The Drivers of the Herd, Part 21
The Docile Herd
Slide 3 http://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes.html
Perhaps you’ve seen Dr. Peter Attia’s emotional TED talk about insulin resistance. I saw it and I found it to be rather odd on several levels.
Slide 4 http://vimeo.com/45485034
Attia also has a video on Vimeo in which he lectures an audience about saturated fat. He mentioned something in passing in that one that you may find curious if you’ve seen his TED talk.
Slide 5 Attia: “Back, you know, when I was clinically practicing medicine, how often subconsciously I sort of judged people who were diabetic and overweight. And it wasn’t a judgment that I don’t think that ever came through in the way that I interacted with them, but it certainly existed in the back of my mind, which was, ‘If you would just stop eating so much …’”
You just heard Dr. Attia say that although he was feeling judgmental toward his patients, he doesn’t think any of them every perceived that judgment. With that in mind, listen to these recollections of his from that TED talk.
Slide 6 http://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes.html
Attia [edited]: “I’ll never forget that day back in the spring of 2006 … I can still remember sort of that smell of rotting flesh as I pulled the curtain back to see her … Why did I hold her in such bitter contempt? … I wish I could speak with that woman again. I’d like to tell her how sorry I am … You didn’t need my judgment and my contempt.”
This is different. Now not only is he saying his judgmental attitude did come through, he recalls a particular instance of this with a powerful multisensory memory that he says he’ll never forget. Now he has a specific person in mind whom he wronged. She would know who she is all these years later. He must have been completely awful to her for that to be true. He is using this public platform to try to reach out to her to apologize.
Slide 7 How do we reconcile these two accounts? I don’t have an answer to that. I just find the fact that they both came from the same person speaking in front of microphones to be rather amazing. I also find it disturbing that this young doctor held his patients in “bitter contempt”.
Slide 8 Hojat, Mohammadreza, et al. "Physicians' empathy and clinical outcomes for diabetic patients." Academic Medicine 86.3 (2011): 359-364.
Doctors often can’t heal their patients. The tools they need just aren’t there. But they can always offer empathy and compassion. There is evidence that doctors who are more empathetic actually deliver better medical care. If someone can’t muster that outlook toward their patients then perhaps that doctor should give up practicing clinical medicine. Whether that was the reason or not, Attia did just that.
Slide 9 http://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes.html
Attia: “As soon as I completed my residency I left, so I did my residency in general surgery at Johns Hopkins and my fellowship in surgical oncology and then just had a real change of heart and decided I didn’t want to practice clinical medicine so I joined the consulting firm McKinsey & Company and actually wanted to get as far from health care as possible …”
That’s a big career change after so much hard work to reach that point.
Slide 10 Shanafelt, Tait. "A career in surgical oncology: finding meaning, balance, and personal satisfaction." Annals of surgical oncology 15.2 (2008): 400-406.
I have no doubt his experience as at Johns Hopkins was grueling. As you can see, residencies for young surgical oncologists are extremely demanding. Their duties leave time for hardly anything else in their lives.
Slide 11 Attia: “Despite exercising three or four hours every single day and following the Food Pyramid to the letter I gained a lot of weight and developed something called ‘metabolic syndrome.’”
I find that story implausible but that’s beside the point. It would be pretty tough to work out four hours a day every single day as a surgical oncologist whose skills are in demand. But now he’s the president of this new low-carb organization. He’s living in San Diego. I’m guessing he sets his own schedule. It’s probably not a bad lifestyle.
His career changes remind me of Gary Taubes’ background. Gary Taubes didn’t start out as a best-selling author of low-carb books. His education was in physics and engineering. Why didn’t he stick with that?
Slide 12 http://youtu.be/HCgTlC8PE0Q from Charlie Rose 2002
Taubes: “I’m not a physicist, by the way. I studied it in college. Had I been a good physicist I might be a physicist now. I wasn’t. That’s why I’m a journalist.”
No judgment from me on that. I’m sure that was a very demanding career path. There’s no shame in washing out. You heard him say his next pursuit was journalism. That’s another tough way to make a living.
Slide 13 Kensing, Kyle. "The Worst Jobs of 2013 | CareerCast.com."CareerCast.com. CareerCast, n.d. Web. 9 Jan. 2014. <http://www.careercast.com/jobs-rated/worst-jobs-2013>.
We all know how revenues are dwindling and careers are going away in journalism in the digital age. A career in journalism has never been easy. Taubes wrote about physics at first but his attention turned to fat promotion when he wrote an incendiary piece about nutrition science published in the New York Times.
Slide 14 Liebman, Bonnie. "Big Fat Lies." Nutrition Action 29.9 (2003): 1-7. Web.
The piece was unbalanced and his reporting was questionable but it did cause a sensation.
Slide 15 Liebman, Bonnie. "Big Fat Lies." Nutrition Action 29.9 (2003): 1-7. Web.
Consequently, Taubes was given a huge advance to write Good Calories, Bad Calories. You don’t get money like that for telling people they should eat their fruits, vegetables, and whole grains. Taubes left behind the lesser-paying and often anonymous work of science journalism for the much more lucrative job of fat-promoting celebrity author. Given the choice you might have made the same career move.
Slide 16 Taubes, Gary. "The science of obesity: what do we really know about what makes us fat? An essay by Gary Taubes." BMJ: British Medical Journal 346 (2013).
Now the organization he founded along with Peter Attia attracts millions of dollars. He is published in medical journals and he appears widely in the media. Not many journalists get that sort of attention.
Slide 17 http://atkinsfoundation.org/uploads/Atkins-2012-IRS-991.pdf
You can see that running a fat-promoting nonprofit can be very lucrative. How many print journalists are pulling down salaries like the people who run the Atkins Foundation? I’m guessing that Peter Attia and Gary Taubes won’t be living monastic lives of self-sacrifice in their new jobs promoting meat and fat.
From his new perch Attia can now afford to be contrite for his brief stint practicing medicine.
Slide 18 Attia: “Maybe you didn’t let the system down. Maybe the system, of which I was a part, was letting you down.”
This is a common theme in the low-carb world. Fad diet promoters love to say we’ve been lied to. You are overweight but you are innocent. You got fat because you were let down by the experts.
Slide 19 http://www.bbc.co.uk/programmes/b01k0fs0
I’ve already made videos criticizing this BBC Two program called “The Men Who Made Us Fat.” Their message was obvious. You didn’t make yourself fat. They made you fat.
Slide 20 Bachman, Jessica L., et al. "Sources of food group intakes among the US population, 2001-2002." Journal of the American Dietetic Association 108.5 (2008): 804-814.
This is objectively false. We know that very few people actually follow official dietary recommendations. I’ve seen whole grain consumption described as between 5 and 10% of recommended levels.
Slide 21 Gross, Lee S., et al. "Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment."The American journal of clinical nutrition 79.5 (2004): 774-779.
You can see in this graph that the consumption of refined sugars has surged while the consumption of dietary fiber has fallen.
Slide 22 McGovern, G. "Eating in America." Dietary goals for the United States of America. Report of the Select Committee on Nutrition and Human Needs. US Government Printing Office (1977).
I talked about the nutrition recommendations of the McGovern panel in 1977 in video 17 of this series. Americans didn’t follow them.
Slide 23 That document bemoans the way Americans were trading complex carbohydrates for simple carbohydrates. They were concerned to see Americans trading starch for sugar.
Slide 24 They recommended baked potatoes, not potato chips. They encouraged simple cooked cereals over processed cold cereals. They said simple carbs had little nutritional value.
But the idea that innocent people have been let down by the authorities allows for the cultivation of a victim mentality that the low-carb promoters find useful. Here’s a case in point. This is Gary Taubes talking about overweight children who are made to exercise in physical education classes.
Slide 25 http://livinlavidalowcarb.com/blog/the-llvlc-show-episode-439-part-1-gary-taubes-speaks-out-against-his-critics/9842
Taubes: “I watch these kids, you know, in recess and they have to jog around the track. And in the front always is the, you know, the short, lean kid who’s flying effortlessly and can run effortlessly. And at 20 yards behind everyone else [is] the two obese and overweight kids. And running for them is torture. They’re literally being tortured. And the idea is if you just torture them enough they’ll become lean and fleet of foot.”
There is so much wrong with that statement. Life is not effortless. Exercising is hard. I’d rather sit on the couch instead of push my body just like the next guy. But I understand I need to forth some effort if I want to have a healthy life. No one is expecting an overweight kid to run effortlessly. What a gym instructor is trying to do for that child is make sure that even if he is not in an environment at home that promotes good health, at least he’ll get some movement in his body at school once in a while. But that’s not the way Taubes wants you to see it. The gym teacher is the authority. The child is being wronged. The child is a victim. The obese listener hears this and recalls similar experiences in his past. Maybe he feels sorry for himself. Read Taubes’ books and you’ll see that he argues that exercise has no bearing on how fat you are, so it is consistent with his beliefs that he sees exercise as pointless torture. Why should a heavy child exercise if exercise won’t help him lose weight anyway?
Slide 26 p.80. Taubes, Gary. Why We Get Fat and What to Do About It. New York: Alfred A. Knopf, 2011. Print.
If you believe what he says about exercise and decide to opt out, he can pander to your victim mentality another way. Health officials like to say that calories matter because they are so attracted to the idea that obesity is a penalty for sloth. They blame the obese for their laziness. Of course, you just heard him say that overweight kids shouldn’t be made to run around. Let them be slothful. But slothfulness is a behavior, and you see he says that to explain obesity through the behavior of the obese couldn’t be further from the truth. So you see he has it covered both ways. Don’t exercise expecting to reach a healthy weight. Don’t expect an overweight kid to learn how to take care of his body. But at the same time no scientist can blame your obesity on your sedentary lifestyle because that’s blaming the victim.
Slide 27 p.82. Taubes, Gary. Why We Get Fat and What to Do About It. New York: Alfred A. Knopf, 2011. Print.
That more people don’t notice the illogic of his pandering to victimhood is disappointing. Here he presents ideas about obesity that he says deserve skepticism. The obese don’t know what they should be doing. They are ignorant. But if they aren’t ignorant, then why is he bothering to write a book for them? He must think they are ignorant of his low-carb dogmas at the very least, right?
It appears the low-carb promoters must be counting on the ignorance of their audience. Take Peter Attia, for example. He has decided the fundamental pathology in obesity is insulin resistance.
Slide 28 Attia: “Most of them actually want to do the right thing but they have to know what that is. And it’s gotta work. I dream of a day when our patients can, you know, shed their excess pounds and cure themselves of insulin resistance …”
First, I don’t know why he’s talking about “our patients”. All he says he’s doing professionally now is advocating for fatty food.
Slide 29 p.82. Taubes, Gary. Why We Get Fat and What to Do About It. New York: Alfred A. Knopf, 2011. Print.
Second, when he says that most people want to do the right thing but they have to know what that is, he’s pretty strongly implying they are ignorant of something. It seems he hasn’t worked out that message with his friend Taubes yet. Third, eating more fat and meat is not likely to do much to help anyone avoid insulin resistance.
Slide 30 Nuttall, Frank Q., et al. "Effect of protein ingestion on the glucose and insulin response to a standardized oral glucose load." Diabetes Care 7.5 (1984): 465-470.
It’s been known for a while that protein is especially stimulatory of insulin secretion in diabetics. I’ve made two videos called “How to Become Insulin Resistant” about this. Eating more meat is not the solution to insulin resistance.
Slide 31 Aune, D., G. Ursin, and M. B. Veierød. "Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies."Diabetologia 52.11 (2009): 2277-2287.
Meat consumption, especially red meat consumption, has repeatedly been found to associate with insulin resistance and diabetes. This was the conclusion of this meta-analysis. If you believe that diabetes rates are rising in the developing world then you should ask yourself why that is happening just as the developing world is eating less starch and more meat. Please see videos 17 and 18 from this playlist for more on that.
Slide 32 Risérus, Ulf, Johan Ärnlöv, and Lars Berglund. "Long-Term Predictors of Insulin Resistance Role of lifestyle and metabolic factors in middle-aged men."Diabetes Care 30.11 (2007): 2928-2933.
Saturated fat consumption has also been found to relate to insulin resistance. Here is a token study for that.
Slide 33 Mayer, Elizabeth J., et al. "Usual dietary fat intake and insulin concentrations in healthy women twins." Diabetes care 16.11 (1993): 1459-1469.
Especially interesting to me is this study of twins. By studying twins we can eliminate the confounding effects of genetics and early environmental exposures. This study identified saturated fat and total fat as associated with insulin resistance, at least before adjusting for obesity. I think such an adjustment is likely to be an overadjustment. I don’t think it’s just a coincidence that obesity and high saturated fat consumption varied with each other in these twins. See video 13 in this series to see why I say that.
Slide 34 Lovejoy, Jennifer C., et al. "Effect of a controlled high-fat versus low-fat diet on insulin sensitivity and leptin levels in African-American and Caucasian women."Metabolism 47.12 (1998): 1520-1524.
If carbohydrates cause insulin resistance, then why would this trial show that a lower-fat, higher-carb diet improves insulin sensitivity? The high-fat phase of this trial had the same number of calories. All the meals the participants ate were specially prepared for them. The fatty diet happened to be disproportionately high in saturated fat. The low-fat diet actually had a disproportionate amount of simple carbs relative to the high-fat diet. The high-fat diet seemed to promote leptin resistance as well. These results were quite the opposite of what the low-carbers would predict.
Slide 35 Valachovičová, M., et al. "No evidence of insulin resistance in normal weight vegetarians." European journal of nutrition 45.1 (2006): 52-54.
If meat and fat are good for insulin sensitivity, then why is this one of the many respects in which vegetarians seem to enjoy a health advantage? The vegetarians here ate more grains than the omnivores. How can a low carber explain this?
Slide 36 Rizzo, Nico S., et al. "Vegetarian Dietary Patterns Are Associated With a Lower Risk of Metabolic Syndrome The Adventist Health Study 2." Diabetes Care 34.5 (2011): 1225-1227.
Here’s a study that found that vegetarians were leaner and had lower blood sugar than omnivores. The low-carbers might say that these vegetarians had other healthy habits that compensated for their diets but that would not be rational. If carbs make you fat and if grains raise your blood sugar so much, then the vegetarians should have been fatter and they should have had higher blood sugar no matter what.
Slide 37 http://www.marksdailyapple.com/does-eating-low-carb-cause-insulin-resistance/
As a low-carb advocate, Peter Attia shouldn’t be getting weepy about insulin resistance. He should just go with it. Other low carbers do. They try to make a virtue of it. They’ve decided to call the insulin resistance from low carb diets “physiologic insulin resistance.” That implies that this is a normal insulin resistance but insulin resistance is not normal, it’s just what happens when you do low carb. They’ve decided this is no problem because they are so sure low carb is a great idea. What does the insulin resistance of low-carb mean for their long term health? They don’t know. No one does. There’s no research on that. But that’s how it works in the low-carb culture. Their elevated blood sugar is simply reimagined as normal. Explanations and assurances are improvised. If you’re a low carber, congratulations! The usual rules don’t apply to you.
Slide 38 Kahan, Dan M., et al. "Motivated Numeracy and Enlightened Self-Government."Available at SSRN 2319992 (2013).
I look at two bright people like Taubes and Attia and I consider all the evidence I’ve shared with you on my channel and I wonder how they can continue to preach the same claptrap. Watching them reminds me of this paper from Dan Kahan and his colleagues about the idea of motivated numeracy. This paper caused more than a few people some despair. One would think that the better one’s math skills are, the more objectively one could sort through issues which require mathematical reasoning.
Slide 39 But when the subjects with better mathematical minds were confronted with the results of a fake experiment that happened to have political overtones, Kahan found they were more likely to interpret the results of the experiment in a way that reinforced their prior political beliefs. In other words, the smarter the person, the more adeptly he interpreted the evidence he saw to support his worldview.
Slide 40 p.291. Fleer, Jack D. Governors Speak. Lanham, MD: University Press of America, 2007. Google Books.
One might think that people advocate positions that fly in the face of vast and robust science because they have made the calculation that doing so will be more advantageous to them, whether in terms of money or something else. But I wouldn’t assume that. Often we’ll hear of politicians who insist their campaign contributions don’t imply a quid pro quo; they had their beliefs first and the donations followed from that. They probably believe it. This reminds me of one of George Costanza’s most insightful comments.
Slide 41 http://youtu.be/UB8TCRUd9rA
Costanza: “It’s not a lie if you believe it.”
From a statistical point of view we should expect that there will be at least a scattering of educated people who believe unreasonable things about nutrition or anything else. And as with politicians we should expect that these people will receive financial support from the interests who might benefit from such a person’s advocacy. A politician’s defense of his campaign contributions or a pro-fat expert’s entreaties to eat more lard may feel sincere to them.
Slide 42 p. 26. Paul, Richard, and Linda Elder. The Thinker's Guide to Fallacies: The Art of Mental Trickery and Manipulation. Dillon Beach, CA: Foundation for Critical Thinking, 2004. Google Books.
But whether the low-carb advocate believes what he says or not, the rest of us should be able to recognize when he is attempting to manipulate us. Is an appeal being made to our cynicism? Take the example of Ancel Keys. When someone recasts an otherwise unassuming and accomplished scientist as a historic villain who engineered a massive deception, do we find that an attractive thought and take on that belief as our own? Unfortunately, if enough accusations are made against someone by enough people, we tend to assume that those accusations have at least a shade of truth. Manipulative people know this. It’s the sort of thing we see in political campaigns. A line of attack is floated. The party faithful take the cue and disseminate the attack.
Slide 43 p.16. Atkins, Robert C, and Sheila Buff. Dr. Atkins' Age-Defying Diet. New York: St. Martin's Griffin, 2003. Google Books.
You heard me explain the falsehood of the libel against Keys in my first video of this set. Here you see Robert Atkins believed the libel. Atkins said Dr. Keys’ Seven Countries study came out in the 1950s even though it was released in 1970. He thought Keys had data for 20 countries available to him, so he isn’t getting that detail of the libel right, either; he meant 22 countries. He thought Keys selected the seven counties that proved his point in that paper from 1953 but he meant six. Close enough for a low-carb guru, I guess. All these errors are in one paragraph, a paragraph in which he’s questioning someone else’s credibility. This is how sloppy Atkins was with his research, yet he made millions selling books like this one.
Slide 44 p.32. Bowden, Jonny. Living Low Carb: Controlled-carbohydrate Eating for Long-Term Weight Loss. New York: Sterling, 2013. Google Books.
Jonny Bowden is happy to repeat the libel. Bowden doesn’t understand that the paper about six countries used WHO data while the Seven Countries study generated its own data from its many research teams around the world. But Bowden is selling a low-carb book so he’s close enough, too.
Slide 45 p.33. Curtis, Ernest. The Cholesterol Delusion. Dog Ear Publishing, 2010. Google Books.
Ernest Curtis likes this libel as well. At least he got the number of countries right even if there was never anything called the Six Country study, proper noun. He says Keys was more interested in pursuing an agenda than finding the truth, but you can tell that Curtis didn’t research this at all.
Ancel Keys has become a symbol of corrupt authority for the low-carb faithful. He is a case-in-point for them of why you should be suspicious of authority figures.
Slide 46 Gary Taubes’ polemical style involves a lot of authority-bashing. Here you see he mentioned “authorities,” almost always pejoratively, 51 times in his book Why We Get Fat. It’s a short book so this really struck me as repetitive after a while.
Slide 47 http://www.rushlimbaugh.com/daily/2013/11/06/quick_hits_page
The authority-bashing then extends beyond the low-carb gurus. Rush Limbaugh read a blog post about the myths that have made the world sick and fat. Here we go with the victim mentality again. It’s interesting to see how attracted some people are to appeals to their victimhood. Someone who believes in personal responsibility wouldn’t imagine vague authority figures exercising control over what he puts in his mouth. Limbaugh explained to his audience that it is “scientifically, medically, biologically proven” that meat, eggs, and saturated fats are not bad for you. Naturally, he has decided that it is a scientific fact that low-carb diets are the “easiest, healthiest, and most effective way to lose weight and reverse metabolic disease.”
Slide 48 http://www.c-spanvideo.org/program/Limba
Now why would he think that he’s in any position to declare what is scientifically, medically, and biologically proven? When did he become an expert on weight loss?
Slide 49 http://www.businessinsider.com/13-nutrition-lies-that-made-the-world-sick-and-fat-2013-10?op=1
All he had to do to attain his confidence in his scientific assessment was read the blog of an authority he trusts, in this case a medical student and personal trainer who decided to call his blog “Authority Nutrition.” What makes him an authority? Nothing. But he wants you to think he’s an authority. Isn’t it obvious that the reason these apologists for fat and meat bash the so-called authorities so much is because they want to be the authorities? They want to be perceived as the gate-keepers of medical knowledge but they don’t want to have to earn that. They don’t have a professional responsibility to get their facts right. No matter. They are happy to go on the attack since no accomplished person would waste their time responding to random bloggers. A blogger doesn’t need to be perceived as a real authority by many people to feel successful. He just needs a very small share of the eyeballs out there to have a considerable audience.
Slide 50 p.38. Taubes, Gary. Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health. New York: Anchor Books, 2008. Print.
Certainly the legitimate authorities have been mistaken in some respects. A perfect example is the Minnesota Coronary Survey. We should remember what went wrong there. In the interest of creating a trial that could be run smoothly while superficially seeming to be well designed, its organizers created a study that had little chance of success. Their trial could only serve as an example of failure which a bad actor like Taubes could later use to mislead people. Taubes presents the Minnesota Coronary Survey as evidence of the failure of diet-heart.
Slide 51 Frantz, I. D., et al. "Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey." Arteriosclerosis, Thrombosis, and Vascular Biology 9.1 (1989): 129-135.
I’ve talked about this trial in my previous playlist. The organizers wanted their experimental diet to be as similar as possible to the control diet. They concocted fatty fake foods that were heavy in trans fats. They seemed to be completely uninfluenced by what was known about the global epidemiology of heart disease at the time.
Slide 52 Ahrens Jr, E. H. "Mass field trials of the diet-heart question (their significance, timeliness, feasibility and applicability)." Report of the Diet-Heart Review Panel of the National Heart Institute) Am. Heart Assoc. Monograph 28 (1969).
That experimental diet actually reflected the guidance of the American Heart Association at the time. Here you see part of a table they created in their manual of instructions for mass diet trials just like that one. Experimental diets were conceived using the very diets that were killing so many Americans as a template. They recommended adapting these harmful foods for the age of diet-heart through the miracles of modern technology. That faith in technology reflected the spirit of the times. Lard was replaced with shortening. Milk was filled with oil. People could eat new fatty foods just like the fatty foods they were already eating.
Slide 53 Dayton, Seymour, and Morton Lee Pearce. "Prevention of coronary heart disease and other complications of atherosclerosis by modified diet." The American journal of medicine 46.5 (1969): 751-762.
One of the authors of that manual was candid about why they had chosen this approach. They wanted to be sure they could meet the expectations for palatability of their participants. He said the people selected for trials because of their high risk of dying from heart disease happened to have variable levels of motivation to adhere to prescribed diets. In other words, the people being slowly killed by their food sometimes wouldn’t give up that food.
Slide 54 These experimental diets had nothing to do with the naturally occurring diets around the world that were known to keep people free of heart disease. Epidemiology would have indicated that a low-fat diet be attempted. But Americans, whose new meaty diets brought them an epidemic of heart disease, wouldn’t tolerate such a thing. I can sympathize with the dilemma of those researchers.
Slide 55 Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002 Dec 17;106(25):3143-421.
Our national leaders never asked us to adopt diets that were likely to solve the heart disease problem but at least they did report to us what could be learned from other cultures. We were told in 2002 that any LDL above 100 mg/dL appears to be atherogenic. Only in populations that maintain very low levels of serum cholesterol throughout life do we find a near-absence of CHD. They told us the truth.
Slide 56 They respected the work of Ancel Keys and understood the significance of the Seven Countries study.
Slide 57 Stone, Neil J., et al. "2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in AdultsA Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines." Journal of the American College of Cardiology (2013).
But we recently received new guidelines that contain no references to Dr. Keys or the other important epidemiology of the diet-heart era, when true low-fat cultures were still around to be observed. Now one could interpret our national guidelines as saying that LDL scores well over 100 mg/dL don’t necessarily warrant concern. This document lays out the new treatment guidelines. It’s mostly about when and how to prescribe statins.
Slide 58 Eckel, Robert H., et al. "2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular RiskA Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines."Journal of the American College of Cardiology (2013).
There was also a related report about lifestyle modification to reduce heart disease risk. It’s references were mostly restricted to diet trials, trials influenced by considerations like those you just saw. Trials like the ones that went into that saturated fat meta-analysis in videos 9 and 10. This approach is called evidence-based medicine and we’re supposed to think it’s the best way of understanding how nutrition affects heart disease risk. It’s as if our leaders have forgotten that there were once places where heart disease hardly ever manifested.
Slide 59 Our current official guidance is far from ideal but it could be a lot worse. How so?
Slide 60 http://eatingacademy.com/cholesterol-2/the-straight-dope-on-cholesterol-part-ix
That’s where NuSI comes in. Peter Attia’s “dream” study would involve a standard American diet as the control diet. Why? Is there a shortage of low-carb trials using the typical bad diet as a control diet? Do we really need a new nonprofit to fund more of these meaningless exercises in addition to the Atkins Foundation?
Slide 61 There you see stage one of their new trial. They have tax-exempt status so they can show us that low carb is better for the obese than a high-sugar diet in terms of some parameter or other. Eventually the results of this will be published and treated like serious research by the press and by bloggers.
Slide 62 Do your own search on low-carb trials. It’s amazing how many of them have been published. In what other field of science do the experts keep asking the same questions over and over and over? Here you see I restricted my search to those studies authored by prolific low-carb promoter Eric Westman. I’ve never seen a study from him that produced an unflattering conclusion about low carb. And yet you have seen in this playlist that other researchers have conducted trials that provoked their alarm. Why is Westman so consistently supportive? What are the odds of that?
Slide 63 Westman, Eric C. "A review of very low carbohydrate diets for weight loss."JCOM-WAYNE PA- 6 (1999): 36-40.
McClernon, F. Joseph, et al. "The Effects of a Low‐Carbohydrate Ketogenic Diet and a Low‐Fat Diet on Mood, Hunger, and Other Self‐Reported Symptoms."Obesity 15.1 (2007): 182-182.
Paddon-Jones, Douglas, et al. "Protein, weight management, and satiety." The American journal of clinical nutrition 87.5 (2008): 1558S-1561S.
LeCheminant, James D., et al. "Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program." Nutr J 6.36 (2007): 1-9.
Westman, Eric C., et al. "Effect of 6-month adherence to a very low carbohydrate diet program." The American journal of medicine 113.1 (2002): 30-36.
Mavropoulos, John C., et al. "The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study." Nutr Metab (Lond) 2.1 (2005): 35.
Here are just a handful of his published articles. Notice that these all acknowledge the Atkins Foundation as a funding source. These studies keep being generated because the Atkins Foundation keeps paying for them to be generated. It appears they keep funding Westman because he is so reliable for them.
Slide 64 http://atkinsfoundation.org/uploads/Atkins-2012-IRS-991.pdf
The Atkins Foundation is worth about $20 million.
Slide 65 They have a bank account in the Cayman Islands.
Slide 66 They say their purpose is to have a positive impact on our health and nutrition. They give out grants to this end.
Slide 67 One of the places they have awarded grant money is the University of Texas Southwestern.
Slide 68 Browning, Jeffrey D., et al. "Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction." The American journal of clinical nutrition 93.5 (2011): 1048-1052.
Researchers from there just coincidentally produced research favoring low-carb diets, including this one asserting a “metabolic advantage” to low carb. You wouldn’t suspect the influence of Atkins money here. Robert Atkins is only mentioned as a reference. The authors stated they had no conflicts of interest pertaining to the subject. The Atkins Foundation paid the school and the school pays these researchers, but there was no conflict of interest.
Slide 69 The Atkins Foundation also sent some money to the University of Connecticut.
Slide 70 Paoli, A., et al. "Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets." European journal of clinical nutrition 67.8 (2013): 789-796.
That’s where long-time low-carb promoter Jeff Volek works. They, too, reported on the benefits of extreme low-carb diets. No one reported any conflicts of interest in this case, either.
Slide 71 Mintert, James, et al. “U.S. Beef Demand Drivers and Enhancement Opportunities: A Research Summary.” Available at http://www.beefboard.org/news/files/factsheets/Beef_Demand_Drivers_January_2009.pdf
The animal food industry understands the economic value of favorable nutrition research. For example, the beef industry observed that good or bad publicity for Atkins-style low-carbohydrate diets can affect its bottom line. You’ll notice up in the top right that this report was funded by the Beef Checkoff program.
Slide 72 http://beefresearch.org/CMDocs/BeefResearch/Nutrition_RFP/FY13_Human_Nutrition_Research_Priorities.pdf
Beef doesn’t have such a good reputation for its effects on health but that doesn’t stop that industry from trying to convince us otherwise. They have a Research Roadmap that is intended to “generate evidence that gives consumers a ‘reason to believe’ beef improves health and well-being.” You see the fingerprints of Beef Checkoff again.
Slide 73 http://www.beefboard.org/blog/2011%20Winter%20Meeting%20Materials/FINAL%20EVALUATION%20BOOK%20PDF.pdf
And so the industry regularly pays for the churning out of favorable research to help their bottom line. Respectable universities and health institutions carry out this mission for a price. Their reputations back up these findings and it all looks totally legitimate.
Slide 74 Notice, for example, that this low-carb trial looking at beef’s effects on cardiovascular risk factors was carried out at Children’s Hospital in Oakland.
Slide 75 Siri-Tarino, Patty W., et al. "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease." The American journal of clinical nutrition 91.3 (2010): 535-546.
It just so happens that Patty Siri-Tarino has an affiliation there. She was the lead author of that pro-saturated fat meta-analysis I discussed in videos 9 and 10.
Slide 76 http://www.heart.org/idc/groups/heart-public/@wcm/@global/documents/downloadable/ucm_424708.pdf
After her paper was published, Dr. Siri-Tarino was invited to speak to the American Heart Association’s nutrition advisory panel meeting in 2011. We can probably guess the sort of things she told them.
Slide 77 http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Industry-Nutrition-Advisory-Panel-INAP-Members_UCM_317375_Article.jsp
And they probably didn’t mind hearing it. That nutrition advisory panel is funded by many industry groups, including those from the egg, pork, dairy, and beef industries. The beef industry funds them through the Beef Checkoff program.
Slide 78 http://www.beefboard.org/about/roleofusda.asp
That program came about through the actions of the U.S. Congress. Our USDA collects the fees that fund the program and they oversee their activities.
Slide 79 Mahanta, Siddhartha. “Big Beef.” Washington Monthly. Jan/Feb 2014. http://www.washingtonmonthly.com/magazine/january_february_2014/features/big_beef048356.php?utm_medium=App.net&utm_source=PourOver
It in turn hands funds over to the National Cattleman’s Beef Association, an organization that relies heavily upon public funding. And as you saw, some of that money is used to carry out the industry’s plan of giving us research that is supposed to convince us to eat more beef. Those studies will be circulated online and some people will decide that the existence of so many favorable studies means “the science” supports beef consumption. It looks like the beef producers see us as just another herd to drive.
Slide 80 p. 25. Paul, Richard, and Linda Elder. The Thinker's Guide to Fallacies: The Art of Mental Trickery and Manipulation. Dillon Beach, CA: Foundation for Critical Thinking, 2004. Google Books.
The basic tactic of most of those studies, whether they be funded by Atkins or NuSI or more overtly by the animal food industry, is to test low-carb against the straw man diet, an unhealthy diet no serious health professional recommends. They do this over and over hoping you won’t notice that they only ever have two bad choices on offer. But you can do better than low-carb and you can do better than junky, nominally “low-fat” straw man diets. It’s hard to believe there are people who still haven’t caught on to this.
Slide 81 Taubes, Gary. "The science of obesity: what do we really know about what makes us fat? An essay by Gary Taubes." BMJ: British Medical Journal 346 (2013).
And it’s amazing how some people still haven’t caught on about Gary Taubes. Considering how forced and poorly reasoned his arguments are, it is incredible that he continues to be given space in respected publications.
Slide 82 http://en.wikipedia.org/wiki/Jayson_Blair
Taubes ostensibly inhabits the role of a journalist, but it seems he gets away with things no real journalist could. When taken to an extreme, false reporting can cause an uproar. This was just one instance when people seemed upset about false reporting in the media. Jayson Blair wrote for the New York Times. Gary Taubes has written for the New York Times, too.
Slide 83 Taubes, Gary. "The science of obesity: what do we really know about what makes us fat? An essay by Gary Taubes." BMJ: British Medical Journal 346 (2013).
And he has been published in the BMJ. Taubes has apparently figured out just how far he can go with making things up and still keep getting published. The British Medical Journal is an old and highly respected professional journal. They publish important papers all the time. But here is Taubes writing in their pages. He tells us that physicians were successfully prescribing high-fat diets to patients before the 1970s. He says those patients could eat as much as they wanted. His reference for this is a doctor named Williams who Taubes says used low-carb diets at Harvard Medical School. His reference is entitled, “Obesity and its treatment.” Because this was in the BMJ, we should expect that this reference will actually say that Williams used fatty low-carb diets and allowed his patients to eat them to satiety.
Slide 84 Williams, Robert H., and WH Daughalay. "Obesity and its treatment; with particular reference to the use of anorexigenic compounds." Annals of internal medicine 29.3 (1948): 510.
But if we go to the trouble of reading his reference, we’ll see that Williams used low-carb diets only with the patients who he said were not very intelligent and lacking in willpower. He recommended lean meat, not fatty meat. He advised against fatty foods. He used diets restricted to as little as 400 calories.
Slide 85 Compare this reference with what Taubes wrote about it. Taubes said patients could eat as much as they wanted. His reference says the diets ranged from only 400 to 1200 calories. How could an honest person interpret those numbers in that way?
Slide 86 Taubes, Gary. "The science of obesity: what do we really know about what makes us fat? An essay by Gary Taubes." BMJ: British Medical Journal 346 (2013).
And how does something like that make it into the BMJ?
Slide 87 This is the same journal that published that Malhotra piece we saw in videos seven and eight. Can’t we expect better than this from the BMJ?
Slide 88 Taubes, Gary. "The science of obesity: what do we really know about what makes us fat? An essay by Gary Taubes." BMJ: British Medical Journal 346 (2013).
As long as there is money to be made from it, the hydra-headed promotion of low-carb diets will go on. Some poorly informed people will continue to fall for the promise of an easy solution to their weight problems. But now you know that in the light of history and science, the promises of the low carbers ring hollow.
Slide 89 http://commons.wikimedia.org/wiki/File:Carotid_Plaque_(121061911).jpg author: Ed Uthman (Houston, TX)
Ask yourself an important question: What foods do you think could cause this? Use your imagination. What might they look like?
Slide 90 Was this what came to mind? Don’t let anyone dull your common sense.
There will always be diet debates in the media. Fads will come and go. It’s all very entertaining and it gives us fun things to argue about. But the stakes are serious and you’re on your own.
Slide 91 “Men, it has been well said, think in herds; it will be seen that they go mad in herds, while they only recover their senses slowly, and one by one.”
– Charles Mackay, Memoirs of Extraordinary Popular Delusions and the Madness of Crowds