As the Calories Churn (Episode 1): Nooooo, not the carbs!!!

Oh the drama!  Some of the current hyperventilating in the alternative nutrition community–sugar is toxic, insulin is evil, vegetable oils give you cancer, and running will kill you–has, much to my dismay, made the alternative nutrition community sound as shrill and crazed as the mainstream nutrition one.

When you have self-appointed nutrition experts food writers like Mark Bittman agreeing feverishly with a pediatric endocrinologist with years of clinical experience like Robert Lustig, we’ve crossed over into some weird nutrition Twilight Zone where fact, fantasy, and hype all swirl together in one giant twitter feed of incoherence meant, I think, to send us into a dark corner where we can do nothing but nibble on organic kale, mumble incoherently about inflammation and phytates, and await the zombie apocalypse.

No, carbohydrates are not evil—that’s right, not even sugar. If sugar were rat poison, one trip to the county fair in 4th grade would have killed me with a cotton candy overdose. Neither is insulin, now characterized as the serial killer of hormones (try explaining that to a person with type 1 diabetes).

But that doesn’t mean that 35 years of dietary advice to increase our grain and cereal consumption, while decreasing our fat and saturated fat consumption has been a good idea.

I have gotten rather tired of seeing this graph used as a central rationale for arguing that the changes in total carbohydrate intake over the past 30 years have not contributed to the rising rates of obesity.

The argument takes shapes on 2 fronts:

1) We ate 500 grams of carbohydrate per day in 1909 and 500 grams in 1997 and WE WEREN’T FAT IN 1909!

2) The other part of the argument is that the TYPE of carbohydrate has shifted over time. In 1909, we ate healthy, fiber-filled unrefined and unprocessed types of carbohydrates. Not like now.

Okay, let’s take closer look at that paper, shall we?  And then let’s look at what really matters:  the context.

The data used to make this graph are not consumption data, but food availability data. This is problematic in that it tells us how much of a nutrient was available in the food supply in any given year, but does not account for food waste, spoilage, and other losses. And in America, we currently waste a lot of food. 

According to the USDA, we currently lose over 1000 calories in our food supply–calories that don’t make it into our mouths.  Did we waste the same percentage of our food supply across the entire century? Truth is, we don’t know and we are not likely to find out—but I seriously doubt it. My mother and both my grandmothers—with memories of war and rationing fresh in their minds—would be no more likely to throw out anything remotely edible as they would be to do the Macarena. My mother has been known to put random bits of leftover food in soups, sloppy joes, and—famously—pancake batter. To this day, should your hand begin to move toward the compost bucket with a tablespoon of mashed potatoes scraped from the plate of a grandchild shedding cold virus like it was last week’s fashion, she will throw herself in front of the bucket and shriek, “NOOOOOO! Don’t throw that OUT! I’ll have that for lunch tomorrow.”

You know what this means folks: in 1909, we were likely eating MORE carbohydrate than we are today. (Or maybe in 1909, all those steelworkers pulling 12 hour days 7 days a week, just tossed out their sandwich crusts rather than eat them. It could happen.)

BUT–as with butts all over America including mine, it’s a really Big BUT: How do I explain the fact that Americans were eating GIANT STEAMING HEAPS OF CARBOHYDRATES back in 1909—and yet, and yet—they were NOT FAT!!??!!

Okay. Y’know. I’m up for this one. Not only is problematic to the point of absurdity to compare food availability data from the early 1900s to our current food system, life in general was a little different back then. At the turn of the century,

  • average life expectancy was around 50
  • the nation had 8,000 cars
  • and about 10 miles of paved roads.

In 1909, neither assembly lines nor the Titanic had happened yet.

The labor force looked a little different too:Labor force 1900 - 2000

Primary occupations made up the largest percentage of male workers (42%)—farmers, fisherman, miners, etc.—what we would now call manual laborers. Another 21% were “blue collar” jobs, craftsmen, machine operators, and laborers whose activities in those early days of the Industrial Revolution, before many things became mechanized, must have required a considerable amount of energy. And not only was the work hard, there was a lot of it. At the turn of the century, the average workweek was 59 hours, or close to 6 10-hour days. And it wasn’t just men working. As our country shifted from a rural agrarian economy to a more urban industrialized one, women and children worked both on the farms and in the factories.

This is what is called “context.”

In the past, nutrition epidemiologists have always considered caloric intake to be a surrogate marker for activity level. To quote Walter Willett himself:

“Indeed, in most instances total energy intake can be interpreted as a crude measure of physical activity . . . ” (in: Willett, Walter. Nutritional Epidemiology. Oxford University Press, 1998, p. 276).

It makes perfect sense that Americans would have a lot of carbohydrate and calories in their food supply in 1909. Carbohydrates have been—and still are—a cheap source of energy to fuel the working masses. But it makes little sense to compare the carbohydrate intake of the labor force of 1909 to the labor force of 1997, as in the graph at the beginning of this post (remember the beginning of this post?).

After decades of decline, carbohydrate availability experienced a little upturn from the mid 1960s to the late 1970s, when it began to climb rapidly. But generally speaking, carbohydrate intake was lower during that time than at any point previously.

I’m not crazy about food availability data, but to be consistent with the graph at the top of the page, here it is.

Data based on per capita quantities of food available for consumption:

1909 1975 Change
Total calories 3500 3100 -400
Carbohydrate calories 2008 1592 -416
Protein calories 404 372 -32
Total fat calories 1098 1260 +162
Saturated fat (grams) 52 47 -5
Mono- and polyunsaturated fat (grams) 540 738 +198
Fiber (grams) 29 20 -9

To me, it looks pretty much like it should with regard to context.  As our country went from pre- and early industrialized conditions to a fully-industrialized country of suburbs and station wagons, we were less active in 1970 than we were in 1909, so we consumed fewer calories. The calories we gave up were ones from the cheap sources of energy—carbohydrates—that would have been most readily available in the economy of a still-developing nation. Instead, we ate more fat.

We can’t separate out “added fats” from “naturally-present fats” from this data, but if we use saturated fat vs. mono- and polyunsaturated fats as proxies for animal fats vs. vegetable oils (yes, I know that animal fats have lots of mono- and polyunsaturated fats, but alas, such are the limitations of the dataset), then it looks like Americans were making use of the soybean oil that was beginning to be manufactured in abundance during the 1950s and 1960s and was making its way into our food supply.  (During this time, heart disease mortality was decreasing, an effect likely due more to warnings about the hazards of smoking, which began in earnest in 1964, than to dietary changes; although availability of unsaturated fats went up, that of saturated fats did not really go down.)

As for all those “healthy” carbohydrates that we were eating before we started getting fat? Using fiber as a proxy for level of “refinement” (as in the graph at the beginning of this post—remember the beginning of this post?), we seemed to be eating more refined carbohydrates in 1975 than in 1909—and yet, the obesity crisis was still yet a gleam in Walter Willett’s eyes.

While our lives in 1909 differed greatly from our current environment, our lives in the 1970s were not all that much different than they are now. I remember. As much as it pains me to confess this, I was there. I wore bell bottoms. I had a bike with a banana seat (used primarily for trips to the candy store to buy Pixie Straws). I did macramé. My parents had desk jobs, as did most adults I knew. No adult I knew “exercised” until we got new neighbors next door. I remember the first time our new next-door neighbor jogged around the block. My brothers and sister and I plastered our faces to the picture window in the living room to scream with excitement every time she ran by; it was no less bizarre than watching a bear ride a unicycle.

In 1970, more men had white-collar than blue-collar jobs; jobs that primarily consisted of manual labor had reached their nadir. Children were largely excluded from the labor force, and women, like men, had moved from farm and factory jobs to more white (or pink) collar work. The data on this is not great (in the 1970s, we hadn’t gotten that excited about exercise yet) but our best approximation is that about 35% of adults–one of whom was my neighbor–exercised regularly, with “regularly” defined as “20 minutes at least 3 days a week” of moderately intense exercise.  (Compare this definition, a total of 60 minutes a week, to the current recommendation, more than double that amount, of 150 minutes a week.)

Not too long ago, the 2000 Dietary Guidelines Advisory Committee (DGAC) recognized that environmental context—such as the difference between America in 1909 and America in 1970—might lead to or warrant dietary differences:

“There has been a long-standing belief among experts in nutrition that low-fat diets are most conducive to overall health. This belief is based on epidemiological evidence that countries in which very low fat diets are consumed have a relatively low prevalence of coronary heart disease, obesity, and some forms of cancer. For example, low rates of coronary heart disease have been observed in parts of the Far East where intakes of fat traditionally have been very low. However, populations in these countries tend to be rural, consume a limited variety of food, and have a high energy expenditure from manual labor. Therefore, the specific contribution of low-fat diets to low rates of chronic disease remains uncertain. Particularly germane is the question of whether a low-fat diet would benefit the American population, which is largely urban and sedentary and has a wide choice of foods.” [emphasis mine – although whether our population in 2000 was largely “sedentary” is arguable]

The 2000 DGAC goes on to say:

“The metabolic changes that accompany a marked reduction in fat intake could predispose to coronary heart disease and type 2 diabetes mellitus. For example, reducing the percentage of dietary fat to 20 percent of calories can induce a serum lipoprotein pattern called atherogenic dyslipidemia, which is characterized by elevated triglycerides, small-dense LDL, and low high-density lipoproteins (HDL). This lipoprotein pattern apparently predisposes to coronary heart disease. This blood lipid response to a high-carbohydrate diet was observed earlier and has been confirmed repeatedly. Consumption of high-carbohydrate diets also can produce an enhanced post-prandial response in glucose and insulin concentrations. In persons with insulin resistance, this response could predispose to type 2 diabetes mellitus.

The committee further held the concern that the previous priority given to a “low-fat intake” may lead people to believe that, as long as fat intake is low, the diet will be entirely healthful. This belief could engender an overconsumption of total calories in the form of carbohydrate, resulting in the adverse metabolic consequences of high carbohydrate diets. Further, the possibility that overconsumption of carbohydrate may contribute to obesity cannot be ignored. The committee noted reports that an increasing prevalence of obesity in the United States has corresponded roughly with an absolute increase in carbohydrate consumption.” [emphasis mine]

Hmmmm. Okay, folks, that was in 2000—THIRTEEN years ago. If the DGAC was concerned about increases in carbohydrate intake—absolute carbohydrate intake, not just sugars, but sugars and starches—13 years ago, how come nothing has changed in our federal nutrition policy since then?

I’m not going to blame you if your eyes glaze over during this next part, as I get down and geeky on you with some Dietary Guidelines backstory:

As with all versions of the Dietary Guidelines after 1980, the 2000 edition was based on a report submitted by the DGAC which indicated what changes should be made from the previous version of the Guidelines. And, as will all previous versions after 1980, the changes in the 2000 Dietary Guidelines were taken almost word-for-word from the suggestions given by the scientists on the DGAC, with few changes made by USDA or HHS staff. Although HHS and USDA took turns administrating the creation of the Guidelines, in 2000, no staff members from either agency were indicated as contributing to the writing of the final Guidelines.

But after those comments in 2000 about carbohydrates, things changed.

Beginning with the 2005 Dietary Guidelines, HHS and USDA staff members are in charge of writing the Guidelines, which are no longer considered to be a scientific document whose audience is the American public, but a policy document whose audience is nutrition educators, health professionals, and policymakers. Why and under whose direction this change took place is unknown.

The Dietary Guidelines process doesn’t have a lot of law holding it up. Most of what happens in regard to the Guidelines is a matter of bureaucracy, decision-making that takes place within USDA and HHS that is not handled by elected representatives but by government employees.

However, there is one mandate of importance: the National Nutrition Monitoring and Related Research Act of 1990, Public Law 445, 101st Cong., 2nd sess. (October 22, 1990), section 301. (P.L. 101-445) requires that “The information and guidelines contained in each report required under paragraph shall be based on the preponderance of the scientific and medical knowledge which is current at the time the report is prepared.”

The 2000 Dietary Guidelines were (at least theoretically) scientifically accurate because scientists were writing them. But beginning in 2005, the Dietary Guidelines document recognizes the contributions of an “Independent Scientific Review Panel who peer reviewed the recommendations of the document to ensure they were based on a preponderance of scientific evidence.” [To read the whole sordid story of the “Independent Scientific Review Panel,” which appears to neither be “independent” nor to “peer-review” the Guidelines, check out Healthy Nation Coalition’s Freedom of Information Act results.]  Long story short:  we don’t know who–if anyone–is making sure the Guidelines are based on a complete and current review of the science.

Did HHS and USDA not like the direction that it looked like the Guidelines were going to take–with all that crazy talk about too many carbohydrates – and therefore made sure the scientists on the DGAC were farther removed from the process of creating them?

Hmmmmm again.

Dr. Janet King, chairwoman of the 2005 DGAC had this to say, after her tenure creating the Guidelines was over: “Evidence has begun to accumulate suggesting that a lower intake of carbohydrate may be better for cardiovascular health.”

Dr. Joanne Slavin, a member of the 2010 DGAC had this to say, after her tenure creating the Guidelines was over: “I believe fat needs to go higher and carbs need to go down,” and “It is overall carbohydrate, not just sugar. Just to take sugar out is not going to have any impact on public health.”

It looks like, at least in 2005 and 2010, some well-respected scientists (respected well enough to make it onto the DGAC) thought that—in the context of our current environment—maybe our continuing advice to Americans to eat more carbohydrate and less fat wasn’t such a good idea.

I think it is at about this point that I begin to hear the wailing and gnashing of teeth of those who don’t think Americans ever followed this advice to begin with, because—goodness knows—if we had, we wouldn’t be so darn FAT!

So did Americans follow the advice handed out in those early dietary recommendations? Or did Solid Fats and Added Sugars (SoFAS—as the USDA/HHS like to call them—as in “get up offa yur SoFAS and work your fatty acids off”) made us the giant tubs of lard that we are just as the USDA/HHS says they did?

Stay tuned for the next episode of As the Calories Churn, when I attempt to settle those questions once and for all.  And you’ll hear a big yellow blob with stick legs named Timer say, “I hanker for a hunk of–a slab or slice or chunk of–I hanker for a hunk of cheese!”


The NaCl Debacle Part 1: Salt makes you fat?

Don’t look now, but I think the Institute of Medicine’s new report on sodium just bitch-slapped the USDA/HHS 2010 Dietary Guidelines.

In case you have a life outside of the nutritional recommendation roller derby, the IOM recently released a report that comes to the conclusion that restricting sodium intake to 1500 mg/day may increase rather than reduce health risks. Which is a little weird, since the 2010 Dietary Guidelines did a great job of insisting that any American with high blood pressure, all blacks, and every middle-aged and older adult—plus anyone who has ever eaten bacon or even thought about eating bacon, i.e. nearly everybody—should limit their salt intake to 1500 mg of sodium a day, or less than ¾ of a teaspoon of salt. The American Heart Association was, of course, aghast. The AHA thinks EVERYBODY should be limited to less than ¾ teaspoon of salt a day, including people who wouldn’t even think about thinking about bacon.

Why are the AHA and USDA/HHS so freaked out about salt?  And how did the IOM reach such a vastly different conclusion than that promoted by the AHA and the Dietary Guidelines?  Fasten your seat belts folks, it’s gonna be a bumpy blog.

First, it is helpful to examine why the folks at AHA and USDA/HHS are so down on salt.  The truth: we have no freakin’ idea. Salt has been around since what, the dawn of civilization maybe? It is an essential nutrient, and it plays an important role in preserving food and preventing microbial growth (especially on bacon). But Americans could still be getting too much of a good thing. Everybody at the AHA seems to think that Americans consume “excessive amounts” of sodium. (Of course, just about anything looks excessive compared to less than ¾ of a teaspoon.) But do we really consume too much sodium?

Back in 2010, Dr. Laurence I-Know-More-About-Sodium-Than-Your-Kidneys-Do Appel (or as his friends call him, “Low-Sodium Larry”), one of the leading advocates for a salt-free universe, acknowledged that “The data is quite murky. We just don’t have great data on sodium trends over time. I wish that we did. But I can’t tell you if there’s been an increase or decrease.”

Well, Low-Sodium Larry, I can, and I am about to make your wish come true.

According to recent research done by that wild bunch of scientific renegades at Harvard, in the past 60 years sodium intake levels have . . .drumroll, please . . .  not done much of anything.

Hey, that doesn’t sound right! Everyone knows that it is virtually impossible to get an accurate measure of sodium intake from dietary questionnaires; people are probably just “under-reporting” their salt intake like they “under-report” everything else. Low-Sodium Larry has previously insisted that one of the reasons the data is so murky is that few epidemiological studies measure sodium intake accurately and that, “really, you should do 24-hour urinary sodium excretions to do it right.”

The guys at Harvard looked at studies that did it right.  This systematic analysis of 38 studies from the 1950s to the present, found that 24-hour urinary sodium excretion (the “gold” standard—omg, I could not resist that—of dietary sodium intake estimation) has neither increased nor decreased, but has remained essential stable over time. Despite the fact that Americans are apparently hoovering up salt like Kim Kardashian hoovers up French fries—and with much the same results, i.e. puffing up like a Macy’s Thanksgiving Day balloon—for whatever reason we simply aren’t excreting more of it in our urine.

According to that same study however, despite the lack of increase in sodium excretion (which is supposed to accurately reflect intake—but that can’t be right), high blood pressure rates in the population have been increasing. Duh. Everyone knows that eating lots of salt makes your blood pressure go up. But have the rates of high blood pressure in America really been going up?

Age-Adjusted Prevalence of Hypertension (2009 NIH Chart Book)

Well, no.  Not really. The Harvard dudes cite a report that goes back to 1988-1994 data, and yes, rates of high blood pressure have been creeping slowly back up since then. This is because from 1976-1980 to 1988-1994, rates of high blood pressure plummeted for most segments of the American population.

We don’t know why rates of high blood pressure fell during the 70s and early 80s. It may have been that the Dietary Guidelines told people to eat more potassium-filled veggies and people actually tried to follow the Dietary Guidelines, which would have had a positive effect on high blood pressure. On the other hand, it could have been largely due to the sedating influence of the soft rock music of that era blanketing the airwaves with the mellow tones of England Dan and John Ford Coley, Christopher Cross, Ambrosia, and the like (youtube it, you young whippersnappers out there). We also don’t know why rates are going back up. Rising rates of obesity may be part of the problem, but it is also entirely possible that piping the Monsters of Lite Rock through every PA system in the country might save our health care system a lot of time and trouble.

This is what we (think we) know:

  • High-sodium diets might possibly maybe sometimes be a contributor to high blood pressure.
  • Rates of high blood pressure are going (back) up.
  • Obesity rates are definitely going up.

Ergo pro facto summa cum laude, it is clear—using the logic that seems to undergird the vast majority of our public health nutrition recommendations—salt makes you fat.  The USDA/HHS has been faced with rapidly rising rates of obesity which, until now, they have only been to pin on the laziness and gluttony of Americans.  But if salt makes us fat, that might explain why the USDA/HHS doesn’t want us to eat it.

After all, the biomechanics of this is pretty straightforward. If you eat too much sodium (which we must be), but you don’t pee it out (which we aren’t), you must be retaining it and this is what makes your blood pressure and your weight both go way up. They didn’t really cover the physics of this in my biochemistry classes so you’ll have to ask Dr. Appel how this works because he knows more about sodium than your kidneys do. But I think it must be true. After all, this is the mechanism that explains the weight loss behind carbohydrate-reduced diets, right? I myself reduced my carb intake and lost 60 pounds of water weight!

And besides, taking the salt out of our food will give food manufacturers the opportunity to make food more expensive and tasteless while adding synthetic ingredients whose long-term effects are unknown—just what the American consumer wants!

For a while there, we thought the whole idea was to reduce sodium in order to reduce blood pressure in order to reduce diseases of the circulatory system, like heart failure, stroke, and coronary heart disease . That didn’t seem to work out so well, because the whole time that sodium intake was staying stable (if we want to believe the urinary sodium excretion data) and high blood pressure rates were going down (although they are starting to go back up), rates of those diseases have gone up:

Age-Adjusted Prevalence of Heart Failure (2009 NIH Chart Book)

Age-Adjusted Prevalence of Stroke (2009 NIH Chart Book)

Age-Adjusted Prevalence of Coronary Heart Disease (2007 NIH Chart Book)

So if reducing blood pressure to reduce cardiovascular disease isn’t the answer, then we must need to reduce blood pressure to reduce obesity! By jove, I think we’ve got it!

The USDA/HHS must have known the “salt makes you fat” notion would be a tough sell, I mean, what with the lack of any shred of supporting science and all that. (But then, the “salt causes high blood pressure which causes cardiovascular disease” argument hasn’t exactly been overburdened by evidence either, and that never seemed to stop anyone.) So the 2010 Dietary Guidelines brought together the American Heart Association’s Superheroes of Sodium Slashing, Low-Sodium Larry and his bodacious salt-subduing sidekick, Linda Van Horn, both of whom had been preaching the gospel of sodium-reduction as a preventive health measure with little conclusive evidence to support their recommendations.  The USDA/HHS knew that with Linda and Larry on the team, it didn’t matter how lame the science, how limited the data, or how ludicrous the recommendation, these two could be counted on to review any and all available evidence and reliably come up with the exact same concrete and well-proven assumptions they’d been coming up with for years.

The Sodium-Slashing Superheroes–Drs. Lawrence Appel and Linda Van Horn– ready to make the world safe for bland, unappetizing food everywhere! (Drawings courtesy of Butcher Billy)

So here’s the cliffhanger:  Will Linda and Larry be able to torture the science on salt into confessing its true role in the obesity crisis?

Tune in tomorrow, when you’ll hear Linda and Larry say: “Science? We don’t need no stinkin’ science.”

“Broccoli has more protein than steak”—and other crap

Of all the asinine things that I read about nutrition—and let me tell you, I read a lot of them—this one has got to be the asininniest: Broccoli has more protein than steak.

I’ve seen this idiotic meme repeated many times, but the primary source of this stupid—see also: delusional, ludicrous, and absurd—notion seems to be Dr. Joel Furhman. My mom—bless her little osteoporotic soul—keeps his books down at the beach cottage. I don’t think she does it to taunt me, but you never know. I was a bad kid, and payback may be in order. My family has forbidden me to read Dr. Furhman’s books, to pick them up, or to even glance at the covers because the resulting full-on nutrition-rant kills everybody’s beach buzz.

However, as of last week, I have officially maxed out my tolerance for just ignoring this nonsense. So, note to my family: Read no further, it will kill your beach buzz.

According the Dr. Furhman’s book, Eat to Live, a 100-calorie portion of sirloin steak has 5.4 grams of protein, and a 100-calorie portion of broccoli has 11.2 grams of protein. This is rubbish. According to the USDA’s Agricultural Research Service’s Nutrient Data Laboratory database, 100 calories of broiled beef, top sirloin steak has exactly 11.08 grams of protein and 100 calories of chopped, raw broccoli has exactly 8.29. I’m not sure what universe Dr. Furhman lives in, but in my universe, 8.29 is less than 11.08.

I can explain the discrepancy in numbers by the simple fact that Dr. Furhman and I used different sources for our information. Dr. Furham wrote his book—the one that contains the piece of drivel under consideration—in 2005, but he chose to reference a nutrition book written in 1986 (Adams, C. 1986. Handbook of the Nutritional Value of Foods in Common Units, New York: Dover Publications). Just to put things in perspective, in 1986, the internet and DVDs had not yet been invented, no one knew who Bart Simpson was, and it would be another couple of years before Taylor Swift even draws her first ex-boyfriend-bashing breath.

Here’s what I can’t explain: Why, oh why did he dig up a reference nearly two decades old and not just use the USDA internet database, which is—and has been since the 1990s—available to anyone with a library card and a half a brain? While I do not wish to speculate on exactly which of these tools Dr. Furhman might be lacking, suffice it to say that it would take less than 10 minutes for any blogger interested in the truth of the matter to find a more recent source of information—assuming of course that bloggers who perpetuate this particular fiction are interested in the truth.

But wait—before you foam at the mouth too much, Adele—8.29 grams of protein is fair bit of protein.  There is only a difference of a couple of grams of protein between broccoli and steak.  Yes, I would agree, those numbers are a lot closer than you might expect, and this might actually be nutritionally important, if—Big If—all protein were created equal. Which it isn’t.

While I am a big fan of coming at nutrition from an individualized perspective, and I am aware that nutrition scientists don’t have any monopoly on truth, we have managed to nail down a few essential things that human must acquire from the food that they eat. In terms of essentiality, after calories and fluid comes protein—or more specifically, essential amino acids (there are more essentials, but they are not the topic of this particular rant). Because these amino acid requirements are so important (a particular form of starvation, kwashiorkor, involves not overall calorie deprivation, but protein deficit in the context of adequate or near-adequate calories), the World Health Organization has established specific daily requirements of the essential amino acids that are necessary for health.

Let’s see how similar caloric intakes of steak and broccoli stack up when comparing how these two foods provide for essential amino acid requirements. A 275-calorie portion of steak (4 ounces) has 30.5 grams of protein and comes very close to meeting all the daily essential amino acid requirements for a 70 kg adult. A 277-calorie portion of broccoli is not only way more food—you’ll be chewing for a long time as you try to make it through 9 ¼ cups of broccoli—exactly NONE of the daily essential amino acid requirements for an adult are met:

EssentialAmino acids (g) Daily requirement 70 kg adult (g) Essential amino acids (g) in 275 calories of steak (4 oz or 113.33 g) Essential amino acids (g) in 277 calories of chopped, raw broccoli (9.25 cups)
histidine 0.70 0.975 ( +0.275) 0.48 (-0.22)
isoleucine 1.400 1.391 (-0.009) 0.643 (-0.757)
leucine 2.730 2.431 (-0.299) 1.05 (-1.68)
lysine 2.100 2.583 (+0.483) 1.099 (-1.001)
methionine 0.70 0.796 (+0.096) 0.309 (-0.391)
cysteine 0.28 0.394 (+ 0.114) 0.228 (-0.052)
threonine 1.050 1.221 (+0.171) 0.716 (-0.334)
tryptophan 0.280 0.201 (-0.079) 0.269 (-0.011)
valine 1.82 1.516 (-0.304) 1.018 (-0.802)

In reality, it takes twice that much broccoli, or over 18 cups, containing nearly twice as many calories, in order to get anywhere near meeting all essential amino acid requirements.  While I’m willing to concede that individual amino acid requirements may vary considerably, I am not willing to concede that similar caloric amounts of steak and broccoli provide a similar supply of those requirements.  I’m no broccoli basher (it’s sooo yummy baked with cheese & a little bacon on top), but as a protein source, even a lot leaves a lot to be desired.

Oh yeah? Well then, “how on earth do animals like elephants, gorillas and oxen get so big and strong eating only plants? A diverse plant-based diet can obviously support a big, powerful body.” Sure it can. If you’re an elephant or a gorilla or an ox.

In general, human bodies don’t work very efficiently without a regular dietary supply of all essential amino acids: “It would be difficult to find a protein that did not have at least one residue of each of the common 20 amino acids. Half of these amino acids are essential, and if the diet is lacking or low in even one of these essential amino acids, then protein synthesis is not possible” [Emphasis mine; reference: Campbell & Farrell’s Biochemistry, 6th edition]. Protein synthesis allows us to grow, heal, reproduce, and function in general. One of the specific outcomes of protein deficiency in humans is stunting, i.e. where humans who would otherwise grow bigger, don’t.

Dr. Furhman seems to think that those of us who “believe” that food from animals provides a more biologically complete source of protein than food from plants “never thought too much about how a rhinoceros, hippopotamus, gorilla, giraffe, or elephant became so big eating only vegetables.” Hmmm. I have to say, I’m thinking the same thing about Dr. Furhman. Maybe he is unaware that humans aren’t really all that much like rhinoceroses, hippos, gorillas, giraffes, or elephants. But then maybe he just hangs out with a different crowd than I do.

Once again, armed with a library card and half a brain, it is not too difficult to figure out—assuming you did think about how those animals got so big eating only plants and didn’t just mindlessly parrot Dr. Furham’s poorly-researched blather—that, as Gomer Pyle would say, surprise! surprise! Humans and other large mammals ARE different.

While non-ruminants (like humans) must get their essential amino acids from their diet, ruminants (like giraffes) “may also acquire substantial amounts of these amino acids through the digestion of microbial protein synthesized in the rumen” (see: Amino Acids in Animal Nutrition, edited by J.P. Felix D’Mello). This may come as a bit of a shock to Dr. Furhman and his readership, but humans don’t actually have rumens and utilizing this particular approach to the acquisition of essential amino acids from plant matter ain’t gonna work for us.

You can get plenty of protein from a plants-only diet by eating like a hippo.

Other non-ruminant grazers—see elephants, rhinos, and hippos—have a different eating strategy. They “eat for volume and low extraction.” In other words, the relatively low availability of protein in the food is overcome by the high volume consumed. In that regard—assuming you aspire to an elephant-like, rhino-like, or hippo-like bod—it may be possible to get sufficient protein from a strictly plant-based diet. If you don’t mind eating all the time. And pooping. Less than half of what is consumed by the high-volume grazers is utilized by the body; the rest—like a handsome stranger—is just passin’ through (see: Nutritional Ecology of the Ruminant, by Peter J. van Soest). If the idea of literally flushing over half of what you eat down the toilet doesn’t bother you, then this strategy actually might work.

ooooh! Can we? Please?

So what about gorillas? This particular primate-to-primate comparison has been tossed all around the internet. Why can’t we just eat plants like gorillas do? Gorillas, although not so good at Jeopardy, are big and strong and they’re vegans, so we should all be vegans too, right? Aside from the fact that we don’t really know exactly what gorillas are eating much of the time, it does seem that they eat a lot of bugs along with their plants. So unless you have a particularly fastidious gorilla, some dietary protein won’t be vegan. Compared to humans, gorillas also have a much larger proportion of the gut devoted to fermentation—again, another source for microbes to contribute to the nutritional completeness of a plants-only diet. And, again, a high volume of food is consumed to compensate for the low nutritional value of it. You won’t have to worry about half your food going down the toilet, though. Those who want to live like gorillas can just eat that poop instead of flushing it. This provides the body with another opportunity to extract nutrition from the substance formerly known as food and may also help explain the willingness of Dr. Furhman’s readers to swallow what he’s shoveling.

I have nothing against a plants-only diet—in whatever form it takes—if that’s what a person want to do and it makes him/her happy. I have no more interest in converting a vegan to omnivory than I do in having a vegan attempt to convert me to swearing off bacon. I am also aware that there is more—much more—to food choices than the nutritional content of the food chosen.

But I’m afraid this is just one of those situations where ideology has been sent to do the work of science. Ideology has its place, and science has its flaws. Truth, facts, and beliefs can be hard to define and harder still to separate. I get all that. But – to quote Neil deGrasse Tyson – “The good thing about science is that it’s true whether or not you believe in it.” Unfortunately, for all those gorilla-wannabees out there, the reverse also applies: Believing in something doesn’t make it true. You can believe all you want that broccoli is a better source of protein than steak, but your ribosomes don’t have access to a keyboard and they might vote differently.

Now, dear readers, if you ever run across some library-card-challenged blogger out there perpetuating Dr. Furhman’s little myth, you have a link to help spill some sunshine on the matter.

A beautifully-written summary by Emily Contois regarding the recent Critical Nutrition Symposium held at UC-Santa Cruz. Organized by Julie Guthman, author of Weighing In, this symposium brought together food scholars from around the country (plus me) and invited us and the audience to participate in a thought-provoking and nuanced conversation about food, nutrition, culture, and ways of knowing.

Emily Contois

On March 8, 2013, I had the pleasure of attending the Critical Nutrition Symposium at UC Santa Cruz, organized by Julie Guthman, author of Weighing In. The event was spawned from a roundtable discussion at last year’s Association for the Study of Food and Society conference. The symposium brought together an interdisciplinary group of scholars to critically examine what is missing from conventional nutrition science research and practice, discuss why it matters, and brainstorm how to move forward in an informed and balanced way. What follows are a few of my favorite key ideas from the day’s discussions.

Adele Hite, a registered dietitian and public health advocate who is not afraid to ask big and delightfully confrontational questions regarding nutrition science, began the day by dissecting Michael Pollan’s now famous aphorism—Eat food. Not too much. Mostly plants. Step by step, she revealed the decades of revisionist myth…

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Vegetable Oil and Heart Disease: New news from the way-back machine

Since the 1970’s, we’ve reduced our sugar, salt, and saturated fat intake, and we’ve dramatically reduced our rates of smoking, high serum cholesterol and high blood pressure. At the same time, rates of chronic disease, including coronary heart disease, have increased—in some cases, dramatically.

The best that we can say is that since the 1970s, rates of myocardial infarction have decreased slightly—but only in white folks.

If the current health prescription is valid, then we should see dramatic differences in rates of disease and mortality between those who follow the prescription and those who don’t, and we should see clear and strong associations between “healthy” food choices and good health (because the same people eating a “healthy” diet are also taking care of their health in other ways). Yet this is not what we see.

Is it possible that our low-fat diet has removed some protective factors from our nutritional profile and exposed us to increased levels of nutrients that have negative impacts on health? I think it is, and a recent study in BMJ supports this notion.

I am a long-time admirer of one of the researchers, Daisy Zamora, and she is a good friend of mine. She’d been dropping hints about this great study she was working on for a while now—but was sworn to secrecy and now I know why. What she and her co-investigators have uncovered is data from a long-ago diet study, conducted from 1966-1973. It’s a decently large, well-run, randomized controlled trial that replaces saturated fat with safflower oil, a vegetable oil particularly high in one kind of PUFA—omega-6 (n-6) linoleic acid—and low in another kind of PUFA—omega-3 (n-3) alpha linolenic acid. The idea was that replacing “bad” saturated fat with “healthy” vegetable oil in men with premature coronary heart disease would improve survival. This did not turn out to be the case. For some reason, though, the original study only reported all-cause mortality and not deaths from cardiovascular disease and coronary heart disease.

Daisy and her co-investigators climbed into their way-back machine and this is what they found: Not only did the participants in the intervention group have an increased risk of all-cause mortality, but they had an increased risk of death from cardiovascular disease and coronary heart disease.

The blue line is the safflower oil group; the red line is the control group. To put it rather simplistically, the widening gap between the two groups means the intervention group died a lot faster than the controls.

Although the switch to safflower oil did lower total cholesterol, these reductions didn’t help those participants live any longer than those who kept eating saturated fat. In fact, as the authors note, “the increased risk of death in the intervention group presented fairly rapidly and persisted throughout the trial.”  (Hmm. Maybe this whole “cholesterol lowering” thing isn’t as important as we thought.)

Furthermore, the authors go on to point out that the relationship between linoleic acid consumption and increased mortality was particularly robust in smokers and drinkers, “suggesting that diets high in n-6 [linoleic acid] may be particularly detrimental in the context of oxidative stress induced by smoking and alcohol.”

Everyone knows that if you are a smoker you should quit and that alcohol should be used in moderation. But, with this evidence in mind, if you decided to keep on smoking and/or you want to drink immoderately, you may want to consider a breakfast of eggs and bacon rather than whole wheat toast and “heart healthy” margarine before you do.

The entire article is available online. Read it for yourself and see what you think.  Anybody besides me wondering how the American Heart Association will respond to this study?

Guest Post: James Woodward on Why Science May Not Be Enough

I’d like to introduce readers to a friend and fellow grad student, James Woodward. His undergraduate work was in economics at Ohio University, and he has a Master’s in public policy from the University of Kentucky. He is continuing at UK as a PhD student in public policy and administration. He and I have had some of the most thought-provoking email threads in any of my correspondence & I give him a lot of credit for helping me think through the economics and policy parts of food-health system reform puzzle. His post will serve as a bridge to my next series on “Eatanomics” which will explore how food, health, and the economy are intertwined. James would like everyone to know that all the disclaimers that appear on this page apply equally to what appears in this post. His views are his own, and as with the best of minds, he anticipates that most are subject to change. But he raises some very interesting questions—he’s nearly as long-winded as I am, but it is worth a read.

Why New Science May Not Be Enough – James Woodward

Before going into my social science background, I thought I would mention my professional background as it relates to food. It’s nearly as extensive as my academic background. I worked in fast food for about two years, a pizza place for about two years, a dining hall for a quarter, and, finally, a pseudo-Mexican restaurant for about two years. As a result, my feelings toward actual food and, especially, its preparation are fairly ambivalent at this point. The fact that I spent large amounts of time working with flour (I made tens of thousands of tortillas over the course of my tenure at the Mexican place) is rather ironic given my recent decision to avoid the stuff as much as possible.

Nutrition Science Initiative founders Gary Taubes and Peter Attia are hoping to give the public some solid science on food-health relationships.

My schooling in economics was concurrent with much of this work and my reasons for working these jobs had much more to do with my own economic situation than with any particular desire to work with food. But my background in economics and, now, public policy, leads to me to view the issue of food and nutrition policy a bit differently than many others writing on this topic. Many approach problems relating to nutrition and health in terms of their public health consequences. Others stress the fact that nutrition policy is the product of bad and/or misinterpreted science. Gary Taubes and Peter Attia just launched their organization, NuSI, to address, and hopefully settle, that particular aspect of this issue. Both lines of research clearly have their merits. Ultimately, though, I think what everyone is most interested in is influencing the behavior of individuals.

Contrary, perhaps, to Peter Attia’s quote from Richard Feynman in a recent blog post, I think there is a role for social scientists to play in understanding the many issues and controversies surrounding diet, health and public policy. Some of us in the social sciences are, in fact, sensitive to the difficulty of establishing real truths from the data available to us. Further, I do not think that social phenomena like behaviors and decision-making are reducible to physical and chemical relationships quite yet. How fitting that nutrition, and especially nutritional epidemiology, often bears more resemblance to bad social science than it does to any sort of ‘hard’ science.

Ignoring the controversy surrounding what it is that makes people fat and what constitutes an ideal diet, it would be hard to argue that people are making “good” decisions about what they are eating, given the high prevalence of (ostensibly) diet-related health problems in the United States, the most visible of which is obesity. Since most people buy their own food rather than growing or raising it themselves, food buying decisions tend to be highly correlated with food eating decisions. So, to me, the ultimate question is: “What influences food buying decisions?” Again, Gary and Peter have, with good reason, chosen to stress the importance of food consumption decisions being driven by good science. But there are clearly more factors that influence food purchasing decisions than a careful weighing of the scientific evidence. I would argue that such an approach to most decisions is, in fact, fairly rare. To the extent that Gary and Peter are ultimately trying to influence public policy, I think it is self-evident based on a reading of the history that policymakers are not that likely to employ such an approach either.

One of the many things besides science that may influence food purchasing and consumption.

This is why I tend to conceptualize the problem in the area of food and nutrition policy as one of bad information rather than attributing it purely to bad science. If one takes the time to dig, there is plenty of science which refutes the conventional wisdom regarding the relationship between diet and health. So, while no rigorous, carefully controlled studies have been performed to refute the conventional wisdom and/or confirm the “insulin hypothesis”, to use Gary’s term, there is already a lot of evidence to suggest that it is valid and plenty of evidence which refutes the conventional wisdom. Performing such a rigorous test of these competing theories is obviously warranted, given the importance of the implications for settling this debate, but there is no guarantee that the results will be convincing to skeptics, policymakers, stakeholders or the public at large.

Thirty-odd years ago policymakers perceived an obvious threat to public health (saturated fat) and saw a clear remedy (tell people not to eat so much saturated fat) which made it more or less a no-brainer to act on that information and tell people to avoid eating saturated fat containing foods. Since then, those original beliefs about diet and health have had time to percolate and become more or less embedded in how most people think about what they eat. Adele and I have talked a little bit about overcoming our own biases when we decided to eat differently, biases that we were not necessarily aware we had in the first place.

How you spend your food dollar may depend on how many food dollars you have to spend.

There are more factors that influence food purchasing decisions than just beliefs about how that food will affect one’s health. Taste, culture, geography, morality, ethics, politics, and socioeconomic status are just a few observable characteristics of an individual that might affect what he or she decides to eat. In many people’s minds, there is very little conflict between these concerns and health-related ones. For example, there is a perception that following a vegetarian lifestyle is good for one’s body, one’s soul, and the environment compared to a diet based around animal products. Upon closer inspection, however, there is a great deal of ambiguity to this belief in all three spheres. Similarly, many athletes seem to be operating under the impression that carbohydrates are required to perform at a high level. Peter’s well-documented experience calls that belief into question. Breakfast is often lauded as the most important meal of the day in the United States yet I frequently snub it to no ill-effect. And so on.

I think it is important to keep these biases in mind when thinking about we’d like to go about changing behavior. It is tempting to think “if only the science were better” people’s behavior would change. This is clearly not enough, in my mind anyway. It is just as important to be convincing as it is to be right. If/when NuSi successfully settles this debate and has the biggest names in the field to back up its research; there is still the matter of convincing everyone else. NuSi does acknowledge this aspect of the issue, though I am interested to see how it is addressed in practice. There are the cognitive biases of all the other scientists to contend with. There are also the material and non-material incentives that seem to be ingrained in many of the stakeholders involved in this particular area of policy. For example, it has been noted elsewhere that stressing the importance of calories is convenient for those involved in the production of food since doing so means no particular foods (e.g., wheat and sugar) are likely to be admonished against because of their unique effects on the body per se but, rather, because of their caloric content. I have to imagine that such firms will do their very best to refute any evidence that says otherwise and may hire their own experts to do so.

In a “calories in, calories out” world, there’s room for all foods in a “healthy” diet.

Beyond the obvious material costs to stakeholders of changing the current nutritional paradigm are the much more difficult to quantify costs of changing people’s beliefs about such things. Despite taking a nutrition course years ago (for an easy science credit, I will admit), I did not have particularly strong thoughts about nutrition prior to about a year and a half ago. I knew I made less than optimal choices about what I ate (according to conventional wisdom that is) but I mostly ignored those concerns since my health seemed fine (more or less). It was therefore fairly costless for me to change my mind about how I approach my diet after the conventional wisdom failed for me. Physicians and dietitians are not like me, however. Many of them have devoted years of their lives to dispensing information and advice that they believe to be correct and helpful. Faced with an opposing and incongruent view, it is perfectly understandable that they would be very resistant to the implication that they have been misleading their patients. In a less extreme form, I am sometimes asked by friends and acquaintances for my thoughts relating to diet and health and then, after giving them, met with resistance and facts or beliefs that supposedly refute my position(s). Most of these people are not experts on this topic but, like most people, they need some justification for what they believe.

So what is my point in all this? It is probably not breaking news that people’s eating decisions are not purely based on a careful reading of the scientific evidence. Better science is probably a necessary part of making the case but I do not think it will be sufficient to affect the type of change that many people in the ‘Paleo’ or ‘Ancestral Health’ communities (or whatever other term you prefer) would like to see. As mentioned, most people are averse to the notion that their beliefs are wrong and, in my experience, will try to come up with some reason for why that is not the case, sometimes resorting to questionable sources for support. This is human nature, I think– cognitive dissonance perhaps, to borrow a term from the psychologists. Based on what I can see, most people are not even willing to entertain the idea that there is a controversy or room for debate about these competing paradigms. Especially skinny people.

I think this state of affairs needs to change if further research is to bear any fruit in the form of affecting individual behavior and/or public policy. Fortunately, there are many bloggers writing on this topic, all bringing their own perspectives to the table. The challenge will be finding enough common ground to get this message to a larger audience so that we get an actual public debate going. I read the New York Times ‘Health’ section fairly regularly (as a barometer for this type of thing, not necessarily for good information) and I am not seeing it so far. It would be a real shame if all that came of this renewed interest in an old paradigm was a relatively minor reduction in the prevalence of obesity.

What Simon Doesn’t Say: An Expose with a Hidden Agenda

The Academy of Nutrition and Dietetics (AND) is squirming over a recent report written by Michele Simon of Eat Drink Politics that address ANDs corporate sponsorship program. The president of AND warns members not to believe everything they read and to mind the source (I supposed the assumption is RDs would be too sheep-like to do otherwise? Good thing Daddy Sheep warned us!), saying  ” . . . the majority of the report consists of publicly available facts filtered through the author’s opinions. She is of course entitled to her opinions. But opinions are not facts.”

I’m no fan of the Academy of Nutrition and Dietetics (AND), although they haven’t yet revoked my membership. I’m also no fan of industrialized food, although I do think the food industry has an important role to play in reforming our food-health system. I am also not a big fan of hypocrisy, which is why I have a good bit of trouble with the report, entitled Are America’s Nutrition Professionals in the Pocket of Big Food?

The answer is—I believe—a resounding “yes,” and Healthy Nation Coalition has explored how this compromised position extends not just to the food industry but the USDA itself. Clearly, the AND is an industry-friendly organization, and the USDA relies on AND-trained dietitians to confirm its own industry-friendly guidelines.

While I applaud Simon’s efforts to hold the AND more accountable for its relationships with industry, AND leadership is correct in pronouncing Simon’s reporting as one-sided and biased.  Simon is happy to slam the health-washing, cultural insensitivity, and hidden agendas of food manufacturers and the Academy, but if the propaganda, insensitivity, and agendas are vegatarian*—well, then she’s just fine with it, thank you very much.

“Healthy” smoothies are okay with Simon; meaty cheesy Big Macs are not.

Simon complains that “the banners at the McDonald’s booth showed images of healthy foods like smoothies,” but didn’t show McRibs and Big Macs. The implication, of course is that “healthy” smoothies” (with 78 grams of sugar and 4 grams of protein) aren’t so bad—even if they are from McDonald’s—compared to those meaty, cheesy foods like a Big Mac. Never mind that your body actually needs the protein that a Big Mac can provide and has little use for the 78 grams of sugar in a smoothie, except for fat storage.

How dare the Dairy Council target lactose-intolerant African-Americans! Every one knows all African-Americans would be healthier on a vegan diet . . .

Simon quotes an RD who points out that it is culturally inappropriate for the National Dairy Council to target African-American and Hispanic communities, considering the high rates of lactose intolerance in those populations, a remark with which I fully agree. Simon then goes on to complain about the inappropriateness of the Pork Board handing out educational material at “a nutrition conference where almost no countering information could be found about how a meat-centered diet can lead to chronic disease”?  In fact it would inappropriate to provide such “countering information” as the declaration that a meat-centered diet leads to disease is an ideological stance and not a scientific one. I would go on to add that it is also a culturally-insensitive stance, as pork is at the center of not only African-American and Hispanic food culture (barbeque, chorizo), but Chinese and Eastern European cuisine as well (lup cheong and kielbasa). It seems cultural sensitivity is fine if it means we can take away meaty, cheesy foods—but not when such sensitivity would allow them.

It’s not culturally insensitive to ban pork products–like these lup cheong– from a healthy diet; we’re just doing everyone a favor.

Simon’s take on the not-so-hidden relationships between the AND and the food industry is well-trod ground as she herself acknowledges, but to Simon some associations are apparently more odious than others:

In 1995, New York Times reporter Marian Burros wrote about criticisms of the [AND] for taking funding from industry groups such as the Sugar Association, the Meat Board, and companies such as McDonald’s, CocaCola, and Mars. According to Burros: “Nothing negative is ever included in materials produced by the association, a fact that critics attribute to its link to industry.” In that same article, veteran sustainable food advocate and Columbia University Professor Joan Gussow noted that giving money to registered dietitians is how industry silences its critics.

Simon pointedly calls out the National Cattleman’s Beef Association as an “especially loyal” sponsor. But if giving money means AND will only say positive things about your food product, it’s difficult to explain AND’s resounding endorsement of vegetarian and vegan diets, with “tips of the day” like “Endless Meat-Free Options” and articles that show you how to “Build Muscle, No Steak Required,” plus the promotion of stories such as “All Red Meat is Bad for You” in their daily newsletter. If I were the Beef Association, I’d want my money back.

Private consulting firms that have a “good” agenda don’t need to be held to the same levels of transparency as the “bad” ones.

I fully commend Simon’s calls for transparency, but the transparency knife cuts both ways. The AND/industry report was authored by Simon under the auspices of Eat Drink Politics, a self-described (by Simon) “industry watchdog” group that is also a “private consulting firm.” As such, while Simon is willing to disclose some of its clients, she states that “Some of our clients and funders prefer to remain anonymous for various reasons and we respect those wishes” (emphasis mine). So while she accuses the International Food Information Council of being “an industry front group” (which I think is pretty accurate), we can’t really tell who or what Eat Drink Politics is a “front” for, although we can take an educated guess.

The Eat Drink Politics website alerts us to an alarming situation regarding Deceptive Health Claims:

“The food industry has a challenge on its hands. Most health experts agree that the optimum diet is one based mostly on whole, plant foods, the kind that come from nature and not a factory. So, to convince Americans they can still eat their favorite meat, cheese, soda and junk food, many companies are using meaningless labels such as “all-natural” and engaging in other deceptive marketing practices” (emphasis mine).

Yup, meat and cheese—that’s about as un-natural as it comes.

It doesn’t take a rocket scientist to look through the science and figure out that “most health experts” don’t actually agree that the “optimum” diet is based mostly on whole, plant foods (actually I’m pretty sure it just takes a journalist, specifically Gary Taubes). It’s also pretty easy to figure out what Simon’s idea of a “whole, plant food” diet is:

“A diet based on whole plant foods minimizes or eliminates all animal products, including meat, poultry, fish, dairy, eggs, and their byproducts.”

Can you say—vegan?

Simon goes to great lengths in her book Appetite for Profit to deny that she has any vegan agenda, as she has been accused of by the Center for Consumer Freedom (a group Simon depicts—again, accurately, in my opinion—as a food and beverage industry front group).  She’s clearly sensitive to the fact that the word “vegan” is too loaded with negative connotations to actually use it when she suggests that “a diet that resembles my own would be optimal for most people.”

She accuses Center for Consumer Freedom of keeping its corporate sponsorship anonymous in order to engage in more provocative PR claims and of manipulating language to make it look like she’s pushing a personal agenda. But she seems pretty comfortable with keeping her own sponsors anonymous, with using provocative claims to alarm the public, and with using consumer-friendly language to gloss over aspects of her own personal biases that the public may find off-putting. I guess she figures it’s okay because she’s believes she’s got “decades of accepted nutrition science” and a “scientifically supported view” on the side of her personal nutritional biases.

I think Simon’s 5 recommendations to AND are long overdue. There is no doubt that AND would benefit from increased transparency; more input from members; sponsorship guidelines; an elimination of corporate-sponsored education; and stronger policy leadership.

But I cannot support is what I think is Simon’s most disturbing suggestion, that AND commit itself to policy action now—specifically taxation of sugar-sweetened beverages**—before a full review of scientific evidence and long-term implications can be ascertained.

According to Simon, “not every policy issue or decision can wait for months (or years) of committee review and analysis.” On the contrary, I would argue that more policy decisions that attempt to manipulate the health behaviors of Americans by relying on unproven assumptions about the relationships between food and health can and should wait for months or years or indefinitely, until consistent, quality experimental data is obtained or until observational data reveal consistent and unmistakably-high risks. Right now, the health crisis that Simon seems intent on addressing (and I applaud her intentions, if not her methods) is at least in part a result of sweeping changes made to our food system 35 years ago without such evidence in hand.

Simon’s unquestioning belief in her own nutritional agenda is a result of that policy experiment, but it isn’t the solution. It’s time we stop trying to change the eating habits of our fellow Americans—which is the underlying intention behind taxing soda and believing that a diet that resembles your own is best for everyone else—and start trying to change the regulatory, economic, and political framework that restricts access to both the food and the knowledge that individuals need to make their own decisions about their own health.


In case you missed my interview with Bob Fenton, a fellow blogger who has type 2 diabetes, you can find it here: 

Adele holds forth on diabetes, dietetics, and why the refusal to admit the limitations of our nutrition knowledge is a dangerous thing.

Next up is a guest post from a friend and fellow graduate student, James Woodward, whose background in economics and public policy gives him a rather different perspective on how we might go about accomplishing the task of reforming our food-health system.  It will also provide a bridge to my next series on “Eatanomics” which will explore how food, health, and the economy are intertwined. 

*”Vegatarian” is a term I use to indicate veganism disguised as vegetarianism. While lacto-ovo-vegetarian dietary patterns are complete and perfectly healthy, vegan diets must rely on fortification or supplementation to be complete, as acknowledged by the promoters of such diets (just read the “fine print”).

**Sugar-sweetened beverages are usually pretty nutritionally useless, but we simply don’t know what sort of unintended repercussions a soda tax will have, or where to draw the taxation line. One study has shown that beer-drinking households responded to a six-month soft drink tax by buying more beer.