The Lucky Years: How to Thrive in the Brave New World of Health (24 page)

• Dad discovers unique way to regrow hair.

• Diet cures cancer.

• Study: Placebo or not, acupuncture helps with pain.

• Vitamin E improves brainpower.

• Low vitamin D levels cause type 2 diabetes.

• Yoga and meditation can reverse heart disease.

• Chemicals in foods make you fat and sick and age you faster.

• Pasteurized milk is toxic.

• GMOs are toxic.

• Sugar is toxic.

• 
You
are toxic!

Aspirational ideas are attractive. It’s human nature to believe that there’s a “secret” to being thinner, younger, sexier, smarter, and richer. While these beliefs can sometimes do us good, they can also lead us far astray from what’s real and what’s actually helpful. And a quick search online to decipher between truth and fiction might not help you out either. In 2014, a study published in the
Journal of the American Osteopathic Association
found significant errors in 9 out of 10 Wikipedia articles related to the ten most costly diseases and conditions in the United States, including coronary artery disease, major depression, diabetes, and back pain.
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The study stated that Wikipedia has become a go-to source for health care information for both patients and practitioners, which isn’t too surprising when you think about it. As I said, we all like swift resolutions, and Wikipedia is always a click away, usually at the top of the list of results to any search. But all sources, even peer-reviewed journals, can contain errors. You just cannot rely on any single source, no matter where it comes from.

Let’s say, for a quick example, that you hear about saw palmetto being good for an enlarged prostate. It’s advertised on television, in articles, and at your local pharmacy or market where supplements line a long aisle of organic wares. You think it’s harmless but potentially
beneficial. No one mentions side effects. And no one alerts you to the fact that saw palmetto changes the way the body metabolizes some drugs. It also slows blood clotting and acts like a hormone in the body. Once you begin to understand these nuances, a whole new picture emerges that’s totally different from the one drawn in your head from advertising.

I always try to make conclusions based on good research, which typically means large-scale, double-blind, placebo-controlled studies that weed out certain variables and have conclusions that clearly reflect the results, are meaningful for people, and can be replicated by others in equally rigorous studies. Unfortunately, such studies are few and far between these days. And erroneous studies and conclusions can remain alive in the public imagination for many years despite new evidence to refute them. Look no further than the current debate about vaccines and autism, which was sparked by an unscrupulous doctor who published a bad study in a prestigious journal more than fifteen years ago.

You likely know some of the story. In 1998, a British doctor, Andrew Wakefield, announced that he had found a relationship between the MMR vaccine (for measles, mumps, rubella) and the development of autism. The MMR shot is usually administered to children at twelve months of age followed by a booster between ages four and six. According to Wakefield, who studied a scant twelve children, three vaccines taken together could alter immune systems and ultimately damage the brain. His findings landed in the British medical journal
The Lancet
and took the world by storm. But soon thereafter, his findings were declared fraudulent, as dozens of epidemiological studies found no merit to his work. His paper was retracted and the British medical authorities stripped him of his license to practice medicine.

But his legacy lives on in communities of people who still believe in his vaccine-autism link. Wakefield himself continues to support antivaccine rhetoric from here in the United States, creating fear among people who can benefit from life-saving vaccines. Among the initial leaders of the antivaccine movement have been celebrities with no
medical degrees whatsoever, and popular bloggers with large online platforms. The science behind these vaccine-averse individuals isn’t science at all. It’s anecdotal evidence: “My son got the shot and then he wasn’t the same.” In Latin, there’s an apt phrase for such fallacy in logic:
Post hoc, ergo propter hoc
. In English, “After this, therefore because of this.” And in plainspeak: Event B follows Event A, so B must be the direct result of A.

Post hoc reasoning is the basis for many erroneous beliefs and even superstitions. An infinite number of events follow sequential patterns that appear to be cause and effect when in fact they are not related at all. For example, you forget your lucky charm and perform poorly on a test. You get a cold, so you drink more orange juice thinking the vitamin C will help, and you feel better a few days later. You get a flu shot and come down with a stuffy nose and sore throat within days, so you conclude it must have been the shot that made you sick. But sequences don’t establish even a probability of causality any more than correlations do. Accidents and coincidences happen. When one thing happens after another, that doesn’t mean the first thing caused the other.

Unfortunately, there’s plenty of bad “evidence” going around the vaccine-autism debate to stir the pot of confusion. Antivaxxers, as they have been labeled, make their “scientific” case by cherry-picking a “peer-reviewed” paper that states what they believe, rather than looking at all the evidence before arriving at a conclusion. And if they did look at all the evidence, they’d have to find a way to reconcile the fact that there are more than one hundred articles that completely and utterly refute any causal link between the MMR vaccine and autism. For more than fifteen years, these papers, written by some of the world’s best biomedical researchers in toxicology, neurology, immunology, microbiology, physiology, public health, and epidemiology, have been published in the top medical journals. The results have been repeated by independent researchers, and the statistical analyses are irrefutable.

But here’s the other interesting thing: it’s hard for us to change our beliefs. This is probably especially true when it comes to matters of life and health.

In 2014, a study came out that showed how stubborn we can be. It revealed that countering a big misperception can backfire. The study looked at people’s concerns about the flu vaccine in particular; more than 4 in 10 Americans (43 percent) endorse the myth that the flu vaccine can infect you with the flu.
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Some people believe it contains dangerous ingredients, such as mercury, formaldehyde, and antifreeze; that it can cause neurological disorders; that you don’t need the vaccine if you’ve never had the flu; and that flu vaccines are a ploy for Big Pharma and doctors to profit, to name just a few of the myths.

Dartmouth researcher Brendan Nyhan, who led the study, noted that we tend to think that communication is a “silver bullet”—when someone corrects you using facts, such as the fact that a flu vaccine does not cause the flu, you’ll then change your behavior and get a flu shot. But no, that actually isn’t the case. Nyhan and his research partner, Jason Reifler of the University of Exeter, first created three groups by randomly dividing up 1,000 people. Then those people were asked how worried they were about serious side effects from vaccines. This allowed Nyhan and Reifler to identify those who were “very concerned” or “extremely concerned” about vaccines generally. Nearly a quarter of people (24 percent) overall met this criteria, and they were split up equally among the three groups.

Next, the researchers strategically dispensed information. They gave one group materials that detailed influenza’s potential dangers. Another group got an explanation of how the flu vaccine cannot make you sick. And the third group received no information; they were left to stick to their own beliefs and assumptions. After the first two groups read the information, all the participants were asked more questions: How likely were they to get the flu vaccine this season? How safe did they think it was for most people? How accurate was it to say you can contract the flu from the flu vaccine?

The materials discrediting the myths of the flu vaccine did make a difference. Among the people most concerned about side effects, 70 percent of people in the group that didn’t receive any information (the
comparison group) thought the flu vaccine could give them the flu, compared with 51 percent who read the information debunking the myths. In those with the least concerns, 39 percent of the comparison group and 27 percent of those who read the myth-buster believed the fiction.

But here’s where the social study got interesting. The debunking materials might have shifted people’s perceptions of flu shots but not necessarily their intentions to get one. Less than half of those in the comparison group who worried about side effects said they planned to get the vaccine, which isn’t surprising since they didn’t read the materials. But only 28 percent of people with high concerns who read the flu facts said they
might
get one, as none of these “concerned” individuals had totally changed their mind. Saying that you might get the vaccine doesn’t mean you will. In the words of Nyhan, “If you can’t change their intentions, good luck changing their behavior.” The study showed that even among those who were provided information about the dangers of the flu, the facts had no effect on their beliefs about vaccine safety or their intentions to vaccinate.

How did the researchers explain this odd behavior that defies logic and common sense? Clearly, if misperceptions of the facts support the antivaccination mentality, then invalidating those myths should increase people’s willingness to vaccinate. But that didn’t necessarily happen in this experiment, suggesting that misperceptions about vaccines “may be a reflection of less favorable attitudes toward vaccines rather than a cause.” In other words, people are going to believe what they want to believe—and those beliefs will drive their behaviors.

Some experts in social psychology and cognitive science call this phenomenon “motivated reasoning.” We make decisions based largely on emotions; it’s our unconscious tendency to fit information to conclusions that suit some end or goal. Put another way, we essentially move the goalposts in our arguments to meet our needs and conclusions while ignoring contrary data, even if there’s plenty of it. People who use motivated reasoning respond defensively to contrary evidence. They actively discredit such evidence or its source without logical or evidentiary justification. It’s confirmation bias to the extreme.

Why do we defend obvious falsehoods? It can’t be just to always feel as if we’re right. Social scientists posit that our desire to avoid “cognitive dissonance,” as they call it, drives motivated reasoning. In other words, self-delusion feels good.

Dan Kahan is a professor of law at Yale Law School. He explains a classic example of motivated reasoning by describing an experiment done in the 1950s when psychologists asked students from two Ivy League universities to watch a film that featured a set of controversial calls made by referees during a football game.
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The game happened to be between teams from their respective schools. The students from each school were more likely to interpret the referees’ calls as correct when they benefited their school’s team than when they favored their rival. The psychologists concluded that the emotional stake the students had in affirming their loyalty to their respective institutions colored what they saw on the tape.

I love how American satirist H. L. Mencken put it: “The most common of all follies is to believe passionately in the palpably not true. It is the chief occupation of mankind.” In
Brave New World
, Aldous Huxley wrote, “One believes things because one has been conditioned to believe them.”

This can be harmful in health circles because it drives foolish ideas that spread over the internet, attracting new subscribers who just don’t know how to distinguish between what’s truth and what’s less than the whole truth or utterly false. Claims that vaccines cause autism, that climate change is a hoax, and that AIDS is not caused by HIV are all examples of motivated reasoning.

In the Lucky Years, we’ll need to reshape our context continually and adapt quickly to new data, especially the kind that should change our behaviors and ways of thinking. But right now, we see what we want to see. We think what we want to think. And we’ll go to the end of the earth (even if we think it’s flat and that the sun revolves around it) to protect our coveted beliefs.

So is there any point in countering all the mythology that lives in our society today so we can benefit more in the Lucky Years? Of course there is. You may not succeed in convincing every person, but,
hopefully, you can tip the scales in favor of the reliable data so newcomers can absorb the facts first before being convinced of something else. First impressions count.

Surprisingly, in the flu vaccine study, people with low concerns about it were no more or less likely to get the vaccine after reading the corrective information. Nyhan brings up a good point: perhaps mentioning the myth to begin with may have negative effects. Earlier research has shown that reminding people of the myth can have the effect of validating it in their minds, creating an “illusion of truth” that may reinforce those falsehoods. Unfortunately, we in the scientific community don’t know yet how to present data in ways that will reliably persuade people to change their minds.

The vaccine wars of today, stirred up most recently by outbreaks of vaccine-preventable diseases like whooping cough and measles, are nothing new. They are as old as vaccination itself. When Edward Jenner, a brilliant English country doctor, developed the vaccine for smallpox in 1796, he was both praised and mocked, lauded and feared. Religious authorities accused him of playing God, and even the equally bright economist Thomas Malthus lost sleep over the thought that vaccines would lead to unsustainable surges in the number of people on the planet. And when people first heard about getting an injection of foreign animal matter into their bodies, they were taken aback.
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Jenner himself was the butt of jokes as cartoons emerged showing cows’ horns shooting up from the heads of recently vaccinated people.