Enjoy the fruits of capitalism with The Goods, a regular series highlighting products that can make life a little bit better.
We live in boom times for vegan alternatives, with new plant-based meat and dairy products seemingly constantly cropping up at grocery stores nationwide. While the momentum around particularly ambitious meat alternatives has cooled in the past year or so, there's still steady growth in the market for vegan protein and dairy alternatives, and even a moderately stocked grocery store is likely to have dozens of plant-based goodies.
The ability to enjoy delightfully creamy ice cream or savory meat dishes without animal cruelty is a boon for my conscience—and my appetite. Capitalism wins again! In my experimental vegan household, we've tried just about every exciting (and weird) vegan product you can name. Here are my favorites.
Guilt-Free Tuna
It might sound weird, but the food I've missed the most since giving up meat three years ago has been tuna melt sandwiches. The only thing that comes close (chickpea tuna salad doesn't cut it) is the tuna pouches from Good Catch. While they're a little pricey, they still manage to regularly sneak their way into my grocery cart.
Lab-Grown Chicken
In August, I got to try lab-grown chicken at D.C.'s China Chilcano restaurant. While GOOD Meat's chicken is definitely better than any other plant-based meat I've tried, the texture is noticeably spongier than actual meat—and it certainly won't fool any devoted meat eaters.
Plant-Based Cream Cheese
Oatly cream cheese is the only good plant-based cream cheese I've ever had. While the plain flavor has a slightly sweet aftertaste, the chive version is absolute perfection that's almost indistinguishable from the real thing.
Mushroom Steak
I'm normally not a huge mock-meat fan (I prefer tempeh and tofu), but I make an exception for Meati's plant-based steaks, which are made from mushrooms. The filets are delightful when smothered in gravy or plopped on a sandwich.
Vegan Mac and Cheese
Gal Gadot's boxed mac-and-cheese brand, Goodles, is the only vegan mac worth your money. The powdered cheese goodness is scarily similar to cult favorite Annie's Shells and White Cheddar and free of any funky aftertastes or textural wonkiness.
Lab-Grown Ice Cream
Every time I visit Cincinnati, I get Perfect Indulgence ice cream at Graeter's, a regional ice cream chain. The ice cream—made of lab-grown, "animal-free" dairy—stands out in a sea of icy, overly sweet vegan ice cream options.
Veggie Protein
Textured vegetable protein has got to be the most prepper-ish protein source out there. "TVP," as it is lovingly called in the vegan community, is made from soy flour and has a vaguely ground chicken–like texture. It's the perfect way to sneak extra protein into soups, pasta sauce, and—in my favorite preparation—well-seasoned and shallow-fried polenta cakes.
Animal-Free Milk
Even before going vegan, I wasn't a big milk drinker—the price tag on Bored Cow's animal-free dairy milk makes me hesitant to ditch my beloved soy milk anytime soon. Bored Cow uses the same tech as Perfect Indulgence to create real milk protein, but in a lab instead of in a cow. For this reason, it rivals most vegan milk varieties as a coffee creamer, and it's great for baking, making it a nice occasional treat.
The post How To Assemble a Vegan Plate appeared first on Reason.com.
]]>There's a gloomy refrain heard every year around this time. It goes something like this: "I don't know what to get [insert person who is hard to shop for]," they say. "[Difficult person, probably a dad] already has everything."
I'd like to begin this year's gift guide with something that will delight the Catholic Reasoners: I have a confession. I, too, have invoked that sorry justification over the years when struggling to conjure suitable gift ideas. But it's an excuse that doesn't hold much water in an era of ever-increasing innovation, abundance, and weird, niche products that the difficult person in your life definitely doesn't have yet.
Let's start with the low-hanging fruit: If you're reading this guide, there's a chance you like Reason. Should your nearest and dearest also like Reason—or should you want to convince them to—you can give the gift of a subscription: one year for $14.97, two years for $25.97, or three years for $37.97. It's a particularly good suggestion for shoppers who struggle with procrastination. You can print out the proof of order and put that baby in an appropriately festive gift bag or box.
For the Reason die-hards in your life, gift them some swag. We have men's and women's apparel, phone cases (for iPhones and for the people in your life who still refuse to get an iPhone), mugs, and ceramic ornaments. I will be sending my precious niece our toddler tee. Start 'em young. (If my sister is reading this, I'm sorry for ruining the surprise.)
And, thankfully, there are a plethora of offbeat, useful, zany, pragmatic, and/or entertaining items that you should consider for those in your life who you would otherwise get a Visa gift card. Go forth. —Billy Binion, associate editor
Long have libertarians complained that the eternal smash-hit board game Monopoly neither depicts free market capitalism accurately nor encourages any useful business skills aside from making lopsided real estate trades with property owners down on their luck. Is there, at long last, any game that portrays business as what it more closely resembles in the real world—inventive and fun?
I found the answer, unexpectedly, at a homeschooling convention in Virginia, where an engaging fella named Elliott Eddie was hawking his own invention that he (appropriately!) conjured to life via a Kickstarter campaign: The Entrepreneur Game. It has become the go-to board game for me and my 8-year-old.
Every session is different, on account of players having to start by creating a new business—either home-based or brick-and-mortar, each coming with different costs and payouts. A crucial caveat: All the other players have to agree the venture sounds plausible. (That shouldn't be too hard when considering, for example, that there is a real market for Bob Ross Chia Pets. You're welcome.) You can then add or subtract or trade businesses from there, in the knowledge that at the finish line, the bank will buy them back. Then you count and compare winnings.
Along the way there are mortgages, potential lawsuits, marketing snafus and bonanzas, competitive jingles, and enough vagueness here and there in the rules that players are impelled to—yes!—invent interpretations and workarounds. Your 8-year-old can and will beat you, and get you thinking that yes, maybe your neighborhood does need that ice cream parlor/lending library across from the park. —Matt Welch, editor at large
Buy The Entrepreneur Game for $49.99
Monopoly Deal—a card-game take on the classic board game—is a fast-paced battle of tradeoffs and risks that in many ways is more enjoyable than its namesake.
Unlike Monopoly, where players simply squat on their properties and wait for someone else to stumble into owing rent, Monopoly Deal puts the onus on each would-be tycoon to earn their big paydays. The game includes three types of cards: money, property, and action. The former two are self-explanatory; the latter type of card allows you to, say, act as the town debt collector (boo!), force people to pay you rent on the properties you own, or even steal properties from other players. (There is no due process, though there are cards that allow you to "just say no" to another's action.) Collect three sets of property cards to win the game.
Something else that sets Monopoly Deal apart from the original: This game runs around 15 minutes as opposed to multiple eons. Like in the marketplace, it moves quickly, and bold risks are sometimes rewarded with the destruction of your competitors. But they can make you a target as well. Earning a big rent payment requires some basic strategy and more than a little luck of the draw. —Eric Boehm, reporter
Forget Monopoly or Catan. Battle Sheep (like Battleship, but not) is the perfect game for the particularly enterprising kid. In the board game, players attempt to dominate (or, erm, baa-minate?) a hexagon-tiled board by placing rows of color-coded sheep. While Battle Sheep is technically aimed at kids and younger teenagers, don't let its simple rules deceive you. The game requires a good bit of strategic know-how and provides ample opportunity to sabotage fellow players, making it an enduring favorite at game nights.
Bananagrams is another classic game that I just can't get enough of. The basic premise is something akin to Scrabble on Adderall, and each game reliably brings 15 or so minutes of fast-paced, occasionally sweat-inducing fun. The whole game fits in a small banana-shaped pouch, making it the ideal stocking stuffer for budding wordsmiths. —Emma Camp, assistant editor
It wasn't long ago that people depended on mammoth mills to produce their flour supply. Either that or you were grinding grains via mortar and pestle, which means it's not unlikely you would've paid for your carbs with an undiagnosed case of carpal tunnel.
Fast-forward a little over a century: I can make my own flour without lifting a finger—and it's significantly more nutritious than what you'd get at the store.
If you want homemade bread and other baked goods, get yourself a grain mill. There are relatively cheap (and not-so-cheap) options. But my husband recently gifted me the All Metal Grain Mill attachment by KitchenAid—meaning I can grind my own grains without even worrying about another appliance crowding the kitchen counter. (Merry early Christmas to me!)
While I'm glad industrialization has made it possible to buy a few pounds of enriched flour at any grocery store whenever I need it, I'm also grateful for the innovation that paved the way for my electric grain mill, allowing me to grind my own flour at home—and without breaking a sweat. —Alyssa Varas-Martinez, assistant editor
Buy the All Metal Grain Mill KitchenAid attachment for $114.99
Gone are the days of expensive eggs (for now, at least). Since reaching a high of $4.82 in January, a dozen Grade A eggs will now run you $2.07 on average, according to the U.S. Bureau of Labor Statistics. The main driver of that decrease is the poultry industry's recovery from a massive avian flu outbreak (despite politicians and pundits blaming "corporate greed" and "price gouging" for the high prices).
The confused economic commentary aside, what's an egg lover to do about this again-affordable stock? Invest in a DASH Rapid Egg Cooker, of course.
The DASH cooker can whip up six different styles of egg in minutes, from hard-boiled to poached. It's much faster than stovetop methods and delightfully consistent. A measuring cup tells you exactly how much water you'll need to add to the cooker to achieve your desired result, and cleanup is a breeze. No more wrangling bulky pots of boiling water.
It's hard to mess up with the DASH cooker. But even if you crack a few eggs in the process, that won't hurt your wallet quite as much as it once would have. —Fiona Harrigan, associate editor
Buy the DASH Rapid Egg Cooker for $16.14
I vary my concealed carry technique depending on dress and setting, but I often default to pocket carry for the sake of comfort. For years, I relied on a DeSantis Nemesis to hold my Springfield XDS 3.3 .45ACP upright and to remain in place when I draw. But while the Nemesis is good, it didn't keep the pistol butt from printing through my pants and even wearing light spots in the fabric. And that just won't do.
But then DeSantis made something I had contemplated as a do-it-yourself project—it added a flap to the holster. The result: the Super Fly.
Held by a hook-and-loop fastener, the rectangular flap flips for righties and lefties. It blurs the outlines of the pistol so that it looks like you have a flat wallet in your pocket. The flap also helps retain the holster so it doesn't exit the pocket with your pistol. When gifting a Super Fly, be sure to specify the make and model of the recipient's gun for proper fit.
Like all pocket holsters, the Super Fly doesn't necessarily look super fly with skinny jeans. But then, nothing does. —J.D. Tuccille, contributing editor
Buy the DeSantis Super Fly for $57.99
I was never a knife guy. That changed when I entered the wonderful world of fatherhood and found myself opening an incredible amount of boxes. (No one warns you about that part.) Toys! Diapers! Abundance abounds!
Thankfully I found the ideal everyday carry knife—the Drifter by Columbia River Knife and Tool. Even better: It won't make you look like you're cosplaying as Davy Crockett or a Navy SEAL, so the Florida dads of the world can sleep well knowing it will pair just fine with, say, some trusty nylon fishing shorts.
This knife is both well-made and affordable, making it a perfect gift for someone who likes a good blade—or who might find themselves needing one in the very near future. —C.J. Ciaramella, reporter
What do space travel and self-care have in common? Answer: red light therapy.
The mystical powers of red light came more sharply into focus after NASA found it helped heal astronauts' wounds. Now red light therapy (RLT) is sweeping the world of wellness, touted for its ability to reduce fine lines and wrinkles, ease muscle soreness, improve sleep, help with inflammation, and much more.
While RLT used to require expensive lasers, innovation has made the treatment accessible for folks who aren't astronauts or wealthy celebrities. The HG300 Red Light Therapy Device by Hooga is a great gadget for home use with its medical-grade red and near-infrared light that delivers quality treatment for those of us who don't have NASA's taxpayer-funded budget.
In other words, this is the perfect gift for just about everyone, whether it's your athletic friend looking to curtail recovery time, your dad who wants relief from his arthritis, or your significant other who obsesses a little too much about her crow's feet. We paid for NASA's research, after all, so why shouldn't we all benefit from it? —Kelvey Vander Hart, communications specialist
Buy the HG300 Red Light Therapy Device for $159
Someday humans might be able to gift their futurist loved ones travel packages to space for the holidays. For now, the new book A City on Mars is a decent substitute.
Authors Kelly and Zach Weinersmith deliver an amusing yet sober take on the prospects of populating the solar system. The prose is broken up by quirky diagrams and cartoons by Zach, creator of the popular Saturday Morning Breakfast Cereal webcomic and illustrator of Bryan Caplan's Open Borders.
The Weinersmiths make clear they are not bullish on the timeline for space settlement. It will probably happen eventually if our species exists long enough—but not anytime soon.
A City on Mars asks not only how humans would get to Mars but, just as importantly, how we might breathe, eat, manufacture, and procreate there. There are many more questions than answers.
Libertarians will be especially interested to read about the economic, legal, and geopolitical implications of a Mars colony. Even if we can do it, will governments let us? —Adam Sullivan, digital marketing specialist
Too late for college, where I drank the likes of Pabst and Labatt Blue, I discovered that beer came in a wide variety of styles, many of which actually tasted good. More recently, my appreciation for what used to be called "tropical" drinks has undergone a similar transformation, thanks largely to Jeff Berry, whose years of cocktail detective work uncovered lost recipes that appear, alongside his own innovations, in Beachbum Berry Remixed, which combines two earlier books by the same author.
Berry's recipe book is also a history book (who doesn't love a two-for-one deal?) that explains how concoctions created by tiki pioneers like Victor Bergeron (Trader Vic) and Donn Beach (Don the Beachcomber) became wildly popular and then, perhaps inevitably, bastardized to the point that they barely resembled their much tastier ancestors. (Currently accepting suggestions for my tiki alter ego, although I'm partial to Jake the Snake.)
Authenticity in this context is a tricky concept, since tiki drinks evoke a world that never existed: a fanciful amalgam of Caribbean and Polynesian elements unified by the appeal of a tropical paradise that could be inhabited in the middle of the city for the price of a drink or two amid ersatz palm trees, water features, bamboo accents, and oversized idols. But the tiki renaissance exemplified by Berry's archaeology of mixology proudly strives for a kind of campy authenticity that is best enjoyed while sipping a well-crafted mai tai or zombie to the strains of Martin Denny or the Tikiyaki Orchestra. —Jacob Sullum, senior editor
Buy Beachbum Berry Remixed for $29.95
Second only to Reason editor Peter Suderman's cocktail newsletter, Raising the Bar: A Bottle-by-Bottle Guide to Mixing Masterful Cocktails at Home by Brett Adams and Jacob Grier is my go-to gift this year. In fact, it could be considered the libertarian's mixology manifesto. Just as libertarianism espouses the value of individual freedom and minimal interference, this book champions a "less is more" approach to the home bar. It's a toast to personal liberty in cocktail form.
Instead of coercing readers into buying an overwhelming array of expensive, single-use ingredients—the mixological equivalent of a bloated government—Adams and Grier advocate for a streamlined, efficient bar that maximizes personal choice and utility. Each bottle becomes a versatile tool in the mixologist's kit, mirroring the ideal of versatile, multifunctional individuals who contribute to society in numerous ways no matter where they come from or what their skills are.
Raising the Bar equips cocktail enthusiasts and beginners alike with the fundamentals of a good drink, allowing them to innovate without the need for a central planner dictating their every move. Each new bottle introduced is like a new idea being shared in the marketplace of cocktails, expanding the drinker's horizon with each chapter. The book's practicality and focus on using what's already in stock makes it the perfect companion for those who value freedom, simplicity, and the joy of making the most out of what you have—whether that's in life or in your liquor cabinet. —Veronique de Rugy, contributing editor
Buy Raising the Bar for $19.96
The average person spends about $2,000 a year on coffee. (With inflation, that may soon be, uh, even more.) For the same cost, you could buy a semi-reliable used car, two David Yurman diamond necklaces, or this giant inflatable game of human whack-a-mole. In other words, your coffee-loving loved ones are probably missing out on a lot. So it's time to help them ditch the $6 caffeine runs by gifting a chic, economical brewing tool that helps make an amazing cup of coffee every time.
Don't be fooled by the Origami Coffee Dripper's simple facade and relatively low price. It comes to us from Japan's Gifu Prefecture, which is known for its over 400-year history of ceramic making. As its name would suggest, the dripper is indeed inspired by origami, the Japanese tradition of paper folding. But that shape is not just for show: The 20 origami-like folds help you control the flow rate of the water and create air channels to make the perfect cup of coffee. And it comes in several colors, so you can personalize it a bit for the recipient. Cheers! —Katarina Hall, staff editor
Buy the Origami Coffee Dripper for $39.95
Holiday traveling—or any long-distance sojourn—can be a buzzkill. Once you reach your destination, chances are you may need some help winding down. A problem: When that winding down comes courtesy of a strong scented herb, it's not always easy to avoid scrutiny.
Take heart! The Firedog Smell Proof Bag is a stylish, polyurethane leather pouch that allows you to discreetly bring your bud wherever—without getting looks from your nosy mother-in-law or the police K-9 at the airport. —John Carter, producer
Buy the Firedog Smell Proof Bag for $11.99
Consumers of illicit substances should have at least two things: a knowledge of their constitutional rights and a stylish way to covertly store their favorite flower, concentrates, edibles, and accessories.
Enter Tulip.
This seven-piece, lockable stash-box set includes multiple jars, doob tubes, and a tray, so you can roll up almost anywhere. Boveda humidity control packs are included which help keep your flower fresh. Tulip comes in a plethora of colors, from vibrant pinks to shades of green and, Reason's personal favorite, orange.
Best of all, the lock provides peace of mind if you get pulled over in an illegal state like I did. You can tell the cops to "get a warrant"—Fourth Amendment, anyone?—and then get on with your day. —Bess Byers, digital marketing specialist
Buy the Tulip 7-piece set for $195
As I was preparing the first edition of Reason's Sindex this summer—compiling data on all the various ways prices on our favorite vices have risen in the last few years—one factoid was most shocking to me: The price of fancy new TVs had gone down. While prices economy-wide have risen by 18.8 percent since January 2020, according to the Bureau of Labor Statistics, prices for TVs dropped 21.3 percent. This last year alone is a similar story: Economy-wide prices have gone up 3.2 percent, while TV prices have dropped 9.4 percent (though the cost of watching live programming on that TV has gone up 5.5 percent).
Whether your current TV is just a little too old or a little too small, there's never been a better time to buy a new one (except, if trends continue, next year). I'm no audiovisual expert, but I've been satisfied with my Samsung TV: The 55-inch variety for $350 seems like a great deal. For those living in 2023 and looking for a smart TV, a 43-inch Hisense with Roku TV has worked well as my house's second option. But if you choose to look for something else entirely, chances are the TVs are better, and cheaper, than they were just a few years ago. —Jason Russell, managing editor
Buy the 55-inch Samsung for $349.99
Buy the 43-inch Hisense for $309.86
Looked at one way, Christopher Nolan's Oppenheimer, which is now available for purchase on 4K Blu-ray, might seem like just another biopic, the story of an important man, J. Robert Oppenheimer, on his tortured quest to lead a team of scientists toward building the atom bomb.
But with its hopscotching timelines, shifting image ratios, and black-and-white-to-color switchbacks, it's very much the product of Nolan's distinctive stylistic tics. It's also the fulfillment of many of the themes that have defined the director's career, from humanistic wonder at what science can do to fears of unchecked mob campaigns and global nuclear destruction.
Not only is it one of the best-executed, most ambitious movies of 2023, it's one of the most searingly prescient, as it serves as a warning about the fragility of human existence in a war-filled world with the capacity to destroy itself. So print out a picture of Cillian Murphy, wrap those sculpted cheekbones in a box, and surprise your friends or family with a digital copy of one of this year's most-hyped films. —Peter Suderman, features editor
You may have heard it before: those words that dredge up a mix of anxiety, confusion, and morbid fascination.
Someone you know is on Pinterest. She (or he, no shame) is lost in the sparkly abyss of DIY projects that promise to make a home look like a Crate and Barrel catalog. Disaster might be near. But it doesn't have to be.
Inspired by my apartment hopping with no one to help me hang my floating shelves—my now-husband was nowhere to be found—you can gift the perfect, newbie-friendly toolkit that won't intimidate the one who doesn't know a hammer wrench from a socket wrench. (I think there's one named Allen too?)
Worst case scenario, the recipient can offer a tool or two to the neighbor, friend, or significant other they draft to assist them with their projects. It fits snugly into any storage space and, better yet, comes in a variety of colors, so your loved one can really channel the decorative spirit. Happy tinkering! —Regan Taylor, video editor
Buy the Cartman 39-Piece Household Kit for $21.99
Ever wonder what it would be like to go to a war college for dragon riders? If you happen to have contemplated that very specific scenario, Rebecca Yarros has you taken care of with her New York Times bestseller, Fourth Wing. You'll have to forgive some of the "enemy-to-lover" romance clichés, but this book is a veritable buffet of the best elements from everyone's favorite fantasy franchises—like Harry Potter, Game of Thrones, and The Hunger Games.
Violet Sorrengail was supposed to be a lowly scribe, spending her days reading and studying. But alas, her mother had other plans—namely, to send her Basgiath War College. As a student there, you have two choices: Bond with a dragon or die trying. Unlike Game of Thrones, however, once riders successfully sync with their dragons, they can communicate with them telepathically. Think of the possibilities.
Every boarding school, real or fictional, has its cliques. But here we see those fractures fade after it becomes clear the school's paternalistic leadership is concealing some big secrets from the student body. Without giving away too much, you can imagine how angsty young adults—armed with dragons, no less—might react to being deceived. It's a wild ride, pun intended.
If you can't get enough of Fourth Wing, you're in luck: The sequel, Iron Flame, recently hit the market, and there are already plans for Amazon Prime to adapt the series into a TV show. At this rate, your nearest and dearest have probably (hopefully?) accepted they're not getting a Hogwarts invite. And they may need to read another book anyway. Thanks in part to capitalism, there are myriad other fantasy worlds you can get lost in—just a few Amazon clicks away. —Natalie Dowzicky, deputy managing editor
The Gen Xer in your life probably has some nostalgia for books on dead tree. And he definitely has nostalgia for the music of his formative years. So get him 60 Songs That Explain the '90s in hardcover.
It's newly released, so he doesn't have it yet. It was born from a podcast, but it's different enough to merit a purchase on its own. In addition to some very solid music criticism from The Ringer's Rob Harvilla, it has essayistic meditations on selling out, censorship, and the eternal allure of music that makes your parents uncomfortable—even for people who are now parents themselves. —Katherine Mangu-Ward, editor in chief
Buy 60 Songs That Explain the '90s for $27.00
Modern American libertarian ideas and thinkers have been winning converts and quietly changing the world for seven decades now—but that didn't mean the bastions of academia and publishing were apt to give them much respect.
That's been slowly changing for the better. This year, Stanford University history professor Jennifer Burns has followed up her smart and often sympathetic 2009 biography of Ayn Rand, Goddess of the Market, with the first detailed, serious, comprehensive biography of libertarian economist, polemicist, and adviser to the powerful, from the U.S. to China to (yes) Chile: Milton Friedman.
In Milton Friedman: The Last Conservative, Burns deals fairly with the controversies surrounding the man. She also does so with a clear-eyed understanding that the libertarian belief in freedom and choice—particularly for their ability to create wealth and improve standards of living—is sincere and based in a serious set of theory and history. That books that treat libertarian thinkers with this sort of deeply-rooted sympathetic understanding are gaining traction should bring holiday cheer to any libertarian. —Brian Doherty, senior editor
Buy Milton Friedman: The Last Conservative for $29.49
Holiday shopping for the metalhead in your life is easier said than done. Odds are their closet is already overflowing with Slayer shirts, and their jean vest couldn't fit even one more patch. So, this Christmas season, consider giving them the gift of Heavys H1H headphones.
Many a metalhead is left ill-served by traditional headphones that collapse thick, layered walls of sound into a tinny, digitally congealed buzz. Enter the Kickstarter-launched Heavys, which promise to remedy these woes with technology "engineered for heavy metal" and meant to "mimic live music." We've got headbanging. We've got entrepreneurship. We've got headbanging entrepreneurship.
The over-the-ear, Bluetooth-enabled Heavys offer a, well, heavy bassy sound that is still nimble enough to allow for vocals and high-pitched guitar solos to be heard clearly above the fray. After recovering from some potential sticker shock, the buyer can soothe themselves knowing that only in a world of increasing wealth and choice could such a niche product for a marginalized audience sell at a luxury price.
Also comforting: In the end, this is really a gift for the giver, thanks to Heavys' noise-canceling ability and long battery life. Come Christmas morning, the recipient can blast Cannibal Corpse to their heart's content while you drink in the dulcet tones of wrapping paper ripped to shreds. It's only up from here. —Christian Britschgi, reporter
Buy Heavys headphones for $249
Are you overseas, perhaps in a country ruled by a hostile regime? Are you involved in research that, though innocent, an internet service provider might find troubling? Or do you just want to be able to surf the web without it being anyone else's business? Then consider a virtual private network (VPN)!
VPNs encrypt your internet traffic by routing it through a separate server, obscuring the contents of your online activity to your internet provider and rendering any potential search warrants ineffective (though one should never assume that any method is completely safe from the National Security Agency, natch). There are a ton of options, but not all VPNs are created equal: Troublingly, some free or cheaper options keep logs of customer activity that can be subpoenaed.
ExpressVPN strikes a good balance between speed and security. It doesn't keep logs, and the company is headquartered in the British Virgin Islands, which has very advantageous data privacy laws. Surf's up. —Joe Lancaster, assistant editor
Buy ExpressVPN for $8.32 a month
Have you ever wanted to give the gift of inspiration? This year, you can do just that when you send your loved one a personalized message from a man who has walked the moon, led the U.S. to Olympic table-tennis gold, scaled the Empire State Building with no harness, and set the Guinness world record for spending the most campaign contributions on Botox and OnlyFans. Quite the bang for the buck.
Give the gift of George Santos.
Of course, Santos has done none of those things (with the possible exception of the latter, should Guinness World Records want to investigate). The erstwhile Republican congressman was recently expelled from the House of Representatives amid criminal allegations that he stole campaign funds to treat himself to designer shoes, gambling excursions, and, yes, Botox and OnlyFans.
But Santos is not in prison (yet). After all, he is innocent until proven otherwise. And he is spending his newfound unemployment as any ousted politician might: by making personalized videos for customers on the video-sharing app, Cameo. He may not have the bloated resume he once promised, but he does have the hustle. For a preview of Santos' portfolio, you can watch the video he made for Sen. Bob Menendez (D–N.J.)—who is also facing some, er, seedy corruption allegations—courtesy of Sen. John Fetterman (D–Pa.). You have to admire the petty.
Not long ago, Santos was charging $200 per video. That has quickly risen to $500—a steep price to pay, yes, but that's the market at work. And while it may be a hefty fee, you can rest assured that the laugh it gives the recipient will be more valuable than anything the public was paying Santos to do in Congress. —Billy Binion, associate editor
Buy a George Santos Cameo for $500
The post This Year's Libertarian Gift Guide: 23 Ideas for 2023 appeared first on Reason.com.
]]>This week's featured article is "Take Nutrition Studies With a Grain of Salt" by Ronald Bailey.
This audio was generated using AI trained on the voice of Katherine Mangu-Ward.
Music Credits: "Deep in Thought" by CTRL S and "Sunsettling" by Man with Roses
The post <i>The Best of Reason</i>: Take Nutrition Studies With a Grain of Salt appeared first on Reason.com.
]]>The controversy over polyunsaturated seed oils is in some respects the mirror image of the fight over saturated fats in meat, milk, and eggs. Omega-3 and omega-6 fatty acids are essential fatty acids. They are "essential" since they must be provided by foods because they cannot be synthesized in the body yet are necessary for health. Both act as structural components in cellular membranes and modulate inflammatory responses.
The three main omega-3 fatty acids are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). The principal sources of omega-3 fatty acids are oily fish, flaxseed oil, and nuts like walnuts. The chief omega-6 fatty acid is linoleic acid. The prime sources of linoleic acid in modern diets are seed oils including soybean, corn, cottonseed, sunflower, canola, safflower, rice bran, and grapeseed oils. The use of these oils has increased in modern diets, and they have been dubbed by some self-proclaimed health and wellness gurus as the "hateful eight."
The main contention by these health gurus is that the modern dietary "balance" between omega-3 and omega-6 essential fatty acids is out of whack, resulting in a host of alleged bad effects on health. For decades, American physician and endocrinologist Artemis Simopoulos has been one of the chief proponents that a present-day imbalance between omega-3 and omega-6 fatty acids in the contemporary diet is the source of many modern ills. Simopoulos appears to have first encountered this hypothesis while attending the 1988 NATO Advanced Research Workshop on Dietary Omega-3 and Omega-6 Fatty Acids in Italy.
Simopoulos became the co-editor of the proceedings volume for that conference, publishing a paper that suggested that the optimal ratio for intakes of omega-3 and omega-6 fatty acids was 1 to 5-6 based on a 1985 study in which a team of French researchers fed 24 nuns different proportions of the two nutrients for five months published in Lipids. The proceedings volume also noted that "the current estimate of this ratio in the western diet is 10-11/1. Evidence based on estimates from paleolithic nutrition and from terrestrial animals (mammals) in the wild indicate a ratio of omega-6 to omega-3 to be 1 to 1 in the diet."
An earlier 1988 summary of that same conference in the Journal of the American Oil Chemists' Society noted that "some conference participants felt that the dietary ratio of omega-6 to omega-3 fatty acids of about four-to-one might be desirable." In her 1989 summary article in the Journal of Nutrition, Simopoulos cited the paleolithic ratio estimate but also reported that conference "participants could not agree on either a recommendation for omega-3 fatty acid intake as a percent of dietary calories or on the ratio of omega-6 to omega-3 in the diet."
However, Simopoulos had made up her mind. In her 1991 review article in the American Journal of Clinical Nutrition, she again asserted that the recent big increase in the availability of seed oils had created evolutionarily suspect "imbalances between omega-6 and omega-3" fatty acids." Simopoulos suggested that this "imbalance" significantly contributed to coronary artery disease, inflammatory disorders, and cancer. She later popularized her theories about the alleged ill effects of increased seed oil consumption in her co-authored 1997 diet book, The Omega Plan: The Medically Proven Diet That Restores Your Body's Essential Nutritional Balance. In the book, she asserted that the "hidden imbalance" between omega-6 and omega-3 fatty acids "makes you more vulnerable to heart disease, cancer, obesity, inflammations, autoimmune diseases, allergies, diabetes and depression—all of the so-called diseases of civilization."
It is worth noting that exercise physiologist and chief originator of the paleo diet, Loren Cordain, participated in a number of nutrition and fitness conferences overseen by Simopoulos in the 1990s. For example, he was one of the promulgators of the 1996 Declaration of Olympia on Nutrition and Fitness that among other things recommended that "nutrient intakes should more closely match human evolutionary heritage," specifically mentioning the role of "essential fatty acids."
In 1997, Cordain was co-author of an article on evolutionary aspects of diet in World Review of Nutrition and Dietetics edited by Simopoulus in which they observed, "The ratio of omega-6 to omega-3 PUFA (polyunsaturated fatty acids) is estimated to have been far lower for preagricultural humans than for Americans." He and his co-author then speculated that this higher ratio of omega-6 to omega-3 fatty acids "may have important physiological consequences." The authors modestly concluded, "Paleonutrition is an intellectually appealing, but unproved, dietary paradigm."
In 1998, Cordain was a co-author of an article focused on fatty acids during the Paleolithic that was published in the World Review of Nutrition and Dietetics, again edited by Simopoulos. While noting that "evolutionary considerations are not (yet) a basis upon which to make nutritional recommendations," Cordain and his co-authors nevertheless went on to observe that with respect to essential fatty acids, "current intake clearly differs from that of our ancestors: preagricultural humans generally consumed omega-6 and omega-3 PUFA [polyunsaturated fatty acids] in roughly equal amounts." Cordain and his co-authors then added, "This pattern fueled the emergence and development of our genus; evolutionary considerations commend its restoration."
And "commend its restoration" Cordain certainly did in his 2002 blockbuster The Paleo Diet. There Cordain endorsed Simopoulos' claims about the health harms of "imbalanced" omega fatty acids. He asserted that "the ratio of omega-6 to omega-3 fats in Paleo diets was about 2 to 1; for the average American, the ratio is much too high—about 10 to 1. Eating too many omega-6 fats instead of omega-3 fats increases your risk of heart disease and certain forms of cancer; it also aggravates inflammatory and autoimmune diseases."
For what it's worth, a 2018 study in Lipids In Health and Disease confirms the modern ratio of fatty acids in the modern American diet when it reported that the omega-6 to omega-3 ratio for U.S children and older adults averages 9 to 1, and 8 to 1 respectively.
Keep firmly in mind that with respect to the problematic subject of nutritional epidemiology, no prior claims about the harms or benefits of any nutrient ever fully disappear. For example, alternative medicine proponent Joseph Mercola is a co-author of the 2023 narrative review in Nutrients that outlines research that purports to demonstrate the deleterious health effects of consuming linoleic acid.
However, as you will see in the main article, the bulk of recent research has not been kind to Simopoulos' assertion that the supposedly imbalanced consumption of linoleic acid found in seed oils "makes you more vulnerable to heart disease, cancer, obesity, inflammations, autoimmune diseases, allergies, diabetes and depression." On the contrary, most research finds that consuming seed oils reduces the risks of these maladies.
The post How Seed Oils Were Demonized appeared first on Reason.com.
]]>Comb through enough nutrition research, and you can find a study confirming or rebutting nearly every belief you may hold about how specific nutrients affect your health. "Meat Increases Heart Risks, Latest Study Concludes," reported The New York Times in 2020. A year earlier, the Times ran this headline: "Eat Less Red Meat, Scientists Said. Now Some Believe That Was Bad Advice."
Pick a different food group and find a similar contradiction. "Moderate Drinking Has No Health Benefits, Analysis of Decades of Research Finds," reported the Times in April 2023. Two months later, Forbes declared: "Light And Moderate Drinking Could Improve Long-Term Heart Health Study Finds—Here's Why."
These headlines were not misrepresentations. Nutritional epidemiology is, by and large, what Stanford University biostatistician John Ioannidis calls a "null field": one where there is nothing genuine to be discovered and no genuinely effective treatments exist.
"I think almost all nutrition studies that pertain to the effects of single nutrients on mortality, cancer, and other major health outcomes are null or almost null," says Ioannidis. "Even the genuine effects seem to have very small magnitude in the best [and] least biased studies."
When it comes to public policy, most nutritional epidemiologists are unclothed emperors ordering the rest of us around or lobbying lawmakers to do it for them.
This doesn't mean you can eat an entire pizza, a quart of ice cream, and six beers tonight without some negative health effects. (Sorry.) It means nutritional epidemiology is a very uncertain guide for how to live your life and it certainly isn't fit for setting public policy.
In short, take nutrition research with a grain of salt. And don't worry: Even though the World Health Organization (WHO) says "too much salt can kill you," the Daily Mail noted in 2021 that "it's not as bad for health as you think."
Back in 2019, Ioannidis called nutritional epidemiology "a field that's grown old and died. At some point, we need to bury the corpse and move on to a more open, transparent sharing and controlled experimental way." He expressed particular concern that nutritional research findings are largely derived from observational studies, which are essentially surveys. In other fields of health science, hypotheses are tested with strictly supervised randomized controlled trials that are designed to filter out the inherent noise in observational data.
Drawing firm conclusions from weak data is the original sin of nutritional epidemiology. Legendary American physiologist Ancel Keys more or less launched the suspicion that eating steaks and hamburgers caused heart disease during the 1950s. Keys and his colleagues hypothesized that cardiovascular diseases were becoming more common because the saturated fats found in red meat and dairy products were boosting levels of serum cholesterol. In his 1957 article "Diet and the Epidemiology of Heart Disease," Keys recommended the "exclusion of saturated fats (in butterfats and meat fats)" as a way to lower serum cholesterol levels. He conversely noted vegetable fats such as corn oil and cottonseed oil had the beneficial effect of reducing serum cholesterol.
Keys based his conclusions on observational data including a positive correlation (reported in his 1953 article, "Atherosclerosis: A Problem In Newer Public Health") between estimates of the amount of fats consumed per capita in six countries and their rates of diagnoses of "degenerative heart disease." He also pointed to studies that reported a correlation between high levels of serum cholesterol and the presence of atherosclerosis. In addition, Keys cited the results of randomized controlled trials he and his colleagues conducted using cohorts of schizophrenic men in Hastings State Hospital. The subjects were, during periods lasting between three and six months, fed diets of varying levels and types of fats. They reported in 1957 that saturated fats in meat and milk boosted their subjects' overall cholesterol levels whereas vegetable oils, corn oil in particular, tended to lower them.
As with many examples of "bad" science, Keys' claims had some basis in fact. There are different types of fats. Some fats are "saturated" with hydrogen atoms; others have one double bond of carbon atoms (monounsaturated) or more (polyunsaturated) in their structure. Generally, saturated fats are solid (lard, cheese, and butter) at room temperature, whereas unsaturated fats (canola, olive, soy, and corn oils) are liquid.
But Keys' campaign—and those it inspired—treated poorly tested hypotheses as settled science. In 1979, the surgeon general recommended Americans eat "less saturated fat and cholesterol, less salt, less sugar," and "less red meat." As recently as July 2023, the WHO issued guidelines warning against consuming saturated fatty acids "because high levels of intake have been correlated with increased risk of CVDs [cardiovascular diseases]."
Today's datasets are possibly even noisier than those of the 1950s. A quick series of searches in Google Scholar combining the terms "red meat," "dairy," and "eggs" with "cardiovascular" finds more than 68,200, 308,000, and 154,000 studies, respectively, and they don't all say the same thing. You can easily turn up numerous studies on either side of the question for each of those foods.
Is the picture clearer with meta-analysis? Yes and no.
A meta-analysis is a study of past studies. By aggregating studies, the ambitious epidemiologist hopes to tease out a real effect. Often meta-analyses clarify what the data say, and sometimes they simply tell us we can't trust the data.
For example, a controversial 2019 meta-analysis published in Annals of Internal Medicine "found low- to very-low-certainty evidence that reducing unprocessed red meat intake by 3 servings per week is associated with a very small reduction in risk for cardiovascular mortality, stroke, myocardial infarction (MI), and type 2 diabetes." It concluded that reduced consumption of processed meats had similarly equivocal effects on cardiovascular health. A companion meta-analysis of just randomized controlled trials by some of the same researchers "found only low- to very-low-certainty evidence that diets lower in red meat compared with those higher in red meat have minimal or no influence on all-cause mortality, cancer mortality, cardiovascular mortality, myocardial infarction, stroke, diabetes, and incidence of gastrointestinal and gynecologic cancer."
The Annals of Internal Medicine meta-analysis concluded that "findings from our review raise questions regarding whether—on the basis of possible adverse effects on cardiometabolic outcomes—the evidence is sufficient to recommend decreasing consumption of red and processed meat."
Naturally, the contrarian Annals study was immediately challenged. "It's the most egregious abuse of data I've ever seen," Harvard nutritional epidemiologist Walter Willett told Medical Daily.
But in 2020, the Cochrane Library issued a systematic review of studies assessing the health effects of reducing saturated fats—that is, replacing animal fats and hard vegetable fats with plant oils, unsaturated spreads, or starchy foods. This review reported that "reducing saturated fat in-take probably makes little or no difference" to all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction, and coronary heart disease mortality. The authors nevertheless concluded that the studies they analyzed "provide moderate-quality evidence that reducing saturated fat reduces our risk of cardiovascular disease."
Other researchers have gone further. In 2022, scientists associated with the University of Washington's Institute for Health Metrics and Evaluation unveiled some techniques they had developed to correct for the uncertainties and biases in the studies being evaluated. Their study, published in Nature Medicine, reported "weak evidence of associations between unprocessed red meat consumption and colorectal cancer, breast cancer, IHD [ischemic heart disease] and type 2 diabetes." No association with strokes was identified. The evidence was so uncertain that they concluded, "While there is some evidence that eating unprocessed red meat is associated with increased risk of disease incidence and mortality, it is weak and insufficient to make stronger or more conclusive recommendations."
If nothing else, those researchers agree on one thing: The available evidence is insufficient to recommend reducing meat consumption. But not everyone even agrees about that: In 2023, Critical Reviews in Food Science and Nutrition published a meta-analysis concluding that "unprocessed red and processed meat might be risk factors for IHD [ischemic heart disease]. This supports public health recommendations to reduce the consumption of unprocessed red and processed meat intake for the prevention of IHD."
Note that word might, followed by a much more confident assertion that public health Cassandras should continue to warn people away from meat. A charitable interpretation of the study would be the authors recommend a cautious approach to meat not entirely supported by the evidence because meat might be bad, even if they can't prove it. It's not an immoral decision per se, but it's also not science—and it certainly doesn't justify anti-meat public policy.
Some of the authors of the Annals of Internal Medicine meta-analysis of red meat and cardiovascular mortality have also examined potential links between red and processed meats and cancer. Unlike most nutritional epidemiological studies, this one helpfully translates the relative risks reported into absolute risks.
They calculate that a weekly reduction of three servings of unprocessed meat will reduce a person's overall lifetime population risk of cancer from 105 per 1,000 to 98 per 1,000. Parsing three breast cancer studies, they calculate that a person's overall lifetime population risk will fall from 46 per 1,000 to 40 per 1,000. For prostate cancer (drawing on two studies), the absolute risk falls from 38 per 1,000 to 37 per 1,000. For colorectal cancer (five studies), they find that there is no absolute risk reduction. They also estimate that cutting the consumption of processed meats by three servings per week will reduce the absolute lifetime risk of cancer by roughly the same amount. These findings track those reported in the 2022 Nature Medicine study cited above.
The team concludes: "Our systematic review and meta-analysis of cohort studies supports the association between red and processed meat intake and increased risk for cancer. The magnitude of red meat's effect on cancer over a lifetime of exposure was, however, very small, and the overall certainty of evidence was low or very low."
But nutritional epidemiologists are nothing if not dogged in the pursuit of uncovering tiny effects. A 2021 meta-analysis in the European Journal of Epidemiology found that eating red meat and processed meats was positively associated with risk of breast, colorectal, colon, rectal, and lung cancers. But the relative risks for each were not much different than those reported in the Annals of Internal Medicine meta-analysis.
When a 2021 meta-analysis in the journal Nutrients looked at cancer risks, it found that "while relative effects for red and processed meat may be positive and statistically significant, absolute effects are small (less than 1%)." It concluded that "the recommendation to reduce the consumption of processed meat and meat products in the general population seems to be based on evidence that is not methodologically strong."
With meat, the concessions have been gradual and reluctant. With dairy, the about-face has been far more dramatic.
For years, nutritional epidemiologists condemned dairy foods and eggs for their high saturated fat contents. For example, the doyen of nutritional epidemiology, Walter Willett, wrote in Science in 1994 that butter and other dairy fats boosted cholesterol, thus probably increasing the risk of coronary heart disease. Therefore, he argued, "saturated fats, particularly those from dairy sources, should be minimized."
Just 20 years later, based on an extensive meta-analysis of saturated fat studies in Annals of Internal Medicine, food writer Mark Bittman famously declared "butter is back." The researchers found "a possible inverse association" between consuming dairy products and coronary disease. In other words, drinking milk and eating butter actually tended to reduce the risk of heart disease.
Since 2014, the majority of nutritional epidemiological studies have found that consuming dairy products is at worst neutral and more likely slightly protective. For example, a March 2022 meta-analysis in Advances in Nutrition reported, "Total dairy consumption was associated with a modestly lower risk of hypertension, CHD [coronary heart disease], and stroke." A 2023 conference summary in the Proceedings of the Nutrition Society concluded: "The association between dairy foods and CVD [cardiovascular diseases] is generally neutral despite many of the dairy foods being the major source of SFA [saturated fatty acids] in many diets. This leads to substantial doubt concerning the validity of the traditional diet-heart hypothesis." Of course, one can turn up more recent studies, such as a 2022 meta-analysis in Critical Reviews in Food Science and Nutrition, that still say consuming high-fat dairy products is associated with cardiovascular disease risk.
The role of eggs with respect to cardiovascular disease is contested. A 2019 Journal of the American Medical Association meta-analysis concluded that "each additional half an egg consumed per day was significantly associated with higher risk of incident CVD and all-cause mortality." A 2021 cohort study in PLOS Medicine similarly found that "intakes of eggs and cholesterol were associated with higher all-cause, CVD, and cancer mortality." Contrariwise, a 2021 cohort analysis in BMJ reported that "no association was found between egg consumption and cardiovascular disease risk among US cohorts, or European cohorts, but an inverse association was seen in Asian cohorts." A May 2023 evaluation of recent evidence in Current Atherosclerosis Reports said that "most studies assessing egg consumption and CVD risk factors found a reduced risk or no association."
The cacophony of murky findings coupled with strong recommendations is not limited to solid foods. Earlier this year, the WHO declared "no level of alcohol consumption is safe for our health." It based the claim on studies that suggest drinking in any amount is associated with higher risks of various cancers.
A team of Italian statisticians contradicted the organization's proclamation in a July 2023 working paper. Their dive into the literature on alcohol's health effects found the field rife with methodological problems, including a huge bias toward positive results and a probably enormous underreporting of actual consumption in surveys of drinkers. They conclude that "given the methodological limitations in detecting the effects of modest alcohol quantities, from a scientific point of view it is incorrect to claim that 'there is no safe level.' We should rather say that 'we are unable to determine if there is a safe amount' and, likely, we will never be."
Nevertheless, since the 1980s, numerous epidemiological studies identified a U- or J-shaped curve—a graphical representation showing the risks for heart disease and overall mortality were lower for light to moderate drinkers than for nondrinkers and heavy drinkers. A June 2023 BMC Medicine study comparing nondrinkers and drinkers reconfirmed the existence of the J-shaped curve. "Compared with lifetime abstainers, current infrequent, light, or moderate drinkers were at a lower risk of mortality from all causes, CVD, chronic lower respiratory tract diseases, Alzheimer's disease, and influenza and pneumonia," it reported. But heavy and binge drinkers had a "higher risk of mortality from all causes, cancer, and accidents."
In a 2022 editorial in European Heart Journal Supplements, Andrea Poli, president of the Nutrition Foundation of Italy, highlighted the health tradeoffs between alcohol's cardiovascular benefits and cancer risks. The association of moderate consumption "with a reduced cardiovascular risk," Poli wrote, "seems to prevail over the increase in [cancer] risk, with the consequence that all-cause mortality is reduced as compared to abstainers." A 2015 study in Drug and Alcohol Review investigated the question of whether industry funding has biased studies of the protective effects of alcohol on cardiovascular disease. The researchers found "no evidence of funding effects for cardiovascular disease mortality, incident coronary heart disease, coronary heart disease mortality and all-cause mortality."
Tradeoffs are an underdiscussed concept in the public health literature, which generally fails to recognize that we are all entitled to balance a desire for a long life with a desire to enjoy living. So how does one weigh the cancer risks of drinking? The lifetime population risk of colorectal cancer is 22.5 per 1,000 people. (Of course, this includes people who drink alcohol, but let's use it as a baseline anyway.) A 2014 British Journal of Cancer article reported that moderate to heavy drinking increased the relative risk of colorectal cancer by 1.17, yielding a 17 percent increase in risk over nondrinkers. That suggests that moderate to heavy drinking increases the lifetime risk of colorectal cancer from 22.5 to 26.3 per 1,000 people.
Interestingly, a 2020 meta-analysis in the International Journal of Cancer identified a J-shaped relationship in which light, moderate, and even heavy drinking was actually associated with a lower risk of colorectal cancer compared to nondrinkers and very heavy drinkers.
"Salt," an unknown wit once said, "is what makes things taste bad when it isn't in them." The Centers for Disease Control and Prevention advises that "most Americans should consume less sodium" because "excess sodium can increase your blood pressure and your risk for a heart disease and stroke." Most of the sodium Americans consume comes in the form of sodium chloride, otherwise known as table salt. The Dietary Guidelines for Americans recommends that adults limit sodium intake to less than 2,300 mg per day—about 1 teaspoon of table salt. The American Heart Association's "ideal limit" of sodium intake for most adults is "less than 1,500 mg a day." Instead, Americans consume an average of 3,400 mg of sodium per day.
In other words, the official nutrition scolds want your food to taste bad, or at least bland.
Remember that the recommendation to cut back on salt is intended to apply populationwide. But more recent research shows individuals exhibit a range of responses to various doses of salt. By some estimates, about 25 percent of people are salt-sensitive, meaning that higher salt intakes tend to increase their blood pressure. Another 15 percent of the population is inverse salt-sensitive, meaning that low intakes of salt conversely increase their blood pressure. A 2023 study in the Journal of Hypertension tested the effects of 7-day low- and high-sodium diets on subjects with normal blood pressure. It found that about 13 percent were salt-sensitive, 11 percent were inverse salt-sensitive, and 76 percent were salt-resistant—that is, consuming salt did not significantly increase or decrease their blood pressures.
Unfortunately, no widely accessible clinical tests have been devised for establishing a "personal salt index" for individuals to let them know if they are salt-resistant, salt-sensitive, or inverse salt-sensitive.
Epidemiological studies focused on the health effects of salt consumption come to different conclusions. For example, a 2020 Cochrane Library review of the effects of low-sodium versus high-sodium diets on blood pressure analyzed 195 randomized controlled trials. It found that "a low- versus high-sodium diet in white people with normal blood pressure (BP) decreases BP less than 1%." Meanwhile, lower sodium intakes led to "a significant increase in plasma cholesterol and plasma triglyceride," which are associated with higher cardiovascular disease risk.
The upshot: The results did not support the idea "that sodium reduction may have net beneficial effects in a population of white people with normal BP." On the other hand, if you're a white person with elevated blood pressure, "sodium reduction decreases BP by about 3.5%, indicating that sodium reduction may be used as a supplementary treatment for hypertension." Lower-sodium diets did tend to reduce blood pressure a bit more in Asian and black subjects, though there hadn't been enough studies to reach separate conclusions for those groups.
In 2020, a comprehensive review in the European Heart Journal pointed to the growing evidence that the relation of sodium intake with cardiovascular events is, like alcohol, J-shaped. That is, both deficient and high sodium intakes are associated with greater mortality and cardiovascular disease risks. The authors conclude that at the population level, moderate sodium consumption—about 1 to 2 teaspoons daily—has been "consistently associated with lower cardiovascular risk, compared to both high and low sodium intake." A 2021 commentary in the Journal of Hypertension noted that at this point, "the 'J-shape hypothesis' cannot yet be either neglected or verified."
A 2021 study in the European Heart Journal tested the hypothesis that high salt consumption was a risk factor for cardiovascular disease and premature death. The authors found that "daily sodium intake correlates positively with healthy life expectancy at birth and healthy life expectancy after age 60 and inversely with all-cause mortality in 181 countries worldwide." They concluded that consuming a moderate range of salt (1 to 2 teaspoons daily) is not associated with increased cardiovascular risk. The American average of 3.4 grams of sodium a day is within that range.
The researchers add that their results are population averages, and that individuals will want to tailor their salt consumption to their specific health circumstances. The best evidence is that people with hypertension should cut back on salt, but whether people with normal blood pressure should is not a settled issue.
If we can't trust the epidemiological establishment, it might stand to reason that we can trust dissenters. Unfortunately, heterodox researchers also have biases.
The controversy over polyunsaturated seed oils is the mirror image of the fight over saturated fats in meat, milk, and eggs. Omega-3 and omega-6 fatty acids are essential fatty acids. These molecules are necessary for health but can't be synthesized by the body, so we must get them from food. Both fatty acids act as structural components in cellular membranes and modulate inflammatory responses. The principal sources of omega-3 fatty acids are oily fish, flaxseeds, and some nuts. The chief omega-6 fatty acid is linoleic acid. The prime sources of linoleic acid in modern diets are oils derived from soybean, corn, cottonseed, sunflower, canola, safflower, rice bran, and grapeseed.
These oils have increased in modern diets, and some health and wellness gurus have dubbed them the "hateful eight." Their main contention is that the modern dietary "balance" between omega-3 and omega-6 essential fatty acids is out of whack, resulting in a host of alleged bad effects on health.
Most recent research has not been kind to these claims. A 2020 meta-analysis in The American Journal of Clinical Nutrition reported that higher linoleic acid intake is "associated with a modestly lower risk of mortality from all causes, CVD, and cancer." A 2020 narrative review in Atherosclerosis found it likely that "both dietary intake and circulating concentrations of [linoleic acid] inversely correlate with cardiovascular disease risk." A 2020 review article in The Lancet Diabetes & Endocrinology concluded that plant oils with lots of linoleic acid "seem to be moderately protective" against coronary heart disease, especially myocardial infarction. That same review reported that a several-fold higher omega-6 to omega-3 ratio "has no adverse effects on either multiple markers of inflammation or oxidative stress." Nor was there any "evidence to suggest an important role of the omega-6 to omega-3 ratio on glucose metabolism." (The latter is relevant to the risk of developing diabetes.)
As for inflammation, a 2012 review of randomized controlled trials in the Journal of the Academy of Nutrition and Dietetics reported that "virtually no evidence is available from randomized, controlled intervention studies among healthy, noninfant human beings to show that addition of LA [linoleic acid] to the diet increases the concentration of inflammatory markers." A 2017 meta-analysis of randomized controlled trials in Food & Function concluded that consuming more linoleic acid "does not have a significant effect on the blood concentrations of inflammatory markers."
And last year, a systematic review in Food Science and Biotechnology concluded that omega-6 fatty acids "have beneficial effects on cancers, blood lipoprotein profiles, diabetes, renal disease, muscle function, and glaucoma without inflammation response."
Nutritional epidemiology as practiced currently is mostly bunk.
"Nutritional epidemiologists valiantly work in an important, challenging frontier of science and health," Ioannidis generously observes in his 2019 article titled "Unreformed nutritional epidemiology: a lamp post in a dark forest" in the European Journal of Epidemiology. "However, methods used to-date (even by the best scientists with best intentions) have yielded little reliable, useful information." As an example, Ioannidis specifically cites the prevailing recommendation to eat less red meat as one of the many "'classics' of nutritional guidelines" that are based on "mostly weak evidence and small (or null) effects." As Ioannidis argued in BMJ in 2013, "almost every single nutrient imaginable has peer reviewed publications associating it with almost any outcome."
In the meantime, the recommendations to "eat this; not that" derived from nutritional epidemiology fervently promoted by nutrition "experts" and the media confuse and frustrate regular folks. They also encourage policy makers and regulators to meddle with what people want to eat. The researchers in the 2019 Annals of Internal Medicine meat study pointed out, "For the majority of individuals, the desirable effects (a potential lowered risk for cancer and cardiometabolic outcomes) associated with reducing meat consumption probably do not outweigh the undesirable effects (impact on quality of life, burden of modifying cultural and personal meal preparation and eating habits)." In other words, the very weak evidence that eating meat might harm their health is most likely counterbalanced by most omnivores' preferences to continue eating steaks and hot dogs.
Ioannidis concludes that nutritional epidemiology as currently practiced is rife with "fervent allegiance beliefs and group-think." Consequently, many, if not most, of the observed effects reported by nutritional epidemiologists largely reflect the magnitude of the biases prevailing among the field's researchers.
So enjoy the pleasures of drink and of the table in moderation, while keeping in mind English poet Alexander Pope's astute observation: "What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease."
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]]>Today's hyperpartisan and frequently negative news cycle ignores one significant and uplifting story: the precipitous decline of global inequality. It's a subject that deserves our attention, for it reveals the power of markets, trade, and human ingenuity to lift up societies.
For decades, critics of globalization lamented the chasm that trade and a growing economic interdependence among nations would ostensibly create between the rich and the poor. In the last few decades, however, we've witnessed a clear reduction in global inequality quite contrary to the doomsayers' old predictions. Emerging economies—many of which were once considered backwaters destined to languish—have taken giant leaps forward by joining the global economy. Millions of people have been raised from abject poverty and wealth disparities have narrowed.
Consider India and even Communist-led China. Despite some recent problems due mostly to renewed authoritarianism, in the last few decades these economies have shifted from being insulated and stagnant to relatively open and dynamic participants in global commerce. By embracing markets and reducing bureaucratic encumbrances, they've catalyzed an economic renaissance. The World Bank's data underscores this transformation, highlighting that in China, over 800 million people have been liberated from the clutches of poverty since 1980. In India, that number sits at 415 million people since 2005.
However, focusing solely on income trends can sometimes blur stories of resilience and progress. Cato Institute scholar Chelsea Follett and George Mason University economist Vincent Geloso developed the Inequality of Human Progress Index (HPI) to better illuminate examples of how humans are flourishing. The index measures relative gaps in international inequality across a greater number of dimensions than those which focus on simple material well-being.
These dimensions include lifespan, infant mortality, adequate nutrition, environmental quality, access to opportunity (measured by education), access to information (measured by internet access), and political freedom. Each are critically important living standards that measures of monetary income might not fully reflect. Finally, the index gives more weight to things that are harder to achieve—like the feat of increasing life expectancy from 70 to 80 compared to the first step of increasing it from 20 to 30.
By measuring the degree to which people share in these improvements of welfare, Geloso and Follett's new index captures in much broader terms what most of us have in mind when we speak of human progress.
So, what does the index find? First, significant progress has indeed been made to improve overall well-being. These improvements appear larger than the ones reported by other measurements, such as the United Nations' Human Development Index, in part because of the other components of human progress measured. This difference demonstrates how a simple index, no matter how useful or how widely cited it is by other experts, can fail to capture many elements of human welfare.
As Follett and Geloso report:
The HPI with internet access included suggests that inequality initially increased in the early 1990s and then began to fall rapidly. Inequality appears to rise because only a few countries saw a surge in internet access at first. However, as internet access spread to other countries, inequality began falling rapidly. By 2018, inequality was between 35.3 and 49.4 percent lower than it was in 1990.
In other words, this progress has been widely shared, to the great benefit of the people at the bottom of the distribution.
In fact, looking at each indicator separately, the authors find spectacular reductions in inequality in all but two: childhood mortality and access to clean air. They suggest that the increase in mortality from pollution could be the result of the "Environmental Kuznets Curve." This curve shows that pollution at first increases with economic growth. It does so until a critical point is reached, after which pollution starts to fall. As Follett and Geloso note, "the hike could reflect that some countries are going through the transition." As for the increase in infant mortality inequality, this result could be a sign that child mortality has fallen, but not as fast in low-income countries as in high-income countries since 1990.
Challenges remain, of course, but the significant reduction in global inequality can't be ignored. These improvements are not just statistics; each testifies to real stories of human betterment and potential and underscores the immense possibilities that arise when individuals are empowered by freedom, barriers are minimized, and nations collaborate. As we navigate the complexities of the 21st century, this story of triumph should serve as both a beacon and a guide.
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]]>Does the artificial sweetener erythritol cause heart attacks and strokes? That's the tenor of a spate of reporting on a new study published this week in the journal Nature Medicine. But there are numerous reasons to be cautious about drawing conclusions from the study's purported findings.
The researchers report that "in patients undergoing cardiac risk assessment…circulating levels of multiple polyol sweeteners, especially erythritol, were associated with incident (3 year) risk for major adverse cardiovascular events," including heart attack, stroke, and death. Erythritol—"one of the most widely used artificial sweeteners with rapidly increasing prevalence in processed and 'keto'-related foods"—was "among the very top" molecules associated with these tragic outcomes.
"Subsequent analyses of stable patients undergoing elective cardiac evaluation confirmed this association," with patients with the highest levels of circulating erythritol in their blood more likely to have cardiovascular disease and more likely to experience major adverse cardiovascular events. "Compared to participants in the lowest quartile of erythritol levels, those in the highest quartile had a substantially increased incident event risk in both" U.S. and European cohorts, the study states.
"The degree of risk was not modest," lead study author Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute, told CNN—one of many major media outlets to report (uncritically) on the study's findings. CNN summed it up like this: "People with existing risk factors for heart disease, such as diabetes, were twice as likely to experience a heart attack or stroke if they had the highest levels of erythritol in their blood."
That sounds bad, right? But let's dig a little deeper.
The first issue to jump out here is that all of the people studied already had metabolic issues of some sort. So it's at least unclear that these results would generalize to populations without these issues.
Another red flag (raised by a neurobiology Ph.D. student on Twitter) is that the people in the highest quartile of erythritol levels look quite different than the people in the lowest quartile. In the first part of the study, for instance, those in the lowest quartile had an average age of 59.8, while those in the highest quartile had an average age of 70.2. The highest quartile had about a point heavier BMI, was less likely to be male, and was significantly more likely to have diabetes (36.7 percent versus 14.8 percent in the lowest quartile). They were more likely to have a history of heart attack and heart failure, and had significantly higher blood triglyceride levels, among other things. And similar differences can be seen in the U.S. and European study cohorts.
The researchers say they adjusted for these factors. But it's difficult to adjust for such a wide range of differences and all the complex metabolic processes that they entail.
Perhaps the biggest issue in the study—noted by University of Oxford researcher Nicola Guess—is that human bodies produce some erythritol naturally, and yet the researchers didn't control for endogenous versus exogenous erythritol.
Like cholesterol, the amount of erythritol in the body doesn't directly correspond to erythritol consumed. Exogenous erythritol—which comes from our diet—is what all the reports on this study are concerned with. (For instance: "Study Suggests Possible Link Between Sugar Substitute and Heart Issues," reported The New York Times in a typical headline about the study.) Endogenous erythritol is a molecule produced internally.
But the researchers in this study did not tease out how much circulating blood erythritol came from each source, leaving open the possibility that a) it's not only or even mostly consumption of erythritol as a sugar substitute that led to high erythritol levels in the cohort with the worst outcomes and b) it's not only or even mostly consumption of erythritol as a sugar substitute that is linked to higher instances of heart attack, stroke, and death.
It still could be—but we certainly can't tell that from this study. And there's good reason to suspect that naturally produced erythritol here is the more likely suspect.
"Erythritol is produced in the body via the pentose phosphate pathway (PPP), a process which might be upregulated by oxidative stress," explained Guess. That is, oxidative stress—itself a major cause of health issues including cardiovascular problems—can lead to increased production of endogenous erythritol.
"In fact, [as far as I know], serum erythritol is somewhat recognised as an early, general marker of cardiometabolic dysfunction," Guess continued.
This recognition that blood erythritol levels can cause problems predates the new study. "Serum erythritol is a predictive biomarker of chronic disease development and complications," according to a 2021 paper published in the journal Current Developments in Nutrition.
A 2020 study published in Clinical Nutrition and Metabolic Care states that "elevated serum erythritol predicts future central adiposity gain and type 2 diabetes mellitus in healthy adults." It points out that "erythritol is a newly recognized human metabolic product of glucose, synthesized through the pentose phosphate pathway."
This pathway is stimulated by a range of things that can also lead to major adverse cardiac events, making the idea that dietary erythritol is the main cause of elevated serum erythritol and adverse outcomes suspect.
As it stands, despite the nature medicine label, they really didn't do the basic legwork to illustrate their findings had anything to do with dietary erythritol. They didn't do any sort of dietary evaluation. They compared quartiles instead of doing regression, which is…
— ????ZK For Tre???? (@ZKForTre) February 28, 2023
Is teen mental health tied to politics? Matthew Yglesias explored research suggesting that liberal teens are more depressed than their conservative counterparts:
But I want to talk about…a 2021 paper by Catherine Gimbrone, Lisa Bates, Seth Prins, and Katherine Keyes titled "The politics of depression: Diverging trends in internalizing symptoms among US adolescents by political beliefs." The CDC survey doesn't ask teens about their political beliefs, but Gimbrone et. al. find not only divergence by gender, but divergence by political ideology. Breaking things down by gender and ideology, they find that liberal girls have the highest increase in depressive affect and conservative boys have the least. But liberal boys are more depressed than conservative girls, suggesting an important independent role for political ideology.
I think the discussion around gender and the role of social media is an important one. But I also don't believe that liberal boys are experiencing more depression than conservative girls because they are disproportionately hung up on Instagram-induced body image issues — I think there's also something specific to politics going on.
Some of it might be selection effect, with progressive politics becoming a more congenial home for people who are miserable. But I think some of it is poor behavior by adult progressives, many of whom now valorize depressive affect as a sign of political commitment. The thing about depression, though, is that it's bad. Separate from the Smith/Levitz project of arguing about recent political trends, I think we need some kind of society-level cognitive behavioral therapy to convince people that whatever it is they are worried about, depression is not the answer. Because it never is.
More here. (See also: Don't be a doomer.)
The outsize role of immigrants in U.S. innovation. A new paper from the National Bureau of Economic Research (NBER) finds "immigrant inventors are key contributors to innovation in the United States, both through their direct productivity and through the spillover effects of their work with native-born collaborators," as an NBER summary puts it:
While accounting for just 16 percent of all US-based inventors, immigrant inventors produce nearly a quarter of total innovation output as gauged by the number of patents and patent citations and the economic value of the patents.
Looking at data on immigrant inventors between 1990 and 2016 (with immigrants defined as people who got a Social Security number at age 20 or later), they found that "immigrants produced 23 percent of all patents over the study period." In addition, immigrants "collaborated with native-born inventors on 13 percent of all patent filings, so they were either directly or indirectly responsible for 36 percent of US patent output during the study period."
You can find the full paper ("The Contribution of High-Skilled Immigrants to Innovation in the United States") here.
VICTORY! South Dakota becomes the latest state to legalize fentanyl test strips. https://t.co/1aKUmLgSWi #CatoHealth #CatoDrugWar pic.twitter.com/RsaE6sGckH
— Cato Institute (@CatoInstitute) February 28, 2023
• The American Civil Liberties Union is launching a new initiative dedicated "to help[ing] those facing prosecution for providing, supporting, or seeking abortion care."
• A new report looks at "how the war on sex work is stripping your privacy rights."
• "Last month, Boulder County spent the first of what it hopes will be millions of dollars for the treatment and prevention of drug addiction, courtesy of lawsuits against the drug manufacturers, distributors and pharmacies that helped fuel America's opioid epidemic," notes Boulder Beat. "Among the spending was money for controversial yet widely used technology to gain access to locked cell phones and computers."
• The encrypted messaging app Signal says it will stop providing U.K. services if the country's proposed Online Safety Bill passes.
What's sad is Signal walking if the #OnlineSafetyBill passes is predictable. What's worse is that I'd bet more services may follow suit.https://t.co/DodtOe1sKi
— Kir Nuthi (@kirtinuthi) February 28, 2023
The post Be Skeptical of the New Artificial Sweetener Scare appeared first on Reason.com.
]]>Last week the Biden administration hosted a conference focused on nutrition, health, and hunger in America. The White House says the conference was intended to help craft a national strategy to "identify steps the government will take and catalyze[] the public and private sectors to address the intersections between food, hunger, nutrition, and health." The conference's goals included improving food access and affordability, integrating nutrition and health, and empowering consumers to make healthy food choices.
The timing of the conference—a lowlight of which included Biden wondering aloud why a recently deceased member of Congress wasn't in attendance—was fortuitous. It was held amidst the double whammy of record-high food prices and obesity rates in this country.
In the lead-up to the conference, the Biden administration announced billions of dollars in public and private contributions—the latter including money and other resources provided by companies such as Doordash, Chobani, Google, and the National Grocers Association—as part of a "transformational vision" to help end hunger and reduce diet-related diseases such as diabetes by 2030.
That certainly sounds nice. But just what did—or can—a conference such as this achieve? As always, the devil's in the details. And those details appear in many cases to involve merely reheating soggy leftover ideas. Indeed, a lengthy strategy document released by the White House suggests its so-called "transformational vision" is largely neither.
The administration's plans to improve food access and affordability include "increasing access to free and nourishing school meals." School lunches may be free for many kids, but those meals are neither nourishing nor—frequently—healthy or edible. As I detail in my book, Biting the Hands that Feed Us: How Fewer, Smarter Laws Would Make Our Food System More Sustainable, the meals' alleged "affordability" comes from the fact the foods contained in them are typically subsidized from farm to fork.
Worse, proposed plans to empower consumers to make healthy choices may include yet another revision of mandatory food labeling requirements for packaged foods. As the conference document notes, Biden was serving as vice president the last time such changes to food labels (which the document refers to preposterously as "iconic") were supposed to accomplish something big.
Perhaps the most troubling element of the document is a proposal to "assess[] additional steps to reduce added sugar consumption, including potential voluntary targets." While I agree Americans should consume far less sugar than they do, the Obama administration already went down this path, and obesity and other diet-related diseases have only risen. Moreover, the words "including potential voluntary targets" strongly suggest mandatory targets for sugar consumption. Indeed, as NPR noted in the wake of the conference, activists "are hopeful the conference serves as a first step towards future… policy changes."
Instead of the whole conference hoopla, a simpler solution, as I've suggested before, would be for the federal government to send cash to people who can't afford to buy sufficient food for themselves and their families. A New York Times report on last week's conference pointed to a recent USDA report that showed 10 percent of American households—13.5 million—are food-insecure. The White House could direct the entirety of the aforementioned $8 billion to those same households (which would work out to around $600 per household per year) and other, greater cash payments as needed. For that comparatively small investment, the federal government could have an immediate, positive impact on the lives of many hungry Americans without foisting still more ineffective or counterproductive policies on the American public. The results, then, could be just those the Biden administration says it wants.
The post Biden's Conference on Food Insecurity and Health Served Warmed-Over Ideas appeared first on Reason.com.
]]>Consumers shrug at mandatory GMO labeling. Beginning this year, federal food-labeling laws require products made with genetically modified ingredients to carry a label saying they are "bioengineered." But short of requiring extra work and costs for food makers and manufacturers, the law is likely to lead to little change.
Research suggests that consumers won't alter their behavior based on mandatory disclosure of genetically modified organism (GMO) food products.
"In the presence of existing voluntary non-GMO labels, mandatory labeling did not have any additional effect on demand," wrote researchers from Cornell University, the University of Massachusetts Amherst, and the University of Wisconsin-Madison in a November 2021 paper. "Our findings suggest that voluntary non-GMO labels may already provide an efficient disclosure mechanism without mandatory GMO labels."
Looking at legislative consideration of GMO labeling in several states and the adoption of such labeling in Vermont, the authors found that public discussion of GMO labeling increased awareness of the issue and may have steered consumers toward products voluntarily labeled as non-GMO. "Heightened consumer awareness" was found to have "increased adoption of products with voluntary non-GMO labels, even absent actual implementation of mandatory GMO labeling," they noted.
"Contrary to previous studies that indicated the mandatory labels for products made with bioengineered food would herald big swings in consumer preferences and buying, this new study shows a more muted effect," points out Megan Poinski at Food Dive. "What did motivate consumers to change behavior was news about GMO food."
The U.S. Department of Agriculture (USDA) has admitted that new federal regulations mandating the labeling of bioengineered food—passed in 2016 under former President Barack Obama and finalized by the Trump administration—may be useless. It "is not expected to have any benefits to human health or the environment," the USDA said in 2018.
The changes are costly, however. "USDA estimates that the costs of the proposed [mandatory labeling] would range from $598 million to $3.5 billion for the first year, with ongoing annual costs of between $114 million and $225 million," it said. ("So not only are the new regulations useless, implementing them will jack up food prices for consumers," as Reason's Ron Bailey pointed out).
Food policy writer Baylen Linnekin has long been warning of the ways in which the National Bioengineered Food Disclosure Act "is a bad law, and likely unworkable." The labeling requirements themselves are confusing:
Under the final rule, a food producer marketing a food that is genetically modified (GMO) or that contains GMO ingredients may comply with the rules in any one (or more) of four ways: 1) by clear wording on a food label; 2) by using the USDA's new symbol "BE" to designate that it is bioengineered food; 3) via a QR code printed on a food label; or 4) by giving the consumer the option to send a text message to the manufacturer seeking more information.
Besides, there's no evidence that "bioengineered" food is anything consumers should be concerned about.
"The move is universally confounding food safety advocate groups," The Washington Post reports. "Eating bioengineered foods poses no risk to human health, according to the National Academy of Sciences and the Food and Drug Administration."
"Critics say the rules devised by the U.S. Department of Agriculture will actually confuse consumers further and make it harder to know what's in any given product," notes NPR. "One advocacy group [the Center for Food Safety] has even sued the USDA to try to block the new regulations from taking effect."
Among other complaints, the ongoing lawsuit objects to manufacturers not being able to use the more widely-known term GMO, instead of bioengineered. It also objects to the fact that many foods made with bioengineered ingredients may be left out.
The USDA defines bioengineered food as "a food that contains genetic material that has been modified through in vitro rDNA techniques and for which the modification could not otherwise be obtained through conventional breeding or found in nature." Foods made with genetically modified material that isn't detectable in the final product aren't considered bioengineered foods, it says.
The bottom line: Voluntary labeling of non-GMO products was working, providing consumers who—for whatever reason—wanted to know that sort of thing with the information they desired and allowing manufacturers who wanted to use non-GMO status as a marketing tool to do so. But since the federal government stepped in, the whole process has become more costly and confusing with seemingly no consumer benefit.
Questioning paranoia about smartphones and attention spans. Journalist Matthew Sweet explores some of the cherry-picked examples and logical fallacies in Stolen Focus, a new book by Johann Hari about diminishing attention spans. (You can read the whole thread on Twitter, starting here.) One example: Hari cites a study about smartphones and distraction and draws some serious conclusions from it:
But not only was the study not the most rigorous (it "was commissioned by the authors of a business self-help book called The Plateau Effect" and is not peer-reviewed, Sweet points out), Hari also leaves out some vital information about how the study was set up. "The distracting messages mentioned were sent by the experimenters, and the subjects were told they contained important information about the test," Sweet points out. "They HAD to respond. So it tells you very little – nothing, I would suggest—about the ordinary seductions of the smartphone."
Does Johann Hari tell us this? No. Instead, he says this research suggests that our species - yes, our species! - is losing 20-30 per cent of its brainpower because it uses mobile phones. Is this a reasonable assertion? I'd say no. I'd call it cherry-picking and exaggeration.
— Matthew Sweet (@DrMatthewSweet) January 6, 2022
New small business creation is thriving. "We're now entering year three of the COVID-19 pandemic, and the U.S. economy is still struggling thanks to inflation, supply chain issues, and continually bad jobs numbers. However, small business creation has been an unexpected economic bright spot since the pandemic began," notes Reason's Fiona Harrigan:
In 2021 (excluding data for December, which the U.S. Census Bureau has not yet released), an average of around 452,000 new business applications were filed monthly. That's a significant increase compared to 2019, when an average of roughly 293,000 new business applications were filed each month. Those numbers dipped in March and April 2020 before catapulting to over 550,000 in July 2020 and remaining above 2019 levels through the end of the year.
The 2021 data look especially promising because new businesses tend to hire employees. From January 2021 through the end of Q3, 1.4 million applications were filed to form businesses likely to hire workers, more than any other comparable recorded period.
• On this day in 2015, terrorists killed 12 people in an attack on the satirical French magazine Charlie Hebdo. See Reason's coverage here.
• Chicago schools are still closed, as the city's leadership and teachers union fight over in-person learning.
• A judge this week ruled that Texas Gov. Greg Abbott doesn't have the authority to prevent local governments in the state from imposing their own mask mandates.
• Hormonal birth control is now available without a prescription in Illinois. "This legislation covers self-administered hormonal contraceptive methods — birth control pills, skin patches, and vaginal rings — which were previously available only with a prescription from a physician," notes Chicago magazine.
• Perpetually truth-challenged and sex work–obsessed pundit Nicholas Kristof can't run for governor of Oregon because he hasn't lived in the state long enough, officials say. On Thursday, "Secretary of State Shemia Fagan announced that her office was rejecting Kristof's bid to run for office, because he does not meet the state's three-year residency requirement," reports Oregon Public Broadcasting. "That decision is likely just the start of a legal fight that will be decided by the courts."
• Encrypted messaging app Signal's crypto payments feature has gone global.
• "Add swim diapers to the list of issues that can get turned into a federal case," writes Ron Hurtibise in the South Florida Sun-Sentinel. In a new federal lawsuit, "a Florida family is suing their condo board over what they say is a rule barring children from using the community pool while wearing swim diapers."
• "The feminist rejection of diet culture can, at times, shift to a rejection of the whole concept of health itself, or at least of the idea that it's probably a good thing to pursue health," points out feminist author Jill Filipovic, in a Substack post calling for both a rejection of unhealthy dieting obsessions but also an understanding that "it does actually matter what we eat — to ourselves, to our bodies, to our souls, to our cultures, and to our planet."
The post Mandatory GMO Disclosure Doesn't Sway Shopping Habits (But Will Drive Up Costs) appeared first on Reason.com.
]]>Last month, a top United Nations official suggested in a tweet that Elon Musk, the billionaire inventor and entrepreneur, could eliminate global hunger if he would just give the U.N. 2 percent of his wealth—or around $6 billion.
In an October 19 tweet, David* Beasley, who leads the U.N. World Food Programme (WFP), congratulated Musk for passing Amazon founder Jeff Bezos for the title of world's wealthiest person—Musk's estimated to be worth around $300 billion—while also asking Musk to help the WFP "help us save 42M people from starvation for just $6.6B!!"
Musk responded, explaining in a series of tweets that he would be willing to sell $6 billion of stock in Tesla, the electric-car company he founded, if the WFP—which was awarded the Nobel Peace Prize last year—would detail publicly how the body would use the money to end global hunger.
"Please publish your current & proposed spending in detail so people can see exactly where money goes," Musk tweeted in response. "Sunlight is a wonderful thing."
"But it must be open source accounting, so the public sees precisely how the money is spent," he also tweeted.
While no one could blame Beasley for shooting his shot—I could do a lot of good with 2 percent of Musk's money, too—Beasley quickly dampened expectations for what results the WFP could achieve with $6 billion. In a tweet responding to Musk, Beasley labeled headlines about his request inaccurate, noting "$6B will not solve world hunger, but it WILL prevent geopolitical instability, mass migration and save 42 million people on the brink of starvation."
Indeed, while $6 billion is a big number, it's not "end hunger" big. For example, I wrote recently about SNAP—formerly known as food stamps—an $85-billion-per-year U.S. Department of Agriculture program that's designed to provide adequate food to Americans who might otherwise be unable to purchase it. The USDA's total overall 2021 budget is $216 billion. $6 billion, while a huge number, is tiny by comparison.
In a more detailed response to Musk this week, Beasley presented a rough sketch of how the WFP would spend a Musk donation. "This $6.6 billion will help the very neediest of the needy in this way: 1 meal a day, which only costs us 43 cents on average to provide, for 42 million people, for one year as COVID recedes," Beasley explains. He promised an "extensive detailed plan" would follow in a matter of days.
Various critics have lashed out both at the WFP and Musk. Some pointed out that the WFP's budget last year was more than $8 billion—and that if the WFP couldn't end hunger for $8 billion, then how exactly is a few extra billion going to do the trick?
As for the Musk critics, while some reports indicated it was "unclear whether Musk was serious about his offer," others are certain Musk's offer is insincere.
MSNBC commentator Hayes Brown, for example, found Musk's mere request that Beasley detail how his WFP donation would end global hunger to be just too much. Musk's offer is a "half-assed, entirely unserious move," Brown wrote in an opinion piece, titled "Elon Musk's offer to donate Tesla stock to world hunger is bogus."
While "Beasley jumped into the [Twitter] thread hoping to engage substantively," Brown writes, Musk's response—asking for details about how the WFP would spend his $6 billion donation—"all but accused the WFP of grift and opacity." Brown doesn't explain why he thinks that. If Musk were serious, Brown complains, Musk could've simply Googled how the WFP spends its funds to learn "that the program has already been clear about where the money goes." (Would Musk's donation simply go to the same place or places?) And, according to Brown, even if Musk's offer were serious, "it would still be shallow compared to what he could be doing with his money." Brown doesn't explain what Musk could be doing with his money that Brown might deem full-assed, non-bogus, and entirely serious.
Unlike Brown, I think that if Musk is indeed skeptical of the way the U.N. spends its money, his skepticism may be properly placed. After all, even some critics inside the U.N. accuse the organization of being "sclerotic, wasteful, adrift, paternalistic and patronizing."
Elon Musk is an inventor and innovator. From the little I know about him, I find it unlikely Musk would hand over billions of dollars so that top bureaucrats at gigantic public institutions such as the WFP can simply do more of what they've been doing. Does that sound like how Tesla or SpaceX or the Boring Company operates?
"You know how to make cars; we know how to feed people," Beasley wrote to Musk in yet another tweet.
No. Edsel knew how to make cars. Ford knows how to make cars. Musk knows how to change the car—and a lot of other facets of modern life—for the better.
The WFP may, as Beasley wrote, know how to feed people. But it doesn't know how to end hunger. That's why, instead of asking Elon Musk for money, Beasley should be asking him for ideas.
*Correction: This post originally referred to David Beasley by the incorrect first name.
The post United Nations Official Suggests Elon Musk Donation Could Solve Global Hunger (Kinda) appeared first on Reason.com.
]]>A lawsuit filed last week in federal court by the Physicians Committee for Responsible Medicine (PCRM) and a trio of doctors affiliated with the group claims U.S. Department of Agriculture (USDA) policies urging Americans to double the average consumption of dairy products has everything to do with protecting and promoting dairy farmers and little or nothing to do with nutrition.
The suit, filed against the USDA, centers largely on 2020 federal dietary guidelines that recommend Americans consume three servings of dairy every day. These latest dietary guidelines, which are updated every five years, were adopted by the heads of the USDA and the Department of Health and Human Services (HHS) and were based on the work of an appointed dietary guidelines advisory committee. While the dietary guidelines don't impose any dietary requirements on individual Americans, they help determine which foods the government serves to prison inmates, members of the military, schoolchildren, and others.
The suit asks the court to order the USDA to stop promoting dairy products, stop "equating 'protein' with meat," and stop "hiding" what the plaintiffs claim are "the ill effects of consuming meat and dairy products." (What are the "ill effects" of dairy? The plaintiffs argue the USDA should not promote dairy products largely because around 1 in 4 Americans is lactose intolerant. The suit claims most Asians, African Americans, Ashkenazi Jews, Native Americans, and Latinos are lactose intolerant, which is supported by independent data.)
Though I eat meat every day and consume dairy products most days—and disagree strenuously with PCRM about the general healthfulness of those foods—I welcome the lawsuit. Indeed, I've long argued against the USDA's foolish and wasteful promotion of dairy products. Despite spending billions in subsidies, the USDA hasn't helped struggling dairy farmers to thrive. In fact, just the opposite is true. Decades of central planning have harmed America's dairy farmers. American cow-milk consumption is plummeting and the nation's dairy farmers are going out of business.
There's a word for money spent that doesn't achieve its intended goal: waste. If successful, PCRM's lawsuit could help eliminate some of that waste.
The problem isn't going away by itself. Absurd USDA dairy policies are highly unlikely to change under President Joe Biden. Current USDA secretary Tom Vilsack shamelessly promoted large dairy interests for eight years as Barack Obama's USDA secretary, then left to become head of the nation's largest dairy promoter, and now is back helming the USDA.
Though it's easy enough to blame the USDA for its practices, the real problem lies with Congress, which hands the agency billions upon billions of dollars to throw at U.S. farmers. That said, the USDA regularly goes above and beyond its congressional mandate to promote the dairy industry. (E.g., paying Domino's to develop a cheesier pizza.)
Like many Americans, I consume some quantity of dairy products almost every day. Some people, including vegans and people who are allergic to dairy products, avoid them at all costs. Neither dietary approach is right for everyone. And the choice to consume dairy products (or any other food) should be left to the individual.
That's why the USDA should neither promote nor restrict my dietary choices, your dietary choices, the dairy industry as a whole, or the dietary preferences of PCRM and its members.
The post Vegan Group Sues the U.S. Department of Agriculture for Promoting Dairy Products appeared first on Reason.com.
]]>Last week, the Center for Science in the Public Interest (CSPI) and the Consumer Federation of America (CFA) sent a letter to the Food and Drug Administration (FDA) that urges the agency to crack down on a popular hard seltzer because the labeling tells consumers something we apparently can't handle: the truth.
The hard seltzer in question, Vizzy, is produced by beer giant Molson Coors. Vizzy markets its product line, which contains added vitamin C, with labeling that touts the fact it contains… added vitamin C. But CSPI and CFA say Vizzy shouldn't be allowed to share truthful information about the addition of vitamin C with consumers because, well, alcohol is bad.
In the groups' joint letter to Susan Mayne, Director of the FDA's Center for Food Safety and Applied Nutrition, CSPI and CFA ask the FDA to "take immediate enforcement action" against Vizzy and to issue a formal policy to "prohibit nutrient content claims on alcohol[] beverages," including Vizzy and its competitors.
Notably, nowhere in their letter do CSPI and CFA claim the information Vizzy provides to consumers is false. Rather, with a flourish of Orwellian denialism, they claim the truthful information Vizzy provides consumers somehow serves to mislead those same consumers.
To bolster their argument, CSPI and CFA cite a nonbinding 2015 FDA guidance document that states the agency "do[es] not consider it appropriate to add vitamins and minerals to alcoholic beverages." Notably, the FDA also opposes similarly fortifying a host of other foods, including candy. The guidance document claims adding vitamins or minerals to such foods and beverages "would disrupt public understanding about the nutritional value of individual foods and thereby promote confusion among consumers, making it more difficult for them to construct diets that are nutritionally adequate."
The assumption that an alcohol beverage cannot and should not be at all nutritious is baked into CSPI's and CFA's position: "all alcoholic drinks provide empty calories."
"You should get your vitamins from foods first, and a multivitamin or supplement as a distant second if you really need it," said Eva Greenthal, CSPI senior science policy associate, in a statement. "Alcoholic beverages are the absolute last place where you should go looking for or expect to find vitamins. The presence of vitamin C in hard seltzer is no reason to drink more than you would otherwise and doesn't make this brand of hard seltzer less damaging to your health than any other."
I doubt very sincerely that the addition of "antioxidant Vitamin C from acerola superfruit" makes Vizzy hard seltzer any more or less healthy to drink, or any more or less healthy than other hard seltzers, including, for example, this certified-organic option. But I also fail to understand how drinking one 100-calorie can of hard seltzer that clocks in at just 5% alcohol by volume is "damaging to your health." After all, the fact many experts believe moderate alcohol consumption can have health benefits isn't exactly a secret.
What's more, as a class of alcohol beverages, hard seltzers typically contain less alcohol and fewer calories than drinks such as beer and wine. Consumers who choose hard seltzer know this and are drawn to these beverages for those reasons. Indeed, a big part of hard seltzer's appeal is consumers' growing "preference for low-alcohol beverages."
I'm one such consumer. For the past decade or so I've mixed equal parts sparkling mineral water and white wine (usually a New Zealand-made Sauvignon Blanc) when I drink at home with meals. (If you believe this is a wine spritzer, you are wrong.) The minerals, light carbonation, and lower alcohol of this mix appeal to me. I also sometimes drink canned hard seltzers for some of those same reasons. San Juan Seltzer, produced in Seattle with local fruits such as Rainier cherries and boasting just 85 calories, no sugar or carbs, and 4% alcohol, is a perfect drink for Seattle's fleeting summers.
Of course, I'm not a nutritionist, medical doctor, nor paid spokesmodel. I'm not urging you to drink alcohol. Neither am I urging you to avoid it. If you're an adult, that choice is and should be yours and yours alone.
By providing consumers with truthful information that distinguishes their products from those of their competitors, companies such as Molson Coors help consumers make more informed choices. The FDA shouldn't prohibit Vizzy, other hard seltzer makers, or any other food or beverage maker from sharing truthful information about its products with consumers. No matter what some "consumer" groups say.
The post Consumer Groups Ask FDA To Force Alcohol Makers To Hide Facts from Consumers appeared first on Reason.com.
]]>This year, not even the government is going to try to tell you not to drink. Updated U.S. dietary guidelines go about like you would expect (eat your vegetables and fruits, stop eating so much processed meat and refined grains, etc.). But the guidelines—updated every five years—are surprising in one way: they don't adopt a recommendation from experts to revise down alcohol limits for men.
The U.S. Department of Agriculture (USDA) and the Department of Human and Health Services (HHS) have the final say on the guidelines. But they take recommendations from a panel of experts—who said in a summer report that men should not drink more than one alcoholic beverage per day. That's down from saying two alcoholic beverages per day is OK for men, and on par with the drink limit recommended for women.
However, the newly released Dietary Guidelines for Americans do not include this recommended change.
Although "the preponderance of evidence supports limiting … alcoholic beverages to promote health and prevent disease, the evidence reviewed since the 2015-2020 edition does not substantiate quantitative changes at this time," it says.
The whole thing is sort of silly, as the nutrition content and health effects of alcoholic beverages are highly dependent on what type of drink is being consumed, as well as how quickly, whether it's with a meal (and what sort), and things like body size, metabolic status, and a host of other personal health factors.
But "sort of silly" is pretty much the mantra of the dietary guidelines, which have always been beholden to business and agricultural interests, nutritional fads, and a whole lot of dubious science, as well as painfully slow to change. "We have the situation where we just cannot reverse out of these policies that were originally based on really weak science," Nina Teicholz—author of The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet—told Reason in 2018.
What the 2020 dietary guideline gurus wrote about alcohol isn't terribly unreasonable, From their executive summary:
Binge drinking is consistently associated with increased risk compared to not binge drinking, and more frequent binge drinking is associated with increased risk compared to less binge drinking. Similarly, among those who drink, consuming higher average amounts of alcohol is associated with increased mortality risk compared to drinking lower average amounts. The Committee concurred with the recommendation of the 2015-2020 Dietary Guidelines for Americans that those who do not drink should not begin to drink because they believe alcohol would make them healthier. Although alcohol can be consumed at low levels with relatively low risk, for those who choose to consume alcohol, evidence points to a general rule that drinking less is better for health than drinking more.
The committee adds that "there is evidence to tighten [recommendations] for men such that recommended limits for both men and women who drink would be 1 drink per day on days when alcohol is consumed."
It also recommends that people cut added sugars (a.k.a. those that don't naturally occur in food)—another update that was rejected.
Vaccine rollout efforts are off to a worryingly slow start. "The goal of Operation Warp Speed, a private-public partnership led by Vice President Mike Pence to produce and deliver safe and effective Covid-19 vaccines to the public, is to ensure that 80 percent of the country's 330.7 million people get the shots by late June," notes CNBC. "To meet that goal, a little more than 3 million people would have to get the shots each day, the math shows." But in the past two weeks since the vaccines started going out, only about 2 million total (of the 11.5 million vaccine doses shipped so far) have been administered.
President Donald Trump issues "Executive Order on Expanding Educational Opportunity Through School Choice." But like so many of Trump's executive orders, this one is basically all smoke and mirrors. While the "headline suggests it creates a federal school choice program for students whose schools have gone all-remote," it actually "creates no program, and what it does do would require about a year of sustained bureaucracy-wrangling and lawsuit-fending-off effort by the White House and the HHS secretary before it would produce any real effect," writes . More here.
BREAKING NOW: LMPD is planning to fire Det. Joshua Jaynes - the officer who obtained the search warrant for #BreonnaTaylor's home. His lawyer confirmed to @WHAS11 a pre-termination notice. pic.twitter.com/yWCFGaoJF5
— Senait Gebregiorgis (@SenaitTV) December 29, 2020
The Senate voted 38-29 to give millions of women access to legal terminations under a new law supported by President Alberto Fernández. The margin was expected to be much smaller. Massive crowds of abortion rights activists and anti-abortion campaigners gathered outside the Palace of the Argentine National Congress to await the results, which came in the early hours of the morning after an overnight debate.
Mexico's Senate passed a bill in late November legalizing recreational marijuana. Lawmakers in the lower house say they will approve a bill by February, though they want to raise the amount of pot consumers may possess in public beyond the Senate bill's limit of 28 grams, or about an ounce. Currently in Mexico, one can possess up to five grams of marijuana without being arrested.
The post The Government Isn't About To Tell You To Stop Drinking Now appeared first on Reason.com.
]]>Critics are lining up to blast a report, issued by a federal committee earlier this summer, that urges the government to make steep cuts to the definition of moderate alcohol consumption. These critics are concerned because the group—the Dietary Guidelines Advisory Committee (DGAC), a rotating crop of experts that meets every five years—is the government's primary vehicle for recommending updates to the nation's dietary policies.
The DGAC, which was established in 1990, "provide[s] the basis for federal food and nutrition policy and education initiatives." Those policies include everything from recommending how many servings of vegetables people should consume in a day to determining what foods to serve to troops, schoolchildren, and prisoners. Now that the DGAC has issued its final report, key federal agencies will review and consider its recommendations, along with public comments, before adopting formal guidelines. Alcohol is one area where the DGAC recommendations are stirring the most controversy.
The report argues in favor of "reducing consumption among those who drink… in ways that increase the risk of harms." That sounds eminently reasonable, until you learn the DGAC decided, despite ample evidence to the contrary, that drinking "in ways that increase the risk of harms" means enjoying a second Bud Light.
Indeed, the report seeks to halve the DGAC's longstanding definition of moderate drinking for men—no more than two drinks per day—to no more than one drink per day. (The recommendation for women, set for years at no more than one drink per day, remains unchanged.)
The proposed change to the alcohol-consumption recommendation is angering everyone from bourbon aficionados to the beer lobbies and wine connoisseurs, who—and this is probably an understatement—are "not happy with the report." But top medical doctors and public health experts, along with lawmakers, are also raising objections.
Last month, five Harvard Medical School faculty doctors—including three who served on one or more prior iterations of the DGAC—submitted comments that are highly critical of the 2020 DGAC report. They argue the push to slash the maximum daily alcohol consumption for men is a "limited, arbitrary, and unsystematic treatment of alcohol consumption" that is based on "limited, arbitrary, and unsystematic evidence."
While rightly noting the dangers of binge drinking and consistent heavy alcohol consumption in their comments, the Harvard doctors note the DGAC appears to have "ignored" three decades of research, drinking patterns, and "relevant recent evidence." They also argue the recommendations demonstrate "scientific inconsistency" and an "arbitrary" and biased selection of research. "These arbitrary selections all appear intended to support claims made by members of the DGAC prior to appointment, rather than as systematic and transparent reviews of existing scientific evidence." In other words, the researchers claim anti-alcohol DGAC members focused only on research that supports arguments those members wanted to make all along.
Wesley Clark, a lawyer, professor, and medical doctor who is also the former director of the U.S. government's Center for Substance Abuse Treatment, argued in comments he submitted that the DGAC's "over-reaching" changes to the alcohol recommendations appear to result from "biased analysis" and might be "a sleight-of-hand vehicle for Prohibition."
Other leading experts are also alarmed.
"There were very serious violations of scientific protocol regarding this proposal that need careful review," said Sam Zakhari, Ph.D., chief scientific advisor with the Distilled Spirits Council and a former senior staffer with the National Institute on Alcohol Abuse & Alcoholism, in a statement emailed to me this week. "The committee acknowledged only one study examined differences in risk amongst men consuming two drinks per day as compared to one drink per day, which does not represent the preponderance of the evidence. Further, the committee members cited numerous studies that were outside of the 60 approved studies for review. It doesn't take a scientist to see that the process was seriously flawed and that this proposal appears to be based on preconceived opinions, not science."
Many lawmakers in Washington aren't happy with the recommendations, either. A joint, bipartisan group of more than two-dozen members of Congress submitted comments opposing the DGAC's dry-ish recommendations. Their comments single out a "lack of scientific evidence to justify any change in current moderate drinking recommendations."
This DGAC controversy does not surprise me. Indeed, it's no stretch at all to argue that the DGAC is best known—in recent years, at least—for its controversial recommendations. In 2015, I blasted the DGAC report for proposing new food taxes, pushing for restrictions on food marketing, and suggesting local food bans. In a separate column that same year, I spoke with a university researcher whose analyses, published in the esteemed, peer-reviewed Mayo Clinic Proceedings, suggests, as I explained, "that the DGAC's work—and the research used to support that work—is so off base as to be scientifically useless." I also detail major shortcomings with the 2015 DGAC's recommendations around sustainability in my book, Biting the Hands that Feed Us.
The 2020 report isn't all bad. For example, unlike in the 2015 report, I didn't find any mentions of food taxes or bans in the 2020 report.
Thankfully, the DGAC report contains recommendations, meaning key federal agencies ultimately choose together whether or not to adopt those recommendations. On alcohol at least, the weight of the evidence suggests the federal government should reject the DGAC's deeply flawed recommendations.
The post 'Limited, Arbitrary, and Unsystematic:' Flawed Federal Dietary Report Targets Alcohol appeared first on Reason.com.
]]>Nutrition researchers and doctors are at each other's throats once again, this time over a recommendation published in the Annals of Internal Medicine that "adults continue to eat their current levels of red and processed meat unless they felt inclined to change them themselves."
This advice runs contrary to the consensus formed by most American medical organizations and the U.S. government, which says the optimal diet is one low in all kinds of meat and processed foods and higher in most kinds of vegetables, fruits, and grains.
It's yet another example of the ways that years of bad government diet recommendations, media myths, and disagreement between competing factions in the world of diet and nutrition science have combined to make for an incredibly confusing environment for people who want to eat better, tastier, healthier diets.
The panel of experts that made the red meat recommendation labeled its conclusions as a "weak recommendation" with "low-certainty evidence." You can read the entire package from the American College of Physicians, which publishes the Annals, or just this summary: "We found low- to very low-certainty evidence that diets lower in unprocessed red meat may have little or no effect on the risk for major cardiometabolic outcomes and cancer mortality and incidence."
This conclusion has sparked a fight between two groups that might best be described as "meat agnostics," who believe that moderate meat consumption is not as risky as recently claimed, and "less meaters," who argue that meat consumption does not occur in a vacuum, and—in the industrialized context—is generally bad. If you buy raw animal proteins, cook them yourself, and eat them with mostly greens, rainbow vegetables, and legumes, you probably agree with the new recommendation. If you eat most of your meat out of a can, wrapper, or bucket, you are why people are mad at the new recommendation.
My own takeaway, as someone who overhauled his diet and successfully lost a lot of weight and brought his blood pressure down to optimal levels, is that this fight does a disservice to people who want to be healthy, or healthier, and feel confused by the daily onslaught of conflicting nutrition research.
If you are in the latter camp, allow me to share with you my own recommendations for meat, plants, and all things food.
Most diet advocates are uncompromising zealots. The best diet is the one that works for you.
I have a good friend who lost 100 pounds eating vegan. I lost 90 pounds eating pork chops for breakfast and meat at every meal, lots of vegetables, but almost no grains, pasta, rice, or fruit. Both of us have sustained our weight loss for many years by continuing to eat our respective diets, and both of us have optimal blood pressure, blood glucose levels, and cholesterol panels. Whose advice should you follow?
The better question is, whose advice do you want to follow? Liking the idea of a diet is a good indicator that you'll at least be able to start it. The next best question is, are you getting the results you wanted, whether it be improved biomarkers, better body composition, or weight loss? The third question is, can you eat this way 90 percent of the time for a long time?
These are the questions that should inform your quest for the optimal diet. People succeed in improving their physical and mental health, testable biomarkers, and body composition using all kinds of different nutrition plans. I prefer something close to the keto diet, which can be adapted for omnivores, vegetarians, and vegans, but if you dig into the research conducted by the National Weight Control Registry, which surveys Americans who have lost weight and sustained that weight loss, you'll find the keys to success are exercise, intentional and disciplined food choices, and keeping a close eye on their weight. In other words, what food types you eat matters less than how much you eat, how much you exercise, and how disciplined you are about eating and exercising.
Processed foods are not inherently bad, but they do present a tradeoff.
The rise of "processed" food that tastes good is both a massive human accomplishment and a double-edged sword. Processed foods, which are basically any food item that has been rendered nonperishable or includes multiple ingredients at the time of purchase, have made life easier by speeding up and simplifying food preparation. "Fortified" processed foods, meanwhile, have made it possible for the poorest people in the developed world to both consume adequate calories each day and get many of the micronutrients previously found only in a balanced diet of perishable meats, fruits, and vegetables.
However, the proliferation of affordable, nonperishable food has played a major role in the rise of obesity and obesity-related diseases; more so, probably, than any other labor-saving technological development of the last century.
This does not mean processed food is bad, or that it should be banned or taxed out of reach, only that consuming processed foods is a tradeoff. These foods often taste fantastic, yet excessive consumption of processed foods can easily erase whatever benefits they provide through micronutrient fortification and time saved.
Expert consensus is hard to come by and overrated.
That the panelists published by the Annals are now under attack by their peers in medicine is just the latest example of the war over nutrition advice. Many academic nutrition researchers believe their work can save entire populations and are frustrated that they have to compete in a marketplace of ideas that does not elevate their findings over those of their peers, the advice of lay diet experts, and the marketing done by food companies. That the federal government has done such a hamfisted job of recommending the "right" advice and is slow to correct recommendations when consensus changes, is all the more infuriating.
What's more, popular media reporting on nutrition is often sloppy, sensationalized, and self-contradicting. Just look at the way the Annals recommendation was covered by The Washington Post: The researchers used the terms "weak recommendation" and "low-certainty" while the Post headlined its piece: "A study says full speed ahead on processed and red meat consumption. Nutrition scientists say not so fast." The study did not say "full speed ahead" and its critics did not say "not so fast." Debates in nutrition science are covered this way every single day in America's most respected media outlets.
The noise around nutrition science should not distract us from the fact that Type 2 diabetes, cardiovascular disease, and other ailments with a lifestyle correlation are, in fact, a major health care expenditure in the U.S. and around the world; and that many humans in the industrialized world who should eat better both can afford to and would likely succeed with the right combination of external motivation and education.
This is why nutrition researchers are constantly at each other's throats. Each faction wants to have the final say, and for their peers and government to rally behind them. But it is futile to expect a single global nutrition paradigm to exist across varying economies, climates, and cultures, especially in the age of democratized media.
You're going to die regardless of what or how much you eat, but, on average, junk habits will kill you faster and decrease your quality of life.
While there is no actual consensus on the optimal ratio of the three macronutrients (fat, carbohydrates, proteins), or on how much (if any) animal protein a person should consume each day, there is an actual, honest-to-God consensus against smoking cigarettes, drinking excessive alcohol, not sleeping enough, and consuming a diet made up mostly of processed foods. If you are the kind of person who desires certainty, nutritionists of every persuasion are certain about the above, if nothing else.
And if you are the kind of person who feels liberated by the possibility that any number of nutritional paradigms can restore your health and improve your quality of life, there is no better time to be alive than today and no better marketplace of ideas than the one we have now.
The post The Latest Fight Over Eating Meat Ignores These 4 Essential Nutrition Truths appeared first on Reason.com.
]]>"I have never seen a thin person drinking Diet Coke," tweeted Donald Trump, himself a frequent consumer of diet soda, back in 2012. Besides being an amusing self-own, Trump's comment helps explain the trouble with most research on diet drinks—including a new study that's been making the media rounds this week.
"It doesn't matter if it's sugary or diet: New study links all soda to an early death," reported The Washington Post on September 4. It was one of many similar headlines. The implication of all of them was clear: Zero-calorie cola is a big fat lie, and if you don't ditch it now you're staring down a premature grave.
But let's back up. Here's what the paper in JAMA Internal Medicine actually found about drinks containing artificial sweeteners: People who consumed two or more per day were slightly more likely than those who abstained from all soda to die from diseases related to circulatory problems. (Consuming one or more sugar-sweetened soda per day, meanwhile, was associated with increase risk of dying from liver, appendix, pancreas, and intestinal diseases.) Whether these circulatory problems are directly related to diet soda is unknown—and there are good reasons to suspect they are not.
"Researchers cautioned that elevated soft-drink consumption may be a marker for an overall unhealthy lifestyle," the Post points out. That is, people who consume sodas daily may also be more likely to eat out at restaurants, consume processed snacks, or engage in other dietary habits that up their disease risk.
Alternately, people who don't drink soda at all may be more likely to engage in some behaviors—drinking more water, say, or consuming other nutritious beverages—that accrue them disease-protective benefits.
And while all sorts of people drink diet soda, it tends to be especially popular among people actively trying to lose weight and/or to give up a non-diet soda habit. Which is to say that diet drink consumers could (as that Trump tweet suggests) be heavier to begin with, or could share some other quality (such as previously high consumption of sugary drinks) that sets them up for future health problems.
The scientist behind this study tried to account for some confounding factors, such as smoking and obesity. But accounting for all lifestyle differences is impossible. Here's what the lead researcher, Neil Murphy, told the Post:
We recognize that a possible explanation for the positive associations found for artificially sweetened soft drinks is that participants who were already at greater health risk (those who were overweight or obese; those with prediabetes) may have switched to artificially sweetened soft drinks to manage their calorie and sugar intake.
Even the notoriously pro-nanny-state Center for Science in the Public Interest urged caution about the latest research. "This new European study is somewhat inconsistent with earlier findings," the group's director of nutrition told the Post.
That's true: Several meta-analyses last year found no association between drinking diet soda and weight gain or increased body mass index. Those studies also found no association between aspartame (the most common artificial sweetener) and negative effects on heart-disease risk factors, fat levels, or metabolic issues.
Brothel lawyer fights for sex worker rights. "You can say, 'No sex without a condom.' You can say, 'No sex until we're married.' But you can't say, 'No sex until you pay me'? And that feels like it really undermines what consent means," Katherine Sears told the Des Moines TV station KCCI.
"Sears is so passionate about the decriminalization of prostitution, she is willing to take prostitution cases on pro bono," reports KCCI in its profile of the lawyer, mother, and part-time Nevada brothel worker.
"Their bodies belong to them," Sears told the station, "and we have absolutely no reason to be telling them that you cannot condition your consent this way."
Medicare for All—or something else? That's become a major question for 2020 presidential candidates. "Given the persistent political and policy challenges to passing and implementing a single-payer system along the lines envisioned by Sen. Bernie Sanders (I–Vt.) and other Medicare-for-All boosters," writes Peter Suderman, "the answer is probably going to be 'something else.'" So what does "something else" mean?
The most likely answer is a "public plan" or "public option"—that is, a government-run health insurance plan that would exist alongside today's insurance options, supplementing employer coverage, Obamacare, Medicare, and Medicaid without fully displacing them. Indeed, should Democrats win both Congress and the White House, the proposal of a public option is, at this point, far more likely than a big push for Sanders-style Medicare for All….
A public option would probably be less radical, less disruptive, and, on paper, less expensive for the government than Sanders' Medicare for All proposal. Yet it would still pose real challenges in terms of cost and political viability.
That hurricane map doctored by thick black Sharpie? The scribbler was Trump himself, @ToluseO + @jdawsey1 report. https://t.co/n1yXQ2xsTt pic.twitter.com/qwBDWNTVKQ
— Ashley Parker (@AshleyRParker) September 6, 2019
"It first started out as just taking nude pictures. And then it became to where it was sexual." She was 15 and the person taking photos was a sheriff's deputy/dispatcher. https://t.co/2aJdAyVU90 @Enquirer @tdemio @jamespilcher @rjstrickleyjr pic.twitter.com/UNlppxXxtq
— Liz Dufour (@ldufour) September 5, 2019
At the same time, a long-term perspective reveals that while drug-related deaths have been rising since the late 1950s, the current increase in suicide and alcohol-related deaths began only around 2000, as the opioid crisis ramped up. Suicide and alcohol-related mortality trends track each other well over the past 45 years, and after accounting for the changing age distribution of the US, combined deaths from the two causes were as common in the mid-1970s as today.
An immensely satisfying take on the Ahmari-French debate by @EggerDC. https://t.co/hRoczx40nI
— Christian Vanderbrouk (@UrbanAchievr) September 6, 2019
The post The Press Fans Overblown Fears About Diet Soda—Again appeared first on Reason.com.
]]>Want to make money giving out diet tips? In Florida, you'll have to get a bachelor's degree and a state license to tell people how to eat better. A federal judge has upheld the Sunshine State's occupational licensing program that censors diet coaching by those who are not officially deemed dieticians.
The case, brought by the liberty-loving and oppressive-occupational-license-fighting lawyers of the Institute for Justice, revolved around the work of Heather Kokesch Del Castillo of Fort Walton Beach. Del Castillo was applying her training from an unaccredited online holistic health program, offering six-month coaching programs to clients for pay. But she is not a licensed dietician in Florida, and when the state found out about her work, they accused Del Castillo of practicing dietetics without a license and threatened her with hundreds of dollars in fines if she didn't stop.
With the help of the Institute for Justice, Del Castillo fought back, arguing in court that this licensing demand violated her First Amendment rights to free speech. Unfortunately for her, Judge M. Casey Rogers of the U.S. District Court for the Northern District of Florida disagreed and tossed her case. Rogers concluded that current court precedents have determined that it's not an unconstitutional abridgment of free speech rights to require an occupational license to earn a living talking about certain issues, "so long as any inhibition of that right is merely the incidental effect of observing an otherwise legitimate regulation."
Rogers turned to a court ruling from Locke v. Shore, another case from Florida from 2011 in which a federal court ruled that it's legal for the state to require that interior designers get licensed to legally practice their craft.
Lawyers from the Institute for Justice argued that subsequent court rulings have weakened Locke, particularly a Supreme Court ruling from 2018, NIFLA v. Becerra, that addressed whether California could require pregnancy centers to carry notices indicating whether or not they were licensed and, if they were licensed, requiring the centers to post notices informing women of the availability of free or low-cost services, including abortions. The Supreme Court ruled that these speech demands were unconstitutional. In the writing of the majority opinion, Justice Clarence Thomas noted, "Speech is not unprotected merely because it is uttered by 'professionals.' This Court has 'been reluctant to mark off new categories of speech for diminished constitutional protection.'"
Rodgers didn't find that argument applicable here. Florida wasn't telling Del Castillo what she could or could not say or what she must or must not say. She could give all sorts of nutrition advice out for free. But in order to earn a living giving advice, she needed to get a license, and Florida made the case that there are valid public health reasons for having such a law. Rodgers wrote, "Notably, it is, at the very least, reasonably conceivable that the unlicensed practice of dietetics could lead to improper dietary advice from unqualified individuals, which in turn could harm the public."
The combination of rulings creates a bit of an odd outcome. Florida can require that Del Castillo get the appropriate degree and pay the appropriate licensing fees in order to legally give out nutritional advice, but it's not clear that they could tell her what kind of nutritional advice she could give. There might be no difference between the advice she gives now and the advice she might give with a degree and an occupational license. A diploma and a license won't actually prevent Del Castillo from giving out "improper dietary advice." Heaven knows the government itself often gets nutritional advice completely wrong.
Lawyers from the Institute for Justice expressed dismay at yesterday's ruling and promised to appeal.
"The court held that talking with a person about their diet isn't speech, it's the 'conduct' of practicing dietetics," said I.J. Attorney Ari Bargil. "The Supreme Court has squarely rejected that sort of labeling game. Giving advice on what an adult should buy at the grocery store is speech, and the First Amendment protects it."
Read the full ruling here. Read more about efforts to try to censor "unlicensed" public health and nutrition advice here.
The post Judge Rules Florida Can Require a License To Give Out Diet Tips appeared first on Reason.com.
]]>There is little or no rigorous evidence that vegetarian/vegan diets are healthier than diets that include meat, eggs, and dairy.
That was the topic of a public debated hosted by the Soho Forum in New York City on May 13, 2019. It featured Nina Teicholz, author of The Big Fat Surprise, and David Katz, the founding director of Yale University's Yale-Griffin Prevention Research Center. Soho Forum director Gene Epstein moderated.
It was an Oxford-style debate, in which the audience votes on the resolution at the beginning and end of the event, and the side that gains the most ground is victorious. Katz prevailed in the debate by convincing 13 percent of audience members to change their minds.
Arguing for the affirmative was Nina Teicholz, whose 2014 book, The Big Fat Surprise, challenged the conventional wisdom on dietary fat. Teicholz's writing has also been published in The BMJ, The New York Times, The Wall Street Journal, The Atlantic, The Independent, The New Yorker, and The Los Angeles Times among others. Teicholz is the Executive Director of The Nutrition Coalition, a non-profit group that promotes evidence-based nutrition policy.
Reason's Alexis Garcia interviewed Teicholz in 2018.
David L. Katz, MD argued for the negative. He's the founding director of the Yale-Griffin Prevention Research Center, which practices community and alternative medicine, and is founder/president of the True Health Initiative, a non-profit organization established to promote a healthy diet and lifestyle. The holder of five U.S. patents, Katz has authored roughly 200 peer-reviewed publications and 16 books to date, including textbooks in both nutrition and preventive medicine.
The Soho Forum, which is sponsored by the Reason Foundation, is a monthly debate series at the SubCulture Theater in Manhattan's East Village.
Music: "Modum" by Kai Engle is licensed under a CC-BY creative commons license.
Produced by Todd Krainin.
Subscribe to our podcast at iTunes.
The post Vegetarians vs. Omnivores: A Soho Forum Debate appeared first on Reason.com.
]]>There is little or no rigorous evidence that vegetarian/vegan diets are healthier than diets that include meat, eggs, and dairy.
That was the topic of a public debated hosted by the Soho Forum in New York City on May 13, 2019. It featured Nina Teicholz, author of The Big Fat Surprise, and David Katz, the founding director of Yale University's Yale-Griffin Prevention Research Center. Soho Forum director Gene Epstein moderated.
It was an Oxford-style debate, in which the audience votes on the resolution at the beginning and end of the event, and the side that gains the most ground is victorious. Katz prevailed in the debate by convincing 13 percent of audience members to change their minds.
Arguing for the affirmative was Nina Teicholz, whose 2014 book, The Big Fat Surprise, challenged the conventional wisdom on dietary fat. Teicholz's writing has also been published in The BMJ, The New York Times, The Wall Street Journal, The Atlantic, The Independent, The New Yorker, and The Los Angeles Times among others. Teicholz is the Executive Director of The Nutrition Coalition, a non-profit group that promotes evidence-based nutrition policy.
Reason's Alexis Garcia interviewed Teicholz in 2018.
David L. Katz, MD argued for the negative. He's the founding director of the Yale-Griffin Prevention Research Center, which practices community and alternative medicine, and is founder/president of the True Health Initiative, a non-profit organization established to promote a healthy diet and lifestyle. The holder of five U.S. patents, Katz has authored roughly 200 peer-reviewed publications and 16 books to date, including textbooks in both nutrition and preventive medicine.
The Soho Forum, which is sponsored by the Reason Foundation, is a monthly debate series at the SubCulture Theater in Manhattan's East Village.
Music: "Modum" by Kai Engle is licensed under a CC-BY creative commons license.
Produced by Todd Krainin.
Subscribe to our YouTube channel.
Subscribe to our podcast at iTunes.
The post Are Vegetarians Healthier than Omnivores? A Soho Forum Debate appeared first on Reason.com.
]]>For all the the talk of arbitrary, capricious, or ideologically motivated deplatforming of people, publications, and groups by Facebook, Twitter, YouTube, and other social media platforms, there's been less discussion about high-profile individuals and companies deleting their accounts in response to what they see as unfair, unethical, or misguided behavior.
That might change now that CrossFit, the immensely popular exercise and nutrition enterprise, has announced that it is permanently pulling its Facebook and Instagram accounts. According to an official statement published yesterday:
Facebook deleted without warning or explanation the Banting7DayMealPlan user group. The group has 1.65 million users who post testimonials and other information regarding the efficacy of a low-carbohydrate, high-fat diet. While the site has subsequently been reinstated (also without warning or explanation), Facebook's action should give any serious person reason to pause, especially those of us engaged in activities contrary to prevailing opinion….
Facebook…serves as a de facto authority over the public square, arbitrating a worldwide exchange of information as well as overseeing the security of the individuals and communities who entrust their ideas, work, and private data to this platform. This mandates a certain responsibility and assurance of good faith, transparency, and due process.
CrossFit, Inc., as a voluntary user of and contributor to this marketplace, can and must remove itself from this particular manifestation of the public square when it becomes clear that such responsibilities are betrayed or reneged upon to the detriment of our community.
The statement lists eight additional complaints about Facebook (which owns Instagram), These include the platform's willingness to censor certain accounts or pages at the insistence of governments, its "weak intellectual property protections," and its alleged willingness to act "in the service of food and beverage industry interests" by removing "accounts of communities that have identified the corrupted nutritional science responsible for unchecked global chronic disease." Despite CrossFit's strong condemnation—at one point, the statement declares that by purging dissenting views about low-carb, high-protein diets, "Facebook is complicit in the global chronic disease crisis"—the company does hold open the possibility of returning if Facebook and Instagram restore "good faith, transparency, and due process."
This is one way that marketplaces—whether for goods and services or for ideas—are supposed to work. In the parlance of political economist Albert O. Hirschman, CrossFit is not simply exercising its right of "exit" by leaving Facebook but also its right of "voice" by complaining publicly.
In the best of all worlds, such actions wouldn't be necessary. Instead of taking it upon themselves to police more than true threats and instead of calling for government regulation of expression, Facebook and other social media services would treat their platforms as free-speech zones and focus instead on providing users with tools to personalize their experiences.
But that isn't the world we live in, so CrossFit's public excoriation of Facebook serves an important corrective function. If more high-profile individuals, companies, content creators, and accounts take similar action, it'll be a more libertarian outcome than the government regulation increasingly supported by both liberals and conservatives.
Bonus video: Six years ago, Reason interviewed CrossFit founder Greg Glassman, who talked about being "a rabid libertarian" and a contrarian when it comes to workouts, diets, and more:
The post Crossfit Deletes Facebook and Instagram After User Group Is Deplatformed appeared first on Reason.com.
]]>Suit takes aim at new school lunch standards. A recent rule change regarding school lunches was greeted with relief by some school districts, who had found that federal mandates from the Obama administration led to food waste, less lunches sold, and more kids buying meals from vending machines. Additionally, schools were still allowed to serve sugary flavored milk, but for some reason it had to be the less nutritious nonfat version.
The changes approved by the Trump administration are relatively minor—more time to comply with reduced sodium levels, no need for flavored milk to be nonfat, and lower whole-grain requirements for some foods—but they address some of the chief criticisms from public schools across the country.
Some state attorneys general don't like that. They're now suing in federal court to make the Obama-era lunch standards permanent.
The suit argues that the recent changes are illegal because Agriculture Department officials didn't provide scientific justification. This is pretty hilarious, considering the sloppy science that the Obama administration relied on when instituting its "Smarter Lunchrooms" program. Many papers from the lead architect of the initiative have since been retracted, after fellow researchers found inconsistencies, errors, and evidence of fraudulent data.
The lawsuit was filed by attorneys general in California, D.C., Illinois, Minnesota, New Mexico, New York, and Vermont. The eternal whackjobs at the PETA-esque Center for Science in the Public Interest have filed a separate lawsuit also challenging the changes.
Warren wants to lower burden of proof for white-collar crime. Some people are defending Sen. Elizabeth Warren's "bad bill to jail executives for negligence" using "the argument that we should trust prosecutors to show restraint," tweets Radley Balko. But this "flies in the face the history of prosecutors."
Read more on why from criminal law professor Carissa Byrne Hessick in this thread.
My concern with the bill is the proposal that we impose criminal punishment on executives who are negligent in running their companies. Negligence is an incredibly low standard for criminal punishment. There are very few crimes that impose punishment on this basis. 3/x pic.twitter.com/GUOiGrrHIj
— Carissa Byrne Hessick (@CBHessick) April 3, 2019
Pete Buttigieg says no to "free college." Behold, the rare Democratic presidential candidate capable of resisting a trendy talking point:
BUTTIGIEG on free college: Americans who have a college degree earn more than Americans who don't. As a progressive, I have a hard time getting my head around the idea a majority who earn less because they didn't go to college subsidize a minority who earn more because they did
— Stephanie Murray (@StephMurr_Jour) April 3, 2019
A Texas prisoner was allergic to his blanket, and it made him break out into sores. He asked for a new blanket. For 10 YEARS, officials refused. So he sued. The prison system fought it for a year instead of just giving him a new blanket. https://t.co/m8AgodbvYH
— Keri Blakinger (@keribla) April 4, 2019
Thus endeth the supposedly HUGE Martin County TRAFFICKING BUST. Two middle aged women, managing a business where women who had agency worked, charged with "deriving support from the proceeds of prostitution". Not pimping, not trafficking. #sexwork https://t.co/DvGNjsaUvU
— Mistress Matisse (@mistressmatisse) April 3, 2019
The post States Sue Over School Lunch Changes, Say They're Not Scientific Like the Obama Rules Based on Retracted Nutrition Studies appeared first on Reason.com.
]]>You've probably heard about how it's critical to eat breakfast—that it may have health benefits, and even help you lose weight.
John Stossel looks at the evidence with nutritionist Ruth Kava, and finds that there's no proof of any of those things.
For example, people push breakfast because, as one cereal maker's ad puts it, "a study from none other than Harvard University states that men who regularly skip breakfast have a 27% higher risk of suffering a heart attack."
That's true—but that's largely because the type of people who skip breakfast are also the type of people who are more likely to smoke, drink alcohol, and eat unhealthy foods. After adjusting for those things, breakfast itself has no significant effect.
As this study notes, "it remains unknown whether specific eating habits … influence coronary heart disease."
Another myth is that eating breakfast helps people lose weight. The US Health and Agriculture Departments claimed in 2010 that "consuming breakfast has been associated with weight loss." Wonderful! But no, a recent review of studies found that, if anything, the opposite is true. The government backed away from its claim.
One possible reason for the myth is industry funding of scientific studies.
"Of the 15 studies involving children mentioned by the government, five list funding from General Mills or Kellogg," Stossel says to Kava.
She replies: "Yeah, well, they're the ones that are interested in having their products sold."
Industry funding doesn't always mean bias. Dr. Andrew Brown, a health professor at Indiana University, told Stossel about a study that found that eating breakfast does not help lose weight.
"The study was supported by Quaker Oats, and presented as abstracts by the authors, but not published as a paper for years," Brown said. "Quaker Oats actually followed up with the authors to make sure the authors published the study that conflicted with their interests."
Kava says: "Good for Quaker Oats."
Bottom line, says Stossel, don't worry about skipping breakfast.
Instead, Kava says, just eat when it feels right to you, adding, "Eat breakfast if you're hungry."
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The views expressed in this video are solely those of John Stossel; his independent production company, Stossel Productions; and the people he interviews. The claims and opinions set forth in the video and accompanying text are not necessarily those of Reason.
The post Stossel: The Breakfast Myth appeared first on Reason.com.
]]>The activist group Physicians Committee for Responsible Medicine is running an anti-bacon campaign in the District of Columbia. The campaign includes advertisements on TV and at bus stops throughout the city under the slogan #BreakUpWithBacon.
Neal Barnard, founder of the Physicians Committee group, said the leading cause of cancer deaths for men and women in the United States is lung cancer, largely attributable to tobacco, and the second leading cause is colorectal cancer, reports The Washington Post. "The message is, 'Bacon is the new tobacco,'" Barnard said. In support of this assertion, Barnard cites data from the International Agency for Research on Cancer that finds that eating 50 grams of processed meat daily, equivalent to about 4 strips of bacon, correlates with an 18 pecent increase in the risk of getting colorectal cancer.
Should you quit bacon? First, eating 50 grams daily amounts to a bit over 40 pounds of bacon annually. Keep in mind that only about 18 million Americans consumed more than 5 pounds of bacon annually in 2018.
Second, the lifetime risk of developing colorectal cancer in the U.S. is about 4.49 percent for men and 4.15 percent for women. Roughly calculated, an 18 percent increase means that the risk would rise to 5.3 percent for men and to 4.9 percent for women. In contrast, the lifetime risk of lung cancer among current male and female smokers is 17.2 and 11.6 percent, respectively, compared to the corresponding risks of male and female non-smokers at 1.3 and 1.4 percent. In other words, smoking boosts lung cancer risk by more than 1,000 percent compared to eating bacon, which increases the risk by 18 percent.
The far more effective way for a person to reduce the risk of getting and dying from colon cancer is to receive regular colonoscopies. For example, a recent study reports that colonoscopies help reduce the incidence of colorectal cancer by 89 percent.
I don't doubt the sincerity of the folks associated with the Physicians Committee for Responsible Medicine, but comparing the cancer risks of bacon consumption to those of smoking basically amounts to scaremongering.
Disclosure: A precancerous polyp was removed during my first colonoscopy in my early 50s. Two subsequent colonoscopies have found no additional polyps. I intend to continue eating the occasional strip of bacon and to submitting to colonoscopies every five years or so.
The post Go Ahead and Ignore Those #BreakUpWithBacon Ads appeared first on Reason.com.
]]>A comprehensive new study on cholesterol, based on results from more than a million patients, could help upend decades of government advice about diet, nutrition, health, prevention, and medication. Just don't hold your breath.
The study, published in the Expert Review of Clinical Pharmacology, centers on statins, a class of drugs used to lower levels of LDL-C, the so-called "bad" cholesterol, in the human body. According to the study, statins are pointless for most people.
"No evidence exists to prove that having high levels of bad cholesterol causes heart disease, leading physicians have claimed" in the study, reports the Daily Mail. The Express likewise says the new study finds "no evidence that high levels of 'bad' cholesterol cause heart disease."
The study also reports that "heart attack patients were shown to have lower than normal cholesterol levels of LDL-C" and that older people with higher levels of bad cholesterol tend to live longer than those with lower levels.
This is probably news to many in government. But it's not news to everyone.
"In fact researchers have known for decades from nutrition studies that LDL-C is not strongly correlated with cardiac risk," says Nina Teicholz, an investigative journalist and author of The New York Times bestseller The Big Fat Surprise (along with a great recent Wall St. Journal op-ed highlighting ongoing flaws in federal dietary advice). In an email to me this week, she pointed out that "physicians continue focusing on LDL-C in part because they have drugs to lower it. Doctors are driven by incentives to prescribe pills for nutrition-related diseases rather than better nutrition—a far healthier and more natural approach."
Cholesterol in our diets comes from animals and animal products—including eggs, meat, fish, and dairy. The government told us for decades that these foods were, to varying degrees, dangerous.
Federal dietary policy is shaped by the Dietary Guidelines Advisory Committee (DGAC), which meets every five years to update its findings. The government touts the DGAC and the dietary guidelines it develops as "an important resource to help our Nation reach its highest standard of health."
The federal government's war on cholesterol, as early DGAC recommendations suggest, dates back decades. For example, the 1995 DGAC report stressed the dangers of dietary cholesterol.
"Most people are aware that high levels of saturated fat and cholesterol in the diet are linked to increased blood cholesterol levels and a greater risk for heart disease," it declares. "Choosing foods with less cholesterol and saturated fat will help lower your blood cholesterol levels."
Only in 2015 did federal dietary guidelines (mostly) halt the assault on cholesterol. Many hailed the news, while still stressing that high cholesterol levels in our bloodstreams is still a danger.
"There's a growing consensus among nutrition scientists that cholesterol in food has little effect on the amount of cholesterol in the bloodstream," a Harvard Medical School blog post noted that same year. "And that's the cholesterol that matters."
"The government's new stance on dietary cholesterol is in line with that of other nations, which do not single out cholesterol as an issue," the Washington Post reported following the release of the most recent dietary guidelines in 2016. "Yet it should not be confused with officials' continued warning about high levels of 'bad' cholesterol in the blood—something that has been clearly linked to heart disease."
But this most recent study is throwing cold water on many of those continued government warnings about blood cholesterol.
What's more, if bad cholesterol isn't so bad, then the benefits of so-called good cholesterol are also under assault. Recently, *HDL, the so-called "good" cholesterol, was itself deemed suspect in some cases.
Dietary fat also appears not to be the danger the government says it is. Another new study, reported on by Ron Bailey this week, suggests, as he writes, that the federal government's warnings to avoid dairy products that are high in fat "is bunk."
I'm not a nutritionist. I don't know if the science on cholesterol is settled. But the federal government has warned us for decades about cholesterol in our bodies and in our food. The fact those warnings are now changing means the government has, despite what I'm sure are the good intentions of everyone involved, been handing out poor dietary advice and developing regulations that reflect that poor advice.
I'm one of many who has called out the DGAC and the federal government for foisting "decades of confusing and often-contradictory dietary advice" upon the American public. I also suggested, in a column last year, that one way the government might back up its claims to possess invaluable and unparalleled expertise in the areas of food policy and nutrition would be stop regularly reversing or altering its recommendations.
"The reason that we don't know about these huge reversals in dietary advice is that the nutrition establishment is apparently loathe to make public their major reversals in policy," Teicholz says. "The low-fat diet is another example: neither the AHA or the dietary guidelines recommend a low-fat diet anymore. But they have yet to announce this to the American public. And some in the establishment are still fighting to retain the low-fat status quo."
I am not your doctor, nor your nutritionist. I have no idea what you should eat. Maybe the government should adopt that mantra, too.
*Correction: This sentence initially referred to LDL as the "good" cholesterol. LDL is widely considered to be an unhealthy cholesterol, while HDL is conventionally considered good.
The post New Research Confirms We Got Cholesterol All Wrong appeared first on Reason.com.
]]>Six nutrition papers retracted from JAMA Network. The prestigious Journal of the American Medical Association (JAMA) Network announced Wednesday that it has retracted six papers that included Cornell University food scientist Brian Wansink as an author.
Wansink made a name for himself over the past decade pushing research on small environmental changes that could majorly effect people's eating habits. His research was widely disseminated in major media and incorporated into government programs—most prominently, a program to encourage healthier eating in school cafeterias called the Smarter Lunchrooms program.
The Smarter Lunchrooms program was spearheaded by the U.S. Department of Agriculture and designed by Wansink and his Cornell colleague David Just. As I noted here last August,
For the better half of a decade, American public schools have been part of a grand experiment in "choice architecture" dressed up as simple, practical steps to spur healthy eating. But new research reveals the "Smarter Lunchrooms" program is based largely on junk science.
The sham data behind the Smarter Lunchrooms program was exposed last year by PhD student Nicholas Brown and by University of Liverpool profressor Eric Robinson. From there, more of Wansink's work started being called into question. Now, the JAMA Network has announced the retraction of six Wansink articles published in its JAMA, JAMA Internal Medicine and JAMA Pediatrics journals from 2005 through 2014.
In May, "notices of Expression of Concern were published regarding articles published in JAMA and the JAMA Network journals that included Brian Wansink," said a statement from the JAMA Network:
At that time, Cornell University was contacted and requested to conduct an independent evaluation of the articles to determine whether the results are valid. Cornell University has notified JAMA that based on its investigation they are unable to provide assurances regarding the scientific validity of the 6 studies.
A response from Cornell stated that "because we do not have access to the original data, we cannot assure you that the results of the studies are valid."
The six retracted papers include research into how serving bowl size effects the amount of food people eat in one sitting; how watching TV affects people's eating habits; why it's a bad idea to grocery shop while hungry; and how to get students to order healthier lunches. Here's the whole list of questionable Wansink studies that have now been retracted:
Kennedy charity to bail out NYC women, teens. The Robert F. Kennedy Human Rights foundation "plans to spend millions of dollars to spring every bail-eligible city inmate that is 16, 17 or a woman in an epic move to promote jail reform," according to the New York Post.
The massive philanthropic move has New York City law enforcement upset, the Post notes.
"If a relative puts their house up for bail, the odds are pretty good that the arrested person will show up in court," fumed one source. "The odds are not that good if some rich person puts up the money. You won't feel as obligated to show up."
A high-ranking police source called the scheme "disgraceful."
Small distilleries dragged down by regulation. "About 55 percent of the sale price from every bottle [of bourbon] Catoctin sells goes to the Virginia Alcoholic Beverage Control Authority and state coffers," writes Eric J. Wallace at VA Growler, in a piece that explores how state regulations are thwarting a burgeoning Virginia distillery scene.
For Virginia's craft distillers, "a tasting room is essentially a break-even business," says Scott Harris, owner of Catoctin Creek Distilling Company. Harris says Virginia's hyper-regulatory spirits laws make it difficult to operate in the state. […] And while craft brewers and vintners can lawfully serve patrons to the point of visible intoxication, distillers are allowed to pour just 3 ounces of product per customer, per day. Exacerbating the problem are the drastically different tax structures. Excise taxes on spirits are presently $19.93 per gallon (the third highest rate in the nation). Beer is taxed at $.26 and wine at $1.51.
One distiller told Wallace that Virginia's regulatory environment for distillers is so bad that she opened her new facility in Pennsylvania instead. "We've tried talking to legislators and they don't want to listen."
Pompeo decided to continue support for the Saudi coalition in Yemen — after being advised not to by regional experts — upon learning it would potentially jeopardize a $2 billion arms sale to Gulf allies.https://t.co/jrgfMdsNrD
— Haley Britzky (@halbritz) September 20, 2018
En banc 5th Cir. rules that prosecutors are not required to reveal exculpatory evidence to defendants before they plead guilty. pic.twitter.com/auMEGxhV8e
— Brad Heath (@bradheath) September 19, 2018
The post Nutrition Studies That Backed Obama-Era School Lunch Programs Get Retracted: Reason Roundup appeared first on Reason.com.
]]>In its latest healthy intake dietary guidelines, the U.S. government recommends that Americans avoid whole fat dairy products and instead consume fat-free and low-fat (1 percent) dairy, including milk, yogurt, and cheese. A new prospective cohort study published in The Lancet suggests that the government's recommendation is bunk.
The study followed the eating habits of more than 130,000 people for more than 9 years. It found that folks who consume higher levels of whole fat dairy products actually lowered their overall mortality and cardiovascular disease risks compared to those who consumed lower amounts or none.
As the study notes, nutritionists have long recommended that people minimize their consumption of whole-fat dairy products on the ground that they are a source of saturated fats and are presumed to adversely affect blood lipids and increase cardiovascular disease and mortality. On the basis of this study, that recommendation is exactly backward: Consuming less whole fat dairy is associated with higher cardiovascular and mortality risk.
How much lower? Eurekalert reports that "among those who consumed only whole-fat dairy, higher intake (mean intake of 2.9 servings of whole fat dairy per day) was associated with lower rates of total mortality (3.3% vs 4.4%) and major cardiovascular disease (3.7% vs 5.0%), compared to those who consumed less than 0.5 servings whole-fat dairy per day."
While the results of all nutrition research should be taken with a grain of salt**, The Lancet's new study reinforces recent arguments that what passes for nutrition "science" is in desperate need of radical reform.
(* Apologies to the American Dairy Association's 1980s advertising compaign.)
(** Though the government's salt consumption recommendations are most likely bunk too.)
The post Whole Fat Dairy: It Does a Body Good* appeared first on Reason.com.
]]>Government nutrition advice based on decades of "research" by nutrition epidemiologists has now been shown to be mostly unwarranted scaremongering, writes Stanford University statistician John P.A. Ioannidis, who has been at the forefront of criticizing the misuse and abuse of statistics to justify the publication of shoddy and just plain wrong research in numerous disciplines.
In his justly famous 2005 PLoS Medicine article, "Why Most Published Research Findings Are False," Ioannidis concluded that "for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias." As the co-director of the Meta-Research Innovation Center at Stanford (METRICS) Ioannidis has turned his attention to what passes for nutrition science in a recent analysis, "The Challenge of Reforming Nutritional Epidemiologic Research," in the Journal of the American Medical Association.
As an example of how badly nutritional research violates good scientific principles, Ioannidis parses the results of a recent meta-analysis of nutritional studies that aimed to "synthesize the knowledge about the relation between intake of 12 major food groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages, with risk of all-cause mortality."
In his critique of the meta-analysis, Ioannidis points out, "Assuming the meta-analyzed evidence from cohort studies represents life span–long causal associations, for a baseline life expectancy of 80 years, nonexperts presented with only relative risks may falsely infer that eating 12 hazelnuts daily (1 oz) would prolong life by 12 years (ie, 1 year per hazelnut), drinking 3 cups of coffee daily would achieve a similar gain of 12 extra years, and eating a single mandarin orange daily (80 grams) would add 5 years of life. Conversely, consuming 1 egg daily would reduce life expectancy by 6 years, and eating 2 slices of bacon (30 g) daily would shorten life by a decade, an effect worse than smoking." These inferences are implausible to say the least.
So what is going on here? Most nutrition research are observational studies that often rely on surveys in which participants unreliably recall what they eat. And since eating is a complex activity researchers are very likely to miss confounding data that would call their epidemiological speculations into question.
Consider the notorious 1981 Harvard study that found that drinking coffee was associated with a higher risk of pancreatic cancer. The effect entirely disappeared when the confounder of smoking was taken into account. As it happens, a 2016 meta-analysis found that "high coffee consumption is associated with a reduced pancreatic cancer risk." Ioannidis is surely right that pervasive nutritional research flip-flops "may have adversely affected the public perception of science."
Instead of performing yet more dodgy observational studies, Ioanndis suggests that "large-scale, long-term, randomized trials on nutrition may be useful." And yet he immediately follows up with a devastating critique of a prominent recent study that purportedly identified beneficial effects from eating a so-called Mediterrean diet.
The Prevención con Dieta Mediterránea (PREDIMED) study supposedly compared three randomized groups: the first was given free supplies of extra virgin olive oil; another a supply of mixed nuts; and the third a bit of advice on what constituted a Mediterranean diet. The researchers were aiming to see if there were any significant differences with regard to the incidence of heart attacks and strokes between the groups.
The initial publication did find some beneficial effects from consuming olive oil and nuts. However it had to be withdrawn and re-analyzed after outside researchers showed that it was actually not randomized. The rejiggered study still found that eating nuts and olive oil reduced by a tiny amount the risk of experiencing a cardiovascular event. On the other hand, there was essentially no difference between the groups with respect to the risk of dying from any cause.
Ioannidis calls for reforming the field of nutritional epidemiology by adopting such measures as requiring that researchers make all of their data available for re-analysis by independent investigators and that results should be presented in their totality for all nutritional factors measured.
Until nutritional epidemiology is radically reformed, we should all keep in mind Ioannidis' observation that the "implausible estimates of benefits or risks associated with diet probably reflect almost exclusively the magnitude of the cumulative biases in this type of research, with extensive residual confounding and selective reporting."
In the meantime, it's probably best to follow your parents' advice with respect to diet and health: Eat and drink in moderation.
The post Most Nutrition Research Is Bunk appeared first on Reason.com.
]]>Good news for fans of diet drinks and sugar-free sweets: You can safely ignore the hype about zero-calorie sweeteners somehow triggering weight gain and metabolic issues, according to a team of U.S. and European scientists.
The potential paradox of diet soda fueling weight gain had a lot of traction in popular health media. But this idea was based on inconsistent rodent research results, plus human studies that found links between artificial-sweetener consumption and ill effects but not a causal relationship .
Beyond Calories
A new article in the journal Obesity Reviews summarizes last year's "Beyond Calories—Diet and Cardiometabolic Health" conference, sponsored by the CrossFit Foundation. The event convened doctors, obesity researchers, molecular biologists, nutrition scientists, and other academics from the U.S., Denmark, and Germany to consider whether all calories are "equal with regard to effects on cardiometabolic disease and obesity."
"There is no doubt that positive energy balance, due to excessive caloric consumption and/or inadequate physical activity, is the main driver of the obesity and cardiometabolic epidemics," write Janet King and Laura Schmidt in the paper's introduction. But there's also evidence that "certain dietary components increase risk" for heart disease and weight gain in ways that go beyond a simple tradeoff between calories consumed and calories burned.
In the case of diet soda and its ilk, there are all sorts of theories about how these drinks could sneakily imitate the effects of sugary beverages. It was posited that they might trigger our sweet taste receptors to crave more sweet things after consumption, that they might alter our gut bacteria in a negative way, or that they induce a biochemical response as if real sugar had been consumed.
Some speculated that "caloric compensation occurs, negating calories 'saved,'" writes Allison Sylvetsky in a section of the article that deals with non-nutritive sweeteners (NNS). "This compensation could be psychological, whereby one's knowledge of consuming a lower calorie NNS containing alternative may lead to giving oneself permission for greater calorie ingestion at subsequent meals," or it "could be physiological, in which consumption of lower calorie NNS containing alternatives promotes heightened hunger and subsequently higher calorie intake."
But that wasn't much more than speculation. "Two separate meta analyses consisting of 10 and eight [randomized controlled trials] both indicated that substituting [artificial sweeteners] for sugar resulted in a modest weight loss in adults," notes Sylvetsky. "In 62 of 90 animal studies, NNS did not increase body weight, and a more recent meta-analysis of 12 prospective cohort studies did not support an association between NNS consumption and BMI."
Embracing Aspartame
The most popular artificial sweetener these days is aspartame, which can be found in most diet soft drinks. Acesulfame Potatassium, Sucralose (sold in the U.S. as Splenda), and substances derived from the stevia plant are also popular. The paper cautions that aspartame has much more safety evidence on its side than the others, as it has been studied much more extensively. (There's no particular reason to think the others will prove any less safe, but they've been studied "for periods no longer than 16 weeks.")
Aspartame has been controversial for decades, but fears over its alleged links to everything from Alzheimer's disease to brain cancer, diabetes, leukemia, and weight gain have proven unfounded. (Such was also the case with saccharine before it.) And there have been ample randomized controlled trials to study its effects.
"It does not appear that any of these [trials] revealed adverse effects of NNS consumption on risk factors for cardiometabolic disease," writes Sylvetsky, summing up the research. In one six-month study, overweight and obese participants were assigned to drink either sucrose-sweetened cola, aspartame-sweetened cola, water, or low-fat milk. Researchers found "no significant differences between the effects of aspartame-sweetened cola and water on body weight, visceral adiposity, liver fat and metabolic risk factors."
In "the longest intervention study conducted to date," 163 obese women were randomly assigned to have or avoid aspartame-sweetened foods and drinks during a several-month weight-loss program, a one-year weight-maintenace program, and a two-year follow-up period. "The aspartame group lost significantly more weight overall," reports Sylvetsky, "and regained significantly less weight during the 1-year maintenance and the 2-year follow-up than the no-aspartame group."
Controlled trials "consistently demonstrate" that consuming aspartame and other artificial sweeteners is associated with decreased calorie consumption, the paper concludes. And "there are no clinical intervention studies involving chronic [sweetener] exposure in which [it] induced a weight increase relative to sugar, water or habitual diet."
The team of researchers suggests that more studies should be done on on the effects of artificially-sweetened beverages on children and on how consumption of these drinks is related to glucose tolerance and inflammation.
The post Don't Worry About That Diet Soda Habit: Artificial Sweeteners Are Harmless, Say Scientists appeared first on Reason.com.
]]>"Government made a big mistake with the dietary guidelines," says Nina Teicholz, author of New York Times bestseller The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. "Given the track record that they have so far, you can really make a plausible argument that they've done more harm than good."
Consumption of meat, butter, eggs, and cheese were once encouraged as part of a healthy diet. Then in the 1950s, a Minnesota doctor named Ancel Keys put forth his diet-heart hypothesis, claiming that saturated fats raise cholesterol levels and cause heart attacks.
Keys produced landmark studies of the relationship between diet and heart disease that transformed nutrition science. He became a powerful figure in the science community. Contemporaries who publicly questioned the validity of his findings risked losing their research funding or becoming pariahs. When the U.S. adopted dietary guidelines in 1980, Keys' recommendations became enshrined in national food policy.
"We have made our policy based upon this weak kind of science called epidemiology which shows association, but not causation," Teicholz explains. "We have the situation where we just cannot reverse out of these policies that were originally based on really weak science."
Keys' flawed research is one reason Americans have been getting fatter and unhealthier for decades. Despite major advances in treatment, heart disease is still the leading cause of death for men and women.
"The really dominant view is that the dietary guidelines are good…and the reason America is fat and sick is that America has failed to follow them," Teicholz says. "That's when you start looking at the data…By every food category you can find, we have faithfully, dutifully followed the guidelines."
Today the science behind Keys' dietary findings is once again being challenged. Teicholz has launched the Nutrition Coalition, which aims to inform food policy with rigorous science.
"Our goal is educate people about how the dietary guidelines have not been successful…and to bring this alternative policy viewpoint to policy makers," says Teicholz. "More and more experts are willing to talk out about the science, and I think that will support change."
Produced by Alexis Garcia. Camera by Jim Epstein.
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]]>Science writer Gary Taubes has a knack for subverting conventional wisdom. Sixteen years ago, he published a groundbreaking feature article in The New York Times Magazine arguing that decades' worth of government-approved nutritional advice was flat-out wrong, ideologically motivated, and contributing to rising rates of obesity and diabetes. Traditional dieting guidance attacking fatty foods and praising carbohydrates, he wrote, was based on "a big fat lie."
Back then, Taubes was excoriated. (Reason published pieces both attacking and defending him.) But today his thesis is gaining ground among health and nutrition researchers. His work has been highlighted everywhere from The New York Times to Time magazine. Protein-rich regimens have taken off after millions of Americans found that stocking their pantries with supposedly "heart-healthy" snacks such as granola bars and fruit juice failed to improve wellness.
Taubes' latest book on the subject is The Case Against Sugar (Knopf), which describes the sweet stuff as a toxic substance akin to cigarettes that can and does kill. "Something's triggering the epidemic everywhere, and it's probably the same thing everywhere," he says. The ingredient "at the scene of the crime"—one that's stealthily packed into even our diet foods, and one we've been consuming in ever-increasing doses over time, he argues—is sugar.
In January, Reason's Nick Gillespie sat down with Taubes in his kitchen in Oakland, California, to talk about food, science, and the politics of both.
Reason: Your book is framed as a kind of prosecutorial case, meant to convict sugar as the chief cause of many of our society's health problems: obesity, diabetes, heart disease, other chronic illnesses. Can you lay out the opening argument?
Gary Taubes: It's meant to indict, but I'm not sure I could get a conviction.
We have obesity and diabetes epidemics everywhere. Worldwide, they manifest whenever a population shifts from whatever their traditional diet is to a Westernized urban diet, and so you could think of the Western diet and lifestyle as the vector that carries obesity and diabetes into these populations.
Describe the "Western diet." Is it processed foods?
Pizza Rolls, Kentucky Fried Chicken, McDonald's, Coca-Cola—
So the things we live for are the things that are killing us?
Something in our diet and lifestyle causes obesity and diabetes. Conventional wisdom is it's basically caloric overload. We eat too much and we're sedentary. Too many foods are available. They're packaged in a way that makes them irresistible. They have too much salt, fat, sugar. There's a whole host of theories around that idea, but ultimately it comes down to [the fact that] we take in more calories than we expend, and that causes obesity. Obesity increases your risk of Type 2 diabetes. Both those increase your risk of heart disease, cerebral vascular disease, stroke, cancer, Alzheimer's, you name it—every major chronic disease.
We see these chronic diseases appearing in populations when they make this nutritional shift, so the question is what is causing it? The argument I make in this book is that sugar has always been the prime suspect.
You say it's always been a prime suspect, but at least in the past 40 or 50 years, we've been told, "Don't worry about sugar. Worry about fat, worry about meat."
That's key to the story, and that's how I entered into it as an investigative journalist. We had this belief system that began as a hypothesis in the 1950s and started to be tested in the 1960s, which is that dietary fat causes heart disease. So by the 1980s, a "healthy" diet was being defined as a low-fat, low-salt diet.
And this explains SnackWell's fat-free cookies and things like that.
A whole genre of food. One of the things that happened in the '80s, when we embraced this low-fat healthy diet synchronicity, is the government, the [Centers for Disease Control and Prevention], started telling industry to produce low-fat foods. So the iconic example is yogurt, a high-fat food by definition. You remove some of the fat and now you have this insipid, watered-down, tasteless thing. To make it taste good, you put back fruit and sugar, and now you've got a "heart-healthy diet food."
Did the shift from a more balanced diet to a low-fat, high-sugar diet achieve the goals that were predicted for it?
You could look at heart disease mortality, and it's come down. The nutrition community says, "Look, people aren't dying from heart disease as much. Therefore, our advice is right." And then people like me say, "Yeah, but we're not interested in mortality, 'cause we're also selling billions of dollars in statins every year and billions of dollars in blood pressure drugs. We're doing hundreds of thousands of heart surgeries a year, putting in stents, doing bypasses. If mortality wasn't coming down, we'd have a real problem." Question is what's happening to the incidence. Are we seeing less heart disease because we're preventing it with changes in diet? And there's no evidence of that.
In the book you write, "One of the common themes in the history of medical research is that a small number of influential authorities—often only a single individual—can sway an entire field of thought." Why do you think that is?
Paradigms are founded when fields are small. They're fertile. The signal-to-noise ratio is high. If those scientists are good, you get paradigm shifts. We got the double helix and our understanding of the general principles of molecular biology when a half-dozen people led by Francis Crick, a former physicist, could determine what was going on. You take them away, you have no revolution.
In diabetes, you had Elliott Joslin in the U.S. He was a very caring, concerned, wonderful doctor, but not that good of a scientist, not that good of a critical thinker. And then you had Harold Himsworth in the U.K., who went on to become the head of the [government's] Medical Research Council. They were writing the textbooks. They were the ones being cited, and they were citing each other. If they got it wrong, everybody got it wrong. Our whole conception of obesity was determined in large part in the 1970s by half a dozen men untrained in science, who were, in effect, self-elected to run the field.
You describe an early battle between academic nutritionists, who overwhelmingly took the energy-balance approach to nutrition—you lose weight if you burn more calories than you take in—and what they characterized as quack doctors writing diet fad books, saying you can eat all the fat you want and you'll be fine as long as you stay away from sugar and refined carbs. Pork rinds good, cookies bad. And yet you say the quacks were actually closer to being right. Is this a place where the marketplace was more effective at hashing out the truth?
Yes. You have an academic research community that is dominated, post–World War II in the U.S., by nutritionists, who are studying animals for the most part. In 1959–60, Rosalyn Yalow and Solomon Berson invent the technology that allows hormones to be measured accurately, and the school of endocrinology explodes. The science finally has the tools to understand things like hormonal regulation of fat accumulation. Yalow and Berson say, look, insulin drives fat accumulation, so maybe the Type 2 diabetics are obese because of the insulin. And nobody cares, except the doctors.
The doctors are like all of us. They're getting fat. What do you do if you're getting fat? Well, you try what everyone tells you to do, which is eat less and exercise more. And if that doesn't work, which it doesn't, then if you're smart you look for other methods. Some of them read the diet books and tried various diets. Some of them read the same medical literature I did—Atkins famously read the same studies I read 40 years later. There's a conventional thinking that carbohydrates are fattening—bread, pasta, potatoes. Women describe them as going right to their hips. Maybe if I get rid of the carbohydrates and replace them with fat, because fat's the one macronutrient that doesn't stimulate insulin secretion, maybe I'll lose weight.
"Are we seeing less heart disease because we're preventing it with changes in diet? There's no evidence of that."
So people outside of the official research community were desperate to get skinny, or have their patients get skinny, so they tried a bunch of different things?
They try a bunch of different things. When you find one that works after a lifetime of failing…
Obesity is one of these subjects where it helps to have a weight problem. The way I describe it in my lecture is a male obstetrician can deliver 10,000 babies and won't understand childbirth as well as one woman who has given birth. It's just a fact of life. If you don't understand what it's like to get fatter and fatter, year in and year out, regardless of what you do, you just don't understand obesity.
You're a trim guy. Were you fat at some point?
I was chubby when I was a kid. My brother, you could see every vein on his body. He couldn't gain weight if he wanted to, and I was just a chubby kid. Puberty helped, and then I became an athlete and that helped. But my brother at his peak was 6'5″ and weighed about 195 pounds. Remember how Freud said anatomy is destiny? So he rowed crew. I was 6'2″ and could get up to 240. I played football. We both ate as much as we could. He was tall and thin. I was short and thick. That's just how we were built.
In the book, you document a long history of public nutrition advice being intertwined with politics in this country. So let's talk about the sugar lobby. How did King Sugar get its crown in the American economy and the American diet?
Well, sugar used to be very expensive and hard to get. It only grows in specific tropical regions. You can't just transport the sugar cane around the world and then refine the sugar out of it afterwards. You've got to get the sugar out quickly. It's a horrible job.
It was done by slaves.
It was done by slaves. The sugar industry is at the heart of the slave trade. Then the industrial revolution comes along beginning in the late 18th century, and suddenly sugar gets cheaper and cheaper to refine. In the 1840s the candy industry, the chocolate industry, and the ice cream industry all start up. In the 1870s–1880s you get the soft drink industry, with Coca-Cola and Pepsi-Cola and Dr. Pepper, and suddenly not only are you creating entirely new ways to consume sugar, but you're targeting children and women as the consumers of sugar. The soft drink industry in particular just explodes.
By 1900, we're consuming about 90 pounds per capita, which is almost a 20-fold increase in a century. It's like an arms race. The nutritionists say, "No, no, no, no, no," and the marketers say "If we don't do it also, we're out of business." By the 1960s, you've got cereals that are 40, 50 percent sugar—
And that are advertising as such, right? It was originally Sugar Frosted Flakes.
Tastes like a milkshake. You've got all of the smartest minds on Madison Avenue in the P.R. industry creating not just cartoon characters but entire Saturday morning cartoons—the ones we grew up on, like Rocky and Bullwinkle. I loved Rocky and Bullwinkle. It was a vehicle to sell cereal.
Gosh, I didn't realize. So in the Hague trial of cartoon characters against humanity, Rocky and Bullwinkle are as bad as Boris and Natasha?
You could look at it that way. Fruit juices come in in the 1930s. Sunkist, the coalition of California orange growers, they have to do something with their oranges 'cause they all come into season at once. You can't sell enough and you can't move enough so you turn them into juice. You sell them as juice and you advertise them as healthy because of the vitamin C. We're coming off this age of the new nutrition, which was all about vitamins and vitamin deficiency diseases.
You go back to what we evolved to eat, the sugar in those apples, and kids are now getting that within 20 minutes of waking up in the morning, and they aren't going more than an hour and a half or two hours without it. Over the course of a day, they're consuming almost a year's worth of what they evolved to eat.
The Department of Agriculture (USDA) and other government agencies that gave dietary recommendations wouldn't even think to say, "Well, glasses of apple juice and orange juice are sugar."
To this day, when you are told to eat a lot of fruits and vegetables, it's because they're vitamin-rich. The conventional thinking is that orange juice is healthy because it's full of vitamins. In the alternative thinking, the world I live in now, it's unhealthy because it's basically sugar water. You could take Coca-Cola, add a vitamin C tablet, and you got the same thing.
Talk about why the government has that blind spot.
The sugar industry was always a very powerful lobby, because sugar was a vital product import. The food industry was dependent on it. [So] the industry creates the Sugar Association basically to help advertise sugar consumption. Post–World War II the artificial sweetener industry begins to come of age. Saccharine had been around since the 1890s and cyclamates since the 1930s, and they're used in products that are sold for diabetics. People start thinking, "Hey, I'm getting fatter. I could drink these sugar-free, calorie-free drinks as well."
The newspapers now have something to measure, which is the amount of diet sodas being produced, so they can write about the diet craze. And the sugar industry has a problem, because people are saying sugar is fattening. So the Sugar Association starts saying a calorie is a calorie. That's the bedrock belief of the obesity community. They start P.R. campaigns to combat the argument that sugar is fattening. They do it by basically just taking what the nutritionists are giving them. But the nutritionists are giving them bad science.
Is the sugar lobby actually paying for studies?
They began paying for research during World War II. That was a common practice. The sugar industry kind of pioneered it. I don't think they did it for public relations reasons—they wanted to find other uses for sugar, so they funded some of the best sugar biochemists in the world. Science magazine would annually run articles about who they were funding. It helped cement some allies, because if somebody's been paying your bills for 20 years, you tend to be fond of them. That's where the conflict of interest comes in. In the 1960s, with this idea that dietary fat causes heart disease, some of the people pushing that happened to be longtime recipients of sugar industry largess.
What about the attack on artificial sweeteners? Cyclamates were banned in the late '60s, right?
In '69, yeah. Saccharine was almost banned, or it was for a bit. Now it carries warnings.
Where did the idea that these sweeteners were problematic come from?
Oh, they came from the sugar industry. The saccharine and cyclamates were direct competitors. Interestingly, here's where the beverage industry and the sugar industry split, because the beverage industry was happy to sell artificially sweetened drinks. Artificial sweeteners are cheaper. So Coke and Pepsi put out Tab and Diet Rite.
And Fresca. I'm thinking of all the horrible-tasting pre–Diet Coke diet sodas.
But the sugar industry saw it as a direct threat to their viability, and it was. There's a quote from The New York Times in my book, a sugar industry executive copping to spending a half-million dollars on research trying to find anything that an artificial sweetener does that's damaging. They would give female rats the equivalent of 60 cans a day of soda and then hope that they would produce rats with birth defects so they could say it was as bad as thalidomide. This executive is quoted as saying, "If someone could undersell you one cent to a dime, wouldn't you throw a brickbat at them if you could?"
So if our government and other public health institutions are consistently offering bad nutritional advice, what is the solution to that?
That's the problem, isn't it?
Is there a solution?
In the science in which I was raised—physics and chemistry, the hard sciences—the last thing you want to do is get an assumption accepted into the theory of how things work without rigorously testing it, because then people will build on it and it will grow and infect the whole thought construction. You end up with, I'm going to beat this metaphor to death, but sort of a house of cards. And there will be no way to go back on it. In a field like nutrition and obesity research, you've now got these enormous institutional dogmas built in that I and others are arguing are simply wrong. How do you get the institutions to change their belief systems?
The British Medical Journal is running a series on nutrition policy, and their way of dealing with it is by assigning writers from these different belief systems. So I'm a co-author on an article on dietary fat, along with the former head of the Harvard nutrition department who thinks I'm the worst journalist he's ever met and who does a form of science that I consider a pseudoscience.
But that is kind of the Enlightenment model of science, right? You have competing truth claims and you put them in a cockfighting ring?
What's the cockfighting ring? That's the key. The cockfighting ring is experimental tests. You have a hypothesis, you do an experiment, you intervene while limiting the number of variables you change. The problem with these sciences is you can't really test the hypotheses. They're too hard to do. I mean, you could if you had enough societal motivation. If you're willing to spend $10 billion, the way we do to try and find out if the Higgs boson exists in high-energy physics. You get everyone to work together, you identify the key questions, and you spend whatever money is necessary to do it.
Food producers spend billions of dollars a year on R&D. Are they capable of doing disinterested research?
Well, the assumption is no. Nowadays there's a whole journalistic industry of identifying conflicts of interest when researchers take money from industry. There are models which work better, where you just have the industry donate money for research to clearinghouses or to the government, which then identifies what things have to be studied. But the argument I'm making is that you have multiple generations of nutrition and obesity researchers who really fundamentally don't know how to do science. They don't know how to think critically, how to keep multiple hypotheses in their heads at one time, what it means to rigorously test hypotheses. So even if you had them do the studies, they would probably do a bad job.
"This whole story is about government interference that went awry. If they had stayed out of things…the scientists might have had time to get the science right."
You compare sugar to a drug. To go into kind of a different register of government malfeasance, the government has arbitrarily declared certain drugs good and certain drugs illicit. The war on drugs has been a failure. The war on tobacco I guess has been successful at helping to drive down the number of people who smoke. Are you proposing anything along the lines of a war on sugar?
No, government interference worries me the same way I think it worries you guys. This whole story is about government interference that went awry. If they had stayed out of things in the '60s through the '80s, and never inflicted us with what I think are these incorrect ideas, the scientists might have had time to get the science right. We might have really understood what's happening.
When the USDA sets up federal guidelines, those influence how people talk about things, how grants get given, what gets served in school lunches, etc. So there's an indirect power by which the government really does get to set a lot of dietary practice.
Yeah. I have what is maybe too simplistic a notion: We have these obesity and diabetes epidemics. Let's unambiguously identify the cause. Now we know what we shouldn't be eating. If we get that message across—
I don't know how much government regulation helped people cut back on smoking, and how much the awareness that smoking causes lung cancer did. I didn't quit because of government regulation. I quit because I don't want to kill myself, and I was coughing all the time. It was clear that was cigarette-related. If we could get people to understand, assuming I'm right, that sugar is the problem, then you get rid of sugar and refined high-glycemic-index carbs if you don't want to be obese and diabetic.
In the '70s and '80s there was a discount clothing guy named Sy Syms. He would always say, "An educated consumer is our best customer." There are always going to be quacks, and who is a quack and who is a legitimate scientist is always going to vary, but is the answer having voices out there forcing people to become educated, critical consumers of their own nutrition?
Well, again, it's hard to do, because there are all these different sources of information, and who do you trust? Do you trust the journalist, do you trust the vegan diet doctor, do you trust the ketogenic diet doctor, do you trust the researchers?
We can agree we don't trust Dr. Oz, though, right?
Yeah, for the most part. Diabetes prevalence in this country has increased 700 percent since the early 1960s. That's unprecedented. We have to get that straight. As long as we think it's eating too much and exercising too little and sedentary behavior, [we're in trouble]. And the obesity/diabetes community will say these are multi-factorial, complex diseases, which means the [National Institutes of Health] will fund thousands of researchers to look at hundreds of things, and we're going to say it's a little bit of this and a little bit of that. But something's triggering the epidemic everywhere, and it's probably the same thing everywhere.
The null hypothesis should be that it's something simple. Sugar's not just at the scene of the crime when it happens in populations. It's at the scene of the crime in the human body, which is the liver.
These are disorders that nobody wants. I think if we truly understood the cause, if we got it right, if that message was consistent from diet doctors to insurance agents to hospitals to physicians, then I think there would be a societal move to fix it. But again, we have to get the science right.
This interview has been condensed and edited for style and clarity.
The post Meet the Man Who Hated Carbs Before It Was Cool appeared first on Reason.com.
]]>Here in the U.S., we tend not think of insects as food, and are horrified when they turn up in food. Though finding a bug in one's meal is often cause for alarm and disgust, the laws around U.S. food standards recognize that bugs making their way into what we eat is simply a fact of life.
FDA regulations known as the "Food Defect Action Levels" allow certain enumerated amounts and types of insects to be present in many foods. Take frozen orange juice. FDA rules specify that frozen orange juice is acceptable for sale if it contains fewer than "5 or more [fruit fly] and other fly eggs per 250 ml or 1 or more maggots per 250 ml." Canned corn, meanwhile may be sold containing "larvae, cast skins, larval or cast skin fragments of corn ear worms or corn borer," so long as the aggregate length of bug parts does not exceed 12 millimeters in 24 pounds of product. (The rules also discuss the maximum number of rodent hairs various foods may contain.)
But in other parts of the world, people eat insects on purpose. The United Nations calls insects "a highly significant food source for human populations." Another source claims people in 80 percent of all countries—one of every three humans—eat bugs. The things we want to keep out of our food are actually a great source of protein, fat, and fiber.
Yet in a world full of willing bug eaters, it's perhaps no surprise that the law—the thing that so often dictates what we may or may not eat—prevents us from thinking of grubs as grub.
A fascinating piece this week by Massimo Reverberi, founder of a Thailand-based bug-pasta company, suggests a regulatory divide between the English-speaking world, which he says has been welcoming of edible bugs, and the EU, which he reveals "have felt the need to have rules and provide approvals before allowing any marketing."
Reverberi writes that the U.S. and its FDA—the same agency that establishes Food Defect Action Levels for bugs in common foods marketed in the United States—has been surprisingly good about establishing permissive regulations for edible-insect foods.
Others recent news backs that up.
"Last week, the Enterra Feed Corporation, based in British Columbia, was approved by the Association of American Feed Control Officials to sell insect-based [animal] feed in the United States," writes author James McWilliams in a piece this month for Pacific Standard.
While rules in the United States aren't unkind to those who would market bugs, this country nevertheless has been slow to adopt the trend of eating creepy crawlers.
In the early 1990s, while a college student in Washington, D.C., I drank many drinks and ate many bugs as the Insect Club, which, as the name suggests, was not only insect-themed in its décor but also in its bar snacks.
I thought the bug trend might take off then. It didn't. But that's clearly changing.
Safeco Field, home of the Seattle Mariners, began offering toasted chili-lime grasshoppers during games last year. I tried them during a spring game and found them to be a damn tasty beer snack. The grasshoppers proved so popular that Poquito's, the local Mexican restaurant that offers up the grasshoppers, was forced to cap sales.
In addition to grasshoppers, crickets seem a particularly popular offering.
"Crickets are the gateway bug," bug-flour entrepreneur Jarrod Goldin told Fortune in 2016.
San Francisco-based Don Bugito started out as a bug-centric food truck specializing in pre-Hispanic foods of the Americas. It now sells a variety of insect-based foods, including chocolate-covered bugs and cricket-flour granola.
A food truck in Belgium has also capitalized on the "roach coach" insult by selling skewered bugs, dubbed "crickets on a stick."
"They aren't really crickets, they're grasshoppers, but it sounds better to say cricket on a stick," says owner Bart Smit.
Bug sales look set to skyrocket.
"[M]arket research predicts farmed insect production will rise 102 percent between now and 2022," writes McWilliams.
I welcome a future filled with more tasty insect culinary choices. As long as regulators at home and abroad don't erect pointless hurdles along the way, that future seems inevitable.
The post Eating Insects Could Be the Future of Culinary Innovation appeared first on Reason.com.
]]>Science writer Gary Taubes has a knack for subverting the conventional wisdom. Sixteen years ago, he published a groundbreaking feature in the The New York Times Magazine, arguing that decades of government-approved nutritional advice attacking fatty foods and praising carbohydrates was flat-out wrong, ideologically motivated, and contributed to rising rates of obesity and diabetes.
He was widely attacked—including in the pages of Reason. His 2007 book Good Calories/Bad Calories followed up on that story, as did Why We Get Fat and What To Do About It, which appeared in 2011. Today, his thesis is gaining traction among heath and nutrition researchers, and has been highlighted once again in The New York Times and Time magazine.
Reason's Nick Gillespie sat down with Taubes in his kitchen in Oakland, California, to talk about his latest book on nutrition, The Case Against Sugar, which recently came out in paperback.
Produced by Zach Weissmueller. Interview by Nick Gillespie. Camera by Paul Detrick, Justin Monticello, and Weissmueller. Additional graphics by Brett Raney.
"The Rat King is Coming" by Krackatoa is licensed under Creative Commons, CC BY-NC-SA 3.0 US
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Photo Credits: Timkiv Vitaly/ZUMA Press/Newscom
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The interview has been edited for clarity. Check all quotes against the audio for accuracy.
Nick Gillespie: The Case Against Sugar is framed as a kind of prosecutorial case. Can you lay out the opening arguments that you make against sugar for us?
Gary Taubes: We have obesity and diabetes epidemics everywhere in the world. Worldwide, they manifest whenever a population shifts from whatever their traditional diet is to westernized urban diet and so you could think of the western diet and lifestyle as the vector that carries obesity and diabetes into these populations. Then the question is, what is it in that diet?
Gillespie: Describe the western diet? Does that mean processed foods?
Taubes: Well, so that's a question. Processed foods, sedentary living-
Gillespie: Totino's pizza rolls, microwaved food?
Taubes: Pizza rolls, Kentucky Fried Chicken, and McDonald's, Coca-Cola-
Gillespie: So the whole reason that we live, the things we wait for, are the things that are killing us?
Taubes: It's a simplistic way to think about it, probably wrong, the things many of us live for and many of us wait for. Anyway, so this is the issue. Something in our diet and lifestyle cause obesity and diabetes.
We see these chronic diseases appearing in populations when they make this nutritional shift, so the question is what is it? The argument I make in this book is that sugar is the prime suspect, always been the prime suspect, cause you can track these epidemics back in time.
Gillespie: Now, you say it's always been a prime suspect but really at least in the past 40 or 50 years, we've been told and this is a lot of your work, what we've been told is don't worry about sugar, worry about fat, worry about meat and that beautiful arc of fat around the edge that you might gristle up a little bit?
Taubes: That's key to the story, and that's how I entered into it as an investigative journalist is we had this belief system that began as a hypothesis in the 1950s and started to be tested in the 1960s and was never confirmed, which is that dietary fat causes heart disease. So by the 1980s, a healthy diet was being defined as a low-fat, low-salt diet.
Gillespie: And this explains Snackwell cookies and things like that.
Taubes: One of the things that happened in the 80s when we embraced this low fat healthy diet synchronicity is the government, the CDC, started telling industry to produce low fat foods. So, we could take foods like the iconic example is yogurt, a high fat food by definition. You remove some of the fat and now you have this kind of insipid watered-down, tasteless thing and to make it taste good, you put back fruit and sugar, high fructose corn syrup, and now you've got a heart healthy diet food that they sell in these little packets and we see them everywhere.
Gillespie: Did the shift from a higher fat, or a more balanced diet actually, to a low fat, low salt, sugar, did it achieve the goals that were predicted for it?
Taubes: You could look at heart disease mortality and it's come down. The nutrition community said, "Well, look, people aren't dying from heart disease as much, therefore, our advice is right." And then people like me say, "Yeah, but, we're not interested in mortality, cause we're also selling billions of dollars in statins every year and billions of dollars in blood pressure drugs. We're doing hundreds of thousands of heart surgeries a year, putting in stents, doing bypasses. If mortality wasn't coming down, we'd have a real problem. Question is what's happening to incidents. Are we seeing less heart disease because we're preventing it with changes in diet? And there's no evidence."
Gillespie: You know, you describe an early battle over many of these questions between academic nutritionists who overwhelming took the energy balance approach to nutrition: you lose weight of you burn more calories than you take in versus what they characterize as quack doctors who writing diet fad books that you can eat all the fat you wan. And yet you say the quacks were actually closer to being right.
Taubes: So you have an academic research community that dominated post-World War II in the U.S. by nutritionists, who are studying animals for the most part. 1959, '60, Rosalyn Yalow and Solomon Berson invent the technology that allows hormones to be measured accurately and the school of endocrinology explodes. The science of endocrinology finally has the tools they need to understand things like hormonal regulation of fat accumulation. Yalow and Berson say, look, insulin drives fat accumulation, so maybe this link between type two diabetes and obesity, maybe the type two diabetics are obese because of the insulin. And nobody cares, except the doctors.
The doctors are like all of us. They're getting fat, right? What do you do if you're getting fat? Well, you try what everyone tells you to do, which is eat less and exercise more and if that doesn't work, which it doesn't, then, if you're smart, you look for other methods. Some of them read the diet book literature and try various diets. Some of them actually read the same medical literature I did, so Atkins famously read the same studies I read 40 years later. Maybe if I get rid of the carbohydrates and replace it with fat, because fats are the one macro-nutrient that doesn't stimulate insulin secretion, maybe I'll lose weight.
If you try it and it works-
Gillespie: So it is a place where kind of people outside of the official research community were desperate to get skinny or have their patients get skinny so they tried a bunch of different things?
Taubes: They try a bunch of different things. When you find one that works, after a lifetime of failing … Obesity is one of these subjects where it helps to have a weight problem. If you don't understand what it's like to get fatter and fatter, year in and year out, regardless of what you do, or to be 50 pounds fatter than your schoolmates in high school regardless of what you do, you just don't understand obesity.
Gillespie: You're a trim guy. Were you a fat load at some point?
Taubes: Nah, I was chubby when I was a kid. It was one of the interesting things, cause my brother who is a mathematician was … you could see every vein on his body, and I was a chubby. He was taller and thin. He couldn't gain weight if he wanted to, and I was just a chubby kid. Puberty helped and then I became an athlete and that helped. But my brother at his peak was 6'5″ and weighed about 195 was a rower. Remember Freud said anatomy is destiny. So he rowed crew. I was 6'2″ and could get up to 240, and I played football. We both ate as much as we could. That's what we did. We were kids. He was tall and thin. I was short and thick. Not … shorter and thick. That's just how we were built. I often wonder it's like why would you possibly think that I was thicker than him because I ate more or exercised less. I was just thicker than him. That was my body.
Gillespie: In the book, you document a long history of public nutrition advice being intertwined with politics in this country. So let's talk about the sugar lobby. How did king sugar get its crown in the American economy and kind of in the American diet?
Taubes: Well, sugar used to be very expensive and hard to get. It's hard to grow. It only grows in specific and tropical regions. You can't just transport the sugar cane around the world and then refine the sugar out of it afterwards. You've got to get the sugar out quickly on refining. It's a horrible job.
Gillespie: It was done by slaves.
Taubes: It was done by slaves. The sugar industry is at the heart of the slave trade. The industrial revolution comes along. Now beginning in the late 18th Century and suddenly sugar gets cheaper and cheaper to refine. 1840s the candy industry, the chocolate industry and the ice cream industry all start up. In the 1870s, 1880s, you get the soft drink industry with Coca-Cola and Pepsi-Cola and Dr. Pepper and suddenly not only are you creating entirely new ways to consume sugar and new vehicles to do it, and you can consume it all day long, you are targeting children and women as the consumers of sugar, children specifically. The soft drink industry in particular just explodes.
By 1900, we're consuming about 90 pounds per capita, which is almost a 20-fold increase in a century. Every industry, it's like an arms race, every industry, the nutritionist say, no, no, no, no, no, and the marketers say "If we don't do it also, we're out of business." They fall one after another. By the 1960s, you've got cereals that are 40, 50 percent sugar-
Gillespie: And that are advertising as such. Right? This is like Sugar Smacks. It was originally Sugar Frosted Flakes.
Taubes: Tastes like a milk shake. You've got all of the smartest minds on Madison Avenue in the PR industry creating not just cartoon characters to sell but entire Saturday morning cartoons, the ones we grew up on, like Rocky and Bullwinkle. I loved Rocky and Bullwinkle. It was a vehicle to sell cereal.
Gillespie: Gosh, I didn't realize. So in the Hague trial of cartoon characters against humanity, Rocky and Bullwinkle are as bad as Boris and Natasha then?
Taubes: Yes, you could look at it that way. Horrible thing. Fruit juices come in in the 1930s. Okay, Sunkist, the coalition of California orange growers, they have to do something with their oranges cause they all come into season at once. You can't sell enough and you can't move enough so you turn them into juice. You sell them as juice and you advertise them as healthy because of the vitamin C. We're coming off this age of the new nutrition, which was all about vitamins and vitamin deficiency diseases.
You go back to what we evolved to eat and the sugar in those apples, and kids are now getting that within 20 minutes of waking up in the morning and they aren't going more than an hour and half, two hours over the course of the day without. Over the course of a day, they're consuming almost a year's worth of what they evolved to eat.
Gillespie: At various points, the USDA or other government agencies that kind of gave dietary recommendations wouldn't even think to say, "Well, glasses of apple juice or orange juice are sugar."
Taubes: To this day, when you are told to eat a lot of fruits and vegetables, it's because they're vitamin rich. The conventional thinking, orange juice is healthy cause it's full of vitamins, and in the alternative thinking, the world I live in now, it's unhealthy because it's basically sugar water. You could take Coca-Cola, add the vitamin C tablet, and you got the same thing.
Gillespie: Talk about why the government would kind of push that or have that blind spot and the role of the sugar industry bringing that pressure to bear.
Taubes: The sugar industry, always a very powerful lobby, cause sugar was a very vital product import. The food industry was dependent on it, so the sugar lobby was always considered incredibly powerful. Beginning of the 1920s, the industry creates the sugar association basically to help advertise sugar consumption. Post-World War II, the diet, artificial sweetener industry begins to come of age. Saccharine had been around since the 1890s and cyclamates since the 1930s, and they're used in products that are sold for diabetics.
People started thinking, 'Hey, I'm getting fatter, I could drink these sugar-free, calorie-free drinks as well.' The industry starts producing and the newspapers now have something to measure, which is the amount of diet sodas being produced, so they can write about the diet craze. And the sugar industry has a problem because people are saying sugar is fattening. So the sugar association starts saying a calorie is a calorie. That's the general … that's the bedrock belief of the nutritional obesity community, so they start advertising widely and started PR campaigns to combat this argument that sugar is fattening. They do it by basically just taking what the nutritionists are giving them. The nutritionists are giving them bad science. The obesity researchers are giving them bad science, and all serves to exonerate sugar.
Gillespie: Is the sugar lobby actually paying for studies or are they paying nutritionists for-
Taubes: They are paying for research. They began paying for research in World War II, but that, again, was common practice. The sugar industry kind of pioneered it. I don't think they did it for public relations reasons. They wanted to find other uses for sugar, so they funded some of the best sugar biochemists in the world, and they wrote about it. Science magazine would annually run articles about the sugar industry, who they were funding, and why they were funding it, because it was a good thing. It helped cement some allies later. Because if somebody's been paying your bills for 20 years, you tend to be fond of them. That's where the conflict of interest come in.
Then in the 1960s with this idea that dietary fat was a problem, dietary fat caused heart disease, some of the people pushing that happened to be long time recipients of sugar industry largess. Now they could pay those people to write articles saying dietary fat is a problem, not sugar. This was conventional thinking. The only people who were claiming sugar was the problem were these sort of fringe British nutritionists who were perceived as quacks.
Gillespie: So what about the attack on artificial sweeteners, so saccharine, certainly cyclamates was banned in the late 60s, early 70s?
Taubes: '69, yeah.
Gillespie: Saccharine was almost banned, or it was for a bit. But it carries warnings on it. Where did the interest in saying these were carcinogenic or these were problematic-
Taubes: Oh, they came from the sugar industry. So the saccharine and cyclamates were direct competitors. Interestingly, the beverage—and here's where the beverage industry and the sugar industry split—the beverage industry was happy to sell artificially sweetened and artificial sweeteners are cheaper. So the beverage industry starts, Coke and Pepsi, they all put out Tab and Diet Rite, they were low calorie-
Gillespie: Fresca. Now, I'm trying to think of all the horrible acid tasting pre-Diet Coke diet sodas.
Taubes: Yeah, but they were happy. But the sugar industry saw it as a direct threat to their viability and it was. There's a quote in The New York Times that I quote in my book, a sugar industry executive saying if he's copping to spending a half million dollars on research trying to find anything that artificial sweetener does that's damaging, they would give female rats the equivalent of 60 cans a day of soda and then hope that they would produce rats with birth defects so they could say it was as bad as thalidomide. I mean they were looking for anything. This executive in The New York Times is quoted as saying "If someone could undersell you one cent to a dime, wouldn't you throw a brick bat at them if you could?"
Gillespie: So if our government and other public health institutions, universities, what not, if they're consistently offering bad nutritional advice, and bad dietary guidelines, what do you do about that? What is the response?
Taubes: That's the problem, isn't it?
Gillespie: Is there a solution here or do we just kind of say screw it and you know?
Taubes: In the science in which I was raised, so physics and the people who taught me science when I wrote my first two books in physics and chemistry, the hard sciences, the last thing you want to do is get an assumption accepted into the theory of how things work without rigorously testing it, because then people will build on it from there and it will grow and infect the whole thought construction. You end up with, I'm going to beat this metaphor to death, sort of a house of cards. And there will be no way to go back on it. Those are sciences that have no influence on every day life. So in a field like nutrition and obesity research, you've now got these enormous institutional dogmas built in that I and others are arguing are simply wrong. Who do you trust and how do you get the institutions to change their belief systems?
Right now I'm co-authoring an article … the British Medical Journal is running a series on nutrition policy and their way of dealing with it is by assigning writers from these different belief systems, so I'm a co-author on an article on dietary fat along with the former head of the Harvard nutrition department who thinks I'm the worst journalist he's ever met and who does a form of science that I consider a pseudo-science.
Gillespie: But that is kind of the enlightenment model of science, right, that you have competing truth claims and you kind of put them in a cockfighting ring-
Taubes: What's the cockfighting ring? That's the key. The cockfighting ring is experimental tests. It is a hypothesis and tests. You have a hypothesis, you do an experiment, you intervene, limiting the number of variables you change. The problem with these sciences, which is you can't really test these hypotheses. They're too hard to do. I mean you could if you had enough societal motivation. If you're willing to spend 10 billion dollars, the way we do to try and find out if the Higgs boson exists in high energy physics. You get everyone to work together. You identify the key questions and you spend whatever money is necessary to do it.
Gillespie: Do you think food producers, obviously they have institutional legacies that they want to protect, but they also … groups like, I don't know, General Mills or Proctor and Gamble, or what not, private industry spends billions of dollars a year on research. Are they capable of doing disinterested research?
Taubes: Well, the assumption is no. Now days there's a whole journalistic industry of identifying conflicts of interest when researchers do take money from industry. There are models which work better, where you just have the industry donate basically money for research to clearing houses or the government, which then identifies what things have to be studied. But if I'm right the argument I'm making is you have entire multiple generations of nutrition and obesity research who really fundamentally don't know how to do science. They don't know how to think critically, how to keep multiple hypotheses in their head at one time, what it means to rigorously test hypotheses. So even if you had them do the studies, they would probably do a bad job.
Gillespie: At various points you compare sugar to a drug. To go into kind of a different register of government malfeasance, the government has arbitrarily declared certain drugs good and certain drugs illicit. The war on drugs has been a failure. The war on tobacco I guess has been successful in terms of helping to drive down the amount of people who smoke. Are you proposing anything along the lines of a war on sugar?
Taubes: No, government interference worries me. The same way I think it worries you guys. This whole story is about government interference that went awry. If they had stayed out of things in the '60s through the '80s, and never inflicted us with this, what I think are incorrect ideas—that a healthy diet is inherently low in fat, low in salt—the scientists might have had time to get the science right. We might have really understood what's happening.
The null hypothesis should be it's something simple. Sugar's not just at the scene of the crime when it happens in populations. It's at the scene of the crime in the human body, which is the liver. If that's true, and you get the message across that these are disorders that nobody wants—nobody wants them in their family, nobody wants their children to have them—I think there will be, if we truly understood the cause, if we got it right, if we knew how to fix it, if that message was consistent from diet doctor to diet doctor to insurance agents to hospitals to physicians—'There is a cause'—if we understand that, then I think there will be a societal move to fix it. But again, we have to get it right. We have to get the science right.
Gillespie: Well, we will leave it there. We have been talking with Taubes. He's a science writer, whose most recent book is The Case Against Sugar, out in paperback. Gary, thanks for talking to Reason.
Taubes: Thank you, Nick.
The post Gary Taubes on How Big Government Made Us Fat appeared first on Reason.com.
]]>"Fish oil or omega-3 supplements won't help people with heart disease," writes nutritionist Alice Callahan in Lifehacker. Her source is a recent JAMA Cardiology meta-study that looked at 10 trials with a total of 77,?917 participants and found that "supplementation with marine-derived omega-3 fatty acids for a mean of 4.4 years had no significant association with reductions in fatal or nonfatal coronary heart disease or any major vascular events."
American consumers were told to supplement with omega-3 (and to eat more fish) based on studies of Inuit people in Greenland who eat a lot of omega-3-rich animals and have exceptionally healthy hearts. You should read Callahan's piece at Lifehacker for the full story (turns out, Inuit genes may be different than yours and mine), then check out the JAMA Cardiology paper if you want more.
The post you're reading right now, however, is about nutrition studies and why you shouldn't think about them too much.
Nutrition studies are confusing and mostly useless for regular people. I do not say that just because a leading nutrition researcher has been exposed for manipulating data for years and years. I say it because most nutrition studies test the validity of small claims that just don't matter in the larger scheme of living a life you love, and because the problems that ail us at the population level cannot be fixed with a bandolier of colloidal silver bullets. There is no "supplement" that can cure heart disease, or melt away obesity, or reverse the effects of inhaling a carcinogen all day, every day, for decades.
Take curcumin. For years and years, people have sworn by the yellowing agent in turmeric as an exceptionally potent natural remedy for almost everything. But as Derek Lowe noted last year, "no curcumin trial has ever reported any convincing positive results." Turmeric is a great ingredient. Put it on everything if you like—but because it tastes good, not because it'll change your genetic predisposition to disease or undo the decades you spent treating yourself like garbage. And if you live up north or are worried about bone health, there's no harm in taking the daily recommended amount of vitamin D in supplement form. Just don't expect it to cure your cancer.
Our desire for incontestable and universally true claims about nutrition reflects our fear of death and our inability to navigate the Age of Abundance, which I posit began in 1863 with the publication of William Banting's Letter on Corpulence, Addressed to the Public, and extends through today, when you can choose from 13 different types of Cheerios.
A wealth of options and of competing health claims, coupled with our ability to consume media everywhere, all the time, seems to have given many of us the impression that living a good life requires reviewing all of that information, deciding whether to believe it, and integrating new products into our lives on a revolving basis. Never mind that most of us aren't capable of critically reviewing the studies that produce these claims (nor are most journalists), or, that many such products are forgettable fads. Remember the pomegranate craze? How about the insanity over echinacea in the late 1990s and early 2000s? We'll probably be talking about coconut oil the same way a few years from now.
There is a simpler method for stocking your medicine cabinet and your fridge, and that is to opt out of the micro-efficacy debate entirely. Enjoy things you like in moderation, eat more things you generally resisted as a child (broccoli; I'm talking about broccoli), and don't throw money at the next big thing. Even if it is mildly carcinogenic, bacon alone probably will not kill you, any more than curcumin alone will allow you to live forever, even if is revealed to be mildly anti-inflammatory. For most Americans, there are bigger and more important questions to tackle: Am I getting enough sleep? How can I eat more perishable (read: fresh) foods? Should I be drinking less alcohol? What's a good way to quit smoking cigarettes? How do I work regular exercise into my schedule?
If you're in the 90th percentile, go nuts on the nootropics and BCAAs; maybe you'll get some marginal improvement. But if you live a sedentary life, sleep four hours a night, chain smoke, and/or eat garbage at every meal, it does not matter what vitamins you take or whether you eat garbage in small quantities five times a day or in larger quantities three times a day. Pursuing optimization strategies as a means to achieving a baseline level of health is like hanging a Kandinsky in a crackhouse.
None of this is to insult nutrition researchers or the general assignment journalist who cover their work. I think they sow confusion mostly by accident, and that many researchers of all stripes wish people read less into their (generally) narrow findings. But you don't need ever to read another nutrition paper or health trend story to live a relatively healthy life. Just sleep and exercise more; consume less alcohol and processed sugar; and for God's sake, quit smoking cigarettes.
You won't live forever, but you'll probably save a few bucks.
The post Free Yourself From the Soft Tyranny of Nutrition Studies appeared first on Reason.com.
]]>File another one under "health research too good to be true." After more than a decade of reports that extra weight could boost longevity and protect against death by heart disease, a new study casts doubt on this "obesity paradox."
The purported paradox first appeared in research on people diagnosed with heart disease. After a diagnosis, overweight and mildly obese individuals lived longer than their normal-weight counterparts, according to research funded by the federal government. In the hands of the health press, this became 1,000 headlines about how being overweight was actually good for your health.
Yet according to Northwestern University's Sadiya Khan, the real reason the data appeared to show this weighty benefit is that overweight patients were developing heart disease earlier in life than their normal-weight peers. Yes, they tended to live longer following a heart disease diagnosis—but that's only because they were getting heart disease years earlier than skinnier people did.
As the Pittsburgh Post-Gazette puts it, "one of the main effects of carrying around too much excess weight is that you get fewer years of disease-free life."
While the mildly overweight live about as long as their normal-weight peers, heavier folks spend more of those years in ill health. And extra weight is also associated with a greater risk of developing cardiovascular conditions in the first place, says the Khan study.
According to Khan's findings, published Wednesday in JAMA Cardiology:
Khan's research relies on data from the Cardiovascular Disease Lifetime Risk Pooling Project, and it includes an analysis of medical information on 190,672 Americans, each of whom were followed for at least 10 years.
Overall, extra weight raised a middle-aged man's lifetime risk of heart problems by somewhere between 18 percent (for the overweight) and 98 percent (for the morbidly obese), relative to their normal-weight counterparts. For middle-aged women, being overweight meant a 42 percent higher chance of heart problems, while being obese raised the risk by 75 percent and being morbidly obese raised the risk by 80 percent.
All this prompts the question: How did previous researchers on this topic manage to get things so wrong?
One answer is that early studies on the topic usually looked only at the period of time following a heart-disease diagnosis or negative heart-related event rather than considering a longer time period. And while researchers themselves often weighed the impact of this limitation—as well as the limitations of using measures such as BMI as a biomarker in the first place, and the danger of putting too much stock in one particular health outcome, like developing heart disease, while ignoring others—the nuances rarely survived a study's translation to a mass audience. Hence headlines like "A few extra pounds may cut risk of early death," "Why being overweight means you live longer," and "Scientists now think that being overweight can protect your health."
But bad health reporting doesn't deserve all the blame. Plenty of the published studies on the "obesity paradox" simply weren't that good, reflecting a larger crisis of credibility in the scientific and academic publishing community—a credibility crisis that's all too often overlooked in our government's rush to push food regulations under the veneer of science. Recently, this led to nationally implemented school "smarter lunchroom" programs that were informed by a body of research found to have serious flaws. Indeed, some of the research may have been entirely fabricated.
The "obesity paradox" is also rooted in the government. It starts with the National Institutes of Health (NIH). In 2005, an NIH researcher named Katherine Flegal published an analysis of Centers for Disease Control and Prevention data on mortality and weight, following this up over the next decade with several more papers in a similar vein.
"A lot of people interpreted this as being the official statement of the U.S. government," Walter Willet, chair of the Harvard Department of Nutrition, told Nature. Willet has not been shy about criticizing Flegal's work, declaring to NPR in 2013 that it was "a pile of rubbish, and no one should waste their time reading it."
Recent research has debunked all sorts of aspects of the supposed paradox. Using data from more than 225,000 long-term study participants, a 2017 study in the Annals of Internal Medicine showed that greater BMI was associated with greater risk of death from all causes, and a greater risk of dying specifically from heart disease; the association held up across sexes and age groups. Another 2017 study showed no obesity paradox when looking at new cases of cardiovascular disease.
Some scientists raised questions about Flegal's research from the beginning. "Closer examination of [obesity paradox] studies raises important questions on the validity of the paradox," stated a paper published in the American Journal of Cardiology in 2006.
"There is compelling evidence that the obesity paradox is not a real biological finding at all but just sloppy science," Boston University professor Andrew Stokes told Vox in 2015.
The post No, Being Fat Won't Help You Live Longer appeared first on Reason.com.
]]>Type II diabetes is one of America's most ubiquitous—and expensive—chronic diseases. Patients often require a suite of pharmaceutical products to manage high blood glucose levels, and the complications that arise over the long term, ranging from loss of vision and limbs to kidney failure and coronary artery disease, strain the resources of patients, their families, and the health care system.
The financial strain on insurance companies, employers, and Medicaid and Medicare is even more enormous. A 2013 study in the American Journal of Preventive Medicine put the lifetime direct medical costs for type II diabetes treatment at $124,000 for patients diagnosed in middle age. With nearly 30 million Americans affected by the disease, the American Diabetes Association estimates the national cost of direct diabetes care to be roughly $176 billion per year.
But unlike type I diabetes, which is an autoimmune disorder that destroys insulin-producing cells in the pancreas, type II diabetes is a lifestyle disease, and thus reversible. Over time, people with type-II diabetes can be made more receptive to their own insulin, which in turn allows their bodies to effectively clear glucose from the blood without insulin medication. The trick for the vast majority of type II patients is as simple as losing weight. ("The relationship between obesity and diabetes is of such interdependence that the term 'diabesity' has been coined," two diabetes researchers wrote in 2005.)
But that "trick" is actually pretty hard. Permanent weight loss without bariatric surgery is practically impossible at the population level. A 2014 study by Kaiser Permanente that looked at incidents of non-surgical diabetes remission in 122,781 patients found that it basically doesn't happen. The most commonly cited number among obesity researchers, meanwhile, is five percent—only five percent of people who lose weight without surgery will succeed in keeping it off over the long term.
Now Virta Health, a Silicon Valley startup, has developed a lifestyle modification system that can reverse the markers of type II diabetes. In a study published this month, Virta researchers found that over the course of a year, they were able to achieve remission of symptoms and a cessation of several pharmaceutical products in nearly two hundred patients using a "novel metabolic and continuous remote care model."
Virta uses a combination of the ketogenic diet—which involves moderate fat and protein intake combined with very low carbohydrate intake—and frequent remote contact with a physician and a health coach to help patients change their lifestyle and lower their body weight, their blood glucose, and their HbA1c (a biomarker for diabetes). In its February study, 94 percent of patients in the intervention arm of the trial were able either to cease using insulin or to radically lower their insulin dose, and all of the patients in the intervention arm were able to stop using a class of antidiabetic drugs called sulfonylureas, which increase the amount of insulin released by the pancreas. The control group meanwhile, increased its insulin use over the course of that same year.
At $370 a month, Virta's model isn't cheap, but it's cheaper over the course of a year than the suite of drug therapies many type II patients require. And if Virta's model is scalable, the long-term savings on dialysis, hospital stays, and management of diabetic foot ulcers could be massive. Already, the company has partnered with Purdue University and Nielsen to offer the Virta system as a covered health benefit to employees with type II diabetes. The company's stated goal is to reverse diabetes in 100 million people by 2025.
I recently spoke to James McCarter, Virta's head of research, about the company's treatment model and the broader landscape of type II diabetes care. McCarter received his A.B. in biology from Princeton, and he got his M.D. and a PhD in genetics from Washington University in St. Louis, where he's an adjunct professor at the medical school. Our conversation has been edited for length and clarity.
Reason: Every doctor recommends lifestyle modification as the first course of treatment for patients with type-II diabetes and pre-diabetes. Yet most patients end up on metformin and eventually insulin and some other pharmaceutical products. Physicians seem jaded about lifestyle modification as a viable treatment. Do they have good reasons to be jaded?
James McCarter: I think endocrinologists and primary care doctors have reason to be jaded, in that they've seen lifestyle modification fail so many times. The conventional advice of "eat less and exercise more" has been shown to not work. People can do caloric restriction for a while, but you know what happens when you calorically restrict without any overall strategy other than just eating less? You get hungry. Exercise, and you get hungry. You can battle that hunger and craving for a while, but eventually it's going to come back. What's generally seen with most lifestyle interventions is that people will lose five pounds and gain it back over the course of a year.
Exercise is great for overall fitness and something that I believe in strongly in terms of maintenance of overall health. But it's not a good strategy for weight loss.
Reason: So instead, type II diabetes patients and their doctors end up treating symptoms instead of trying to reverse the disease itself.
McCarter: I think that's right, and I think to your point about physicians being jaded, they've seen that lifestyle modification only works in a minority of people. They're not surprised when a patient comes back three months, six months, or a year later and the disease has progressed.
Reason: If one of the problems with lifestyle modification is that only a tiny fraction of patients can self-motivate or self-direct an effective change, what does the Virta model do differently? How do you help the patient who can't pull off lifestyle modification?
McCarter: If you look at a large study that was done by Kaiser a number of years ago, they saw that their remission rate of type II diabetes was well under 1 percent. We're seeing well over 50 percent. So what's causing that 50-times improvement in our results? It really comes down to two things. Let's talk first about the physiology and then we'll talk about the behavior change.
First of all, using nutritional ketosis as an underlying part of the physiology approach has a tremendous impact on people's ability to succeed in getting glycemic control, which is reduction in medications, improvement in metabolic health, and reduction in weight.
The reason for that is that unlike a willpower approach, where you're just trying to force yourself to eat less, using nutritional ketosis allows you to tap into body fat for fuel. That means you have incoming energy from your body fat storage and from dietary fat. As a result, people will naturally tend to eat fewer calories because they are satiated.
We ask people everyday, "Tell us on a four-point scale how you feel about your hunger, cravings, mood, and energy. What we see is that as people achieve nutritional ketosis, energy and mood go up, hunger and cravings go down.
In effect, the physiology of ketosis is providing you with a tail wind. It's making the whole process much easier.
Reason: Various kinds of diets can work for almost everyone for at least a little while. How do you make those new eating habits stick?
McCarter: The other part of our model is the coaching. The number of people who can just read a diet book and implement its recommendations without any monitoring or coaching is small. What we're doing with Virta is we're providing five things: We're providing a physician with telemedicine for medication management; a health coach with an ongoing, one-on-one daily relationship who consults on nutrition and behavior change; education that's provided online; biometric feedback; and an online community.
Essentially, we're providing a whole support environment that allows people to understand what they're doing and why.
Reason: Is there a calorie deficit? It seems like there would have to be for weight loss, but I'm also guessing that it would be a small one because you seem to be very skeptical of crash diets or excessive calorie restriction. Or does keto somehow defy the claim that calories out need to exceed calories in?
McCarter: Rather than measuring calories, what we're doing is having people monitor their approximate macronutrients. Roughly how many carbohydrates am I having on a daily basis? How much protein am I having on a daily basis? It's a low-carbohydrate, moderate-protein diet.
What we have people do instead of an elaborate food diary is measure daily blood beta hydroxybutyrate. That's one of the ketone bodies, and by seeing an elevation in beta hydroxybutyrate, we're able to say, "Oh, you're actually in nutritional ketosis which means you're burning fat for fuel which is what we want to achieve."
It doesn't mean you have a caloric deficit necessarily, but at least you're getting your diet and other aspects of your lifestyle correct in a way that supports nutritional ketosis. And we're looking at glucose as well. That way we can say on a daily basis, are you on track or off track?
Now, calories still do matter. What generally happens, even though we are not asking people to count calories, is that because they are feeling satiety in their meals at an earlier point, they're creating a deficit. Rather than having a second or third helping, they're saying after one helping, "Gosh, I feel you know, adequately full." They are generally eating less, especially in the first six months.
Reason: So instead of having the goal be "I will eat 500 fewer calories today than my body needs," patients are focused on getting the macro ratio roughly right and checking their efforts against the ketone blood test?
McCarter: Right, and it's going to be a different journey for everyone. Some people just get it right out of the gate. Other people will take quite a few weeks or even months before they really figure out exactly how to do this. One of the key things we've found is a need for individualization. We want this to work not just for the quantified self-optimizer, but for somebody who has had diabetes for 10 or 20 years, who is on insulin or other potent diabetes drugs they want to stop taking. It has to work for somebody who is a stay-at-home parent, for a business traveler, for somebody working the night shift. It has to work for different ethnic cuisines; it has to work for different dietary restrictions.
That's what both our software and our health coaches aim to do. Make changes that work for specific individuals.
Reason: Where do you think the rest of the medical community is on the utility of a low carbohydrate diet for weight loss? In the realm of nutrition science, the debate over dietary fat still seems pretty contentious.
McCarter: Conventional wisdom has shifted somewhat. Many physicians would describe it as effective for weight loss, but most would say that it is a short-term measure that is not sustainable. Many do worry about dietary fat. There is a growing movement that counters the status-quo. While the number of physicians that recommend a sustained low carb approach for weight loss and metabolic health is still limited, it is growing rapidly. For instance, the international petition [Dr. Sarah Hallberg of Virta and Indiana University Health] started for Dr. Tim Noakes last week has garnered nearly 35,000 signatures, including many physicians and medical professionals. [Editor: Tim Noakes is a South African physician who pioneered early research into the low-carb, high-fat diet as a treatment for type II diabetes. The Health Professions Council of South Africa is attempting to revoke Noakes' medical license because he told a woman on Twitter that she could feed her baby such a diet when the child finished breastfeeding.]
We find that when we start taking care of a patient, their primary care doctor, who often begins as a skeptic, quickly converts to a supporter based on the results we obtain and the supporting scientific literature we provide.
Reason: It seems like the ability to do a lot of this coaching and guidance remotely is what's going to make this model scalable for Virta and anybody else that wants to help large numbers of people make lifestyle modifications. Because if everybody needed to check in with someone who lived where they lived, this seems like a thing that could maybe only go so far.
Jim: You're exactly right. It doesn't work without technology and it doesn't work without the ability to provide what we call continuous remote care. We actually tested that in our clinical trial. Of the 262 people with type II diabetes that were in the intervention arm, half received everything remotely—the physician, the health coach, the education, all of it.
The other half received all the remote stuff but also came to an in-person classroom setting with 10 to 20 other people and a health coach at our clinic. Initially, it was once a week, and then less frequently over time. The outcomes between the in-person group and the remote-only group were statistically indistinguishable.
Reason: Most of my own weight loss was self-directed, but I recently signed up for a remote coaching service with daily lessons as a way to get better about my eating habits, and I noticed that the combination of check-ins with a real person and daily lessons on a website is strangely compelling for reasons that aren't entirely related to the content. I feel watched, but not in a bad way.
Jim: That's part of the reason we structured Virta the way we did, with an actual one-on-one relationship with a coach. There are prior clinical studies that have shown that when you have this coaching relationship, as opposed to entirely automated or entirely self-directed program, people will do better.
Reason: What do you make of the fact that some patients in your trial couldn't come off of metformin? Does that mean some aspects of type II diabetes are not actually reversible? That it could take longer to reverse the symptom that metformin treats?
Jim: Let me talk you through the medications a little bit and address Metformin as part of that. The first thing I should say is that medication reduction is symptomatic of an overall improvement in metabolic health.
Of all the medications for type II diabetes, there are things that can be done right away and there are things that take more time. First off, we want to avoid hypoglycemic events, which is low blood sugar. If you're on potent hypoglycemic medications, which are medications like sulfonylureas and insulin that lower your blood sugar, and then you go on a carbohydrate-restricted diet, that's going to drive you toward low blood sugar levels. So what we try to do early on is very aggressively remove sulfonylurea. Fully everyone in our trial were off that within the first three months.
After that, we're aggressively titrating the insulin downwards, so that about half of the insulin was gone by three months and another nearly half of patients had it reduced. Ninety-four percent of people in the intervention group were able to either reduce or eliminate their insulin use.
But the one that we generally will leave alone and not aggressively reduce is metformin. The reasons for that are that it is generally well-tolerated, it's generally inexpensive, and there's a growing body of evidence that it's effective in prediabetes. The American Diabetes Association now recommends metformin for people with prediabetes to prevent progression to diabetes, and there is also emerging evidence that it may have some other benefits, including longevity benefits.
That's the rationale to leave metformin in place if it's well-tolerated. Our definition for having reversed diabetes is that patients have glycemic control, which means they've lowered their hemoglobin A1C lower than 6.5, which is the diabetes threshold, without diabetes medications other than metformin.
Reason: Chronic diseases require decades of expensive treatment, which means effective lifestyle modification could save payers—be they insurance companies, patients, or employers—thousands of dollars a year per person. Can you talk a little about Virta's disruption potential and what kind of blowback that might attract?
McCarter: There's plenty of work to be done, so I'm not worried about what's going to happen to many of the incumbent players. For instance, there are not enough endocrinologists to take care of all the people with type II diabetes in the United States. If Virta is successful over time, maybe this allows endocrinologists, who are incredibly well-trained, to concentrate on more challenging diseases, like type I diabetes and other extremely challenging endocrine disorders.
As for the pharmaceutical industry, there's plenty of disease out there to be handled. There are also people for whom the types of behavior change we're advocating are not a fit for them. It's not as if we're going to get 100 percent adoption. The industry is going to be disrupted over time, but it will adjust.
Reason: So it's overly dramatic to say that one thing will work for everyone, or that an effective new treatment option will crater incumbents overnight?
McCarter: To get a sense of how industries adapt, it helps to look back at the late 1970s, which is when the dietary recommendations for low-fat foods came out. You can see that within about five years, the food industry rolled out thousands of products where they just removed fat and put in sugar and starch. That probably didn't do consumers any favors, but it showed the speed with which industry can respond.
Reason: The food industry seems to be changing again right now. I've noticed with delight that a ton of products now advertise their protein content on the package, the same way they used to advertise their low-fat content.
McCarter: Yeah, people are focusing on protein. In the coming five years, I think you're going to see a return to the idea that fats can be beneficial. As opposed to saying something is low-fat, I think you're going to see things that advertise as being high-fat.
Reason: That still feels far away to me, but maybe not that far. The number of products and recipes that incorporate chia and coconut and almonds has increased quite a bit. Those are all very fatty, delicious, and thus satiating things. It seems like the next logical step for manufacturers is being more explicit about why they think these products are good for us.
McCarter: There was actually a report from Credit Suisse a couple of years ago, maybe two years ago now, where they basically predicted all of this. It was kind of an industry direction report suggesting that fat was a marketing tool.
Reason: A health care tool potentially being scalable and scaling a health care tool are two different issues. How does Virta scale?
McCarter: On the commercial side of things, our goal is to make this available and affordable to everyone over time. To begin to break through, we've been concentrating on employers. Self-insured employers are on the hook for the costs. What we can do is we can go to that employer and say, "Hey, work with us to have your folks with type II diabetes join the Virta Clinic and turn that around." We put a fair amount of the fee structure at risk. It's outcomes-based, so if we don't succeed in reversing type II diabetes, we don't get paid.
Reason: Does Virta currently have a way to follow study participants past the 12-month mark? The Kaiser study you mentioned covers a pretty long time horizon, and I know obesity researchers like to point out that weight regain gets likelier with each passing year.
McCarter: Absolutely. The Virta-IUH trial (see clinicaltrials.gov listing) was originally designed for two years and has recently been extended to five years. You can read the description on our blog. We will be publishing two-year and five-year outcomes. We are also following our commercial patients long-term, with more to come on that in a few months. The longterm view is super important.
The post Is Keto the Cure for Type II Diabetes? appeared first on Reason.com.
]]>Most nutrition advice starts by telling you what not to do. Don't consume salt, eggs, butter, or fish. Don't drink. Avoid red meat.
It's not a fun way to eat. And according to Aaron Carroll, a doctor, columnist, and director of the Center for Health Policy and Professionalism Research at the Indiana University School of Medicine, it's an overly restrictive approach that is also not supported by the evidence.
In his new book, The Bad Food Bible: How and Why to Eat Sinfully, Carroll explores the history of nutritional advice, from media-driven fad diets to faulty government nutrition guidelines, and explains how to judge solid nutrition science from junk studies. He rounds up the evidence on butter, salt, dairy, gluten, alcohol, red meat, and more, and finds that much of what we think we know about healthy eating is based on shaky research or plain old myth. Ultimately, he argues that we should enjoy food, not fear it.
Over email, Carroll and I discussed the enduring appeal of dietary moralism, government's poor track record with nutrition advice and food policy, what nutrition science says about Thanksgiving, and his professional medical opinion about my ideal diet of potato chips, fried chicken, and whiskey.
Reason: Something I really appreciate about your book is that it's not moralistic or restrictive. Although you do issue some warnings about certain behaviors to avoid, a big part of your message is that it's actually fine to consume most food and beverages. It's a book that repeatedly says, sure, it's okay to eat or drink that, at least in moderation.
That's quite a bit different from a lot of the diet advice we see, which tends to be heavily restrictive and focused on what you should avoid consuming. And it's also different than the moralism found in a lot of hand-me-down health wisdom, which is all about which foods are inherently good and which are inherently bad.
What's the appeal of restrictive diet moralism? Why does it persist—and in many cases spread? It can't be because it's pleasurable to eat that way!
Aaron Carroll: For as long as I can remember, nutritional advice has always been about telling me I'm doing something wrong. It was always telling me I was eating the wrong things. Don't eat cholesterol. Don't eat fat. Don't eat carbs. You have to eat something.
I think there are likely a few reasons for this. One is that some people think that making people feel shame is a motivating factor. Another is that we tend to think that being overweight or obese is somehow your "fault" and that you, therefore, are to "blame". Too often we equate being overweight with a moral failing.
We also shouldn't discount the financial drivers. There's lots of money to be made by making people feel afraid, and it certainly works in food.
Reason: On a related note, I want to thank you for giving your official medical professional's blessing to my all fried chicken, potato chips, and whiskey diet. Oh wait, that's probably not right either. How do you balance the twin extremes of diet restrictionism and permissiveness? It seems like a hard thing for people to think about.
AC: There's always the danger that people will take what I'm saying and translate it into a license to eat anything they want all of the time. That's not what the book says. I would, however, say that the occasional dinner of fried chicken, potato chips, and whiskey isn't going to kill you either.
Too many medical professionals think that people can't hear nuanced messages. I get emails from them all the time saying we have to tell everyone to eat very low salt diets—even if they benefit few people and might be bad for some—because if we don't, then the people who need to restrict salt won't. I think most people are smarter than that. I think they can handle the nuance.
There are some guidelines in the last chapter of the book that would allow for a wide range of eating habits, including many "bad" foods, that would still be considered healthy.
Reason: Another thing I like is the way you handle the "study says" part of the healthy eating tips business. Every chapter debunks myths about food and drink related health risks, many of which have been spread using dubious, or dubiously interpreted, science. It really seems like you are taking aim at the entire diet advice industrial complex. What accounts for the huge amount of bad advice about eating that we see everywhere—from government sources and mainstream publications and even in scientific journals?
AC: Some of it is an overreach of science. Humans are complicated animals. The reasons we eat certain foods, or do anything for that matter, are much more complex than other species. Yet so much nutrition research is predicated on small studies of mice for short periods of time.
It's not just mouse research either. A lot of the human research done is observational, which is fine for looking for potential links between behaviors and outcomes, but isn't so good at figuring out causality. The number of good, long-term randomized controlled trials in nutrition is very, very small.
There are professional conflicts of interest all over the place, too. Many academics have made careers out of promoting things like a "low-fat" diet. When you get used to the grant money and prestige of being part of the consensus, it's very hard to change paths.
There's plenty of blame to go around with respect to the media as well. They trumpet results from flawed studies far too often. They also take each new study, no matter how small, as overturning all previous research without considering it in context. Well researched articles that consider all of the evidence, old and new, are harder to write and not nearly as click-baity.
Reason: Let's talk specifically about the government for a moment. Libertarians have been arguing for a while that the government has historically gotten an awful lot wrong when it comes to nutrition. The most notorious examples are the promotion of low fat diets and the—related—demonization of both saturated fats and salt.
Your book contains many examples in which advice or policy from official institutions has been either wrong or counter productive: Beyond mistaken diet advice, you talk about the USDA's promotion of milk and dairy products, restrictions on genetically modified foods in Europe and Vermont's state-level GMO (genetically modified organism) labeling, the World Health Organization connecting red meat and cancer. A lot of the mistakes went on for years, even decades, as contrary evidence piled up. You also write that nutrition guidelines are starting to catch up, at least in some instances.
It seems to me that, even limiting myself to examples in your book, the track record of government when it comes to diet and nutrition advice is not great. Doesn't the history here suggest that we should at least be cautious, a little skeptical—or maybe even very skeptical—when it comes to both government nutrition guidelines and policy interventions designed around that advice? Or, to put it another way, how can we be certain that we've gotten it right this time?
AC: If you're looking for me to argue against this, you've got the wrong guy. I've written multiple columns—and this book!—on how we've gotten food policy wrong, and how the USDA and other parts of the government continue to promote nutritionally questionable things. This includes support for the dairy industry, the demonization of eggs, and the many, many iterations of the food pyramid. During World War II, one of the seven food groups was "butter and fortified margarine." I think the policies around GMOs, around menu labelling, etc. have just more to do with politics than science.
That said, I think government is no better or worse than many other organizations when it comes to questionable food policy. Many professional medical organizations are just as guilty of being on shaky footing.
Reason: Relatedly, isn't there another problem with the sorts of nutrition guidelines we often see from official organizations, which is that a proper diet is going to be different for different individuals? It depends on all sorts of idiosyncratic personal factors: health history, activity levels, personal tastes, what you are optimizing for.
In your book, you note that one can eat a very broad range of foods you can eat in the context of a healthy diet. But a lot of nutrition advice, whether from official sources or from diet gurus, seems designed to push people into a fairly narrow range. The inherent problem with general guidelines seems even stronger when you're dealing with government guidelines, since they end up having so much influence. Without going so far as to say that no nutrition advice can ever be broadly applicable, it strikes me that there are real limits, and I wonder if you agree and what you think those limits are.
AC: Unfortunately, it's much easier to tell people what not to do than to tell people what to do. But I think you're noting the flaw with medical guidelines, in general. We have a general sense—because we have studies—of what to do in particular situations for particular people, usually at high risk. We get into problems when we start broadening those recommendations into other groups to catch a wider net. The benefits go down while the harms remain the same.
It's easy to spot people we know are eating really unhealthily and say, "don't do that." The problem is that we don't have the evidence base to tell reasonably healthy people—and most people fall into that group—what to do. I'm amazed when I talk to healthy, fit friends and they relate to me that their doctor just told them to make a drastic change in their life. Why?
You can make a lot of money by selling a new fad diet, but they are almost never evidence-based. They are always super-prescriptive, as well. In general, I think there are many, many diets that can fit into a "healthy" eating pattern. I try and get into those in the last chapter of the book. I doubt that will make me a lot of money.
Reason: Poor journalism on nutrition science is something you deal with a lot. Too many media reports are based on low quality studies, or single studies that are contradicted by other evidence. Your book guides readers through how to make better judgments about study quality, explaining differences between observational studies and randomized trials, and why reviews that aggregate multiple high quality studies tend to be best of all.
This is quite helpful. But it also seems, honestly, like a lot of work, especially for non-oddballs who don't enjoy that sort of research and don't have a lot of time to track down and read the studies themselves. What are you supposed to do if that describes you—besides, of course, buy your book? I almost wonder if, for many people, the best advice is to basically ignore the majority of media reports about diet and nutrition. But full on diet-science nihilism doesn't seem ideal either.
AC: You stole my good answer, which was to buy my book. But the longer answer is still similar. Find people you trust to report on the science, and not because they tell you what they want you to hear. The best sources in this area will tell you why you should or should not believe a study, not just what the study says. But if you need broader guidelines, if the news article you're reading is about a large, randomized controlled trial of human beings in the real world, I would pay attention. If it's not, then I'd check to see if it places the new study in context with everything that's come before. If it doesn't do that—I'd ignore it.
When my friends ask me this question, I always tell them, somewhat sarcastically, that they should ask me. I like to track down and read the studies. I even put a lot of them in convenient book format.
Reason: Cancer risk is something that comes up a lot in nutrition advice and in your writing. And in a lot of cases, your message in basically just: Don't worry about it too much. Even when studies do show increased risk factors, the increase in risk is often so small as to be almost meaningless. So when it comes to food and drink, is it safe to say that most relatively healthy people more or less shouldn't worry about cancer risks?
AC: Yes. One of my favorite studies ever was a 2013 systematic review that collected the research on 40 common ingredients selected from a cookbook. They found more than 260 studies that focused on at least one of the ingredients. They basically showed that you can find evidence to show that pretty much all of them could both prevent and cause cancer. If you cherry-pick, you can say almost anything you want about many ingredients and cancer.
Of course, some ingredients have more evidence that's bad than good. Even then, the absolute risks are small. Perhaps the best example is processed red meat, which the WHO thinks will raise your relative risk of cancer by 18 percent. That sounds scary. That's still debatable, but even if it's true, then it would mean that if I declared today that I would eat an extra three pieces of bacon every day for the next 30 years, my absolute risk of colon cancer might go from 2.7 percent to 3.2 percent. That's… not that scary. And I'm not going to eat that much bacon, so it's likely much less.
Reason: As you may have picked up, my biggest question when it comes to nutrition science is basically just: How certain can we really be? The science is complex, the studies are often weak or contradictory, and individual bodies have so much variation that even good studies can sometimes only provide us with limited information. There's been a lot of bad diet advice over the last few decades, and a lot of it has been based on what looks like scientific evidence.
And yet, like you, I am also reasonably confident that there's a lot we can and do know—about some of the risks with trans fats and sugar, for instance. So I'm curious, what are you least certain about when it comes to nutrition? What do you think the prevailing scientific consensus in 2017 is most likely to have gotten wrong, or to have not fully understood?
AC: I think I'm least certain about saturated fat. There are still some people who think that saturated fat is no big deal. I'm not so sure. I think the evidence base against it is still much weaker than many say, but I wouldn't go eating unlimited amounts of the stuff.
Unsaturated fats, on the other hand, appear to be much less harmful than many originally thought. Even the most anti-fat groups now seem to be saying that you should replace saturated fats with unsaturated fats as much as possible, but not with carbs which is, of course, not what they always said.
As to what we might be getting wrong—I think salt might be my top choice. There's a growing body of evidence that says that for many people, very low salt diets might not be a good idea. A lot of advocacy groups haven't grappled with that yet. I also think the anti-gluten fad will pass at some point.
Reason: Finally, Thanksgiving is coming up. It is, I think most would agree, the greatest food holiday. The entire celebration is built around the preparation and consumption of an extravagant, often gigantic meal. It is not quite a celebration of gluttony, but it is very much not a holiday concerned with moderation. So, what sort of advice can you give us about Thanksgiving dinner? What does diet science have to say about the plate—okay, plates—full of turkey, buttered rolls, and mashed potatoes that I plan to consume on Thursday?
AC: Science doesn't say much at all, I think. It's one meal a year—and, in my opinion, one of the best. I let it go that night. I eat extra pie, lots of mashed potatoes and gravy, and as much turkey as I can stomach. What you do on that one day isn't nearly as important as what you do on the other 364. It's a holiday. Enjoy it. That's what makes it special!
(This interview has been lightly edited for clarity.)
The post You Don't Have to Listen to the Government to Eat the Foods You Like. appeared first on Reason.com.
]]>The State of Florida is threatening a woman with jail unless she stops telling people what to eat.
To clarify: Heather Kokesch Del Castillo of Fort Walton Beach is not wandering around the supermarket in giving unsolicited advice. People have been asking her—and paying her—for dietary and nutritional advice. Though all she is doing is talking to people as a health coach, the state has declared her an unlicensed dietitian and fined her more than $750. She faces misdemeanor charges if she doesn't shut her mouth, with further fines of up to $1,000 for each incident and possibly even a year in prison.
She has turned for help to the lawyers at the Institute for Justice, who have been fighting overreaching occupational licensing schemes for years.
In this case, according to the institute's lawsuit, a licensed dietician looking to eliminate some competition snitched to the state. An investigator with Florida's Department of Health then posed as a potential customer and asked Kokesch Del Castillo for information about a potential weight-loss program. According the the lawsuit, she responded with information about her coaching services but at no point claimed to be a licensed dietitian.
Absurdly, the Department of Health held that by giving someone advice on how to lose weight, she was behaving like a licensed dietitian anyway. And as long as she didn't have the appropriate license, the government said, she'd have to stop. Becoming a licensed dietician in Florida requires a bachelor's degree in the appropriate field, completing 900 hours of supervised practice, taking a test, and paying fees. This would take years and cost thousands of dollars.
Yet if Kokesch Del Castillo put all her advice in a book, she could sell it to whomever she wanted. That's what makes the licensing law so absurd. It's obviously censorship, but they're disguising it as a public safety need in an attempt to bypass the First Amendment.
The Institute for Justice isn't having it:
The advice Heather offers is pure speech, no different from the constitutionally protected speech of the cookbook authors whose philosophies and recipes she recommends to her clients. In fact, under Florida law, it would be perfectly legal if Heather published her advice in a book. And under binding Supreme Court precedent, laws that restrict speech based on its subject matter are subject to the most rigorous level of constitutional scrutiny. Moreover, the Supreme Court has repeatedly held that the mere fact that a person is paid for their speech has no effect on its level of constitutional protection.
Florida is not the first or only state trying to censor diet tips as a form of occupational licensing. The Institute for Justice previously assisted a North Carolina blogger who the state tried to shut down for giving paleo-centered diet advice. The blogger won his fight, and the state issued new guidelines that didn't attempt to suppress free speech.
Nutritional guidance isn't the only sort of speech that has been censored via occupational regulation. The Institute for Justice also intervened when Kentucky's Board of Examiners of Psychology tried to treat a syndicated parenting advice column as an "unlicensed practice of psychology." Most recently, city officials have tried to use occupational licensing to control who is allowed to give paid tours of their communities.
Watch an Institute for Justice video below highlighting the absurdity of Kokesch Del Castillo's case:
The post Florida Threatens Woman with Fines, Jail for Giving Diet Tips appeared first on Reason.com.
]]>An international nutrition study spanning more than a decade has turned up unexpected findings that researchers say should cause health experts to reconsider global dietary guidelines.
The ongoing Prospective Urban Rural Epidemiology (PURE) project has found both saturated and unsaturated fat intake linked to better heart health, that a high-carb diet is a better predictor of health risks than fat consumption, and that the health benefits of fruit, vegetables, and legumes like beans and chickpeas may plateau at three to four servings per day.
The new analysis, presented at the European Society of Cardiology meeting this week in Barcelona, included 135,000 adult participants between ages 35-70 living in Africa, Europe, North America, South America, south Asia, southeast Asia, China, and the Middle East.
These participants responded to food-intake and lifestyle surveys between between January 2003 and March 2013, with an average follow-through of 7.4 years. Researchers considered health outcomes for participants through March 31, 2017, recording 5,796 deaths in total and 4,784 "major cardiovascular events" such as strokes, heart attacks, and heart failure.
Overall, carbohydrate intake in the highest versus lowest consumption groups was associated with 28 percent higher risk of death.
"Our findings do not support the current recommendation to limit total fat intake to less than 30 percent of energy and saturated fat intake to less than 10 percent of energy," said Mahshid Dehghan, a nutritionist from Canada's Population Health Research Institute at McMaster University. Dehghan is the author of one of several papers on the latest PURE-study findings.
Dehghan recommends "a total fat intake of about 35 percent of energy" in conjunction with lowering carbohydrate intake.
Looking Again at Legumes, Fruits, and Vegetables
Perhaps most notably, while higher fruit, vegetable, and legume consumption was associated with lower total mortality risk and less risk of death from non-cardiovascular causes, this benefit appears to max out at three to four servings, or around 375-500 grams, per day.
"Previous research, and many dietary guidelines in North America and Europe recommended daily intake of these foods ranging from 400 to 800 grams per day," said Andrew Mente, lead researcher on the fruits and veggies study published this week in The Lancet. "Our findings indicate that optimal health benefits can be achieved with a more modest level of consumption."
Fruit intake was linked to lower risk of death from heart disease and from other causes; frequent consumers of legumes had lower rates of death from all causes and from non-cardiovascular causes; and raw vegetable intake "was strongly associated with a lower risk of total mortality," while "cooked vegetable intake showed a modest benefit against mortality," Mente and his team found. (See more data from the study here and Mente's presentation to the European Society of Cardiology here.)
Cut Some Carbs, Keep the Fat
Looking at the link between macronutrients and heart disease, researchers found high carbohydrate consumption—defined as diets where more than 60 percent of calories come from carbs—increased the risk of overall death (though not the risk of heart disease or death from heart-related causes specifically).
Meanwhile, eating saturated, monounsaturated, and polyunsaturated fatty-acids was associated with lower death risk.
"Each type of fat was associated with significantly reduced mortality risk: 14 percent lower for saturated fat, 19 percent for mono-unsaturated fat, and 20 percent for polyunsaturated fat," according to the study. Higher saturated fat intake was also linked to a 21 percent decrease in stroke risk. (See more data from the study here, and Dehghan's conference presentation here.)
The same group of researchers also looked at the effect of fats and carbohydrates on blood lipids like cholesterol, triglycerides, and apolipoprotein. They found that LDL cholesterol, a measure that informs many government dietary guidelines, "is not reliable in predicting effects of saturated fat on future cardiovascular events." A better predictor, they found, is apolipoproteins A and B levels—something no one is talking about.
"For decades, dietary guidelines have focused on reducing total fat and saturated fatty acid intake based on the presumption that replacing [saturated fats] with carbohydrate and unsaturated fats will lower LDL [cholesterol] and should therefore reduce" heart and metabolic problems, noted Dehghan. But these recommendations rely largely on North American and European populations. "PURE provides a unique opportunity to study the impact of diet on total mortality and [heart disease] in diverse settings, some settings where over-nutrition is common and others where under nutrition is of greater concern," she said.
Not surprising, then, that their conclusions challenge common assumptions about nutrition.
But don't ditch grains entirely just yet. As Mente reminds us, the research supports the idea that high-carb diets are bad, but not necessarily that low- or no-carb diets are optimal. "It's [the high-carb eating] population that needs to reduce carb intake to more moderate levels," he said. "Our data doesn't support low carb but certainly it supports a moderate carb intake of 55 percent."
Mente also cautions against confusing population-level effects with individual risk reduction. "The effects are modest effects, in the neighborhood of a 20 percent reduction in relative risk," he said. "So if the annual [absolute] risk of mortality is 1 percent, it would be reduced to 0.8 percent. At the individual level, it is tiny…. Having said all that, at a population level, if these small effects are true and not due to confounding, they would translate into thousands or even millions of fewer deaths annually, depending on the size of the population, if the exposure is common which is certainly true for diet."
At any public health level—with the aim of better government dietary advice—"the findings are important," he said.
The post More Evidence That Everything the Government Teaches Us About Eating Is Wrong appeared first on Reason.com.
]]>For the better half of a decade, American public schools have been part of a grand experiment in "choice architecture" dressed up as simple, practical steps to spur healthy eating. But new research reveals the "Smarter Lunchrooms" program is based largely on junk science.
Smarter Lunchrooms, launched in 2010 with funding from the U.S. Department of Agriculture (USDA), is the brainchild of two scientists at Cornell University: Brian Wansink, director of the school's Food and Brand Lab, and David Just, director of the Cornell Center for Behavioral Economics.
The program is full of "common sense," TED-talk-ready, Malcolm Gladwell-esque insights into how school cafeterias can encourage students to select and eat more nutritious foods. Tactics include things like fruit before chips in cafeteria lines; pre-sliced rather than whole fruit; non-fat white milk prominent in beverage displays; giving fruits and vegetables "creative names;" providing "fruit factoids" on cafeteria white-boards; hiding cafeteria cleaning supplies; and having lunchrooms "branded and decorated in a way that reflects the student body."
This "light touch" is the foundation upon which Wansink, a former executive director of the USDA's Center for Nutrition Policy and Promotion and a drafter of U.S. Dietary Guidelines, has earned ample speaking and consulting gigs and media coverage.
Recently, however, scientists are challenging Wansink's work, pointing out errors and inconsistencies going back decades. For instance…
A History of Inconsistency
In a new paper—which has not yet been peer-reviewed or published—Eric Robinson, a professor with the University of Liverpool's Institute of Psychology, Health, & Society, points to problems ranging from simple sloppiness to errors that seriously call into question the integrity of all of Wansink's work.
Earlier this year, Nicholas Brown, a PhD student at the University of Groningen, discovered that much of Wansink's work was lifted directly from his previous work without citations or acknowledgement—a practice that's at least frowned upon in academia. And in at least one instance, two Wansink papers that purportedly rely on vastly different data sets yielded almost identical end results, down to decimal points, but with enough slight differences to discount simple clerical error.
"If the two studies in question are the same, then it would appear that there has been duplicate publication of the same results, which is not normally considered to be a good ethical practice," writes Brown. "On the other hand, if the two studies are not the same, then the exact match between the vast majority of their results represents quite a surprising coincidence."
In a January paper titled "Statistical heartburn: An attempt to digest four pizza publications from the Cornell Food and Brand Lab," researchers Tim van der Zee, Jordan Anaya, and Nicholas Brown analyze four articles from Wansink and his colleagues, finding "a remarkably high number of apparent errors and inconsistencies." These include:
In total, they found approximately 150 inconsistencies in reported statistics from the four papers.
Those papers are all based on one data set, from a single field-research experiment involving diners at an Italian lunch buffet. "However, none of the articles mentions that they are based on the same data set as their predecessors, even though they were published over a period of many months," the van der Zee study notes. "We consider that this may constitute a breach of good publication ethics practice."
In a now-deleted blog post, Wansink characterized his Italian-buffet experiment as a "failed study which had null results." But when Wansink's first thesis (which he never reveals) didn't pan out, he went looking for ways to reverse-engineer the data he did have into a thesis.
When [a visiting fellow] arrived, I gave her a data set of a self-funded, failed study which had null results (it was a one month study in an all-you-can-eat Italian restaurant buffet where we had charged some people ½ as much as others). I said, "This cost us a lot of time and our own money to collect. There's got to be something here we can salvage because it's a cool (rich & unique) data set."
I had three ideas for potential Plan B, C, & D directions (since Plan A had failed). . . . Every day she came back with puzzling new results, and every day we would scratch our heads, ask 'Why,' and come up with another way to reanalyze the data with yet another set of plausible hypotheses. Eventually we started discovering solutions that held up regardless of how we pressure-tested them. . . .
Wansink's colleagues—including Andrew Gelman, director of the Applied Statistics Center at Columbia University—quickly called him out on this cavalier attitude toward theory and apparent willingness to hack statistics into something publishable.
"Statistical tests are a messy business, our criteria are not stringent, the samples are small, something is bound to come up as significant if we look hard enough," noted neuroscientist Ana Todorovic. "Now, it's significant whether we looked at it or not–testing the data in many different ways is not the problem. The problem is not reporting all the other variables that were collected and all the other tests that were carried out. Because if we knew this was one result out of, say, 200 tests, then we would be less likely to give it much credence."
Gelman called Wansink's work "run-of-the-mill, everyday, bread-and-butter junk science."
As Jesse Singal at New York asked in March: "What possible reason is there to trust [the Cornell Food and Brand Lab's] output at all, let alone for journalists to continue to publicize its findings?"
Or, we might add, for the federal government to continue funding its implementation?
Far from being a well-tested approach, the Smarter Lunchrooms program was implemented in schools across America before the first randomized control trials on its effectiveness were even begun. "The speed at which this intervention approach has been implemented in schools surprised me because of the limited and low quality evidence base supporting it," wrote Robinson in the most recent comprehensive critique of Wansink's work.
The first serious study testing the program's effectiveness was published just this year. At the end of nine weeks, students in Smarter Lunchroom cafeterias consumed an average of 0.10 more fruit units per day—the equivalent of about one or two bites of an apple. Wansink and company called it a "significant" increase in fruit consumption.
But "whether this increase is meaningful and has real world benefit is questionable," Robinson* writes.
Nonetheless, the USDA claims that the "strategies that the Smarter Lunchrooms Movement endorses have been studied and proven effective in a variety of schools across the nation." More than 29,000 U.S. public schools now employ Smarter Lunchrooms strategies, and the number of school food service directors trained on these tactics increased threefold in 2015 over the year before.
One study touted by the USDA even notes that since food service directors who belong to professional membership associations were more likely to know about the Smarter Lunchrooms program, policy makers and school districts "consider allocating funds to encourage [directors] to engage more fully in professional association meetings and activities."
Earlier this year, Wansink responded to criticism by promising that he and his colleagues would review the data involved in questionable studies and make it publicly available. But this has not happened yet, and the blog post where Wansink made this offer has since been deleted.
A spokesman for the USDA told The Washington Post that while they had some concerns about the research coming out of Cornell, "it's important to remember that Smarter Lunchrooms strategies are based upon widely researched principles of behavioral economics, as well as a strong body of practice that supports their ongoing use."
Some might wonder what it hurts to put fruit in front of chips in school-cafeteria lines or ask lunchroom staff to consider aesthetics. For libertarians, one answer is obvious: we are shelling out all sorts of money and government resources to incentivize activity with no measurable benefit (all while creating new administrative positions and layers of bureaucracy to oversee these efforts).
Not only is there scant evidence to support the pricey program, the "Smarter Lunchrooms" boondoggle also distracts from figuring out how to really reform school cafeterias—something that folks on all sides should find concerning.
We might disagree on whether federal authorities should micromanage lunchroom menus or if local school districts should have more control, and what dietary principles they should follow; whether the emphasis of school cafeterias should be fundraising or nutrition; or whether school meals need more funding. But confronting these challenges head-on is a hell of a lot better than a tepid consensus for feel-good fairytales about banana placement.
*Correction: Eric Robinson, not Anderson, is the author quoted here.
The post The Junk Science Behind 'Smarter Lunchrooms' appeared first on Reason.com.
]]>The Centers for Disease Control and Prevention states that "most Americans should consume less sodium." The CDC asserts, "Your body needs a small amount of sodium to work properly, but too much sodium is bad for your health. Excess sodium can increase your blood pressure and your risk for a heart disease and stroke. Together, heart disease and stroke kill more Americans each year than any other cause."
Yet, evidence has been gathering for years that the amount of salt consumed by most Americans is not causing them appreciable harm. A new study that followed more than 2,600 people for 16 years in the Framingham Offspring Study, once again, debunks the Federal nutrition nannies' dire claims about salt. The new results are being reported by at the American Society for Nutrition Scientific Sessions during the Experimental Biology 2017 meeting in Chicago.
"We saw no evidence that a diet lower in sodium had any long-term beneficial effects on blood pressure," said Boston University School of Medicine lead researcher Lynn Moore. "Our findings add to growing evidence that current recommendations for sodium intake may be misguided."
The press release announcing the results noted:
The 2015-2020 Dietary Guidelines for Americans recommends limiting sodium intake to 2,300 micromilligrams* a day for healthy people. For the study, the researchers followed 2,632 men and women ages 30 to 64 years old who were part of the Framingham Offspring Study. The participants had normal blood pressure at the study's start. However, over the next 16 years, the researchers found that the study participants who consumed less than 2500 milligrams of sodium a day had higher blood pressure than participants who consumed higher amounts of sodium.
Other large studies published in the past few years have found what researchers call a J-shaped relationship between sodium and cardiovascular risk–that means people with low-sodium diets (as recommended by the Dietary Guidelines for Americans) and people with a very high sodium intake (above the usual intake of the average American) had higher risks of heart disease. Those with the lowest risk had sodium intakes in the middle, which is the range consumed by most Americans.
"Our new results support these other studies that have questioned the wisdom of low dietary sodium intakes in the general population," said Moore.
The researchers suggest that some subset of Americans may be especially salt sensitive and would benefit from consuming less. Better tests should be devised to identify such people so that the rest of us can consume our sodium in peace. As always folks, if your goal is to protect your health strive for moderation in what you eat and drink.
For more background on the ongoing collapse of dietary puritanism, see my article "The Red Meat, Eggs, Fat and Salt Diet."
*Press release said "grams," but as astute readers noted, it's really micromilligrams**. Fixed. **Haste makes mistakes.
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]]>
The Case Against Sugar, by Gary Taubes, Knopf, 368 pp., 26.95.
Less than 1 percent of Americans—1.6 million people—were diagnosed with Type 2 diabetes in 1958. As of 2014, that figure had risen to 9.3 percent, or 29.1 million. If current trends continue, the figure could rise to more than 33 percent by 2050. Something has clearly gone wrong with American health.
The rising rate of diabetes is associated with the rising prevalence of obesity. Since the early 1960s, the percent of Americans who are obese—that is, whose body mass index is greater than 30—has increased from 13 percent to 35.7 percent today. (Nearly 70 percent of Americans are overweight, meaning their BMIs are over 25.) Roughly put, the prevailing theory is that rising fatness causes rising diabetes.
But what if both are caused by something else? That is the intriguing and ultimately persuasive argument that Gary Taubes, author Why We Get Fat (2011) and cofounder of the Nutrition Science Initiative, makes in his new book, The Case Against Sugar.
For Taubes, sugar—be it sucrose or high-fructose corn syrup—is "the principal cause of the chronic diseases that are most likely to kill us, or at least accelerate our demise," explains Taubes at the outset. "If this were a criminal case, The Case Against Sugar would be the argument for the prosecution." In making his case, Taubes explores the "claim that sugar is uniquely toxic—perhaps having prematurely killed more people than cigarettes or 'all wars combined,' as [diabetes epidemiologist] Kelly West put it."
Taubes surveys the admittedly sparse research on sugar's psychoactive effects. For example, researchers have found that eating sugar stimulates the release of dopamine, a neurotransmitter that is also released when consuming nicotine, cocaine, heroin, or alcohol. Researchers are still debating the question of whether or not sugar is, in some sense, addictive.
In the course of his exploration, Taubes devastatingly shows that most nutrition "science" is bunk. Various nutritionists have sought to blame our chronic ills on such elements of our diets as fats, cholesterol, meat, gluten and so forth. Few have focused their attention on sugar. His discussion of how nutritionists started and promoted the now-debunked notion that eating fats is a significant cause of heart disease is particularly enlightening and dismaying. Nowadays the debate over the role of fats in cardiovascular disease consists mostly of skirmishes over which fats might marginally increase risk.
Interestingly, Taubes finds that a good bit of the research on fats was funded by the sugar industry. It is not just a coincidence that the low-fat food craze took off when the U.S. Department of Agriculture issued its first dietary guidelines in 1980 advising Americans to eat less fat. The added sugar that made the newly low-fat versions of prepared foods more palatable contributed to the rise in sweetener consumption. The USDA guidelines did advise Americans cut back on eating sugar, but they also stated that, "contrary to widespread opinion, too much sugar in your diet does not seem to cause diabetes." By the way, Taubes agrees since both sucrose and high-fructose corn syrup are essentially half glucose and half fructose there is no important metabolic differences between them.
Taubes reviews the global history of sugar consumption. The average American today eats as much sugar in two weeks as our ancestors 200 years ago consumed in a year. The U.S. Department of Agriculture estimates that per-person annual consumption of caloric sweeteners peaked at 153.1 pounds in 1999 and fell to only 131.1 pounds in 2014. A 2014 analysis of data from 165 countries found that "gross per capita consumption of sugar correlates with diabetes prevalence."
So how does eating lots of sugar cause disease? Reviewing the scientific literature, Taubes suggests that the high consumption of sugar eventually produces insulin resistance in the human body. That is, cells require higher and higher levels of insulin in order to coax them into metabolizing the extra glucose floating around in our bloodstreams. As a result, in order to reduce glucose levels in the blood, the pancreas produces more and more insulin—a spiral that often leads to diabetes. Taubes also cites findings that eating sugars boosts both cholesterol and triglyceride levels in the bloodstream, compounds that are associated with higher risks of cardiovascular diseases.
What happens to the fructose component of sugar? It is not regulated by insulin. Instead the oversupply of fructose goes to the liver, where it is directly transformed into fat. According to Taubes, additional glucose appears to increase the rate at which fructose is metabolized into fat. This process may well account for a good portion of the increase in obesity rates. Fat cells are not quiescent; they release various factors that increase inflammation, contributing to all sorts of chronic maladies, including arthritis, high blood pressure, heart disease, kidney disease, and dementia. A recent Australian study found that the lives of people who are diabetic at age 50 are on average three years shorter than those folk who are not.
What's the safe threshold for consuming sugar? Based on history, Taubes suggests that diabetes is rare until annual consumption begins to exceed 70 pounds per capita. He concludes that "enough evidence exists for us to consider sugar very likely to be a toxic substance, and to make an informed decision about how best to balance the likely risks with the benefits." He admits that his case is not definitive, but many readers will come away agreeing that sugar is a likely suspect in a great many modern maladies.
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]]>Less than 1 percent of Americans—1.6 million people—were diagnosed with Type 2 diabetes in 1958. As of 2014, that figure had risen to 9.3 percent, or 29.1 million. If current trends continue, the figure could rise to more than 33 percent by 2050. Something has clearly gone wrong with American health.
The rising rate of diabetes is associated with the rising prevalence of obesity. Since the early 1960s, the percent of Americans who are obese—that is, whose body mass index us greater than 30—has increased from 13 percent to 35.7 percent today. (Nearly 70 percent of Americans are overweight, meaning their BMIs are over 25.) Roughly put, the prevailing theory is that rising fatness causes rising diabetes.
But what if both are caused by something else? Eating way too much sugar.
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]]>I didn't vote for Donald Trump (I proudly voted for Gary Johnson, thank you very much) and I do worry about some (most?) of his policy ideas. Yet unlike many progressives, liberals, Democrats, libertarians, conservatives, and #NeverTrump, I'm not trembling in fear or quaking in anger over the transfer of power that happens on January 20. Part of the reason for my lack of pants-wetting is because of two books I've read in the past year. Neither is specifically about Trump—or even contemporary politics—but each holds some great lessons about how to deal broadly with the billionaire developer and the bigger question of out-of-control government power.
Penn Jillette's Presto! How I Made Over 100 Pounds Disappear and Other Magical Tales is a lean, mean diet memoir by the well-known magician that is leavened with tales of his two tours on the Trump-hosted Celebrity Apprentice. You'll not only learn how to go cold turkey from what Jillette calls the "Standard American Diet" (or SAD!) but get a strong sense of what makes the Donald tick. The other is a sobering book about the long-range hangover from the "noble experiment" in banning booze during the 1920s. Harvard historian Lisa McGirr's The War on Alcohol: Prohibition and the Rise of the American State is a tour de force of deep, serious research and analysis that's also a real page-turner. Most important to the current moment, she documents how federal powers don't ever really disappear. Instead, like parasites they find a new host to do their bidding after their original purpose is served.
Presto! begins a couple of years ago, with Jillette weighing in somewhere north of 330 pounds (folks that fat, he notes, stop weighing themselves). After years of high-blood pressure, self-delusion about what a "fat fuck" he had been for years, and a serious cardiac event, he's given an ultimatum by his doctor to lose lots of weight in six months or submit to stomach stapling. Jillette follows the diet advice of his friend Ray Cronise, a former NASA engineer turned nutrition guru. He eats nothing but plain potatoes for a couple of weeks and then slowly adds back other vegetables, fruits, and whole plants, all while losing almost a pound a day. Once he hits his target weight of around 230 pounds, he settles into a version of the "nutritarian" approach elaborated by Joel Fuhrman, the medical doctor behind Eat To Live and an ever-expanding web empire. It's a rollicking and profane story of self-control and literal and figurative reinvention. "The kind of guy I am," writes Jillette, "if I couldn't eat nothing, I was going to eat everything….There is nothing fun and sexy about moderation. To be thin, I needed to find a way to make my diet as extreme as my other lifestyle choices."
But what about Trump? As a very public libertarian who supported Gary Johnson throughout the presidential race, Jillette had little love for the Democratic nominee. "Eating pizza is voting for Hillary Clinton," he writes, meaning that casting a ballot for her would be the equivalent of one of his old comfort-food binges during which he would slather a hunk of cheese with peanut butter while driving to The Cheesecake Factory and eating two entrees and a dessert or three before heading to the movies and downing a bucket of buttered popcorn in which he's tossed a boxful of Milk Duds. And yet, he has warmer feelings for her than his TV boss on Celebrity Apprentice (indeed, in a complicated vote-swapping gambit, he actually voted for her in tightly-contested Nevada in exchange for a dozen other people voting for Johnson). "I really thought there could be no one worse than Hillary Clinton, and there is no one worse than Hillary Clinton except Donald Trump." Jillette likens Trump's hair to "cotton candy made from piss" and that's the closest he comes to a compliment.
Trump, Jillette says in a characteristic passage, has "filled our country with embarrassment, hate, and fear…fuck Trump in the neck." Presto! doesn't suggest that we can simply shed Trump the same way Jillette lost weight, but there's a clear lesson that we can at the very least take control of our own bodies and lives in profound ways that minimize the ability of Trump (or any other politician) to screw us over. And we can remain outspoken in our defiance of illegitimate power, wherever we find it. "Everything you love in life, everything you're proud of, you had to work for," he writes. "Live outside the law."
That's often easier said than done. Indeed, Lisa McGirr's profoundly disturbing The War on Alcohol underscores the high price paid by many of the people who did live outside the law during Prohibition. In New York (state and city) under the governance of Al Smith and Franklin Roosevelt, the ban on liquor wasn't particularly harshly enforced, but other parts of the country were a different story. Part of the power of McGirr's account is that revises our understanding of Prohibition as a set of rules that were widely scoffed at. In many—perhaps most—parts of the country, there were no loopholes to enforcement, especially if you were poor, female, immigrant, or black. Indeed, Prohibition is best understood as a means by which Progressives and Ku Klux Klanners alike could control undesirable behaviors and populations. "I believe in Prohibition" declared Eleanor Roosevelt in 1930 while Progressive leaders railed that "Alien illiterates rule our cities today; the saloon is their palace; the toddy stick their scepter." A Dallas-based Ku Klux Klan paper spoke in similar terms of the "fight…against the Homebrew and the Hebrew."
Prohibition, writes McGirr, gave rise the first truly national forms of law enforcement and, as important, to a then-unprecented state and federal prison boom. What became the FBI was empowered by Prohibition and so were other federal agencies that were created to enforce national liquor laws. When "the war on alcohol was over…the expansion of state authority that the war had engdendered…did not disappear; it merely lurched forward in new directions." The war on booze explicitly morphed into a war on drugs, with different "illicit" substances being identified with different sub-populations (marijuana was a Mexican threat, cocaine a Negro menace, opium a uniquely Chinese vice). Richard Nixon reinvigorated the war on drugs as part of his "law and order" campaign promises, but every president since Nixon, whether liberal or conservative, has increased the amount of money, resources, and prison beds for drug offenders. McGirr says that Prohibition was figuratively a "dry run" for the drug war by giving rise to a "carceral state" which has resulted in the United States holding the dubious honor of being the world's greatest jailer-nation.
Which brings us yet again to Donald Trump, who explicitly called back to Nixon by announcing he was a "law and order" candidate. It's not simply, or even mostly, drug laws that empower the president of the United States in the 21st century to do whatever he pleases. First under George W. Bush and then under Barack Obama, we've witnessed an incredible expansion of executive-branch power in which secret interpretations of law gave rise first to torture and later to a "secret kill list," among other awful things. Presidents no longer even pretend to consult Congress when engaging in war-making, for instance, and the use of so-called signing statements, executive actions and orders, and the use of recess appointments vastly multiplied first under a Republican and then a Democratic president.
And now whatever power has accrued to the Oval Office will be at the service of Donald Trump, a man who has shown little interest in or patience for limits on his behavior. Beyond telling the stories of people who had been ignored in previous histories of Prohibition, The War on Alcohol lays out why it's never a good idea to cede power to the government simply because you agree with the people wielding it at the moment. Sooner or later, McGirr's book reminds us, your enemy is going to be king of the hill.
That's the whole point of a principled libertarianism, which argues for a limited government, regardless of who is wielding power. It's not enough to change your positions on, say, executive power, simply because your tribe is calling the shots. Trump will enter office having garnered just 46 percent of the popular vote and even though he will work with a Republican majority in both houses of Congress, the Party of Lincoln is fractured enough that they will hopefully not work in lockstep. Despite winning the popular vote in the presidential race by almost 3 million votes, the Democratic Party, like its conservative counterpart, is not really a national party in any real sense of the word. Rather, each is governs different regions of the country when it comes to national politics.
If Donald Trump's victory bothers you—and there are many good reasons to be worried—this is the time to start whittling down what the president, Congress, and the federal government can do to you, me, or any us.
Watch Penn Jillette talk with Reason about Donald Trump, Hillary Clinton, Bob Dylan's genius, and losing 100 pounds:
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]]>Is eating too much sugar bad for you? And what's too much? As it happens average American per capita consumption of caloric sweeteners like refined cane sugar and high-fructose corn syrup is down from 111 grams per day in 1999 to 94 grams per day today. However, 94 grams per day adds up to over 75 pounds of sugar per year per person. Nearly 80 percent of the sugar we consume is found in candy, snack foods, and sweetened beverages, and is not inherent in the fruits and vegetables we also eat. A year ago, the government recommended that Americans get no more than 10 percent of their daily calories from added sugars. In 2,000 calorie per day standard diet, that would mean eating fewer than 200 calories in the form of sugar. Current consumption of 94 grams of sugar translates to 358 calories per day. (The U.S. Department of Agriculture has a different calculation in which per person annual consumption of caloric sweeteners peaked at 153.1 pounds in 1999 and fell to only 131.1 pounds in 2014.)
In September my colleague Elizabeth Nolan Brown reported on the recent study in the Journal of the American Medical Association that revealed that the drafter of the U.S. dietary goals was bribed by Big Sugar to demonize fat in the 1950s and 1960s. In this way, the sugar lobby managed to take the nutritional focus off of their own product as possibly delterious to good health. As Brown noted, "And this demonization of fat actually helped increase U.S. sugar consumption, as health conscious Americans replaced morning eggs and sausage with carbs like bagels, or turned to low-fat and fat-free offerings where added sugar helped fill the taste void."
Now Big Sugar strikes back? A new study (paywalled) just published in The Annals of Internal Medicine (AIM), purporting to review the dietary guidelines relating to the consumption of sugar issued since 1995 by various countries and international health agencies, finds that they do "not meet criteria for trustworthy recommendations and are based on low-quality evidence." The authors consequently conclude that "at present, there seems to be no reliable evidence indicating that any of the recommended daily caloric thresholds for sugar intake are strongly associated with negative health effects."
The Annals of Internal Medicine also published a companion editorial strongly critiquing the main article. First, the authors of the critique point out that the funders of the study are associated with sweetened beverage and candy manufacturers. In addition, they assert that including standards in the study that were devised in 20 years ago is misleading since scientific understanding of the role of sugar in metabolism and diet has advanced. Finally they further argue that applying the AGREE II clinical practice evaluation instrument is inappropriate for gauging the risk of consumption of added sugars at a population level.
In fact, as Americans consumed more calories, including more calories from added sugars, per capita the rates of obesity and Type 2 Diabetes soared.
As my colleague Brown astutely observed:
A report published last fall found that government nutrition rules have been and are still based more on money and politics than sound science. The latest update to federal dietary guidelines still cautions against saturated fat and sodium. Members of the committee that developed these guidelines have accepted funding from industry groups, such as the Tree Nut Council, and food companies such as Unilever. …
Funding good nutrition research is expensive, and we shouldn't automatically look at industry-funded studies or researchers who accept food-industry funding as suspect. But let's not pretend like this sugar scandal is simply a relic of the bad old days of non-disclosure and undue influence. There continues to be every bit as much reason to look skeptically at government dietary advice today as there was in the 20th Century.
In any case, it would be well to take findings of the new AIM study with considerably less than 10 grams of sugar.
Heads up I will be reviewing Gary Taubes' new book: The Case Against Sugar soon.
The post Sugar Wars: Junk Food, Junk Science, or Both? appeared first on Reason.com.
]]>The Food and Drug Administration issued proposed guidance in June to the food industry aiming to reduce the amount of sodium in many prepared foods. In its draft guidance, the agency stated:
Average sodium intake in the U.S. is approximately 3,400 mg/day. The draft short-term (two-year) and long-term (10-year) voluntary targets for industry are intended to help the American public gradually reduce sodium intake to 2,300 milligrams (mg) per day, a level recommended by leading experts and the overwhelming body of scientific evidence. The targets are also intended to complement many existing efforts by food manufacturers, restaurants, and food service operations to reduce sodium in foods.
The FDA further asserted:
CDC has compiled a number of key studies, which continue to support the benefits of sodium reduction in lowering blood pressure. In some of these studies, researchers have estimated lowering U.S. sodium intake by about 40 percent over the next decade could save 500,000 lives and nearly $100 billion in healthcare costs.
So, the science of salt is settled, right? Actually, no. The FDA asked for public comments on its draft guidelines and it evidently received sufficient pushback that it extended the deadline for comments until December 2, 2016. As I reported earlier more and more studies are calling into question that idea that reducing salt consumption at the population level will actually result in net health benefits. For example, the New England Journal of Medicine published a study in August 2014 finding that people who consume less 1,500 milligrams of sodium (about 3/4ths of a teaspoon of salt) are more likely to die than people who eat between 3,000 to 6,000 milligrams of sodium per day (1.5 and 3 teaspoons of salt).
The free-market think tank, the Competitive Enterprise Institute has submitted comments that show that the FDA's confident claim that reducing salt consumption by Americans will save lives is at best, a hope, and at worst, tragically wrong. The CEI comments to the FDA nicely summarizes the relevant scientific studies. Here is the nub of the issue:
Reduced sodium consumption affects different individuals in different ways. Only an estimated 17 to 25 percent of the population is "salt sensitive"—they experience higher blood pressure with increased dietary sodium—while 75 percent are considered salt resistant and will experience no change in blood pressure with altered dietary sodium. However, an estimated 11 to 16 percent of the population are inverse salt sensitive, which means reduced dietary sodium can increase their blood pressure. With this heterogeneity in response to salt, trying to force a population-wide reduction in sodium availability in order to reduce incidences of hypertension would be ineffective at best and counterproductive at worst.
Among other evidence, CEI cites a 2014 metanalysis in the American Journal of Hypertension of more than two dozen sodium studies which concluded that risk of death appeared to be lowest among individuals consuming between 2,565mg and 4,796 mg of sodium a day with higher rates of death in the upper and lower range. The FDA itself notes that average daily consumption - 3,400 mg - is right in the middle of that range.
CEI correctly argues:
For a minority of the population, reducing dietary sodium can be an effective means of lowering cardiovascular and hypertension risk. But identifying for whom sodium restriction may be beneficial and by how much is something that individuals and their doctors must determine. For the general population, sodium reduction is, by no means, a silver bullet to reducing hypertension and has the potential to increase risks for a large portion of the population.
Treat people as individuals not just as members of an undifferentiated public health herd. Let's hope that the FDA will heed this advice and withdraw its misguided draft guidance.
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]]>Newly released historical documents show how the sugar industry essentially bribed Harvard scientists to downplay sugar's role in heart disease—and how the U.S. government ate it up.
The link between a high-sugar diet and the development of metabolic problems had begun emerging in the 1950s. In 1965, a group called the Sugar Research Foundation (SRF) funded a study assessing previous studies on this possibility. That literature review, published in the prestigious New England Journal of Medicine in 1967, concluded that fat and cholesterol were the real culprits when it came to coronary heart disease.
"The SRF set the review's objective, contributed articles for inclusion, and received drafts," according to a new paper published in JAMA Internal Medicine "The SRF's funding and role was not disclosed."
The New York Times wants this to be a story about junk-food bigwigs screwing with science to the detriment of American health. And it is, in part. But beyond that, the findings also indict "dietary science" that the U.S. government has been pushing for decades, and still continues to push.
As we know now, high cholesterol levels in the blood may portend heart problems, but consuming high-cholesterol food—such as eggs, long demonized as a heart-health no-no—doesn't correlate to high blood-cholesterol. And saturated fats come in many forms, some bad for you and others some of the healthiest things you can consume.
But for decades, conventional wisdom in America said that dietary fats and cholesterol were to be extremely rare in a nutritious diet. Meanwhile, sugar got a rep for rotting your teeth (and maybe packing on a few pounds) but was otherwise considered benign. And this demonization of fat actually helped increase U.S. sugar consumption, as health conscious Americans replaced morning eggs and sausage with carbs like bagels, or turned to low-fat and fat-free offerings where added sugar helped fill the taste void.
How did Big Sugar pull this off?
With a little help from Harvard scientists, for starters. SRF—now called the Sugar Association—paid three of them the equivalent of $49,000 in today's dollars to publish the misleading literature review. One of these scientists, the late D. Mark Hegsted, went on to become a major driver of U.S. dietary advice.
In the early '60s, Hegsted had developed what came to be known as the "Hegsted equation," which allegedly showed how saturated fats in eggs and meat raise blood cholesterol. A few years after he was paid by the sugar industry to demonize fat and cholesterol, he was elected to the National Academy of Sciences and edited its Nutrition Reviews for a decade.
Hegsted would also go on to help the U.S. Department of Agriculture (USDA) draft its first "Dietary Goals for the United States," a 1977-precursor to today's federal Dietary Guidelines for Americans, and to be hired by the agency as the head of its nutrition division, a position he held from 1978-1982.
"Even though the influence-peddling revealed in the documents dates back nearly 50 years, more recent reports show that the food industry has continued to influence nutrition science," the Times notes. That's also true. What the Times doesn't say, however, is how much the food industry continues to influence federal food policy and advice even independent of any shady research.
At the 2015 National Food Policy Conference, a two-day affair I attended in downtown D.C., food-industry associates gave talks alongside federal officials and their logos— Nestlé, Dannon, Cargill—were splashed everywhere. The food industry has and continues to influence nutrition "knowledge" because federal agencies encourage it.
A report published last fall found that government nutrition rules have been and are still based more on money and politics than sound science. The latest update to federal dietary guidelines still cautions against saturated fat and sodium. Members of the committee that developed these guidelines have accepted funding from industry groups, such as the Tree Nut Council, and food companies such as Unilever. (Last fall also brought revelations of some questionable connections between Unilever, the American Egg Board, and the U.S. Food and Drug Administration in a bizarre plot to take down vegan mayonnaise).
Funding good nutrition research is expensive, and we shouldn't automatically look at industry-funded studies or researchers who accept food-industry funding as suspect. But let's not pretend like this sugar scandal is simply a relic of the bad old days of non-disclosure and undue influence. There continues to be every bit as much reason to look skeptically at government dietary advice today as there was in the 20th Century.
The post Drafter of U.S. Dietary Goals Was Bribed by Big Sugar to Demonize Fat appeared first on Reason.com.
]]>Is orange juice healthy? Unhealthy? What about butter, steak, hamburgers, turkey, bacon, beer, wine, soda, wheat bread, white bread, peanut butter, and coconut oil?
Earlier this week, the New York Times's Upshot blog released the results of a survey of consumers and nutritionists that asked about their respective perceptions of whether dozens of foods are healthy or unhealthy. Those perceptions often differ markedly. And it's not clear whose opinions, if anyone's, is "right"—or even if there's such thing as a right answer.
"Unfortunately," Upshot writers Kevin Quealy and Margot Sanger-Katz conclude, "the answer is anything but simple."
The study's results are, in many cases, an eye opener. Ninety percent of nutritionists say cottage cheese is healthy, but only around fifty-five percent say the same of cheddar cheese. An overwhelming majority of consumers and nutritionists agreed that hamburgers aren't healthy, but that steak is.
"No food elicited a greater difference of opinion between experts and the public than granola bars," write Quealy and Sanger-Katz. "About 70 percent of Americans called it healthy, but less than 30 percent of nutritionists did."
Fascinated by the study—at a time when more and more government bodies seek to write rules based on what foods they believe are or are not objectively "healthy"—I asked a diverse handful of experts from various food-related fields to respond to four questions about the quality of the survey, any surprises they saw in the responses of those surveyed, and the overall lessons they feel the survey conveys.
The respondents are:
Mostly, as their comments below demonstrate, it appears that there's at least as wide a gulf between the experts I surveyed as there is between the consumers and nutritionists surveyed by the New York Times.
Edward Archer, Ph.D., obesity theorist and Chief Science Officer for EnduringFX
1) What is your overall opinion about the results? What, if anything, does the study get right/wrong?
The study is based on a false dichotomy and a flawed narrative. We are not what we eat. Our health is the confluence of our inherited physiologic properties (e.g., our metabolism) and our behaviors. Therefore, 'health" is a property of the person and not an inherent property of foods and beverages.
2) On which foods (if any) do you side with consumers rather than nutritionists?
The dichotomy of "healthy" vs. "unhealthy" is unscientific. For example, how would you save a starving child? Would you feed him or her a "root-beer float" (i.e., a sugar-sweetened beverage and ice cream), or a "healthy" meal of organic carrots, quinoa, and kale? If you answered the root-beer float, you would save the child's life. If fed the "healthy" diet, the child would starve due to a lack of protein and/or energy.
3) On which foods (if any) do you side with nutritionists rather than consumers?
As long as the foods or beverages on the study's list do not contain large amounts of pathogens and are consumed by a healthy person, everything on the list is safe to eat. But be careful not to conflate "safe to eat" with "healthy." These terms are not synonymous.
4) What broad trend(s) or idea(s), if any, do you identify in the study results?
The false dichotomy and flawed narrative upon which the study was based demonstrates the scientific illiteracy of the persistent myth "we are what we eat," and the erroneous notion that we can diet our way out of a sedentary lifestyle.
Dr. Joy Dubost, dietitian, Washington, D.C.
1) What is your overall opinion about the results? What, if anything, does the study get right/wrong?
The results are interesting but what was the point of the survey and does this create more confusion on nutrition? I tend to focus more on overall healthy diets rather than force fitting specific foods into what is essentially being classified as "good" or "bad" foods. Interesting to note at the end of the article the nutritionists note there is "no special rules or restrictions" for diets. If this is truly the case why classify the foods if all foods fit into a diet?
2) On which foods (if any) do you side with consumers rather than nutritionists?
Sushi. This is one of those cases that it is a "broad" category and can become dependent on what comes with the fish, particularly within a roll. I would suspect one can argue sashimi is healthy, but I would be hesitant to state that all sushi is healthy. Wine. The research indicates any potential benefits from moderate consumption of alcohol are directly related to the ethanol content, which includes beer, wine and spirits.
3) On which foods (if any) do you side with nutritionists rather than consumers?
Coconut oil. Emerging evidence indicates that not all saturated fat is created equal and thus has the same detrimental effects. However at this point, I would be hesitant to recommend using coconut oil versus other oils that contain higher amounts of mono and polyunsaturated oils.
4) What broad trend(s) or idea(s), if any, do you identify in the study results?
Much of this depends on the trends within restaurants and retail, as well as media headlines a particular food may receive. The more consumers are inundated with headlines and popular opinion on a specific food, the more their own opinion is shaped regardless of where the science stands.
Michael Greger, M.D., Director, Public Health and Animal Agriculture, Humane Society of the United States
1) What is your overall opinion about the results? What, if anything, does the study get right/wrong?
Well, the premise of this comparison appears to me to have a serious flaw. The "experts" are called nutritionists, but "nutritionist" is one of the few titles which [does] not require any formal training, certification, or degree. So the difference between the public and the nutritionists, is that the nutritionists self-identify as such (not that the nutritionists actually have any more training than the public).
2) On which foods (if any) do you side with consumers rather than nutritionists?
Consumers are correct on granola. While most processed granola bars would not make the cut (based on the 5:1 carb:fiber rule) However, the largest nutrition population studies in the world associate the consumption of whole food plant-based foods (such as granola bars when made from foods like whole grains, dried fruits, nuts, and seeds) with health and longevity.
3) On which foods (if any) do you side with nutritionists rather than consumers?
Around the world, the longest lived people are those who eat beans every day-whether it's the Japanese eating soy, the Swedes eating brown beans and peas, or those in the Mediterranean eating white beans, lentils, and chickpeas. Did you know 2 tablespoons of beans a day is associated with an 8% reduction in the risk of premature death? So the research says: hummus for the win!
4) What broad trend(s) or idea(s), if any, do you identify in the study results?
Despite the fact that global fast food revenues last year were $570 billion, it does appear that everyone polled now realizes that processed foods, and foods that contain saturated fat, cholesterol, added sugar or salt cannot be called healthy. So now we just need to align what we know with what we actually consume (and what businesses we support with our consumer dollars).
Julie Kelly, National Review Online contributor and food/agricultural writer, Orland Park, Ill.
1) What is your overall opinion about the results? What, if anything, does the study get right/wrong?
It's interesting to gauge the opinion of the two different groups, but whether a food is "healthy" or not is mostly subjective. What might be healthy for a teenage athlete (protein, fat, sodium, etc.) might not be the right diet for an overweight middle-age man trying to lose weight. I've said that I think we are making a big mistake, for example in school nutrition programs, applying adult diets to children or teens. What's healthy for one age group/gender might not be for another.
2) On which foods (if any) do you side with consumers rather than nutritionists?
None. I can't believe anyone would think a Slim Fast shake is "healthy."
3) On which foods (if any) do you side with nutritionists rather than consumers?
Wine for sure, not just some physical health benefits but moms around the world depend on this elixir for mental health. Hummus is good as long as it's not too doctored up with other ingredients. Tofu should be outlawed.
4) What broad trend(s) or idea(s), if any, do you identify in the study results?
Overall, I think people are starting to embrace fat again, not just as science disproves a correlation between animal fat and some diseases, but because its more satisfying and filling. When I taught cooking classes, most of the moms were shocked I used whole dairy products and butter. Food tastes better, you are less hungry during the day and there may be some health benefits as well.
Pete Kennedy, Esq., attorney, Farm-to-Consumer Legal Defense Fund
1) What is your overall opinion about the results? What, if anything, does the study get right/wrong?
The results are not something that anyone should adopt as their own personal dietary guideline. The study underestimates the nutritional value of red meat; also it does not distinguish between raw and pasteurized dairy–they are different food categories. Tofu is NOT a health food. I agree with eggs being rated nutritious by both groups.
2) On which foods (if any) do you side with consumers rather than nutritionists?
I side with consumers on the nutritional value of coconut oil and on the lack of nutritional value of tofu.
3) On which foods (if any) do you side with nutritionists rather than consumers?
I side with the nutritionists on the nutritional value of shrimp and I agree on the lack of nutritional value of the SlimFast shake and American cheese.
4) What broad trend(s) or idea(s), if any, do you identify in the study results?
I notice there's still an unfounded fear of higher cholesterol foods such as meat and dairy. The overall belief that carbohydrates are healthier than fats remains. Unfortunately, it seems that the dietary pyramid that the pharmaceutical companies have funded over the years still has too much influence.
The post Does Classifying Food as 'Healthy' or 'Unhealthy' Miss the Point? appeared first on Reason.com.
]]>For several years, so-called "food deserts"—low-income neighborhoods devoid of nutritious food options—were an oft-cited culprit for America's high obesity levels. Everyone from state senators to Michelle Obama had ideas about how to fix the issue, from launching new farmer's markets in these neighborhoods to state grant programs designed to entice more fruit-and-veggie offerings to bans on new fast-food restaurants opening in these areas. The kicker was a multi-million dollar federal initiative, spearheaded by the First Lady, to promote farmer's markets and attract more grocery-store chains to food-desert neighborhoods.
"Since 2011, the Federal Government has spent almost $500 million to improve food store access in neighborhoods lacking large, well-stocked grocery stores," according to the U.S. Department of Agriculture (USDA). "States and local governments have also launched programs to attract supermarkets or improve existing stores in underserved areas. For example, the Pennsylvania Fresh Food Initiative has provided $30 million of public funds (matched with $117 million of private investment) to help address limited store access in underserved urban and rural areas throughout Pennsylvania."
The theory was simple: poor people simply lacked easy access to healthy food options. If you put fruits, vegetables, and whole grains in front of them, they would soon be singing the praises of Michael Pollan, too. And voila: no more obesity epidemic in these neighborhoods.
But of course things didn't work out that way. As many business owners in these neighborhoods and other food-desert skeptics have pointed out, the problem wasn't that they simply hadn't thought to offer more wholesome items. The problem was that these items just didn't sell. You can lead human beings to Whole Foods, but you can't make them buy organic kale there.
The USDA just admitted as much, with a new report on food deserts published in its magazine, Amber Waves. Highlights from the article note that proximity to supermarkets "has a limited impact on food choices" and "household and neighborhood resources, education, and taste preferences may be more important determinants of food choice than store proximity."
While limited early research "found a positive correlation between access to a supermarket (or other stores selling a wide variety of healthful food) and diet quality," these studies generally only measured food purchases for a short time period and often failed to "consider the fact that most households have access to a vehicle and are able to travel beyond the local food environment to shop for groceries." More recent and robust data "show that the effect of food store access on dietary quality may be limited."
Using data from several national food studies, the USDA determined that both low- and higher-income households tend to shop at supermarkets. Overall, 90 percent of households in a 2012-2013 study shopped for groceries at "a supermarket or supercenter." The figure was nearly identical for households that participate in USDA's Supplemental Nutrition Assistance Program (SNAP)—what used to be known as food stamps—or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and for households deemed as "food-insecure."
Both low and higher-income households also tend to travel to shop, often bypassing the nearest market when getting groceries. "This behavior was consistent across transportations modes; even those who walk, bike, or take public transit traveled, on average, farther than the distance to the nearest supermarket to do their primary food shopping," the USDA states. This suggests "that most U.S. households are not limited by the food stores in their own neighborhoods."
In low-income neighborhoods defined as food deserts, "limited food store access showed a modest negative effect on the nutritional quality of consumers' diets," with consumers in these neighborhoods purchasing 4.3 percent less fruit, 2.4 percent less vegetables, and 10.4 percent less low-fat milk products than consumers not living in such areas." (Why the government persists in defining low-fat milk as the healthiest milk option is a mystery.) Customers in these areas also bought more diet drinks, more red meat, more poultry, and more fish.
The USDA notes that another recent study found SNAP beneficiaries "were more sensitive to price than to food store access. Participants with very difficult access purchased smaller amounts of perishable foods than shoppers with easy access. However, the prices of different food groups were more important determinants of purchase decisions than was access. When price and demographic factors were accounted for, the effects of food access were negligible." When considering 13 food groups, "price increases led to statistically significant declines in purchases by SNAP households for all 13." But difficulty in accessing an item was associated with fewer purchases of only one food group (noncanned fruits and vegetables).
Research looking at specific low-income neighborhoods and the effect of new grocers opening found no association between shopping at the new store and dietary improvements and found slightly decreased consumption of fruit and vegetables. A 2014 study of two neighborhoods in Philadelphia found the opening of a new supermarket improved "residents' perceptions of food accessibility in the neighborhood" but did not lead to increased consumption of fruits and vegetables.
The post Five Years and $500 Million Later, USDA Admits That 'Food Deserts' Don't Matter appeared first on Reason.com.
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