This was not on the menu at the “Is Nutrition Research Keeping Pace with Policy and Consumers” panel at the Consumer Federation of America’s National Food Policy Conference.
I’m not sure what I expected, but I was encouraged by the fact that during other presentations at the conference, I had heard murmurs that perhaps we don’t really know what we mean what we say “healthy food” and that the public has some real concerns about what they are being told about nutrition. So I was manifestly disappointed to hear just another rallying cry for the status quo from the academics and policymakers on this panel.
A panelist from the National Cancer Institute asserted–despite those rumors heard elsewhere in the conference–that we “do have consensus” about what constitutes a healthy diet: “lean meat, whole grains, more fresh fruits and vegetables, and reduced saturated fat, sugar, trans-fats, and sodium.” Linda Van Horn, who chaired the 2010 Dietary Guidelines Advisory Committee, told the audience that: “We know what the problem is in obesity. It’s the calories. The calories.” She went on to let us all know that if we just had policies that would help Americans follow the recommendations that are already in place, we could reverse the obesity crisis. Sigh. Make the healthy choice the easy choice for poor stupid fat Americans? Again? Already?
And–yes–in case you are wondering, I was quivering with rage by the time the panel finished talking (yogic breathing sadly not helping). When my turn to ask a question arrived, I reminded the panel of the changes that we’ve already made in our diets–reduced red meat and egg consumption, increased whole grains and fresh fruits and vegetables, switched whole milk for low fat milk–and yet obesity and chronic disease continue to rise. My question to them was, “When are nutrition experts and policymakers going to quit blaming the consumer for not following the food rules and start thinking about whether or not the advice we’ve been given is truly effective?”
After the panel, the gentleman next to me said “Good question.” Yeah, I thought so too, but I got a truly lousy response from Dr. Van Horn: “We may have reduced red meat, but we’ve increased sugar.” Have we? Why might that have happened–if indeed it has?* “No one is blaming the consumer; the fault lies with the food industry.” This, at a conference devoted to showing consumers how their choices have driven the actions of industry. To blame industry is to blame the consumer; it’s just a sneaky and, frankly, dishonest way of doing it.
Ironically, the next day BMJ published an editorial with a completely different perspective. In it, Gary Taubes (science writer and champion for the return of common-sense and intellectual rigor in the world of nutrition science)** suggests that instead of yet another round of “making the healthy choice the easy choice” for poor stupid fat Americans who haven’t the good sense to lose weight and stay healthy the way they’ve been told to for the past 35 years, perhaps nutrition experts might try a different tact:
“We believe that ultimately three conditions are necessary to make progress in the struggle against obesity and its related chronic diseases—type 2 diabetes, most notably. First is the acceptance of the existence of an alternative hypothesis of obesity, or even multiple alternative hypotheses, with the understanding that these, too, adhere to the laws of physics and must be tested rigorously.
Second is a refusal to accept substandard science as sufficient to establish reliable knowledge, let alone for public health guidelines. When the results of studies are published, the authors must be brutally honest about the possible shortcomings and all reasonable alternative explanations for what they observed.
Finally, if the best we’ve done so far isn’t good enough—if uncontrolled experiments and observational studies are unreliable, which should be undeniable—then we have to find the willingness and the resources to do better. “
While I find plenty to disagree with here (high glycemic grains? really?), Taubes outlines some fascinating aspects of the history of obesity research and sheds some light on why the calories in-calories out hypothesis won out over the endocrinological (say it 5 times fast) one—and what nutritional mayhem has ensued since. (Read the whole thing. You’ll be glad you did. I’ll wait here.)
His editorial reminds us that when it comes to the question of what dietary pattern will prevent obesity and chronic disease, we really don’t know much. And it makes clear that what is needed now is a view toward a future where we will approach this question with much more humility and caution than we have in the past.
I’m going to suggest now–and you dear readers help me remember–that this time next year, we need to take Consumer Federation’s Food Policy Conference by storm. It isn’t expensive (I think registration is $90, cheaper still if you are a student). We are, after all, consumers. The meeting is full of industry reps, policymakers, journalists, as well as academics. It’s a small enough venue that I believe we can make our voices heard. We can let them know that the current definition of “healthy food” doesn’t work for all of us & we, as consumers, want different choices and different information.
I get the impression that the current crop of nutrition experts and academics isn’t interested in trying this new dish–humility with a side of caution. Since these folks seem to want to persist in keeping the public’s health on a trajectory where they can be the solution to the problems they have caused, perhaps we can find some ways to “make the reasonable choice the easy choice” for them.
I’ll rent the hotel room & anybody who wants to can bring a sleeping bag–paleo sleepers can spread their bearskins on the floor. Let’s do it.
*The truth is we don’t really know how sugar intake has changed. Dietary data and food availability data offering conflicting views. A mean of 15.8% of consumed calories was from added sugars in this study; data from 2010. This study estimated that 26% of calories were from added sugar; data from 1977-1978.
**Full disclosure: I know, and usually actually like, Gary Taubes. But he does not pay me to say nice things about him & I disagree with him as much as I agree.