell the reader what it means. The legal definitions for some of the more “common” words do not mean what they do in everyday English. For example, a “person” and an “individual” are foreigners; not citizens of the United States. How does Occam’s Razor fit into this setting? Incorrect assumptions are why the law has been misapplied.
“Everything should be made as simple as possible, but not simpler.”
Christian apologists fall into this trap all the time when they argue that the multiverse hypothesis couldn’t possibly be true because Occam’s Razor would rule out trillions upon trillions of other universes, there fore there must be a creator.
The reality though is that some sort of multiverse hypothesis only requires a handful of assumptions such as some mechanism that can repeatedly generate new regions of space-time (or if you prefer a single infinite stretch of space or time) and some mechanism that allows different regions to have different physical constants.
It’s not as if each new universe needs to be a new assumption on its own.
Why does anybody care about non-productive mental masturbation that can never be verified one way or the other? Speaking about non-productivity, what did Stephen Hawking do to help the human race? Theorizing (speculating) about black holes did absolutely nothing to help the human race. He brought welcome attention to disabled people, but this had nothing to do with his physics.
Many (myself included) would argue that the acquisition of knowledge is good in and of itself, and researchers who advance mankind’s understanding of the universe are doing a great service for the human race, even if that research doesn’t have immediate applications. Further, who knows what future advancements and inventions might be based on his research. Arguing that research must have an immediate tangible benefit for humans for it to be worthwhile is extremely short-sighted and narrow-minded.
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I should also add that he did far more than simply speculating. The calculations that his work was based on hardly qualify as “speculation.”
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I understand those points. But there is a huge amount of wasted money in “research” at least in medicine, an area I am qualified to speak about (but also in astronomy). I love my microwave, apparently born from NASA research. I used to be of the same opinion when I was younger (all research is good because you never know when there may be unexpected benefits) but then I realized how organizations like government expand to fill the available space and NO organization curtails its activities where jobs may be lost. It’s staying in business that matters. I have a degree in theory math but I am not questioning the accuracy of the calculations. I am questioning the relevance of understanding black holes and helping the human race. No unexpected finds here that have helped humans. And the race to put men on Mars when that money can and should be used to help millions at home? It’s not just out of town projects, billions of dollars have been spent and many otherwise avoidable premature deaths have occurred from trying to make elevated cholesterol the cause of heart disease (a belief fighting to stay relevant when overwhelming evidence is accumulating that it is refined carbohydrates, not cholesterol (the official dietary policy of LFHC)). Statins do more harm than good. There is usually a deception of some sort below the surface and that deception is directly tied to economics. I know I sound cynical but these facts speak for themselves. https://www.westonaprice.org/ignore-the-awkward-by-uffe-ravnskov/
For the first half of your post, you and I simply disagree philosophically about what is and is not valuable research, and I don’t see any real value in arguing that since it is a matter of personal priorities and values.
The second half of your post is more concerning to me, as it sounds to me very much like the type of comment I get from science deniers (i.e., accuse scientists of biasedly trying to prove something, assert that it is all about the money, etc.). I have not studied the cholesterol topic at length, but from what I have studied, your comment appears erroneous as there is a lot of pretty compelling evidence that certain types of cholesterol are in fact harmful and statins do more good than harm. Science-based medicine talked about some of this evidence (most importantly a large meta-analysis) here
Yes, there are philosophical differences so there is no point in discussing those topics any further. I wanted to briefly explain some of the reasons that I don’t buy into the mainstream explanation of the diet-heart hypothesis. I worked for Joseph Goldstein, MD in medical school in 1974-1975 (this helps to show that I not only understand the diet-heart hypothesis but am capable of understanding the LACK of evidence in the subsequent years despite billions of dollars poured into research that did not show what the researchers “expected” the research to show). Even now, that sinking ship cannot be rescued; most of the researchers behind current dietary policy are dying out so this is an opportunity to correct things.
Because beliefs = emotion + logic, many if not most beliefs are at least initially immune to objective evidence that they are wrong. The 39 Heaven’s Gate suicides twenty years ago included 4 computer programmers who had to understand logic rules. But they all believed that they were not going to die but instead be “transported” to an alien spaceship hidden behind the Hale-Bopp comet. They ignored all attempts to reason with them and chose to ignore what they knew from experience, which was that all successful suicides result in the death of the person without exception, and they do not come back. Cleanup of ALL the bodies was somewhat gruesome, except that they were neatly arranged on the beds.
Now we know that saturated animal fats are protective against CVD and do not cause CVD. The research is now showing that there is a dramatic increase in CVD in people on LFHC diets. All inflammatory markers are elevated on LFHC diets, which is not a good thing. As noted at the end, we did not evolve to process refined carbohydrates and manufactured vegetable oils (because they do not exist in nature).
My previous note gave a link to Uffe Ravnskov, MD, PhD who for the last 25 years has turned over every rock about statin research. Most important has been the substitution by researchers of relative risk for absolute risk, which grossly misleads the reader (including http://www.sciencebasedmedicine.org), about the true efficacy of statins. When absolute risk is examined, the benefits of statins are no more than 1-2 %, and this is for men who have had a prior heart attack. So, for most people taking statins these drugs do nothing to prevent heart attacks and strokes, which the unchanged all-cause mortality and cardiovascular mortality makes abundantly clear.
This exposes the economic connection hidden below the surface. Drug companies have made billions of dollars from this largely ineffective therapy with so many side effects that many people stop taking them after a year. See: https://spacedoc.com/. Believers in the diet-heart hypothesis had no problem with interruption of the cholesterol metabolic pathway early on in that pathway, when cholesterol is hugely important (the cholesterol in the brain is 75% dry weight). They were so CERTAIN in their “belief” that elevated cholesterol causes heart disease that they ignored anything to the contrary (the backfire effect). In fact, elevated cholesterol is protective against infections in older people; such people have half the infection rate of those who have normal to low cholesterol levels. All this time, heart attacks were “inexplicably” happening in people with low cholesterol levels, including the ones taking statins.
1-2% efficacy means that 98% receive no benefit at all for these hugely expensive drugs. With statins, there is no change in cardiovascular or all-cause mortality, which is understood once the deception of replacing absolute with relative risk is known. So exactly why are they prescribed to so many people? For most people, because taking statins do nothing they are unaware that they are simply waiting for a (or the next) heart attack or stroke to happen.
Does this make any sense? Since the underlying causes of CVD, type 2 diabetes, and stroke have not changed (most cardiologists continue to recommend a low fat high carb diet), then one who keeps up with the science has a decided advantage. It would be dumb not to take advantage of the new evidence and stop eating refined carbohydrates.
So I am anything but a science denier. Meta analyses are of limited value. “However, there are many critical caveats in performing and interpreting them, and thus many ways in which meta-analyses can yield misleading information.” https://www.mdedge.com/ccjm/article/94919/practice-management/meta-analysis-its-strengths-and-limitations
You may not be interested in objective evidence that the diet-heart hypothesis is wrong, but how politics and the dedication of one man (Ancel Keys) started and continued this dietary policy disaster (LFHC) for so many years that has directly contributed to a huge increase in obesity, diabetes, CVD and other acute and chronic diseases since 1980 at least is discussed in a great book by Nina Teicholz entitled: “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet” ; https://thebigfatsurprise.com/
This evidence is impossible to ignore. These diseases were known about but rarely diagnosed in the 19th century, which was before food technology created cheap but toxic vegetable oils that do not exist in nature as well as access to cheap refined carbohydrates that do not exist in nature. There were plenty of old people who did not die of trauma and infections. They only ate meat and some vegetables and very little sugar. This is real world stuff, not philosophy.
As an aside and the end of my comments on your website, I appreciate your philosophical discussions about logic and other matters that you clearly understand and know a lot about.
First, sorry that your comment didn’t show up right away. For some reason it got caught in wordpress’s automatic spam filtering.
Second, quite a few of your statements seem to be clearly false. For example, although some research certainly has deceptively used relative risk (this is actually a topic I have written about previously), that is not always the case and the meta-analysis I cited actually talks about both relative and absolute risk. For example, it found that for the high cholesterol group, statins resulted in 4.3 fewer deaths per 1000 person-years. In my mind, that is a substantial improvement. Nevertheless, you repeatedly made claims like, “With statins, there is no change in cardiovascular or all-cause mortality.” That is false. The all-cause mortality did decrease with statins.
You also seem to be committing a strawman by acting as if those who accept the evidence that statins are useful think that they are a cure all and that cholesterol is the one and only cause of heart attacks (I don’t think anyone would deny that it is more complex than that). For example, you said, “All this time, heart attacks were ‘inexplicably’ happening in people with low cholesterol levels, including the ones taking statins.” No one ever said that statins were 100% effective or that people with low cholesterol can’t have heart attacks. That’s about like an anti-vaccer saying that vaccines don’t work because some people who receive vaccines still get the disease.
Your criticism of the meta-analysis is also problematic. I disagree with the statement, “Meta analyses are of limited value.” When done correctly (as this one seems to have been) they are very powerful tools. Granted, they do have to be done correctly, and there are a lot of caveats with them, but that does not give you carte blanche to disregard any meta-analyses that disagree with you. You need to point out specific reasons why this particular meta-analysis is flawed.
Finally, your comment is riddled with anecdotes, appeal to authority fallacies, a correlation fallacy, etc. You said, “You may not be interested in objective evidence that the diet-heart hypothesis is wrong.” I’m all about objective evidence, but anecdotes, correlation fallacies, etc. aren’t objective evidence. I want to see the large, carefully controlled peer-reviewed studies that show that statins do more harm than good, high cholesterol is actually beneficial in the elderly, etc.
Again, just to be 100% clear, I am not saying that cholesterol is the only thing that matters for heart health. There are obviously other factors, but evidence like the meta-analysis and studies cited therein seem like pretty compelling evidence that cholesterol is a factor and statins help to reduce it.
I don’t have anything to say about your criticisms of my writing style because I don’t respond to ad hominem comments. You say that your assessment of the evidence supports what the statin manufacturers want people to believe. And you consider yourself qualified to judge this evidence based on a few links to supporters of the diet-heart hypothesis? We have different evidence standards.
If you really want to see objective evidence that statins are of very limited value, including in depth analysis of the articles that claim that the risk of a heart attack is significantly reduced with statins, go to the Uffe Ravnskov link I sent earlier. He has spent 25 years doing this and is much better than anyone else I have seen. But something tells me you won’t do it….
I don’t know of anybody who wants to plow through the evidence/lack of evidence for statins and the diet-heart hypothesis and try to find a succinct conclusion one way or the other. Some of the important findings have been summarized below. I hope that there are a few readers of these posts who may be suspicious that mainstream medicine has led them down the wrong path:
1. Vitamin D is synthesized from cholesterol by sunlight.
2. Cholesterol is the precursor for a whole class of hormones known as the steroid hormones that are absolutely critical for life … a primary component for most sex hormones, bile acids, aldosterone, cortisol and calcitriol (necessary for maintaining the proper calcium in our bodies.)
3. Cholesterol and fats are not related.
4. “There is no connection whatsoever between cholesterol in food and cholesterol in blood. And we’ve known that all along. Cholesterol in the diet doesn’t matter at all unless you happen to be a chicken or a rabbit.” Ancel Keys (fabricator of the cholesterol myth).
5. Fats and cholesterol are moved through the system by lipoproteins.
6. HDL, high density lipoprotein, (not cholesterol).
7. LDL, low density lipoprotein, (not cholesterol).
8. VLDL, very low density lipoprotein, (not cholesterol).
9. VLDL’s are manufactured in the liver used to transport fat and cholesterol.
10. LDL’s are the reduction of VLDL’s after the fats and cholesterol have been delivered.
11. VLDL’s are raised by eating carbohydrates.
12. High fat diets lower VLDL’s … check out the results from the Atkin’s diet studies or any of the other high protein low carbohydrate diets.
13. Regardless of the variability of VLDL’s, LDL levels remain relatively constant.
14. It has never been proven that saturated fats raise or lower LDL’s. Dr. William Castelli, Director of the Framingham Study [the largest continuous study of its kind in the world] states that the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower people’s serum cholesterol (LDL). Dr. George Mann, New England Journal of Medicine, regarding the diet-heart hypothesis: “The greatest scam in the history of medicine.”
15. Statins block the Mevalonate pathway in the liver affecting the distribution of other important items necessary for healthy cell production and operation. The most notable is CoQ10, a primary support for heart cell growth and operation. Reduce cholesterol synthesis by 50% and you also reduce CoQ10 by 50%. If you take statins, you must take CoQ10. Statin drugs are now known to suppress the nuclear factor-kappa B response and thereby open a veritable Pandora’s box of unpredictable consequences. Statin drugs also inhibit dolichol, vital to the intricate process of neuropeptide formation, consequently another broad range of potential behavioral manifestations.
16. After an eleven year study, the Surgeon General’s office could not find evidence to support the diet-heart hypothesis i.e. saturated fat causes heart disease.
17. Even taking the best possible figures, from selected trials, and painting them in the best possible light…if you took a statin for thirty years, you could expect five to six months of increased life and that is only for men with pre-existing heart disease. For women it is pointless and cannot extend your life by even one day.
18. The French have the highest rate of saturated fat consumption in Europe (Switzerland #2) yet have the lowest rate of heart disease (Switzerland #2).
19. After World War II, Switzerland’s fat consumption increased by 20%. Heart disease fell.
20. The PROSPER pravastatin trials (as published in The Lancet) showed that though there was a reduction in cardiovascular disease (CVD), the increase in cancer deaths completely offset the slight decrease in CVD.
21. Professor Michael Oliver, Finland study ten year follow up, found that people who followed the controlled cholesterol-lowering diet were twice as likely to die of heart disease as those who didn’t.
22. High cholesterol is not a risk factor for strokes.
23. The cholesterol levels in Japan since WWII have risen by 20% but the rate of strokes has fallen by 600%
24. Framingham Study: There is a direct association between falling cholesterol levels and an increase in CVD death rate.
25. No controlled, randomized study has ever been done in which raising HDL levels have reduced the rate of heart disease.
26. Veins don’t develop atherosclerosis unless they are removed and used to bypass an artery.
27. The brain contains over 25% of the total amount of cholesterol in the body and cholesterol is over 25% of the total weight of the brain. If you want the brain to function, it requires cholesterol.
28. Low cholesterol levels lead to reduced serotonin [anti-depressant] levels in the brain
29. From the Royal College of Psychiatry paper titled “Low Cholesterol May Indicate a Risk of Suicide” … Lower cholesterol levels were related to higher levels of self-reported impulsivity….
30. Statin drugs have been linked to over 300 side effects … primary known statin side effects: polyneuropathy e.g., sensation changes, memory, speech impairment, joint pain, muscle pain & muscle damage (widely reported), fatigue, liver damage, cancer, cataracts, sexual dysfunction, serious degenerative muscle tissue condition (rhabdomyolysis).
31. 2012, FDA Adds New Warning Labels to Statin Drugs … Liver damage, Memory loss and confusion, Type 2 diabetes, Muscle weakness.
32. 900 studies that show statin drugs are dangerous.
33. In forty years examining the link between saturated fat, cholesterol and heart disease, NO direct role for these substances in the causation of cardiovascular disease has ever been established. At best, it is still a hypothesis.
34. Coronary heart disease (CHD) deaths have been declining – which includes non-fatal disease – CHD is not; it is remaining steady or even increasing i.e. people are having just as many heart attacks as ever – if not more – but emergency medical treatment has become increasingly adept at saving their lives. Framingham Study: “Our data indicate that the decline in mortality was primarily the result of improved survival among persons with new cases of cardiovascular disease, rather than the result of a substantial decrease in the incidence of the disease.”
35. The AHA (American Heart Association) earns more than $650 million/yr. primarily from endorsements and licensing fees (drug companies). … From the Wall Street Journal and stated by the president of AHA, “Our philosophy was that to get more money from politicians, we had to show that good things were happening”.
36. High cholesterol levels have been associated with increased mortality before the age of fifty, but after this age cholesterol levels in men and women showed NO relationship with cardiovascular disease (CVD), stroke, or total mortality. Framingham Study: Those whose cholesterol levels had decreased during the study experienced an increase in both total CVD and mortality.
37. Muldoon’s reports in the medical literature documenting cognitive impairment in 100% of statin users if sufficiently sensitive testing is done.
38. 12,000 Osaka residents age 40 – 69: every 39mg/dl drop in blood cholesterol was associated with a 21% increase in overall mortality. The lowest overall mortality rate was in patients whose total cholesterol (TC) was between 200 – 259mg/dl. The highest death rate was observed in those whose TC was below 150mg/dl.
39. MRFIT, 36,000 men 35 – 57: Those in the lowest cholesterol category, less than 140 mg/dl, had a higher all-cause death rate than all but the very highest category. The lowest mortality was seen across the 160 – 219 mg/dl.
40. Use caution when reviewing mortality results: total mortality vs. CVD mortality should take precedence. If you are dead, you are dead regardless of the cause. Overall total mortality begins to rise when blood cholesterol drops below 180 mg/dl. Low cholesterol showed significant associations with death from cancer, liver diseases, and mental diseases. “The low cholesterol effect occurs even among younger respondents, contradicting the previous assessments among cohorts of older people that this is a proxy or marker for frailty occurring with age.”
41. NHLICB, special conference: Evidence from a multitude of studies was presented linking low blood cholesterol levels to increase in various cancers, hemorrhagic stroke, respiratory and digestive diseases, and violent death.
42. Muldoon: Low cholesterol levels can impair normal brain functions … mean total reaction time of men in the lowest category of blood cholesterol (avg. 152mg/dl) was 12.7 milliseconds slower than that of the highest category (avg. 242mg/dl).
43. Japanese experience a low rate of heart disease and the longest average life expectancy in the world. By 2000 total fat and animal fat intake in Japan had risen over 250% from 1961 levels.
44. In 1960 the leading cause of death in Japan was stroke. Since both stroke mortality and incidence decreased dramatically, animal fat and protein intake markedly increased, blood cholesterol levels increased, while dietary salt intake and blood pressure levels decreased.
45. Japan studies: 1984 -2001, men and women with the highest intake of animal fat had a 62% lower risk of ischemic stroke deaths. The highest quartile of saturated fat intake had a 70% lower risk of hemorrhagic stroke than those in the lowest quartile.
46. Framingham Study: “…in Framingham, MA, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol … we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least, and were the most physically active.”
47. NCEP “experts” (funded by drug companies) cite compelling evidence and recommend LDL levels less than 70 mg/dl. Researchers however looking for the “compelling” evidence stated: …”no clinical trial subgroup analyses or valid cohort or case-control analyses suggesting that the degree to which LDL cholesterol responds to a statin independently predicts the degree of cardiovascular risk reduction.”
48. Statin trials are controlled by drug companies who exclude patients e.g. women of childbearing age, history of drug or alcohol abuse, poor mental function, heart failure, arrhythmia and other cardiac conditions. Would you be allowed into a trial? This is hardly a sampling of the general population, the people that these drugs will affect the most.
49. 51% of prescription drugs are found to have serious side effects not detected prior to regulatory approval.
Hold on a second here, I never said anything about your writing style, nor did I make anything even approaching an ad hominem. Every part of my comment was addressing problems with your reasoning and evidence, and at no point did I attack you. Exactly what part of it are you reading as ad hominem? This response reeks of a refusal to deal with contrary arguments and problems with your reasoning. Pointing out that someone made a logical blunder is not ad hominem.
As far as standards of evidence, my standard is the peer-reviewed literature, which I why I presented a massive meta-analysis which you simply ignored rather than actually pointing out any problems with it. That is the very definition of science denial.
Regarding your link to Uffe Ravnskov, I followed the link when you first posted it, but it goes to a book review, and I don’t have that book sitting in front of me at the moment, so I can’t exactly evaluate it for this conversation. Further, I am inherently skeptical of books like this because it is so easy for an author to cherry pick and misrepresent studies (that’s why groups like anti-vaccers love books like this). That’s why I prefer systematic reviews and meta-analyses. To put that another way, books have to be carefully fact checked against the peer-reviewed literature, so why not just start with the literature?
You seem to be making quite a few assumptions about my willingness to look at contrary evidence, even though I keep asking you for it and you keep failing to provide it. I gave you a large meta-analysis that says you’re wrong, and you are just ignoring it without giving me any primary sources to the contrary.
I clearly don’t have time to fact check and respond to your entire gish gallop, but from quickly scanning through it, I’ll make two comments. First, to the best of my knowledge, many of your points are correct. Again, I’m not saying that all cholesterol is bad, it’s 100% a result of your diet, etc., but I haven’t seen any evidence to convince me that you are correct that it plays no role in heart conditions, statins do more harm than good, etc. (and I’ve seen plenty of studies to the contrary). Second, again, I want evidence, not just statements of what you think is true. The burden of proof is on you to provide actual studies to back up your position. I presented you with a meta-analysis that shows that statins save lives, so explain to me why that analysis was wrong and give me the studies that demonstrate that statins do more harm than good.
Do you have a copy of the original article? https://jamanetwork.com/journals/jama/article-abstract/2678614?redirect=true
I have two PDF articles to send you (and anybody else who wants to see the unadulterated evidence) that have more than sufficient detail to back what I said, but are a whole lot better organized and therefore easier to read. Is there a way to attach these?
I’m not aware of any mechanism for attaching pdfs. Are these actual studies, or more secondary sources?
In response to your question about the meta-analysis, I have a copy via my university’s library, but I’m not sure how to give it to you. You should be able to download a copy from Sci-Hub though https://sci-hub.tw/
From Customer Support:
For you to attach PDF in your comments on https://thelogicofscience.com, the site owner needs to install a plugin, not you.
To deliver your pdf, you could upload the pdfs to your own site, then include the links in your comments.
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The only plug in I have been able to find that enables this is for wordpress.org sites (the paid version of wordpress) and mine is a wordpress.com site (the free version). Unfortunately, as you might expect, the features and plug ins available for the free version are quite limited.
These download links should work for those papers:
Click to access ExpertRevClinPharmacol2015StatisticalDeceptionInStatinResearch.pdf
Uffe adds these comments,
“Obviously the authors have excluded trials with the opposite result because there are many more statin trials than the 34 mentioned. The first paper has been attacked by many of the statin advocates, but none of them have been able to find a study with the opposite result.”
Sorry for the slow reply. I just haven’t found the time to read these papers and several others that I found, and obviously I can’t evaluate them and make a rational response without actually reading them first. I’m hoping to find time tomorrow.
Reading the original research articles about statins is difficult even for physicians. As you are well aware, language and statistics can be used in a deceptive manner and this has been done perhaps unconsciously, but there is a lot (meaning mostly money) riding on the conclusions of these studies. The objective evidence, once teased out completely, is much easier to understand after people like Ravnskov do it, who is then very good at summarizing so that it is easier to understand. If there are specific questions then one can always track backwards to the data in the articles. Ravnskov has no conflicts of interest and uses his own money. There is nothing to be gained financially but that is not his motivation.
Although a physician must do no harm, there is a lot of pressure from mainstream medicine (or whatever the official policy) to do what they say when dealing with patients. On the other hand, every individual should be able to decide for themselves how they want to be treated or not treated. Personally, I have never taken statins. Once I understood that doing so meant at best a 1-2% benefit, then I started looking elsewhere. I am not trying to convince anyone to believe like I do, but I do think that they need to be able to see both sides of an issue. As a result of looking elsewhere, the most recent data are very concerning about the role of refined carbohydrates, particularly sugar, in the genesis and progression of heart disease and I have eliminated them from my diet.
Here is something very interesting and pertinent to the epidemic of “chronic” diseases of our time. Type 2 diabetes, coronary vascular disease, and obesity were known about in the 1800’s but rarely diagnosed. There were none of the refined carbohydrates that do not exist in nature that we eat today except sugar and the sugar price dropped considerably by the 1850s while consumption increased (because it was cheaper). In addition, there were no manufactured vegetable oils (yet) but by the turn of the century, men who were born in the 1850’s were consuming up to 90 pounds of sugar per year. It was in the 1920’s that the CAD epidemic started (mostly in men 60+ years old)
Given all the food choices today, it was a near ideal environment for isolating dietary variables.
In the 1700’s and 1800’s the clinical presentation of too much narrowing of the coronary arteries was pretty straightforward; a person with the disease presented with chest pain (angina) or was DOA after the sudden onset of chest pain (many first heart attacks are fatal). Without the advanced cross sectional imaging of the second half of the 20th century, being more precise before death wasn’t possible. In the 1800’s there were plenty of old people who did not die of trauma or infections whilst eating mostly meat and sometimes vegetables so if these diseases existed to any extent, then they would have been diagnosed.
I have a great graph of the drop in sugar prices paralleling an increase in consumption that accelerated around the 1850’s but cannot add images here. Googling finds some easy to understand information about this paradigm shift:
I finally found time to read the studies you cited as well as doing some digging through the literature myself. I’ve certainly haven’t had time to do a truly comprehensive reading of the literature, so I acknowledged that I would need to study this topic further before I could make any adamant statements of what the literature does and does not say. Having said that, I found plenty of evidence to make me very, very skeptical of the claims that cholesterol doesn’t play a role in heart health and statins do more harm than good.
Let’s start with the review that your provided. While reading through it, I had some serious concerns about confounding factors in the studies that they were using. Indeed, the authors even acknowledged that some of the patients may have started using statins during the trials. This study has also been heavily criticized by the Center for Evidence-based Medicine. https://www.cebm.net/2016/06/cebm-response-lack-association-inverse-association-low-density-lipoprotein-cholesterol-mortality-elderly-systematic-review-post-publication-pee/
Ideally, I’d like to read through all of the studies that they used myself, as well as doing a thorough literature search for other relevant papers that they might have missed (search criteria were another potential issue), but unfortunately I don’t have time for that at the moment. So, for sake of argument, let’s assume that this study is correct. Would that negate the connection between cholesterol and heart health? No. Beyond the confounding factors that the studies hopefully corrected for (e.g., statins) there are tons of other factors associated with the elderly (e.g. other medications and health conditions) that can result in different effects for them than for everyone else. So, at best, this review would demonstrate that cholesterol and heart attacks aren’t linked in the elderly. You can’t extrapolate from that to the general population.
Moving on, I found plenty of evidence on other age groups showing that cholesterol is a factor in heart health. For example, this massive meta-analysis https://www.ncbi.nlm.nih.gov/pubmed/18061058?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Now, specifically regarding statins, the evidence seems pretty clear that they do actually reduce mortalities. Even the studies in the Ravnskov opinion paper you cited demonstrate this, and the meta-analysis I cited previously demonstrated this. There are also plenty of other papers supporting that conclusion, such as this meta-analysis of RCTs http://www.saofranciscoodontologia.com.br/images/online/Cholesterol_Safety_and_Efficacy_Metanalise_Lancet_downloads.pdf
So your extreme claims that cholesterol has nothing to do with heart health and statins do more harm than good seem clearly to be wrong. You can’t look at study after study after study that found significantly fewer mortalities in the statin group and then say that they are doing more harm than good. The evidence doesn’t support that position.
Nevertheless, you could try to take a more nuanced position and say that they do some good, but it is minimal. This seems to be what Ravnskov is doing with his arguments about relative risk. I have several objections to this, however. First, the studies that I looked at all talked about absolute risk as well as relative risk, so there is something of a straw man occuring. In the meta-analysis of randomized controlled trials, for example, they reported that for people without a history of cardiovascular problems, statins prevented 25 deaths out of 1000 people, and for people with history, they prevented 48 deaths out of 1000 people (those numbers are for a cholesterol reduction of one fifth per mmol/L LDL). As far as I’m concerned, that is significant and beneficial.
Second, Ravnskov is correct that you can play games with relative risk to make it look like the benefit is greater than it is, but the inverse is also true. You can present absolute risk in a biased way that makes benefits appear smaller than they are (which is what you and Ravnskov are doing). An absolute improvement of 1-2% sounds tiny by itself, but when you consider that the initial risk was fairly small to begin with, then the benefit is actually meaningful. So you need to look at both types of risk.
Let me put it this way, if the absolute risk is 2% to being with, and with a treatment drops it to 1%, it would be silly to say that a change of 1% isn’t important. There are two reasons for this. First, that is a reduction of 50% relative risk, which is important, because it does mean that half the people who would have died from the condition won’t. Second, if we are going to say that 1% isn’t important, then why were we even worried about the 2% risk in the first place? In other words, if an improvement of 1-2% absolute risk doesn’t matter, then why were we so concerned about a 2% risk at all? Do you see my point? This argument simultaneously says that a 2% risk is serious but a 1-2% reduction is not. That’s not logically consistent.
In addition to all of that, there is evidence that the benefits of statins increase greatly for people who have already had a heart attack. In other words, they are quite good at preventing a second heart attack (this further demonstrates their usefulness and refutes the argument that cholesterol and heart health aren’t linked).
Regarding the primary literature vs secondary literature, scientific studies can be hard to understand. Fortunately, in my case, I have about a decade of training and experience in understanding them and doing statistics. So, while my medical knowledge is certainly not on par with an MD’s, I do have the necessary training, experience, and qualifications to evaluate the statistical methodologies of studies.
Further, the problem with relying on secondary sources is inherently that you are placing your faith in someone else’s abilities and objectivity. Ravnskov does have a conflict of interest because he makes money from his books, but even ignoring that, someone with no conflicts of interest can still be very biased and very passionately wrong. When you have a few lone authors like this vs the rest of the medical/scientific community, it is usually the lone authors who are wrong. Anti-vaccers, after all, have tons of books that they claim tell the real objective story, and they also criticize the opposing literature as being corrupted by money (which is the exact same argument you are making). Additionally, several other skeptic sites that are usually fairly reliable are critical of his work. That obviously doesn’t make him wrong, but it does make me skeptical enough that I’m not about to place blind faith in him and will continue to get my information form the peer-reviewed literature.
Finally, regarding your comment below about changes in rates of things like diabetes over time, I suspect that you are fully aware of the problems with using correlation as evidence of causation. After all, anti-vaccers, the anti-fluoride crowd, etc. also point to the changes in various conditions overtime as evidence for their pet views, as well as arguing that in the past there were plenty of people who lived to an old age with vaccines (if it is wrong for them to make those arguments, then it must be wrong for you to do it as well).
I’m afraid that this will have to be my last comment on this topic because I don’t have any more time to invest in it.
This is the epilogue from Ravnskov’s first book and a link his newsletters. They are written in a way so that intelligent lay people can understand it.
After a lecture, a journalist asked me how she could be certain that my information was not just as biased as that of the cholesterol campaign. At first I did not know what to say. Afterwards I found the answer.
She could not be certain. Everyone must gain the truth in an active way. If you want to know something you must look at all the premises yourself, listen to all the arguments yourself, and then decide for yourself what seems to be the most likely answer. You may be easily led astray if you ask the authorities to do this work for you.
This is also the answer to those who wonder why even honest scientists are misled. And it is also the answer to those who after reading this book ask the same question.