Big Fat Fake

The Atkins diet controversy and the sorry state of science journalism.

Michael Fumento from the March 2003 issue

(Page 3 of 6)

Having circumvented this mass of peer-reviewed literature readily open to public scrutiny in libraries and often online, Taubes instead tried to make his case with a mere five studies. All five were (and are) available only in abstract form. That is, they are summaries of about 300 words each that have been presented at various obesity conferences. "The results of all five of these studies are remarkably consistent," Taubes averred. "Subjects on some form of the Atkins diet...lost twice the weight as the subjects on the low-fat, low-calorie diets."

One of the five studies, conducted at the Durham Veterans Administration Medical Center in North Carolina, was funded by the Atkins Center. Those researchers repeatedly have publicized their interpretation of their findings and unsurprisingly have conferred their full blessings on the diet.

They did so most recently in late November, garnering tremendous favorable media attention. (See "Hold the Lard" at www.reason.com/hod/mf120502.shtml.) The authors of the other four studies, however, have been reticent about releasing their data, in part because pre-publicity in the lay press makes it more difficult to get published in medical journals. But when I interviewed researchers for two of the other studies, they all insisted Taubes grossly mischaracterized their findings.

"The Atkins diet produces weight loss, as does the grapefruit diet, the rotation diet, and every other fad diet out there," says one of the researchers, Colorado's James Hill. "I haven't seen any data anywhere saying Atkins is better than these other diets for weight loss. Taubes is trying to fly in the face of the scientific evidence." Referring to the book deal, he says, "Taubes sold out."

Hill's co-researcher, Gary Foster of the University of Pennsylvania, says "the probable explanation for the greater weight loss in the groups on the Atkins regimen" is that it "gives people a framework to eat fewer calories, since most of the choices in this culture are carbohydrate driven....You're left eating a lot of fat, and you get tired of that. Over time people eat fewer calories." That would make the Atkins plan nothing more than a low-calorie diet in disguise.

Another of the abstracts came from the University of Cincinnati. The Atkins-like group "did have twice as much weight loss, and to completely lose that point would be unfair," says one of the co-authors, Randy Seeley of the university's Obesity Research Center. But his explanation is similar to Foster's, if more colorful. "If you're only allowed to shop in two aisles of the grocery store, does it matter which two they are?" he asks.

All the researchers I interviewed also insisted the studies weren't long enough to be conclusive, with none lasting more than a year. And the kicker is that all five were intervention studies, conducted using the same methodology that Taubes cites to dismiss the mountain of published material that undercuts his position.

Seeley and co-researcher David D'Alessio were also upset that Taubes made use of their material at all and not just because it hurt their chances of publication. "One of the things I object to most in the Taubes article is the idea that we're going to carry out this scientific debate in the lay press with data that's unavailable for scientists to review," says Seeley. "I believe in the peer-review process." Indeed, one "danger of trying to conduct this out in the lay press," he says, is that "you have a guy like Taubes going through it and just picking up the pieces that support his opinion."

3,000 MIAs

Taubes also ignored the approximately 3,000 members of a database called the National Weight Control Registry. For 10 years, the registry has tracked people who have lost at least 30 pounds and kept it off for at least a year. The average member has maintained a loss of about 60 pounds for about five years.

Co-administered by Hill in Denver and Rena Wing of the University of Pittsburgh, the registry is aimed at finding out what works and what doesn't. According to its members, what doesn't work is a high-fat diet. On average, they consume only 23 percent of calories from fat. "Almost nobody's on a low-carbohydrate diet," Hill says. Another important lesson that may be drawn from the registry is that the importance of any type of diet in weight control may be overemphasized. Ninety-one percent of the subjects said they regularly exercised.

While relying on self-interpretation of unpublished abstracts is valid methodology to Taubes, he insists the registry is so unscientific as to be worthless. One problem, he told me, is that it represents only a tiny fraction of all those who have succeeded at weight loss. Further, the sample is entirely self-selected rather than randomized. "Its method of recruiting could bias the selection toward those who use low-fat diets," he says.

Yet the registry data have been considered valid and important enough to have been written up in such peer-reviewed medical publications as the American Journal of Clinical Nutrition, the Journal of the American Dietetic Association, the International Journal of Obesity, Health Psychology, and Obesity Research.

"You can't get around" the problem of self-selection, says Suzanne Phelan, a co-investigator of the registry at Brown University Medical School. "But why would non-Atkins people select in and Atkins ones stay out?" Atkins dieters, she notes, "seem to be very dedicated." (Other researchers have described them as having an almost religious fervor.) Originally, recruits were selected "based on a random-digit dialing procedure," she says. But that proved onerous, and "as media such as USA Today and CNN began talking about the registry, we just let them take over" the recruiting process. "There's no reason to think that people who see those media are more likely to have a certain diet," Phelan says.

Oh, and there's another place where joining the registry has been promoted: the Atkins Web site. So we're left wondering why successful low-fat eaters would be especially likely to select into the registry or why the purchasers of over 11 million Atkins diet books consistently opt out.

Comments

|10.22.09 @ 3:57PM|#

Having read all three pieces in this debate, Fumento's critique of Taubes is so wholly inadequate I feel embarassed for him, and disappointed that Reason didn't vet Fumento seriously before publishing his original critique of Taubes. Taubes' position is increasingly permeating the research community and will likely be vindicated, leaving Fumento's piece as an embarassing example of Reason failing its mandate to provide critical analysis of contemporary debates. Reason's standards should be higher than merely being a forum for dissent -- you should have some standards for the dissent, and recognize dogmatic clinging to establishment thinking when you see it. The sooner the Lipid Hypothesis dies and refined carbs are recognized for their negative health effects the better the health of the world. We owe Taubes a serious debt of thanks for his integtrity and iconoclastic pursuit of reason. He shouldn't have had to offer this defense, likely only read by a fraction of those who read the original critique.