Taubes: Why Nutrition Is So Confusing
One of the things I respect most about Gary Taubes is how driven I see he is to root out and tell the truth -- the best evidence-based truth he can get his hands on.
He is one of those people who will tell you straight out when he doesn't know. In this, he's in the minority.
Taubes writes in The New York Times:
Back in the 1960s, when researchers first took seriously the idea that dietary fat caused heart disease, they acknowledged that such trials were necessary and studied the feasibility for years. Eventually the leadership at the National Institutes of Health concluded that the trials would be too expensive -- perhaps a billion dollars -- and might get the wrong answer anyway. They might botch the study and never know it. They certainly couldn't afford to do two such studies, even though replication is a core principle of the scientific method. Since then, advice to restrict fat or avoid saturated fat has been based on suppositions about what would have happened had such trials been done, not on the studies themselves.Nutritionists have adjusted to this reality by accepting a lower standard of evidence on what they'll believe to be true. They do experiments with laboratory animals, for instance, following them for the better part of the animal's lifetime -- a year or two in rodents, say -- and assume or at least hope that the results apply to humans. And maybe they do, but we can't know for sure without doing the human experiments.
They do experiments on humans -- the species of interest -- for days or weeks or even a year or two and then assume that the results apply to decades. And maybe they do, but we can't know for sure. That's a hypothesis, and it must be tested.
And they do what are called observational studies, observing populations for decades, documenting what people eat and what illnesses beset them, and then assume that the associations they observe between diet and disease are indeed causal -- that if people who eat copious vegetables, for instance, live longer than those who don't, it's the vegetables that cause the effect of a longer life. And maybe they do, but there's no way to know without experimental trials to test that hypothesis.
The associations that emerge from these studies used to be known as "hypothesis-generating data," based on the fact that an association tells us only that two things changed together in time, not that one caused the other. So associations generate hypotheses of causality that then have to be tested. But this hypothesis-generating caveat has been dropped over the years as researchers studying nutrition have decided that this is the best they can do.
He argues for what's missing -- truth-telling about what's missing instead of the rush to treat hypotheses as facts.
He winds up his piece with this:
Obesity and diabetes are epidemic, and yet the only relevant fact on which relatively unambiguous data exist to support a consensus is that most of us are surely eating too much of something. (My vote is sugars and refined grains; we all have our biases.) Making meaningful inroads against obesity and diabetes on a population level requires that we know how to treat and prevent it on an individual level. We're going to have to stop believing we know the answer, and challenge ourselves to come up with trials that do a better job of testing our beliefs.Before I, for one, make another dietary resolution, I'd like to know that what I believe I know about a healthy diet is really so. Is that too much to ask?
Then of course pretty much all the medicines that they experiment with are done on men. Only one medicine, zolpidem or trade name Ambien, has different dosing guides based on gender.
But even an aspirin a day has different effects between men and women.
Jim P. at February 10, 2014 4:47 AM
Nutrition IS confusing! What one person does, and has success with, may not work for someone else. My BF needs more carbs per day than I do, and calories in = calories out works very well for her. She cannot eat the amount of fat I do and lose weight.
I was diagnosed as diabetic 26 days ago. At Amy's recommendation, I read Gary's book. I cut my carbs to 20% a day, protein to 20% and fat is now 60%, for a total of 1800 calories a day. My blood sugars have already dropped 42 points and I have lost 8.2 pounds.
I haven't exercised one minute, and actually, I have been less active than usual. Per the standard nutritional wisdom, I should have lost just under 4 pounds, because I have only reduced my caloric intake 527 calories a day. Instead, I have lost twice that.
My doc congratulated me on cutting back on my saturaded fats because my HDL was up by 9 points, my LDL was down by 28 and my triclycerides down by 60. Cut back?! Ha! I replaced my coffee mate with straight heavy whipping cream.
Until they do actual studies on actual people, over a wide range of ages, ethnicities and regional origins, over a lengthy period of time, I think we each need to try and try again until each of us finds what works. There is no "one size fits all" solution.
KLC at February 10, 2014 8:28 AM
The answer to many of the great questions, dietary, and otherwise is a resounding "we don't know".
Too bad most people are genetically predisposed to be happier with a wrong answer, than no answer at all.
Isab at February 10, 2014 10:27 AM
Hey Amy you might find this interesting.
Anti psychotics are known to cause massive amounts of weight gain and instead of doctors saying "we don't know why it happens" they like saying
"It's because you are eating too much"
Well geez thanks, now do I solve the homeless problem by telling them to get homes?
Ppen at February 10, 2014 1:31 PM
In my opinion, EVERYBODY should read Taubes' book. I would have sent my copy to a friend, but I still need it.
When I was pregnant with my daughter in 2009, I had gestational diabetes, and my nutritionist taught me to count carbs. She prescribed between ten and thirteen per day. Not only did my blood sugar remain within healthy limits, but I gained no weight for the last two months of my pregnancy--which was a good thing because I had already gained 60 pounds.
So I was already sold on low-carb, but it took Amy's constant endorsement of it to get me to really start cutting back two years ago. I lowered my daily carb intake to 4 (maybe that's high to some people but it works for me), and I lost 13 pounds in 13 weeks while not exercising at ALL. I was a few weeks from putting on my high school jeans when I got pregnant with my son.
This time my gestational diabetes got out of control, despite my efforts to eat the same way that I did when I was pregnant with my daughter. I think it was the stress of having a toddler and my husband traveling. I gained 70 pounds and my son was delivered by scheduled C-section at 10 pounds 5 ounces.
I only recently convinced my husband to renounce his usual breakfast of cereal and orange juice. It's definitely been easier to cut carbs now that we're both doing it. My son turned 1 last month and I'm wearing the aforementioned high school jeans while I'm typing this. I also just bought a bra in a size I haven't worn in 14 years!
Sosij at February 10, 2014 1:45 PM
Amy Alkon
https://www.advicegoddess.com/archives/2014/02/taubes-why-nutr.html#comment-4250177">comment from SosijWow, cool, Sosij.
And Ppen, it is just disgusting about the anti-psychotics and what doctors tend to say.
Amy Alkon
at February 10, 2014 2:01 PM
The trouble with carbs, is that they are both unsatifying and addictive. So once you start eating them, you get really cranky when you stop.
I find myself having to distract myself to take my mind off of wanting to snack on carbs, I have to make sure, if I eat any, it is not a high carb low fat kind of food, or I will binge.
Kind of like booze, it is a lifetime struggle for some of us.
Isab at February 10, 2014 4:13 PM
My snack cravings usually go towards fatty and salty foods like potato chips. I've found that I love snacking on laver - the pressed seaweed that is toasted and dressed in olive oil & salt. You can buy them in snack packs in bulk at Costco or in sheets in the Korean markets. It satisfies my salt cravings and is tasty, to boot!
Oh, and Gary Taubes is just an excellent writer. Rarely do you find writers of his quality and integrity.
prawntohe at February 11, 2014 11:09 AM
p.s. The shitkicker in me wants to send this article to all of my nutritionist friends masters degrees who think they know science and yet have never heard of Taubes...
prawntohe at February 11, 2014 11:11 AM
I give you the glory, Amy. :)
Sosij at February 12, 2014 7:27 PM
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