“Alcohol is a social lubricant that brings people together … there’s nothing healthier than having a good time with friends …. [just] don’t have it for breakfast,” one of the Trump administration’s top health officials declared earlier this month.
Mehmet Oz, director of the Centre for Medicare & Medicaid Services, enraged the puritans that dominate the public health bureaucracy, even as he made some of us feel a little less bad about our festive season excesses. But the former surgeon was right to point out “there was never really good data to support” longstanding government advice that more than two (one) standard drinks a day is unhealthy.
News that inflation jumped substantially in December, contrary to official forecasts, was another reminder of the ignorance and propaganda that often underpins official or political pronouncements on economic topics, itself partly a consequence of the massive disagreement among experts about how the economy works, even 250 years after Adam Smith wrote The Wealth of Nations. Yet the public remains far too wedded to the idea that when it comes to medicine and science the official advice reflects some well-meaning, objective and optimal distillation of human knowledge.
That’s far from the truth: these are a function of vested interests and group think as other areas. Richard Horton, editor of the respected medical journal The Lancet since 1995, wrote “much of the scientific literature, perhaps half, may simply be untrue … in part because of flagrant conflicts of interest … and obsession with fashionable trends”.
Scientists, he wrote more than a decade ago, “too often sculpt data to fit their preferred theory of the world”. Individuals don’t necessarily become saints when they don a lab coat or pick up a stethoscope. Good and bad people permeate all sectors.
In 2003, Canadian professor Joel Lexchin wrote in the British Medical Journal that he found a “fourfold greater chance of a clinical trial finding favourable results for a drug if that trial was sponsored by the pharmaceutical industry”.
The Global Financial Crisis revealed how the “revolving door” between financial regulators and big financial institutions can corrupt regulations.
The disastrous official response to Covid-19, which now appears to have fewer and fewer supporters as the years go on, suggests similar problems extend to the health sector. The bulk of Australia’s Therapeutic Goods Administration, for instance, which regulates pharmaceutical products, is funded by the pharmaceutical industry. That industry in turn is dominated by a few larger powerful firms, which have had to pay billions of dollars in fines for numerous offences in the US over many decades.
In the latest Dietary Guidelines for Americans, 2025–2030, issued earlier this month, the famous “food pyramid” had been inverted, up-ending decades of health dogma about the relative merits of different types of food. Bread and carbohydrates used to be at the bottom and fats and sugar at the top, implying they should be consumed a lot and a little, respectively. In the new version, “healthy fats”, proteins and dairy have been prioritised, with carbohydrates and fruit demoted, while sugar doesn’t feature at all.
Gary Taubes, author of numerous books on health eating, declared “a return to common sense”, deeming the changes “a necessary rejection of the focus on plant-based eating that was a direct outcome of the cholesterol dogma of the 1980s”.
Certainly most of us don’t have the expertise to evaluate competing claims about technical subjects but it’s possible governments could have contributed to the growing and shockingly high rates of chronic disease, especially in the US where 70 per cent of adults are obese, by downplaying the damage addictive sugars.
Big Food has a dubious history, too, having established in the 1960s the Sugar Research Foundation to pay Harvard scientists to downplay the negative impacts of sugar.
Health secretary Robert F Kennedy, Donald Trump’s most controversial cabinet pick, has courted controversy by reducing the number of recommended vaccines for children from 17 to 11. Some experts have attacked the change as reckless. Kennedy pointed out the new schedule was modelled on Denmark’s and the US had recommended more vaccines than the vast bulk of developed nations.
Is Denmark or the US correct? It’s hard for non-experts to know, but it’s a fair guess the focus of global pharmaceutical lobbying has been in Washington not Copenhagen.
It’s also a fact the number of recommended vaccines in the US soared since their manufacturers were given immunity from being sued over vaccine injuries by a federal law they lobbied for in 1986.
Whatever the scientific merits of Kennedy’s Make America Healthy Again health reforms, he’s given a voice to critics of the health establishment. And if there’s one thing we learned from the devastating response to the pandemic, it’s that the health establishment has been guilty of group think and institutional inertia.
Scientific and medical advances have radically improved our standard of living over decades, but there is still much we don’t know, especially in the moving feast of nutrition science, where it’s difficult to conduct controlled experiments. As Kennedy joked last week, Trump is still alive and fighting fit at 79 despite his own “poisonous” diet.
“To say physicians, nutritionists, and all those researchers and influencers who study or discuss the effect of diet on body weight and health live, in effect, in an intellectual church is not an unreasonable assertion,” Taubes added in his article.
Science isn’t a democracy. And as it’s practised by government officials has more in common with politics and religion than most of use realise.
