Again, in 3-part harmony–it’s not about “the science”

Let me be straight.  I don’t believe in conspiracy theories.* There’s no Bacon-gate.  No Cowspiracy.  No Salami-mafia out to suppress sandwich meat.  But, as the students in my Introduction to Science, Technology, and Society course will tell you, there are professional interests (only one of which is funding) and careerism.  There is also the human desire to simply not be wrong.  In nutrition, this desire is personal.

(If I were queen of the world, every research article published about nutrition and chronic disease would list, in addition to “author affiliations” and “conflicts of interest,” what each researcher typically eats for breakfast every day.  You’d find out a lot more about “affiliations” and “interests” from that information than from anything else.)

And so there is this:  Meat and fat intake and colorectal cancer risk: A pooled analysis of 14 prospective studies.  It’s an abstract from the Proceedings of the American Association of Cancer Research, from back in 2004.  It found:

Greater intake of either red meat (excluding processed meat) or processed meat was not related to colorectal cancer risk.

Typically, such abstracts are presented at a conference, then later published.  This one never made it publication.  We don’t know why.

Trevor Butterworth does some speculating about the “whys” here:

When contacted by, Smith-Warner said they wanted to add a few more studies before publishing their results next year. But the fact is that their colorectal cancer study had more subjects than many of the other studies published by the Pooling Project – and the four-year delay in publication cannot but raise the question of whether their results just didn’t fit in with the nutritional beliefs of Harvard’s School of Public Health, one of whose senior figures – Dr. Walter Willett – has long recommended limiting red meat and who, coincidentally, is a board member of the World Cancer Research Fund.

It’s not the first time studies that contradict the status quo in nutrition never made it publication.  This study also never got past conference proceedings, though there was an article about it in the Harvard Gazette and Walter Willett (who certainly seems to practice what he preaches) has his name on the abstract:

Greene, P., Willett, W., Devecis, J., and Skaf, A. (2003). Pilot 12-Week Feeding Weight-Loss Comparison: Low-Fat vs Low-Carbohydrate (Ketogenic) Diets (abstract presented at The North American Association for the Study of Obesity Annual Meeting 2003), Obesity Research, 11S, 95-OR.

Greene’s study found that a higher calorie low-carb diet resulted in more weight loss than a lower-calorie low-fat diet.  I’m not arguing about what this study might prove about diets in general, so back off, all you folks out there foaming at the mouth to pick it apart.  Truth is, you can’t really critique it, because it never got published.

Another study that almost didn’t make it out of the gate concluded that:

Our findings do not support the hypothesis that a diet consistent with the 2005 DGA benefits long-term weight maintenance in American young adults.

In a nutshell, Daisy Zamora found that black participants with a higher Diet Quality Index (according to the Dietary Guidelines for Americans) gained more weight over time than whites (with either a higher or lower Diet Quality Index).  More surprisingly, these black participants also gained more weight over time than blacks with a lower Diet Quality Index.

Again, I’m not arguing the strengths or shortcomings of this research. The part of the story that matters here is that Zamora worked on this study as part of her PhD research at UNC-Chapel Hill.  She found a tremendous amount of resistance to her findings, to the extent that she was counseled to “redo” her work without examining racial differences.

I’ve been hip-checked into the rails by the politics of nutrition science myself.

I guess that’s why, to some extent, I feel that all of the talk about “good” science vs. “bad” science in nutrition is misplaced.  How do we even know that the part of “the science” we get to see fairly represents the work that has been done when the whole process is so highly politicized and ideological?  How many grad students slogging away in labs or poking away at databases find things that never make it to publication because it would compromise the prevailing paradigm and their advisor’s funding (and don’t have the huevos that Zamora had to get her findings published anyway)? I feel pretty certain this doesn’t just happen in nutrition, but in nutrition it really matters to each of us, every day–and even more so to those who rely on government programs for food.

How did nutrition science become so politicized?  Dietary Guidelines, I’m looking at you.  When policy “chooses” a winner and a loser in a scientific controversy, things change. Science gets done differently. And when policy (dressed up as science) chooses a side in what we should/should not eat in order to prevent ostensibly preventable things like obesity and disease, well, all hell breaks loose. When we act like we “know” what foods cause/prevent disease, good health becomes entirely the responsibility of the individual.  If you get fat or sick–no matter what else is going in your world or in your body–it’s your own damn fault.

How do we un-politicize nutrition science? This article from Daniel Sarewitz, “Science can’t solve it,” offers some clues.  Although he’s focusing on new biotechnologies that have out-run our ethical frameworks for dealing with them, these remarks could just as well apply to diet-chronic disease science.  He calls for discussions and deliberations that:

… could address questions about what is acceptable and what isn’t, about appropriate governance frameworks for research, and about the relative priority of different lines of study given ongoing and inevitable uncertainties and disagreements about risks and benefits.

If there’s one thing we’ve got in diet-chronic disease science, it is “ongoing and inevitable uncertainties.”  It’s highly unlikely that science is going to solve those uncertainties anytime soon.  As for ethical frameworks, we have never given serious consideration to the ethical implications–not to mention the outright absurdity–of subjecting everyone in our diverse population to a single dietary prescription designed to prevent all of the major chronic diseases (none of which have ever been established as primarily nutritional in nature).

Until we get to these kinds of discussion, the creators of the 2015 Dietary Guidelines ought to listen to what Paul Marantz had to say back in 2010:

 When the evidence is murky, public health officials may best be served by exercising restraint, which is reflected by making no recommendation at all.

And when they don’t (cuz who can resist telling all those stupid Americans how to eat?), at the very least, we’ll all get a little smarter about “the science.”  As @Ted_Underwood put it on Twitter:

A stubborn love of bacon just taught Americans the diff. between p-values & effect size better than 100 stats courses could.

Works for me.


Many thanks to Dr. Sarah Hallberg, without whom it would have taken me another 5 years to stumble across some of these articles.

*Run one PTA meeting and try to get a half-dozen fairly intelligent, well-educated adults to coordinate plans for a yard sale, and you’ll see what I mean.  We can’t agree on whether used children’s books should be 50 cents or $1–figuring out whether to ruin the health of Americans by buying off the media or silencing the scientists would be beyond any possible reckoning.

Dietary Drama–an Update (but not by me)

My favorite reality show–The 21st Century Diet Wars–has been off the charts drama lately.  Since I’m not going to be writing any commentary about it anytime soon, I thought I would point my faithful readers (all both of them) in the direction of my favorite moments so far.

1) Just in time for Halloween, Georgia Ede, MD, publishes a post on the scary Dietary Guidelines Advisory Report (just why they are scary depends on your own personal food orientation:  They’re letting cholesterol off the hook!  They’ve reduced meat to a footnote!) and the crapstorm that Nina Teicholz raised in the BMJ when she “attacked” that most sacred of (pasture-raised, GM free, organic, speaks Chicken as a second language) cow.  [Word to the rhetorically wise:  If someone accuses you of “attacking” some belief system, you can be sure they think that system should be beyond question. That’s why “questioning” gets framed as “attacking.” ]

Read it and laugh, or weep:  here.

2) This would be in the read it and weep category.  Mark Anthony Neal posted some excellent points–in an article by Lawrence Ware and Rebecca Martinez–about the whole “processed meat and cancer” issue.  While #smugvegetarians and #smugvegans are making like Church Lady and doing their superior dance in response to the new WHO report …

Remember Church Lady and her “superior dance”? Smugness never goes out style.

… what is often omitted is that observed links between these two factors may be related to issues of class as much–or more so–than any biological mechanism.  Outside of foodie-sharcooderie land, processed meats tend to be poor people food (I’m pretty sure the observational studies that linked processed meat to cancer didn’t have a huge representation of house-cured sopressata, air-dried bresaola, and lamb shank terrine).  This means that processed meats cluster with a whole lot of other health-related factors not necessarily under an individual’s control:  stress, limited access to health care, environmental pollutants–you get the picture. Whether or not there is a direct link between processed meat and cancer is less to the point than the article’s closing remarks:

We have a health crisis in this country.  Obesity, diabetes and cancer are ravishing disadvantaged communities. Too often this crisis is centered in personal responsibility, but we must also look at systemic conditions lest we blame the victims of poverty without equipping them with the tools necessary for positive health outcomes.

Tell it.  I raise this challenge to anyone who regularly reads (or writes) articles on nutrition epidemiology.  Show me a situation where a food, food component, or dietary pattern is linked to an adverse health outcome and the population that consumes that dietary evil is not also a population with significant differences in health behaviors and/or socioeconomic factors relative to the healthy outcome population.  I’ll be here, waiting.

Slice up your hot dogs, add tiny pickles, and whaa-laa: charcuterie.

Slice up your hot dogs, add tiny pickles, and whaa-laa: charcuterie.

Or maybe we should just encourage those poor folks to slice their store-brand hot dogs in creative ways and serve them with fancy mustard and tiny pickles.

3) And, then–this:

You’re welcome.


I am emerging (briefly) from grad school hibernation–my husband jokes that I’m taking all my classes “pass/flail”–for a special cause that hits close to home, even though Jennifer Elliott, a dietitian who has been going the rounds with her various professional organizations and institutions, lives in Australia.

She apparently had the gall to suggest to a patient with type 2 diabetes that a low-carbohydrate diet might be beneficial.  Heavens.  What is the world coming to?  Next thing you know, people will start telling us that if we are allergic to poison ivy and it makes us itch all over, we might not want to roll in it.

If you haven’t had a good eyeball roll or facepalm for the day, you should check out her blog, where she recounts one episode after another of Orwellian-level doublespeak with the Dietitian Association of Australia.  It’s a situation I’m quite familiar with, albeit on a much smaller scale and with our homegrown Academy of Nutrition and Dietetics here in the US of A.

The most recent episode reveals her local health district administration (Southern New South Wales Health, SNSW Health to the locals), her former employer, forbidding Jennifer–or anyone else, one must presume–from offering advice about low-carbohydrate diets to patients or clients with diabetes.  What caught my attention was this remark, by Jennifer:

“Can you imagine having to tell a client with diabetes, who has lowered his BGLs [blood glucose levels], lost weight and come off all diabetes medications by reducing his carb intake, that he now has to start eating more carbs because SNSW Health says so !?”

Well, cue the Twilight Zone music, because we are going there.

What would it be like to tell someone (like my dad, another way this story hits close to home) who has been controlling their diabetes very-well-thank-you with a low carb diet, that they now must eat more carbs, cuz we said so?  Samuel Beckett, eat your heart out.**


Enter “patient who could be my dad.” Let’s call him Mr. Louis Corbin (LC).  He greets the dutiful dietitian (DD) who is determined to adhere to SNSW Health policies.

LC:  G’Day Ms. Dietitian.

DD:  Hello, Mr. Corbin.  How can I help you?

LC:   Well, I feel like I need to change up my diet a bit, and I’d like some help from a wise, caring, trained professional who will treat me like an individual and not like an aggregated average of a dataset.

DD:  (Laughs demurely.) Well, of course.  As a trained professional, it’s my job to use my clinical judgment to help patients find out what works best for them.

LC:  Beauty!  So, I was diagnosed with pre-diabetes about 10 year ago.

DD:  Really?  Looking at your lab report, your blood sugar and HgA1c levels look perfectly normal.  Tell me about the medications that you are using.

LC:  Well, I’m not actually on any medications.  When I got my diagnosis yonks ago, I borrowed my cousin’s glucometer and figured out which foods were making my blood sugar go up.  I really limit those in my diet now, and my blood sugar seems to be well under control. But I’m getting a little tired of eggs and sausage for brekky every morning.

DD:  Eggs and sausage?  Is that it?

LC:  And some sautéed spinach or sliced tomatoes, most days.  But I’m hoping you can help me with some other brekky ideas.

DD:  Wait now.  There’s simply too much fat in the eggs and sausage, and there’s really not enough carbohydrate–you know, sugars and starches–in that meal–or in your diet in general it seems.  You’ll need to add some fruit and a couple of servings of whole wheat bread or cereal to your breakfast and …

LC:  But tomatoes are technically a fruit …

DD:  But they are a “low carbohydrate” fruit and so they don’t count.

LC:  … and I don’t eat bread or cereal–not even whole wheat.  Those were the things that made my blood sugar go up!

DD:  Of course. We need your blood sugar to go up.  You do know that your brain won’t work without glucose from healthy, whole grains, right?

LC:  My brain seems to be working fine.  I finished “The Age” crossword puzzle while I was in the waiting room!

DD:  Well, it’s quite clear to me that your brain must not be working properly–you’ve put yourself in grave danger.  You need AT LEAST 3 servings of carbohydrate per meal, and not just at breakfast I might add, in order for your body to function properly.


LC:  Three servings per meal!  Crikey! That will make my blood sugars go up for sure!

DD:  Well, yes.  As I said, your blood sugars need to go up.  You see, Mr. LC. , in your addled state, you’ve failed to understand that diabetes is a PROGRESSIVE disease.  And your diabetes hasn’t progressed at all.  In fact, it seems to be quite stalled.

Without progression, we’ll be unable to prescribe pre-insulin drugs like metformin and engage you in the numerous diabetes education programs we have ready and waiting.  Once you’ve been thoroughly well-versed in carbohydrate counting, let’s hope that we can get your diabetes back on track.  Hmmm.  We may need to start you out at 4 servings of carbohydrate per meal …

LC:  But, but, I don’t really want my diabetes to progress.

DD:  Nonsense.  That’s what diabetes does.  You’re deluding yourself if you think otherwise.  I’ve seen hundreds of patients with type 2 diabetes, and I treat them all the same way–with the official Australian Diabetes Society diet–and they all have gotten progressively worse.  So there.

Yes, I understand that your diabetes hasn’t progressed in 10 years on a low carbohydrate diet, but it’s clear why that is.  It’s good that you’ve come to me so we can reverse that trend.  I can help you choose foods that will be sure to start you down the road to full-blown diabetes.

LC:  But I’m feeling bloody top notch.  I’ve even lost a little weight since I started reducing my sugars and starches.

DD:  Oh dear.  I didn’t realize that.  You’ll really need to fill your plate with healthy whole grains so we can get some of that weight back on.  You’re never going to end up on insulin at the rate you’re going.  But no worries.  If you can stick with at least 4 servings of carbs per meal, we might be able to get you on insulin in a few years or so.  Once we’ve got you on a regular dose of insulin, you’ll keep packing the weight on, no problem.

LC:  But I don’t want to be on insulin …

DD:  No “buts.”  Sir, you don’t realize the seriousness of this situation.  It’s not just about the insulin.  Not only do we have prescriptions that need prescribing and diabetes educators that need to educate, we have wound clinics that need wounds, dialysis clinics that need failing kidneys, testing laboratories that need labs to test.  Have you any idea how many people you might put out of work by stalling your diabetes in its tracks?

Sponsors of the ADS

A “Who’s Who of pharmaceutical and medical supply companies”? Nah, just the sponsors of the last Australian Diabetes Society conference.

DD (Continuing): You’ve not only put yourself in danger, you’ve endangered our whole healthcare supply economy!  We have injections to make your blood sugar go down.  We have glucose tablets to make your blood sugar go back up.  We have monitors and supplies and diaries and trackers and coolers and carriers for all of the THINGS you will need when you have diabetes.

We have diabetes foot cream, insoles, socks, and shoes.  And wheelchairs for when your toes rot off–which I can assure you they will if you’ll only improve your diet.  Then you’ll get to use the freight elevator and get one of those special parking passes.  If you play your cards right and follow your diet as I prescribe it , you may even end up with one of those cute little scooters for getting around the grocery store.

LC:  But …

DD:  Now then.  Not to worry.  You’re on the right path now.  You wanted some brekky ideas? Here’s a low-fat, vegetarian recipe for blueberry hotcakes, with 46 grams of carbs.  It’s from “Diabetes Australia,” so you know it’s perfect for someone with diabetes!  It should get your blood sugar going for sure!  And here’s some coupons from the Australian Breakfast Cereal Manufacturers.  I picked up tons of them at my last dietitians conference–they’re working with us to make sure everyone has a healthy, whole grain, cereal product brekky EVERY DAY!

LC:  But …

DD:  No “buts.”  I’ll expect to see you back in about 6 months.  We’ll get that HgA1c moving in the right direction this time and have you on the road to complete and total dependence on the health care system in no time!  Bye now!


What can you do besides resolve not to move to New South Wales anytime soon?  Write a quickie email to the New South Wales Health Minister, Jillian Skinner, telling her about your experiences as a patient, clinician, family member in successfully managing type 2 diabetes/pre-diabetes/metabolic syndrome/etc. with a carbohydrate-reduced diet.


CC Jennifer at:

And, what the hey, let the Dietitians Association of Australia know what you think too:

If you are feeling particularly feisty, go to Jennifer’s blog and post your letter there too, to let her know you stand in solidarity with her.

I personally will be sending Minister Skinner a copy of this post :)

**And many thanks to Disco Stew who provided the authentic Australian translation of this conversation!


Update:  In an appalling case of life-imitating-blog-imitating-life, Disco Stew sent me a link to this piece, written by Jane Feinmann, about type 2 diabetes and the continued use of a low-fat, carbohydrate-laden diet to “treat” it:

When I wrote about this dilemma in the Daily Mail recently, the piece triggered over 200 responses from readers caught in this invidious position.

Mary Megan from London was ‘stunned’ last year when her GP “recommended eating carbohydrates as part of a ‘healthy balanced diet’ when I know for a fact from having tested my blood sugar over the years that carbohydrates are the exact cause of my high blood sugar.”

Way to go, 21st century health care system. Sigh.

I went to the 2015 Dietary Guidelines Report oral comments session and all I got was this lousy video clip

I had the pleasure of sharing the condensed version of my summary of the 2015 Dietary Guidelines Advisory Committee Report with the folks in Washington earlier this week.

If your idea of fun is watching paint dry, you can catch the full series of comments here.  I’m at 46.24 minutes (at the end, you can play “spot the dietitian” who doesn’t think my comments are one bit amusing).

If you sit through it all, you’ll notice that it’s pretty much an industry vs. vegans cage-match.  Which, unfortunately, leads the folks in the D.C. bubble to think that all “regular folks” (i.e. non-industry) are vegans.

Do me a favor.  Head on over to and provide some written comments of your own.  They can be short, sweet, to the point, but add something! Oral comments (like mine) do not have any more “weight” than written ones.

Yeah, I know what you’re thinking.  Why bother? It’s not going to change anything.  You’re probably right.  It isn’t.  But do it anyway.  The vegatarian community has been vocal, active, present, and heavily invested in this process since the Dietary Guidelines began.  How do you think a vegan diet went from being a “dangerous fad” back in the 1970s to being part of national nutrition policy in 2010?  It’s not like it somehow got “healthier.”

If I try to make the case to policymakers that the rest of America kinda likes eating dead animals, the response is, well, why didn’t we hear from them?  Like attending a funeral “to pay respects to the dead,” it seems (and is) pretty pointless in some regards.  But it does matter.  If not for these specific Guidelines, then for the next ones.

Healthy Nation Coalition has a preliminary analysis of the DGAC Report here that you can use for inspiration.  Or take a few tips from our coalition letter here.

Better yet, tell the folks writing the Guidelines your own story about food and health.  Let them know their Guidelines don’t work for everyone.  And get any friends, neighbors, and co-workers who would rather not have a “culture of health” enforcing their right to eat lentil burgers to pitch in too.

Hey, if I can wear pantyhose for 6 hours straight in order to look presentable at this meeting, the least you can do is go fill out a form.  You can do that in your pajamas.

Written comments accepted through end of day on May 8.

The 2015 Dietary Advisory Committee Report: A Summary

Last week, the Dietary Guidelines Advisory Committee released the report containing its recommendations for the 2015 Dietary Guidelines for Americans.   The report is 572 pages long, more than 100 pages longer than the last report, released 5 years ago.  Longer than one of my blog posts, even. Despite its length, and the tortured governmentalese in which it is written, its message is pretty clear and simple. So for those of you who would like to know what the report says, but don’t want to read the whole damn thing, I present, below, its essence:

Dear America,

You are sick–and fat.  And it’s all your fault. 

Face it.  You screwed up.  Somewhere in the past few decades, you started eating too much food. Too much BAD food.  We don’t know why.  We think it is because you are stupid.

We don’t know why you are stupid.

You used to be smart–at least about food–but somewhere in the late 1970s or early 1980s, you got stupid. Before then, we didn’t have to tell you what to eat.  Somehow, you just knew. You ate food, and you didn’t get fat and sick.

But NOW, every five years we have to get together and rack our brains to try and figure out a way to tell you how to eat–AGAIN.  Because no matter what we tell you, it doesn’t work. 

The more we tell you how to eat, the worse your eating habits get. And the worse your eating habits get, the fatter and sicker you are.  And the fatter and sicker you are, the more we have to tell you how to eat. 

DGA - Length & Obesity 1980-2010

Look. You know we have no real way to measure your eating habits.  Mostly because fat people lie about what they eat and most of you are now, technically speaking, fat.  But we still know that your eating habits have gotten worse. How?  Because you’re fat.  And, y’know, sick.  And the only real reason people get fat and sick is because they have poor eating habits.  That much we do know for sure.

And because, for decades now,  we have been telling you exactly what to eat so you don’t get fat and sick, we also know the only real reason people have poor eating habits is because they are stupid.  So you must be stupid.

Let’s make this as clear as possible for you:

sick fat stupid people

And though it makes our hearts heavy to say this, unfortunately, and through no fault of their own, people who don’t have much money are particularly stupid.  We know this because they are sicker than people who have money.  Of course, money has nothing to do with whether or not you are sick.  It’s the food, stupid.

We’ll admit that some of the responsibility for this rests on our shoulders.  When we started out telling you how to eat, we didn’t realize how stupid you were.  That was our fault.

In 1977, a bunch of us got together to figure out how to make sure you would not get fat and sick.  You weren’t fat and sick at the time, so we knew you needed our help.

We told you to eat more carbohydrates–a.k.a., sugars and starches–and less sugar.  How simple is that?  But could you follow this advice?  Nooooooo.  You’re too stupid.

We told you to eat food with less fat. We meant for you to buy a copy of the Moosewood Cookbook and eat kale and lentils and quinoa.  But no, you were too stupid for that too.  Instead, you started eating PRODUCTS  that said “low-fat” and “fat-free.”  What were you thinking?

We told you to eat less animal fat. Obviously, we meant JUST DON’T EAT ANIMALS.  But you didn’t get it.  Instead, you quit eating cows and started eating chickens.  Hellooooo?  Chickens are ANIMALS.

After more than three decades of us telling you how to eat, it is obvious you are too stupid to figure out how to eat.  So we are here to make it perfectly clear, once and for all.

FIRST:  Don’t eat food with salt in it.

Even though food with salt in it doesn’t make you fat, it does raise your blood pressure.  Maybe.  Sometimes.  And, yes, we know that your blood pressure has been going down for a few decades now, but it isn’t because you are eating less salt, because you’re not.  And it’s true that we really have no idea whether or not reducing your intake of salt prevents disease. But all of that is beside the point.

Here’s the deal:  Salt makes food taste good.  And when food tastes good, you eat it.  We’re opposed to that.  But since you are too stupid to actually stop eating food, we are going to insist that food manufacturers stop putting salt in their products.  That way, their products will grow weird microorganisms and spoil rapidly–and will taste like poop.

This will force everyone to stop eating food products and get kale from the farmer’s market (NO SALT ADDED) and lentils and quinoa in bulk from the food co-op (NO SALT ADDED).  Got it?

Also, we are working on ways to make salt shakers illegal. 

Ban Salt Shakers


NEXT:  Don’t eat animals. At all.  EVER.

We told you not to eat animals because meat has lots of fat, and fat makes you fat.  Then you just started eating skinny animals. So we’re scrapping the whole fat thing.  Eat all the fat you want.  Just don’t eat fat from animals, because that is the same thing as eating animals, stupid.

We told you not to eat animals because meat has lots of cholesterol, and dietary cholesterol makes your blood cholesterol go up.  Now our cardiologist friends who work for pharmaceutical companies and our buds over at the American Heart Association have told us that avoiding dietary cholesterol won’t actually make your blood cholesterol go down.  They say:  If you want your blood cholesterol to go down, take a statin.  Statins, in case you are wondering, are not made from animals, so you can have all you want.  

Eggs? you ask.  We’ve ditched the cholesterol limits, so now you think you can eat eggs?  Helloooo?  Eggs are just baby chickens and baby chickens are animals and you are NOT ALLOWED TO EAT ANIMALS.  Geez.

Yes, we are still hanging onto that “don’t eat animals because of saturated fat” thing, but we know it can’t last forever since we can’t actually prove that saturated fat is the evil dietary villain we’ve been saying it is.  So …

Here’s the deal:  Eating animals doesn’t just kill animals.  It kills the planet.  If you keep killing animals and eating them WE ARE ALL GOING TO DIE.  And it’s going to be your fault, stupid.

And especially don’t eat red meat.  C’mon.  Do we have to spell this out for you?  RED meat? 

RED meat = COMMUNIST meat.  Does Vladimir Putin look like a vegan?  We thought not. 


 If you really must eat dead rotting flesh, we think it is okay to eat dead rotting fish flesh, as long as it is from salmon raised on ecologically sustainable fish farms by friendly people with college educations. 

FINALLY:  Stop eating–and drinking–sugar.

Okay, we know we told you to eat more carbohydrate food.  And, yes, we know sugar is a carbohydrate. But did you really think we were telling you to eat more sugar?  Look, if you must have sugar, eat some starchy grains and cereals. The only difference between sugar and starch is about 15 minutes in your digestive tract.  But …

Here’s the deal:  Sugar makes food taste good.  And when food tastes good, you eat it.  Like we said, we’re opposed to that.  But since you are too stupid to actually stop eating food, we are going to insist that food manufacturers stop putting sugar in their products.  That way, their products will grow weird microorganisms and spoil rapidly–and will taste like poop.

This will force everyone to stop eating food products and get kale from the farmer’s market (NO SUGAR ADDED) and lentils and quinoa in bulk from the food co-op (NO SUGAR ADDED).  Got it?

Ban cupcakes


Hey, we know what you’re thinking.  You’re thinking “Oh, I’ll just use artificial sweeteners instead of sugar.”  Oh NOOOO you don’t.  No sugar-filled soda.  No diet soda.  Water only. Capiche?

 So, to spell it all out for you once and for all:

DO NOT EAT food that has salt or sugar in it, i.e. food that tastes good.  Also don’t eat animals.

DO EAT kale from your local farmers’ market, lentils and quinoa from your local food co-op,  plus salmon. Drink water.  That’s it. 

And, since we graciously recognize the diversity of this great nation, we must remind you that you can adapt the above dietary pattern to meet the your own health needs, dietary preferences and cultural traditions. Just as long as you don’t add salt, sugar, or dead animals.

Because we have absolutely zero faith you are smart enough to follow even this simple advice, we are asking for additional research to be done on your child-raising habits (Do you let your children eat food that tastes good?  BAAAAD parent!) and your sleep habits (Do you dream about cheeseburgers?  We KNOW you do and that must stop!  No DEAD IMAGINARY ANIMALS!)

And–because we recognize your deeply ingrained stupidity when it come to all things food, and because we know that food is the only thing that really matters when it comes to health, we are proposing  America create a national “culture of health” where healthy lifestyles are easier to achieve and normative.

“Normative” is a big fancy word that means if you eat what we tell you to eat, you are a good person and if you eat food that tastes good, you are a bad person. We will know  you are bad person because you will be sick. Or fat. Because that’s what happens to bad people who eat bad food.

We will kick-off this “culture of health” by creating an Office of Dietary Wisdom that will make the healthy choice–kale, lentils, quinoa, salmon, and water–the easy choice for all you stupid Americans.  We will establish a Food Czar to run the Office of Dietary Wisdom, because nothing says “America, home of freedom and democracy” like the title of a 19th century Russian monarch.*

The primary goal of the “culture of health” will be to enforce your right to eat what we’ve determined is good for you. 

This approach will combine the draconian government overreach we all love with the lack of improvements we expect, resulting in a continued demand for our services as the only people smart enough to tell the stupid people how to eat.**

 Look.  We know we’ve been a little unclear in the past.  And we know we’ve reversed our position on a number of things. Hey, our bad.  And when, five years from now, you stupid Americans are as sick and fat as ever, we may have to change up our advice again based, y’know, on whatever evidence we can find that supports the conclusions we’ve already reached.

But rest assured, America.

No matter what the evidence says, we are never ever going to tell you it’s okay to eat salt, sugar, or animals.  And, no matter what the evidence says, we are never ever going to tell you that it’s not okay to eat grains, cereals, or vegetable oils.  And you can take that to the bank.  We did.

Love and kisses,

Committee for Government Approved Information on Nutrition (Code name: G.A.I.N.)


*Thank you, Steve Wiley.

**Thank you, Jon Stewart, for at least part of this line.


Figure out Food: Eat what works!

No, that’s not the name of my new blog (although it is awfully catchy, isn’t it?), but it sure does capture the spirit of my own approach to nutrition these days.

It’s the name of what I think will be the future of nutrition–an app that helps you figure out what to eat to be healthy by connecting what you eat to how you feel.  Can I get an “It’s about damn time”?

Kenny's app

Wading through the muck of nutrition science and public health, I’ve learned just a few things that I can say with assurance:

1) We know very little about the relationship between diet and prevention of chronic disease.  Somebody tells you that they have a scientifically proven diet for preventing chronic disease?  This person may have a diet, it may even work (as far as we can tell at the moment), but it not going to be scientifically proven because we simply don’t have the science to prove it.  As they say in the biz, our methodology sucks green tomatoes.

2) The focus in public health (and private care) on weight loss is misguided.  Weight loss does not equal health and even if it did, we’re really bad at helping people do it successfully and long-term.  Does weight loss result in better health?  Sometimes.  But is that due to the weight loss per se, or due to whatever metabolic changes had to happen in order for weight loss to occur?  And, truth is, sometimes attempts at weight loss compromise health.  Loss of muscle mass, disordered eating patterns, nutritional deficiencies, restricted lifestyle, hunger, fatigue, general misery and bitchiness–all of these can accompany attempts at weight loss & may cause more problems than they solve.

BUT–and it’s a big but, like it always is–food is really important.  Some foods make us feel satisfied and full of energy and ready to leap over tall buildings with nary a second thought.  Other foods make us Sleepy and Sneezy and Dopey and a few other dwarves that Snow White didn’t meet:  Cranky, Burpy, and Farty.

And foods that make my body happy are not necessarily the ones that make yours happy.

How do we know which foods are which?  

Ta-da!  Kenny Gow to the rescue with a totally cool app that he’s been working on for a while now.

The main thing to know about this app is that it’s about having health now (not about weight loss or disease prevention–see above) and it’s about you (not an aggregate of information from datasets full of people who aren’t you).

I think it’s pretty cool & when I eventually get back to working with patients, I hope this app is there to help me help them.  But–for that to happen, he needs some support from us.

With that in mind, check out his Indiegogo campaign, which I’m about to donate to, as soon as I finish this blog post.

Fist-bump to Gingerzini who beat me to it.





What if there were no Dietary Guidelines?

I don’t get excited about much these days.  Mostly because I’m too sleep deprived from studying until 2:00 AM.  But I’m pretty excited about this.

I’ve been wanting to write this piece for a long time.  The wonderful folks at encouraged me to go ahead and do it.

Check it out:  What if there were no Dietary Guidelines?  


Examine com pix