Or at least that’s the title of this article at that wretched hive of misinformation, the Huffington Post. I’ve written before about Huffpo HuffPoo and More HuffPo HuffPoo: The Annual Flip-Flop Warning.
But this time they’ve outdone themselves.
What they’ve done is show themselves to be totally incapable of reading a (fairly simple) scientific paper. But to be fair (kind of), they obviously didn’t read the scientific paper. All they did was look at somebody else’s article—somebody else who also didn’t read the scientific paper.
Scientists have produced study after study proving what women already know: Heels hurt your feet. A lot. Specifically, shoes with heels strain your calf muscles, permanently shorten your tendons, damage your posture and twist your ankles.
But we’ve got some consolation for all your heel devotees: High heels do NOT give you bunions!
That’s not what the study shows at all. What the study (maybe) shows is that there is some genetic component to bunions, that is, hallux valgus.
The article they link to is this one: Bunions — family not footwear to blame, which comes with this cringe-inducing photograph.
The BBC article is actually not too bad; it’s just the headline that sucks. But, as these articles often do, they do get a statement from an idiot of a podiatrist. The article quotes the author of the study, Dr. Marian Hannan, saying (quite reasonably) that “These new findings highlight the importance of furthering our understanding of what causes greater susceptibility to these foot conditions.” And then the podiatrist, Richard Hanford, gets it all wrong and overlays his prejudices on that:
This is what we tell our patients — as opposed to the myth that shoes cause bunions.
No, that’s not what the study showed at all. And it is no myth that shoes cause bunions.
The HuffPo article goes on to say
To drive the point home, the researchers titled their report of the findings, “Blame Your Parents for Bunion Woes.”
No they didn’t. The title of the scientific article is Hallux Valgus and Lesser Toe Deformities are Highly Heritable in Adult Men and Women: the Framingham Foot Study.
So where did “Blame Your Parents for Bunion Woes” come from? That’s the title of the press release put out by the publisher, and was almost assuredly written by some clueless editor.
Anyways, let’s take a look at the study itself.
First, Framingham, MA, is rather famous for where the Framingham Heart Study is going on. That is a long-term heart study that has followed, with extensive surveys and records, three generations of the people of that town. It turns out that there is also a Framingham Foot Study.
So what the scientists were able to do was also look at the incidence of hallux valgus. They looked for a family history of bunions (and some other foot disorders).
Here’s how it works: you share about 50% of your genes with each parent, and about 50% of your genes with each of your siblings. The researchers put together a bunch of such pairings in 429 families (1,370 total participants) and looked at the correlations between bunions of the pairings. Now, if a predilection towards bunions is hereditary, then people within the same family will be more likely to have the same bunion-status (either yes or no) than people randomly chosen not to be in the same family. And that is what they found. That is all they found: bunions tend to run in families.
But what, you say, about nature versus nurture? It’s never actually stated in the study, but it is assumed that all the participants live in a similar environment and that all the variation they are seeing comes from genetics, not from a difference in environment.
That’s probably not too bad of an assumption, but it is an assumption, and one that I take some issue with. One environmental factor that could skew the results is that “fashion” runs in families, but fashion isn’t heritable. If your mother really loves fashiony high heels, might the kids prefer flashy shoes, too? If your family is athletic and mostly wears those kinds of shoes, might not the kids end up the same? Or if your parents are more into comfort than style, might you be similar when you grow up? (Not all the time, but just enough to show a correlation.)
Suri Cruise, I suspect, is an excellent example of how bunions could be passed down through one’s environment.
One thing that the study points out (as part of their background section) is that
Hallux valgus is one of the most common foot disorders, affecting approximately 23% of people aged 18 to 65 years and 36% of those aged over 65 years.
That’s not quite complete. Let me fix it for them:
Hallux valgus is one of the most common foot disorders, affecting approximately 23% of shod people aged 18 to 65 years and 36% of the shod aged over 65 years.
We know this because of studies of habitually barefooted populations. One famous study (famous among barefooters) is Samuel Shulman’s Survey in China and India of feet that have never worn shoes, with its extensive tables of foot problems. Hallux valgus doesn’t even appear in the tables, and is relegated to a footnote:
No instances among the barefoot feet were found of: Onychocryptosis, Hyperidrosis, Bromidrosis, Hallux Valgus, Hallux Varus, Bursitis at the first or fifth metatarso phalangeal articulations.
Similarly, a study by Lam Sim-fook, A Comparison of Foot Forms Among the Non-Shoe and Shoe-Wearing Chinese Population, found that 33% of their subjects who wore shoes had hallux valgus while only 2% of the unshod had it.
There was also a study of Nigerians, by N. A. Barnicott, The position of the hallux in West Africans that also showed a lack of hallux valgus. (This also compared the barefooted to some shod soldiers who also did not have bunions—however, you can be sure that those soldiers grew up barefooted, and we don’t know how long they’d been wearing army boots, which, by the way, generally have broad toes.)
In the Framingham study, it was stressed that the study subjects were exclusively Caucasian (Framingham is pretty white: only 6% black, for instance), so it is possible that European Caucasians have some sort of special susceptibility to hallux valgus (I say “European” since Indians, as in the Shulman study, are also generally Caucasian). But I doubt it.
So, what do I think the study has shown (even assuming that there are no environmental factors)? That when you cram a foot into a shoe, there is some sort of genetic predisposition for that to lead to bunions.
Some feet are genetically able to better resist the abuse.
Some feet may have a somewhat better shape (or internal properties) for shoes. They may be more like What Feet Are Supposed To Look Like:
You don’t get hallux valgus with those feet, do you?
Let me finish by revisiting the title from the BBC story,
Bunions — family not footwear to blame.
That’s like a headline saying
Sunburn — family not the sun to blame.
Sure, there’s a genetic component to getting sunburned; but that doesn’t mean the sun is blameless.
And yes, there may be a genetic component to bunions, but it is abundantly clear that shoes are needed to really bring them to the fore.