You Say Potato...

Potato chips give one-third of Americans the runs!

This is one of the many ways to interpret the study on the gastrointestinal effects of the new miracle fat substitute Olestra, reported in the February 16 issue of the Annals of Internal Medicine ("We Can Kick The Archives of Internal Medicine's Ass") and sponsored by Procter & Gamble, who don't have a Satanic logo anymore so stop spreading those rumors. Olestra is, as some of you may recall from several breathless articles in the mainline news media a couple years ago, a product that somehow fools your taste buds into thinking it is fat and then drops the shameful charade and reveals its true non-fatty self in the lower gastrointestinal tract.

The good side of this is that you think you're eating tasty fat...mmmm...fattening....Ahem. The bad side, or so some discovered, is that Olestra performs some other strange maneuvers in your lower gastrointestinal tract whereby it persuades it that the Olestra, and anything else that happens to be sitting around in the tract at the time, need to be expelled real soon.

Obviously this is a reputation that, once gained, would be hard to shed and overcome. It would require the finest minds at Duke University Medical Center, except that they only hired one. (Note to readers: this author was the "lead" author, so his affiliation, the reasonably independent-sounding Duke University Medical Center, shows up in my personal database, covering up the detachment of P&G personnel who did the entire rest of the work. Sneaky.) It would require a "randomized, placebo-controlled" trial, which means here that they were sending random potato chip-eating families either Olestrafied chips or the regular arteriosclerotic omen kind, without telling them which they were chowing down on. And it requires a bunch of incomprehensible statistical equations, all of which come down to two main results:

1. Olestra wedges gave 38.2% of users gastrointestinal symptoms, which would sound like a lot, except that
2. Regular fatty potato chips gave 36.9% of users gastrointestinal symptoms. Thus Olestra was not more, at least after any statistical significance test. So while Procter & Gamble wants to put forward the story that Olestra is comparable to regular ol' fat, perhaps the real story should be "FRITO-LAY DIARRHEA MENACE!"

And, as my buddy Howard M. Spiro of Yale University noted in the funniest editorial I have ever read in a medical journal, 44% of people who thought they were eating Olestra had problems, and 31% who thought they were eating regular had problems; "in other words, just thinking they were eating olestra caused digestive distress," Spiro notes. To close with verse:

If your bowels are erratic
It's probably psychosomatic
Gastrointestinal symptoms, cha cha cha
Gastrointestinal symptoms, cha cha cha

I feel it important to note that Spiro's editorial was actually funny (for the conflict-of-interest disclosure section, he wrote "I'm fat, and I welcome olestra-containing products as potential allies") simply because scientists are so incredibly poor at humor in general, which is probably why so few of them have second careers as stand-up comedians. For example, the following from the March 1 Journal of Urology ("Male Pain Illustrated!"), titled "With Apologies to Shakespeare":

"To treat or not to treat? That is the question! Whether 'tis nobler in the mind to suffer the slings and arrows of the activist and capitulate to the temptation to do something in the face of adverse urodynamic findings or resist and spare the parent of the child with myelomeningocele the added burden of intermittent catheterization."

Damn, you better apologize to Shakespeare, boy, especially for using the anti-euphonious word "myelomeningocele." Methinks perhaps a PET exam would turn up adverse neurological findings for this doctor, which perhaps (I've seen too many college papers written in the wee hours that read like this) are related to issues being studied at Vanderbilt University's Institute for Coffee Studies.

Yeah, that's right, the fluid 75% of Americans wish came in an IV drip now has its very own institute with $6 million to spend on finding out stuff about it. It sez here in Nature Medicine ("There's Nothing Wrong With Not Being Good Enough For Nature Magazine Itself") that drinking coffee has "inverse correlations" with "suicide, cirrhosis, and colon cancer," which I guess is why you see so few Brazilians spurred to felo-da-se by their liver and rectum problems. In any case, the institute has been set up to answer the question of why exactly these inverse correlations exist, and certainly not to investigate why people get so snappy and irritable if they have either too little coffee or too much, as the whole thing is being funded by, um, coffee growers. They say there'll be no conflict of interest, we're not on the coffee payroll, NIH bought us this Mercedes, blah, blah, blah. Still, it's easy to subconsciously skew a result when you're aware that you're beholden to someone who wants you to come up with something salable. Just look at Olestra, for example. As Hamlet might say, "There is oftimes a special providence in the fall of a gastrointestinal symptom, particulary when you are being paid to notice these things."

So if you see the New York Times trumpeting a cure for cirrhosis on the front page any time soon, remember to be wary. As with the "cancer vaccine," it might well just be a case of the New York Times psychosomatically summoning bovine gastrointestinal symptomology. Cha, cha cha.

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