This is a bit of a long post, but it’s important!  It’s part of a series where I hope to help you to find out how to make decisions about life!  Big aim!  In this post we will discuss knowledge, epistemology, paradigms, statistics, and how journalists, marketeers and others try to pull the wool over our eyes.  Here we go …

When I began this post it was a chapter for my book; the chapter was called “Back to School”.  But I was worried about the chapter title: I hated school and if I saw a chapter called “Back to School” in a book it might have put me off. I suppose if you’re still reading then it hasn’t put you off!

I hope not, because this information is important (and I’ll do my best to make it unlike my experience of school). But here’s the problem: there is an awful lot of information out there about diet and nutrition. Some of it is useful, some of it is downright wrong. Some is misleading. Some is relevant to some of the people, some of the time and not relevant to others. How on earth are you going to be able to make up your mind what to do? How are we going to find out the knowledge we need, and differentiate it from knowledge that’s unhelpful?

To make matters worse I believe that there are a lot of people that we might think we can trust to have the knowledge we need: dietitians  doctors and the like. It turns out that many of them don’t really know either! My evidence for that is simply that if you start reading you will find that there are doctors out there who violently disagree with one another. They can’t all be right, so some of them must be wrong! But each believes that they know what they are talking about. In order to be able to begin to unravel this mess, we need to spend a little time thinking about how we know what we know (and, hence, how other people, like the doctors and nutritionists, know what they know).

What I am aiming to do in this post is to give you the knowledge that you need to be able to make up your own mind about what seems right for you and how you might judge who to believe and who not to believe.

This subject (how do you “know what you know”) is called epistemology (eh-piss-tem-ology) and is a key part of philosophy.  It may all seem terribly esoteric and too complicated to worry about.  But have you ever been in the position of being absolutely convinced that you were right about something, and then discovering that you were wrong?

The philosophers talk about knowledge being “justified belief”, and it is this question of “justification” that is the key.  You thought that you were justified in believing something, but it turned out that you weren’t.  If I were to tell you that I am a “young earth creationist” and I believe in the absolute truth of every word in the Bible, then, depending on your beliefs, you’ll either believe everything I say, or write me off as a nutter and disbelieve everything I say.  On the other hand, if I tell you that I have a PhD in applied physics and that I am a convinced atheist, then a different set of people will believe me or reject what I have to say.

This is because different people have different ways of justifying their beliefs; of having faith in what they know.  What I want to do here is to show some of the tricks of the trade, so that you are better able to work out whether the knowledge that people offer you is a justifiable belief, or not.

Just so you know, I am not an atheist, nor even an agnostic.  I have both philosophical and scientific training.  I am not a “young earth creationist”, and I believe that you can find nutters with unjustifiable beliefs in just about every school of thought out there!  I try to avoid calling them out in public: it won’t change their minds and it just makes enemies.

While we’re on the subject of jargon, I want to introduce another word that may be new, “paradigm” (para-dime).  The word has been around for centuries but was used in the last century by Thomas Kuhn to talk about what he called “scientific revolutions”.  A paradigm is a whole set of beliefs that all seem to support one another, until you get a “prevailing world view” that seems, to almost everyone” to be “true”.  One example was the paradigm about the earth as the center of the universe, with the sun going round it.  When Galileo called that idea into question it almost got him killed.

It is in the nature of “scientific paradigms” that we have a whole set of beliefs that all seem to hang together, except, maybe, for one or two minor, irritating bits of data that don’t fit.  Most people say that the observations that produced those irritating bits of data were just wrong.  But eventually more and more bits of irritating data turn up, until someone has a sudden insight, and a whole new idea (or paradigm) is born.  If you had a scientific education that included a bit of science history, you may have come across the “phlogiston” theory, or the theory of the “ether“.  One with which we struggle now, that is relevant to our concerns, is the theory that dietary fat is bad for you and that we should all be eating “healthy carbs”.  To many people this isn’t a “belief”, or a theory or a paradigm, it is the TRUTH!

The irritating bit of data is that, despite pushing this advice for 50 years, we are all getting more and more obese, there is an increase in diseases of inflammation, and auto-immune disease are also increasing at an alarming rate.

Liz Lipski, PhD, CCN, CHN

This “inconvenient data” is dismissed in various ways by those committed to the old paradigm, as are the “unscientific people” who are looking for alternative theories that embrace and acknowledge these facts.  I think I may be revealing my personal biases here.  And although no-one has been burned at the stake for saying that dietary fat isn’t bad for you, there have been incredibly intelligent, knowledgeable and high-qualified people who have been pilloried by the establishment for being heretics.  One example is Liz Lipski, PhD, CCN, CHN, a highly-qualified nutritionist in North Carolina, USA, who has been denied the right to practice, despite having 30 year’s experience in the field.  Passions are raised!  Check out her story on the web page set up to try to defend her.  By the way, back in primitive times people could be killed for their beliefs, or, slightly less extreme, they could be exiled.  Of course, that wouldn’t happen today, would it?  Well, Liz Lipski used to live and work on North Carolina.  Now she’s based in Maryland.  I wonder if the reactionaries will follow her there?

Arthur Fry, inventor of the Post-it note, with one on his forehead with a picture of a light bulb. Wikipedia Collective Commons

Over 30 years ago I learned something called “co-counselling” (it’s what’s behind “Together We Can”). I can still remember the first Saturday morning that I sat in a co-counselling seminar in someone’s living room in a house in Esher, Surrey. One of the seminar leaders said, “In co-counselling it’s the client who is in charge”: I had one of those bolts of insight: a “road to Damascus experience” (or a “light-bulb” moment, or an epiphany). I suddenly realized that, up to then, if I had gone to see a doctor, or a counsellor, or any other person whose profession it was to help me in some way, my attitude was slightly aggressive and along the lines of “well, you’re the professional; fix me”. You see it in medical dramas on the TV. The poor long-suffering doctor, being very polite, says to the patient, “what seems to be the problem?” and the pugnacious patient responds, “well, you’re the doctor; aren’t you supposed to know that?” and we, the TV audience, wonder how the doctor manages not to slap the patient round the head. I realised that, in the past, I had been lucky not to have been slapped by my doctor!

Ever since my light-bulb moment in that seminar I have changed. Now, when I go to the doctor my attitude is: you’re the doctor and you have studied illness and health and you know a lot, but maybe not everything. I’m a reasonably intelligent person, and I know a lot about me. Here are my symptoms or worries; I’d appreciate hearing your opinion. And having heard that opinion I may, or may not, decide to take the offered advice or the offered medication.

From time to time I get gout. My favourite ever doctor, Dr Halfpenny, counselled me to take allopurinol, the most popular drug for gout. My uncle was one of the first people ever to be put on allopurinol and he swore by it. But it’s something you take every day, and I didn’t want that.  I discovered I had gout many years ago when I slipped in the foot bath at a public swimming pool and stubbed my toe very painfully. The hospital thought I’d fractured it and put me in plaster (from the ball of my foot to my knee, when the pain was in my big toe!) By the following week my whole leg was inflamed and I went back to the hospital. A doctor looked at it and said, “I know what that is: it’s gout!” and I said thank you and left the hospital before anything else could be said.

[simpleazon-image align="right" asin="B000GFHP02" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/41mclx7JJuL._SL160_.jpg" width="160"]When I got home I spent ages reading books and articles on the internet and found that there were a number of recommendations for eating cherries to cure gout. It seemed weird, but worth a try. All I can say is that it works (for me, and for many others). That was maybe 20 years ago: since then there has been a lot more recognition that cherries work for gout, and Montmorency (tart) cherries best of all. You can even get cherry capsules from health stores. If you ever get gout, try it. For me it works like a miracle. My worst ever attack was in January 2010. It was so bad I was contemplating asking for a wheelchair (we were in Fort Lauderdale, about to board a cruise liner). Susan hiked off into the local shopping mall and came back with cherry juice, fresh cherries, and cherry powder capsules. Two days later I was Nordic Walking up the highest hill on Sint Maarten with not a twinge of pain.

I said that, in this chapter, I want to give you the information you need to make up your own mind about the diet you will follow. That’s not just information about “this food does this and that food does that”. The most important information that I can pass on is about how to judge information that you are offered (including mine!) You will find diet and nutritional information everywhere. How can you judge which may have something important to say, and which not is the question here.

For an example of the “who do you believe” stuff on the internet, here’s an example of a hyper-intelligent person saying that the “cherries cure gout” thing is just gullible fools being taken in by snake-oil salesmen.

The blog post is called “Thinking is Dangerous“.  His thesis is that there has been little serious scientific research done on the effect of eating cherries on helping with gout.  True.  However, there are countless people out there who have tried it and who swear by it.  They, of course, being “unthinking non-scientists” don’t count.  But for most people, eating a bowl of cherries isn’t going to do any harm, and if it relieves the pain of gout (which is really bad) then it has to be worth a try. He sums up:

You can see for yourself that the evidence is weak to non-existent. Of course, that doesn’t mean the evidence won’t be there in the future, the point is they don’t need it. They have people willing to be duped in to believing it works (placebo-effect alone), with the press as their willing conduits – it seems churlish not to put yet another fawning, uncritical Daily Mail link in time-honoured fashion, so here it is, from Sept 2008.

Oh, by the way, this blogger publishes neither his name nor his picture.

All we know about him is that he says that he’s from the UK and works in manufacturing.  He believes that who he is, is irrelevant to whether the knowledge (or opinions) he shares are relevant.  That’s up to you to judge.

So. I maintain that eating cherries is good for curing gout on the basis that it has worked for me over many years and I have heard the same from many other people.  Is that serious scientific research?  No.  So if your only basis for a justified belief is serious scientific research, you won’t accept that from me.  On the other hand, you might decide to check out this assertion by looking it up on the Internet. If you Google “cherries gout arthritis” you will find that the US Food and Drug Administration (FDA) are threatening manufacturers and cherry growers with legal action unless they stop “making unsubstantiated claims that cherries and other fruits can help with arthritis”. On the other hand, the US Department of Agriculture (USDA) has run research that shows that sweet Bing cherries can help arthritis and gout (gout is a form of arthritis) . I am delighted by the USDA research because it confirms my experience (you could say that it confirms my prejudices) when I was very irritated by the FDA.  At the bottom of that USDA internet article it does say:

The grower-sponsored California Cherry Advisory Board helped fund the research.

My reaction is “well, good for them; helping to find simple solutions for people suffering from painful conditions”. On the other hand, if the Tobacco Growers Association sponsored research that showed that smoking 10 cigarettes a day lowered the risk of getting gout I would be spitting fire and pouring scorn on the research. So now you know even more of my biases!

But I digress. How can you find advice about diet that works for you? Firstly I want to teach you about some tricks that advertisers and newspapers do … and even people who want to push their particular diet plan. I came across it this morning when I took the top off a tub of miso soup paste and inside there was a circle of paper that says, “Miso Soup Consumption linked with up to 50% Reduced Risk of Breast Cancer*”. In very small print round the bottom of the circle of paper it says, “*As reported in the journal of the National Cancer Institute, Vol. 95, Issue 12”.

The first thing you need to notice here is the word “linked”. This is a “warning word” and it warns you that this was an “epidemiological study”. Sorry about the long word: “epi-deemy-o-logical” is how you pronounce it and it means (from the Greek) “outside the skin”. In other words this research didn’t look at what was going on inside the women who did (or didn’t) consume miso soup. It was merely (note my use of an emotive word there, “merely”) a statistical exercise. They counted women who drank miso soup (and those who didn’t) and they counted the women who got breast cancer and those that didn’t, and they did statistics on the numbers to see if they could find a connection. They didn’t look at the chemistry of miso soup or the biochemistry of breast cancer; it was all numbers “outside the body”.

Let me give you an example. Let’s suppose that we find two women. One of them absolutely loves miso soup, believes it’s good for her, and drinks a bowl almost every day. The other woman hates it, neither knows nor cares whether it has any health-giving properties and wouldn’t touch the stuff if you paid her. We follow these women through their lives and eventually the woman who hates miso soup gets breast cancer and, sadly, dies. The other woman lives to be 103 and on her 103rd birthday when all the journalists are interviewing her and asking her how she got to be so old she says that she puts it all down to drinking miso soup. The miso soup manufacturers are over the moon with excitement and put her picture on all their packets and sales of miso soup soar.

What isn’t mentioned in this story is that the woman who died has a family history of breast cancer: her mother and sister both died of it and she worked in a nuclear power station handling nuclear fuel rods. The woman who lived to be 103 lives on a remote island in the Pacific where the air is clean, the water pure and most people live to be 120 without drinking miso soup. Now we see that drinking or not drinking miso soup may have nothing whatever to do with the one woman dying young and the other living to be a grand old age.

Now, let me go look up that study. You can see the summary for yourself . Basically the study looked at nearly 22,000 Japanese women aged 40-59. They got them to fill out “self-administered” questionnaires (that means the women took the piece of paper home and filled it out themselves: not the most reliable way of getting data) and the researchers looked for a statistical relationship between women who said they drank miso soup and women who got breast cancer and the researchers found an “inverse relationship” (meaning the soup drinkers were less likely to get breast cancer). So far so good. Anyone for a bowl of soup?

Next we need to look at that “50%”. Looks impressive, doesn’t it? But what was the risk of getting breast cancer anyway? If, as a Japanese woman between the ages of 40-59, there is a 90% risk of getting cancer and you can cut that down to 45% by drinking miso soup, then it looks like a no-brainer, doesn’t it? Swig it down! But what if the risk of getting breast cancer was only 1%? Reducing your risk from 1% to half a per cent doesn’t sound like much, does it? And when you read the paper further it says that the effect is greater in post-menopausal women. Now you have to judge where you are (I guess you’ll know whether you are post-menopausal or not!) The paper does say that they corrected for various things:

Results: Consumption of miso soup and isoflavones, but not of soyfoods, was inversely associated with the risk of breast cancer. The associations did not change substantially after adjustment for potential confounders, including reproductive history, family history, smoking, and other dietary factors.

(Oh, by the way, of the 21,852 women that they studied between 1990 and 1999, 179 got breast cancer, which works out at about 0.8%. So maybe that label should say “drinking miso soup could reduce your absolute risk of getting breast cancer from 0.8% to 0.4% if you’re a Japanese, post-menopausal woman between the ages of 40-59”. But that’s not so snappy, is it?)  Please note: I am not decrying miso soup.  I am not saying that the manufacturers are lying.  But when you delve into the research a little, you discover that it isn’t quite as exciting as you may have imagined.  And if breast cancer is a concern, there may be other, more effective things you can do to mitigate your risk.

There are a few other bits and pieces I want to mention here. Firstly, the word “confounders”. An epidemiological study looks for “correlations” but it does not indicate causality. Just because the women drinking the soup didn’t get so much cancer doesn’t mean that it was the soup that saved them.  For instance, let’s say that it is widely believed in Japan that miso soup is good for you (I don’t know whether that’s true, but stay with me here). Then we might guess that the women who drink miso soup are the sort of women who take good care of themselves and are careful about what they eat. That might be the real reason for the reduction in cancer risk. Maybe (again, I don’t know) miso soup is very expensive. Maybe only rich people who generally eat better-quality food are the ones who drink miso soup. Maybe miso soup is much easier to get hold of in quiet, rural communities. All these possibilities that I am raising are what are called “confounders”. Because the very nature of this sort of research is that the researchers are looking for correlations such as “people who drink miso soup get less cancer”. But we must not get fooled that we have found causation: we haven’t discovered that people get less cancer because they eat miso soup.

But this is what the advertisers and newspapers do. They bamboozle us into thinking that correlation is causation. It isn’t. The researchers above say that they have adjusted their results to take into consideration such confounders as “reproductive history, family history, smoking, and other dietary factors”. Good. But what about just plain coincidence? After all, a reduction from 0.8% to 0.4% isn’t exactly massive, is it?

So, what would I do if I was a woman and concerned for my health? On the basis of what I have learned here I think I might drink the odd bowl of miso soup. How many I might drink I don’t know—the research doesn’t mention that!  It would probably depend on how much I enjoyed it.  (Actually, the nutritional guidelines I currently follow are a bit anti-soy, so I would probably go and do some more research f my own.)

Stanley Young: Assistant Director for Bioinformatics, NISS

If this stuff fascinates you, I have found a wonderful (but pretty difficult unless you’re a university-level statistician) presentation that compares the paradigms of epidemiologists (who use a lots of statistics) and of statisticians (who also use a lot of statistics, but don’t always approve of the way non-statisticians use them).  It is called “Everything is Dangerous: A Controversy” and says:

The basic thesis is quite simple. Epidemiologists have as their statistical analysis/scientific method paradigm not to correct for any multiple testing. Also, as part of their scientific paradigm they ask multiple, often hundreds to thousands, of questions of the same data set. Their position is that it is better to miss nothing real than to control the number of false claims they make. The Statisticians’ paradigm is to control the probability of making a false claim. We have a clash of paradigms.

This paper is by S Stanley Young of the National Institute of Statistical Sciences.  He is the Assistant Director of Bioinformatics.  You can read everything (relevant) about him on his webpage.  No hiding for Dr Young: go read his CV; certainly impresses the heck out of me!

We have looked at one sort of research: epidemiological research. What other sorts are there? Epidemiological research is “outside the body”. If you go and read that article about cherries, those researchers were looking inside. They took blood samples. They knew the sort of chemicals in the blood stream that cause, or are indicators of, gout. They then fed the women in the study cherries and took more blood samples. Here we are seeing more directly that the cherries appear to be reducing the chemicals in the blood that cause gout. However, here’s a big difference between an epidemiological study and a study of this kind. The miso soup researchers monitored nearly 22,000 women for 10 years. The cherry researchers worked with 10 women for a week.

Nutrition research on human beings is really difficult. Just to go back to the miso soup research: the researchers got their data by asking the women to fill out self-administered questionnaires. We have no idea how accurate the women were, or whether they lied. There is a tendency for people to report what they think you want to hear.

A major problem in self reported dietary studies is people who under-report their true habitual food intake, or change their diet, during the period of the survey.
The problem of accuracy in dietary surveys. Analysis of the over 65 UK National Diet and Nutrition Survey, Adrian Cook, Jane Pryer, Prakash Shetty, J Epidemiol Community Health 2000;54:611-616 doi:10.1136/jech.54.8.611

Maybe the women over-reported. Maybe they just lied. Who knows? And the research was done over 10 years. Maybe some of the women had been drinking miso soup all their lives and others took it up once they were in the study. Maybe they’d never thought about it before, but the study may have made them think about it. Maybe the long-term drinkers drank a bowl a week, but the newcomers decided to drink a bowl a day to catch up. And what about cultural differences? Are Japanese women more or less likely to follow instructions than, say, American men (I’m sure that we all have opinions about this: but has anyone done the scientific research?!)

To do really hard scientific research on nutrition you need a population that you can really control and where you can measure just about everything. You probably need them in cages where can you measure to the nearest gram exactly what they eat and where you can operate on them to see what’s going on under the skin. And in any even remotely decent society that isn’t going to be possible with humans. Which leaves us wondering how relevant it is that rats fed on this or that diet, contracting, or not, this or that disease, has any relevance to us.

There is some famous research, about which really violent arguments rage on the internet, where rats were infected with a toxin often found in food that is “off”: aflatoxin. These rats were then divided into two groups and one was fed a diet that had 20% of an animal-derived protein called casein and the other group was fed a 5% casein diet. The 20% group got more cancer than the 5% group. The researchers are dedicated vegetarians and they say, “Look, a diet with higher levels of animal protein causes cancer”. The meat-eating researchers looked deeper into the results and said, “yes, the 20% rats got more cancer. That’s because the 5% rats died of a protein deficiency before they had the chance to get cancer”.  (If you like watching fights, you’ll love this: it’s an almost religious war!)

And then there’s bias. This may come as a shock, but scientists are human beings. They have axes to grind, they have masters to please. In order to do research a scientist needs money: he has to pay his own and his family’s food bills, pay the rent, put fuel in the car. Someone needs to pay for the research. If Bill and Melinda Gates, determined to do good in the world, put up the money from their foundation to pay for the miso soup research that’s one thing. But, be honest, if it turns out that the miso soup research was paid for by a consortium made up of soy producers and food manufacturers, do you think you would trust it quite as much? Probably not. Consider the cherry research paid for by the cherry growers: does that change your faith in the results?  I’m probably not making you feel good now, am I? Who are we to trust?

All is not lost: there are ways around this, and that is to do your own research, using a study group of one (or more, if you cook for the family or friends!) In its extreme form this is called bio-hacking. Extreme bio-hackers do their own DNA sequencing at home and wire themselves up to all sorts of machinery. At my end of the scale it’s called “suck it and see” and involves choosing the advice that seems reasonable to me and trying it out, taking what measurements I can (like weighing yourself, taking your own blood pressure and, if you’re diabetic or pre-diabetic, monitoring your own blood glucose levels. With all these things it’s probably an excellent idea to discuss them with your doctor before you start.)

But how do we find some advice that we want to “suck and see”–some knowledge that we want to test?

It used to be that I never read books on nutrition because they were so confusing. Everyone seemed to contradict everyone else and with many of them I couldn’t see where the advice was coming from.

For instance, many years ago someone recommended the food-combining diet to me. I thought that it should have been called the food separating diet because, it seemed to me, it was mostly about not eating this sort of food with that sort of food. Mostly it was about not eating carbohydrates in the same meal as proteins. That meant you could have a fried egg for breakfast, but you couldn’t have toast at the same time. And that would mean the yolk would run all over the plate.  I needed the toast as a “raft” to convey the egg from plate to mouth (took me some time to switch to eating scrambled eggs!) And what about beans such as baked beans or lima beans? They are both protein and carbohydrate at the same time. Should I have beans as a carbohydrate meal or a protein meal? The books seemed to say I could decide for myself, which to me was tantamount to saying that this diet was whatever I wanted it to be. Despite the fact that it was recommended by people I liked and trusted, it didn’t make sense to me; I couldn’t understand what it was based on.

Then one day I was having dinner with a group of people I hadn’t met before and made this point about the beans. One of them said, “Aha!” Beans proved the point of the food-combining diet, for we all know that beans are pretty indigestible. They give us gas and make us worried in polite company. That, said my new friend, is precisely because they are both carbohydrate and protein. Hmm. That made sense to me. Not enough sense, I have to admit, to make me switch to a food-combining diet, but it made me think.

Mind you, on that basis egg on toast should make you fart, and I’m not aware that it does!

So here’s what I recommend that you do. Well, no: here’s what I do!

[simpleazon-image align="right" asin="0307474259" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/51Ni96jsZzL._SL160_.jpg" width="104"]Someone recommended that I read a book: “Why We Get Fat and What To Do About It” by Gary Taubes.  Long ago I stopped accepting recommendations to read this or that diet book, simply because they were all so contradictory, and I had no basis for deciding between them. For some reason this one caught my attention. It was available on Kindle, it was cheap, and, on a whim I bought it and actually read it!

[simpleazon-image align="left" asin="0394584562" locale="us" height="75" src="http://ecx.images-amazon.com/images/I/41TgOIPB5YL._SL75_.jpg" width="49"]Reading it was another “road to Damascus” experience and completely changed my life and my thinking (I blogged about it elsewhere). Gary Taubes isn’t a doctor and he isn’t a nutritionist. He’s an investigative journalist especially interested in (bad) science. Having written a book about the infamous “cold fusion” physics research, someone suggested to him that if he was interested in bad science he should look at the science of nutrition.  (By the way, if you want an example of “paradigm wars” click that Amazon link for the cold fusion book, and read the customer reviews, comparing the 5-star reviews and the 1-star reviews.  There are some folks there with a near-religious attachment to the idea of cold fusion, and they are seriously angry with Gary.  But, you will notice, his book doesn’t persuade them.  Probably nothing will.)

Gary spent a long time looking at the research and wrote a huge tome called “Good Calories, Bad Calories[simpleazon-image align="left" asin="1400033462" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/41ikBliWK8L._SL160_.jpg" width="105"]” (in the UK it is called “[simpleazon-link asin="0091924286" locale="us"]The Diet Delusion[/simpleazon-link]”). It is 500 pages long and has 75 pages of references. Its Amazon.com ranking is truly amazing for a heavy-duty text book (as of March 22, 2013: it will have changed by the time you look at it):

Amazon Best Sellers Rank: #1,664 in Books (See Top 100 in Books)
#1 in Books > Medical Books > Medicine > Internal Medicine > Occupational
#7 in Books > Cookbooks, Food & Wine > Special Diet > Low Fat
#11 in Books > Health, Fitness & Dieting > Diets & Weight Loss > Low Carb

Having written that magnum opus a lot of people asked for an easier version that they could hand to their partner, doctor, patients, et cetera and Gary wrote “[simpleazon-link asin="0307474259" locale="us"]Why We Get Fat: And What to Do About It[/simpleazon-link]”. It ranks even higher:

Amazon Best Sellers Rank: #636 in Books (See Top 100 in Books)
#2 in Books > Health, Fitness & Dieting > Diets & Weight Loss > Food Counters
#3 in Books > Health, Fitness & Dieting > Diets & Weight Loss > Low Carb
#5 in Books > Cookbooks, Food & Wine > Special Diet > Low Carbohydrate

Clearly he is connecting with a lot of people. “Why We Get Fat” is available on the Kindle for $6.86 or £4.27. (And if you don’t have a Kindle you can download “Kindle for the PC” or “Kindle for the Mac” for free and read Kindle stuff on your computer). It won’t break the bank!

Now here’s what I got from Gary’s book: it made sense to me and it showed where a lot of the “received wisdom” in the diet world doesn’t make sense. For instance, for most overweight people if you go to the doctor and say, “doc, I’m worried about my weight, what should I do?” most doctors (and nutritionists and “health experts” and diet gurus and general know-it-alls) will say “eat less, exercise more”.

This has been the advice for the last 60-70 years.

Look around you. This advice isn’t working.

If you ask the “eat less, exercise more” crowd why the advice isn’t working they will say that it’s because all of us fatties are lazy and greedy and we don’t do as we’re told. As if that would explain how come babies are being born obese nowadays: born lazy and greedy!  (Note the inconvenient data that doesn’t fit the current paradigm about the causes of obesity.)

And if you were to go to a health expert and say, “I’ve been invited out to dinner by a very important business client. They are excellent cooks and will serve up a big dinner. I don’t want to look rude; what can I do to make sure I have a good appetite that day?” They will tell you to skip breakfast and lunch and go for a long walk. In other words “eat less, exercise more” is the recipe for getting a good appetite. And that’s what they recommend to “people of size” who want to lose weight. Hmm.

Now think for a moment about teenage boys. They lay around in bed for most of the day and when they do manage to haul themselves upright they come down stairs and empty the fridge. And they grow; almost overnight it seems. But we don’t say “my son has grown six inches taller in the last year because he is greedy and lazy”. He grows because his hormones are telling his body to grow. It takes a lot of energy to grow, which means he needs to take on a lot of energy and he frequently doesn’t have much to spare for doing chores (although amazingly he does have energy for chasing girls: obviously it’s a different sort of energy).

So, maybe, just maybe, there is a different explanation (different paradigm) as to why we obese people get to be this way. Taubes says that our hormones (a different set of hormones than the teenager’s hormones that tell him to grow up) are telling us to grow out. We aren’t fat because we eat too much; we eat too much because we are fat.  That blew my mind. I had to go back and read it several times. I won’t reproduce Gary’s arguments here: if you want to check them out, go buy the book on your Kindle or on your PC and read it: it’s a pretty easy read. Or really splash out and buy a real copy that you can carry around with you.

The biggest effect that this book had on me was to show that there are nutritional principles in common use that were just plain wrong. There is some inconvenient data.  Maybe our paradigm is wrong.

And that there are also some nutritional principles that are based on ideas that just seem to make sense to me. I get to choose which to believe and which to use to base my own personal research on.

For instance, the whole “fat is bad for you, eat low fat stuff” is based on some really bad epidemiological studies. The idea was introduced into American national consciousness because the authorities were worried about an increase in death from heart disease. Well, it’s controversial to say the least whether or not there was an increase in deaths from heart disease at the time, but there certainly has been a massive increase since we’ve been following the “low fat” ideas. Not to mention obesity, diabetes, Alzheimer’s syndrome and a whole host of other nasty and expensive things.

The powers that be are convinced that it’s because we’re all fat, lazy and greedy (and stupid, I suppose) and won’t do as we’re told. Grrr! Taubes provides a (for me) believable and viable alternative, and he provides the facts and figures to back it up.

Gary’s book opened up some new doors for me and on the other side I saw the whole nutrition field in a different light. I was able to see some large groupings of ideas and within those I could see some that made sense (to me); some that didn’t. Some that were clearly just commercial, some that came from people who believed something with huge passion, which I can respect, but I didn’t have the same beliefs as I do. So that saved me a lot of time. I could see that the vegans were principled people with their hearts in the right place; I wasn’t going to damn them, or even try and convert them. However, I didn’t believe that veganism was for me. And I was vegetarian for about 10 years or so, but that hadn’t worked for me, and when I finally gave it up several illnesses cleared up within days. But again, I’m not about to try and convert any vegetarians (my own daughter is vegetarian: I wouldn’t dare!) I’m sure that there are plenty of vegetarians who can tell you stories of things that cleared up for them when the stopped eating meat.

There are fierce arguments between vegetarians and meat eaters and both can point to anecdotal evidence to support their arguments (that means “I can tell you an anecdote about a friend of mine who did _______ and ______ happened”).  All true scientists dismiss anecdotal evidence out of hand.  And if there is just one anecdote, that’s reasonable.  But when thousands of people try something over and over and you have tens of thousands of anecdotes, then there is something that, maybe, needs further investigation.  And if 10,000 people report that cherries cured their gout, and you can’t construct a research study that confirms that, then I would tend to believe that it’s more likely that there’s something wrong with your research design than that 10,000 people are deluded.  (And I have no basis what-so-ever for knowing how many people believe in the cherry-gout thing.)

One of the biggest confounders that both of these armies often miss is this.  Although there are millions of people concerned with nutrition and the diet industry is huge, the vast majority of people pay almost no attention to their diet: they eat what they see on TV or on the shelves of the supermarket. In America, amongst people who know about this stuff, it’s called the Standard American Diet or SAD (how appropriate!). Those people are eating artificial food that is packed with sugar and high-fructose corn syrup. It is processed to the point where it isn’t food: people talk about “food-like substances”.  This TED-talk video shows how one person (Robyn O’Brien) switched their paradigm from “there can’t be anything wrong with food in the supermarket”, to being concerned and doing her own research:

 httpv://www.youtube.com/watch?v=rixyrCNVVGA

Now there are no meat-eaters who would say that you shouldn’t eat fresh vegetables and salads (well, there may be one or two, but they are off the scale!).

So when you find a vegetarian who can point to people who got better from various illnesses when they switched to a vegetarian diet, or you find someone who recommends the cave-man diet who can point to similar success stories, it’s probably because those successful people switched from the SAD diet and started to think about what they were eating.

Whether you go Atkins or South Beach, or Paleo or Vegetarian or Vegan, or 100% meat eater, or ketogenic … all those arguments pale into insignificance when compared with whether you are eating artificial “food-like substances”, or food: food that your great-grandmother would have recognised as food. Some people (and I will be one of those … just give me a while to get around to it) will argue that it might be a good idea to eat food that your great-great-grandmother 200 times over would have recognised as food, but let’s start with just one grandmother at a time!

So here’s something that may be different between you and me and our grandparents. In our modern western society we don’t have to know much about food if we don’t want to. We don’t need to know how to catch it, find it, prepare it, cook it, or keep it. We can just go to the supermarket, buy something in a box, sling it in the microwave, eat it out of the packet; not even have to wash up. Job done. My mother-in-law went into hospital in February 2012 and we flew out to help her move home in April. In the fridge was half a loaf of bread: it had been there for three months. As far as we could see there was nothing wrong with it. I can’t quite get my head round what a manufacturer must have done to that bread to keep it from going stale or mouldy for three months. And this is in Florida: in Florida you only have to stand still for 10 minutes before you start growing mould! It’s a state-wide obsession.

We may live to be 100, in full health, on such a supermarket regime. But it’s not likely.  My dad made it to age 91 having been a moderately heavy smoker all his adult life.  And he didn’t die of cancer or lung disease.  But that doesn’t mean smoking is good for you.

If you are choosing your food this way, you are doing the same as I was before I learned co-counselling, when I went to see the doctor. You’re saying to a food manufacturer, “you’re the expert; feed me” and assuming that that food manufacturer has your good health as his primary motivator, when you don’t.  There is vanishingly little evidence to support that belief and almost overwhelming evidence to the contrary, as I will list elsewhere.

Remember what my co-counselling teacher told me?

The client is in charge.

It’s sort of like that old Latin saying, caveat emptor, “Let the buyer beware”. It’s a principle of law that says it’s up to you to make sure that what you’re buying does what you want. Around the world laws are changing to give “the consumer” greater rights and protection, but the manufacturers are always one step ahead, except when they are two steps.  Around the world there is a principle that says you can’t introduce new things into the food chain until they are proved safe.  In America it’s the other way round: you can’t prevent new foodstuffs until they are proved dangerous.  So people have been going to court and asking for a judicial injunction on planting GMO crops in their neighbourhood until proved safe.  The US Congress has just passed a law that says judges can’t issue such injunctions.  Many would argue it’s unconstitutional.  I would argue that if you want to stay healthy you need to learn about this stuff!   When it comes right down to it, doesn’t it make sense to get educated, to learn about your own health and your own nutrition, and to make your own decisions?

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