Taubes

Jacques Peretti

Brilliant new TV series on BBC 2: The Men Who Made Us Fat.  As of today (17th June 2012) you can still watch Episode 1 on BBC iPlayer.  For those of us who have been studying this for a while, there are our new heroes (Gary Taubes, Dr Robert Lustig), and some old ones (Dr John Yudkin), as well as those baddies we all love to hate (Ancel Keys and George McGovern, amongst others).

The programme is hosted by Jacques Peretti: he has a blog here, and an article “What caused the obesity crisis in the West?” on the BBC News website.

The programme is now available on You Tube: start watching below, and when it  begins click the link about the play list.

httpv://www.youtube.com/watch?v=iE-H__aIEFE

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I know that I’m a bit of a pedantic thinker, but I am getting fed up with people who say that diets don’t work, especially when they don’t define what they mean by the word “diet”.  So let’s start with where the word comes form:

The term …  is derived from Medieval Latin dieta, meaning both “parliamentary assembly” and “daily food allowance”, from earlier Latin diaeta transcribing Classical Greek δίαιτα diaita, meaning “way of living”, and hence also “diet”, “regular (daily) work”.

That’s from the on-line etymological dictionary, by way of Wikipedia.  And looking at that, it’s not unreasonable to take the meaning of the word from the dictionary:

di·et
noun
1. food and drink considered in terms of its qualities, composition, and its effects on health: Milk is a wholesome article of diet.

2. a particular selection of food, especially as designed or prescribed to improve a person’s physical condition or to prevent or treat a disease: a diet low in sugar.

3. such a selection or a limitation on the amount a person eats for reducing weight: No pie for me, I’m on a diet.

4. the foods eaten, as by a particular person or group: The native diet consists of fish and fruit.

5. food or feed habitually eaten or provided: The rabbits were fed a diet of carrots and lettuce.

Dictionary.com

So, by and large, “diet” means “what we eat”.  So what does the phrase “diets don’t work” mean?  It can’t mean “don’t eat anything”, a) because that’s silly, and b) because, logically, even if you’re on a hunger strike and have decided not to eat anything, that’s still your diet.

And we haven’t defined “don’t work”, either.  I think what people who say this are trying to say is:

“restricting the amount of food you eat, as a way of losing weight, is ineffective”.

Well, you could argue against that, too.  If you are strong-willed enough then, at least for a while, you will lose some weight.  You’ll probably (almost definitely) put it all back, and then some, and if you are very strong-willed, and manage to restrict what you eat for a significant amount of time, you will probably damage your health.

So let’s define our terms for this blog.  The blog is called “Live Free From Obesity”, and maybe I should have also said “and its co-morbidities”, because it’s possible (a good friend of mine has done it) to lose sufficient weight to no longer be considered obese (she’s got her BMI down to 25), but still have metabolic syndrome.  Her blood sugar is dangerously high, her blood pressure is also high, and she still has abdominal fat, and our business here is to help people deal with all these problems.

Jon Gabriel before and after

My chief protagonist in the “diets don’t work” wars is Jon Gabriel: he says it over and again in his book, The Gabriel Method, but I think it’s only said for effect, because Jon very definitely recommends changes you can (and should, for the sake of good health) make in the way you eat: he is recommending a different diet from the one that you are probably on.

However, his recommendation is radical.  What he says is, don’t deliberately cut out anything from what you currently eat.  He recommends starting to add in some extra “good stuff”, and he recommends doing some work on those conditions in your life that are causing you to be fat.  As he would put it, the conditions that are causing your body to want to be fat.  He says that when you do that, you will begin to automatically drop the foods that make you fat.  It won’t be a matter of willpower; it will just happen.  He gets you to work on your mind, and I certainly don’t have a problem with that.

You will find yourself just naturally changing to a different diet.

So maybe what Jon should be saying is:

“dietary regimes which require you to force yourself, against your body’s own bio-chemistry, to restrict your food intake, in order to lose weight, will, over the long term, be ineffective and probably counter-productive”.

OK, I admit that isn’t as snappy as “diets don’t work”, but at least we know what we’re talking about now!

[simpleazon-image align="left" asin="1582702187" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/514y%2BP4rk4L._SL160_.jpg" width="100"]I read Gabriel’s book immediately after reading Gary Taubes, and Gary had so switched me on to clear, logical thinking, doing good science, and writing very clearly, that anyone that I subsequently read would suffer in comparison.  In fact Gary’s book effectively gives us the science behind Robert Atkins’ diet, so I read Atkins’ “New Diet Revolution”.  Because Taubes had persuaded me of the science, I kept going through to the end, but if I hadn’t read Taubes first I would have thrown the Atkins book into the bin.  Too much anecdotal evidence, and too much blowing of his own trumpet, and not very well written, so it just irritated me.  But there was some good stuff there.

And because I had watched the Hungry for Change video (watch a trailer below)

httpv://www.youtube.com/watch?v=7-WWp9wlvwU

and heard Jon say that he had had a stand up fight with Atkins in his office, I felt the need to get his book and see what the fuss was about.  Well, Jon also suffered a little by closely following Taubes in my reading list (pretty much anyone would), but he has some good things to say, and his testimonials, and his own example suggest that his method works.  After all, in the latest edition of his book and on his website he says that 350,000 people have read his book.  And he tells us (from a sample of one … himself) that the Atkins diet doesn’t work.

On the other hand, Atkins tells us that, from an exactly similar sample of one (himself) it does work … and as his first book was published in 1972, some time after he was using the method with his own patients, he has probably got a larger anecdotal database, and more testimonials than Gabriel.

Many years ago the founders of Neuro-Linguistic Programming (Richard Bandler and John Grinder) would introduce classes on hypnotherapy by one of them saying that “everything is hypnotism” and the other saying “there’s no such thing as hypnotism”.

By the same token I think we can probably say of almost any dietary regime, “this diet doesn’t work” and, at the same time, “this diet does work”.  Depends what you mean by “work” and depends what group of people you are talking about, and, I suspect, who it is that’s pushing the diet.

My experience of NLP was that sometimes it worked, and sometimes it didn’t.  When I finally stopped going to NLP classes run by lesser mortals and went and got trained by Bandler himself I realised that a key factor that no-one mentioned was the powerful personality and charisma of the practitioner … and there are few people in the world whose personality and charisma outweigh that of Richard Bandler.

I haven’t met Jon Gabriel, but I have read his book, watched him on the Hungry for Change video, and on video clips on his own website.  He’s no retiring wallflower!  And he believes passionately in what he is doing, which is, I believe, another key factor.  I also notice that in most of his testimonials he either appears with the person who has lost weight, or has obviously worked with them.  I’m not decrying the method because of that, simply saying that if you can work one-to-one with him I believe you’re more likely to achieve success than if you just buy the book.  If you want to see more of him, this “Jon Gabriel You Tube link” will show you a number of videos featuring him.

So, both Gabriel and Atkins (and probably every other diet writer on the planet) has some anecdotal evidence (probably quite a lot of anecdotal evidence) that their diet (or method) works, and other people’s don’t.  It occured to me to wonder if we could learn anything from Amazon.com sales ranks, and was fascinated by these results:

[simpleazon-image align="right" asin="1439190275" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/51C4YyKhT2L._SL160_.jpg" width="106"]Atkins: Amazon Best Sellers Rank: #7,246 in Books
#33 in Books > Cookbooks, Food & Wine > Special Diet > Low Carbohydrate

[simpleazon-image align="right" asin="1582702187" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/514y%2BP4rk4L._SL160_.jpg" width="100"]Gabriel: Amazon Best Sellers Rank: #8,369 in Books
#47 in Books > Religion & Spirituality > New Age > Mental & Spiritual Healing

[simpleazon-image align="right" asin="0307474259" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/51Ni96jsZzL._SL160_.jpg" width="104"]Taubes: Why We Get Fat: Amazon Best Sellers Rank: #607 in Books
#2 in Books > Health, Fitness & Dieting > Diets & Weight Loss > Food Counters
#9 in Books > Cookbooks, Food & Wine > Special Diet > Low Carbohydrate
#21 in Books > Health, Fitness & Dieting > Exercise & Fitness

[simpleazon-image align="right" asin="1400033462" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/41ikBliWK8L._SL160_.jpg" width="105"]Taubes: Good Calories — Bad Calories: Amazon Best Sellers Rank: #2,002 in Books
#12 in Books > Cookbooks, Food & Wine > Special Diet > Low Fat
#41 in Books > Medical Books > Medicine > Internal Medicine
#53 in Books > Health, Fitness & Dieting > Nutrition

Much as I love Taubes’ writing, I just didn’t expect to see him so far ahead of both Atkins and Gabriel … even for his massive tome, Good Calories — Bad Calories.

So, my conclusion in all this is the same one I began this whole website with:

  • You will need to change what you eat, but hopefully the change will happen naturally when you change what you think.
  • You will need active and trained support from other people when you change what you think
  • You will need and want to do some exercise, but hopefully that will happen naturally, too!

You pays your money and takes your choice!

BTW.  The New Atkins book was written by Phinney and Volek, who have their own books out:

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Having read Taubes exhaustively, and tried the regime he recommended, and having read Atkins and Gabriel, and starting to read Holford’s Low GL regime someone said, “but this high protein, high fat, low carb diet causes cancer and heart disease … have you read The China Study?”

And, of course, I hadn’t.

So I checked it out:

The science is clear. The results are unmistakable.

 

Change your diet and dramatically reduce the risk of cancer, diabetes, heart disease and obesity.

 

Respected nutrition and health researcher, Dr. T. Colin Campbell reveals the truth behind special interest groups, government entities and scientists that have taken Americans down a deadly path

 

Even today, as the low-carb craze sweeps the nation, two-thirds of adults are still obese and children are being diagnosed with Type II diabetes, typically an “adult” disease, at an alarming rate. If we’re eating healthier, why are Americans stricken with heart disease as much as we were 30 years ago?

says their website.  Oh dear: Gary was SO clear, SO persuasive, and here’s a “respected nutrition and health researcher” contradicting all I had just learned.

What to do?  Because I don’t have the skill, clear thinking, and research ability that Gary has, so I went searching.
First thing I came up with was the Diet Detective interviewing Gary, and asking him about the China Study.  Gary says:

Diet Detective: What if you’re mistaken, too? What about all the research showing that saturated fat may cause cancer — the China Study, for example? And the research showing that whole grains are good for the body? Was there any leap of faith in your interpretation of the scientific literature, or were you just reporting on evidence that should be perfectly clear and obvious to everyone?

Gary Taubes: Well, if I’m mistaken then I apologize. I do say in my books that this is a hypothesis that has to be tested, but I also say that the evidence — in my mind, at least — is sufficiently compelling that it should be treated as the null hypothesis. That is, the hypothesis that needs remarkable evidence to reject. As for the China Study, the study itself — not to be confused with Colin Campbell’s book by that title, which I will discuss shortly — is just a list of associations between hundreds of variables and health conditions in different counties in China. If you actually look at the raw data (page 106 of the massive academic publication on the data, Diet, Life-styles and Mortality in China, which I own), there is no association between animal protein and mortality from cancer. None. People who ate more animal protein did not have more cancer, or at least no more of them died from cancer than people who ate less. And it’s cancer that the Colin Campbell is concerned with in his book, The China Study.

In that book, Campbell massages the evidence through a series of steps until he can make the opposite claim. So he doesn’t tell you that animal protein is not associated with cancer in this study, but he says that blood markers of protein consumption are so associated, even though he gets this wrong as well. He never makes the claim, nor do any serious researchers anymore, that saturated fat causes cancer. Although it’s always been an open question whether poly–unsaturated fats do.

(the emphasis is mine.  You can read the entire Diet Detective-Taubes interview here).

Denise Minger

Denise Minger

Wondering if I was getting a little too committed to my hero, Taubes, I started to look at what other people have been saying about Campbell and The China Study, and came across a truly remarkable young woman, Denise Minger.  She is as sharp as Taubes in her ability to spot bad science and to analyse bad statistics.  She did a really thorough, point by point critique of Campbell’s work, which he then critiqued in turn.  She then provided a really comprehensive analysis, and posted it on line.  Here’s what Denise says in her introduction:

When I first embarked on an analysis of T. Colin Campbell’s The China Study, I did not anticipate the range or magnitude of responses it would invoke—reactions that have been at times controversial, at times impassioned, and at times downright heated, but above all else intellectually provocative. It seems “The China Study” is a book that, in many cases, is either intensely revered or vehemently criticized, and its ability to generate ongoing discussion signifies a deep-seated division in the scientific community.

 

I would like to thank Dr. Campbell for his cordial response to my critique, as well as for the time he has taken to elucidate his philosophy of nutrition and his approach to research. While I do not agree with some of his conclusions, I honor his contributions to the field of health and nutrition, and deeply admire his courage to promote an unpopular message amidst a research sector dominated by special interests and opposing views.

 

I propose that Campbell’s hypothesis is not altogether wrong but, more accurately, incomplete. While he has skillfully identified the importance of whole, unprocessed foods in achieving and maintaining health, his focus on wedding animal products with disease has come at the expense of exploring—or even acknowledging—the presence of other diet-disease patterns that may be stronger, more relevant, and ultimately more imperative for public health and nutritional research.

 

Having lit a proverbial fuse, I feel called and compelled to make the sum of my findings available to the public so that they may add, in whatever extent or direction, to the symphony of voices engaged in this discourse. My intent with this paper is not to discredit Campbell as a scientist, nor to promote or discourage a particular diet—but rather, to present new ways of looking at the China Study data and related research while highlighting the shortcomings in Campbell’s specific conclusions. I hope this information can be valuable to readers while—above all else—encouraging the use of independent, critical thought to advance our understanding of health.

She has oodles of stuff about the China Study on her blog, as well as stories about her contributions to Wikipedia being summarily deleted.  You have to understand that Campbell’s book provided all the evidence that Vegetarians and Vegans needed to persuade us all to follow their paths to health and happiness, and here was a raw-food aficionado and one-time vegan preaching apostasy.  It got some people really mad at her.

However, I would say, having read through her stuff until very late at night, and given myself a severe headache from studying her statistics (never my strong subject), that all she is doing is showing us what Gary has already told us: there’s a lot of really bad science in the field of public health!

Here’s Denise’s final response on the subject, and here’s her blog page that summarises all the various claims and counter-claims.

One last thing.  If the logic and science and math and statistics in Taubes’ work, and Denise’s work (I’m sorry, I just can’t call her “Minger” … it’s a slang word in British English, and anyone less of “a minger” I find it hard to imagine!) … if they faze you, here’s a quick summary of what it’s all about.  To quote from Denise’s paper “The Truth About Ancel Keys” (the man who started the whole “fat is bad for you” shtick):

Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t causation. Correlation isn’t a cucumber. (Just making sure you’re awake.)

Let me give you an example.  Aspirins alleviate headaches.  Taking daily low doses of aspirin has been shown to lower the risk of stroke.  So, clearly, if aspirin cures headaches and aspirin prevents strokes, it must follow that headaches cause strokes.

Not.

That was a correlation, not a causation.

You may also find both Denise and Gary using the term “confounder”.  Here’s an example.  We do some research and discover that a high proportion of the residents of Town A die from cancer.  We also discover that a high proportion of people in Town A eat red meat.  So we draw the conclusion that eating red meat causes cancer.  But we fail to mention (because it doesn’t suit our cause) that Town A is heavily industrialised, has chemical factories whose effluents are poorly controlled, and has a nuclear plant.  And a high proportion of the residents smoke.  You see, adding in some extra data confounds our original hypothesis.  Of course, it may still be that it’s red meat that’s causing the cancer.  But is it because the red meat comes from cattle that graze on pasture downwind of the chemical plant?

That’s enough … I just wanted you to get the idea that a lot of these diet books are based on what is NOT sound science, even when their authors have impressive-sounding academic qualifications.  One last quote from Denise:

In rebuttals to previous criticism on “The China Study,” Campbell seems to use his curriculum vitae as reason his word should be trusted above that of his critics. His education and experience is no doubt impressive, but the “Trust me, I’m a scientist” argument is a profoundly weak one. It doesn’t require a PhD to be a critical thinker, nor does a laundry list of credentials prevent a person from falling victim to biased thinking. Ultimately, I believe Campbell was influenced by his own expectations about animal protein and disease, leading him to seek out specific correlations in the China Study data (and elsewhere) to confirm his predictions.

 

It’s no surprise “The China Study” has been so widely embraced within the vegan and vegetarian community: It says point-blank what any vegan wants to hear—that there’s scientific rationale for avoiding all animal foods. That even small amounts of animal protein are harmful. That an ethical ideal can be completely wed with health. These are exciting things to hear for anyone trying to justify a plant-only diet, and it’s for this reason I believe “The China Study” has not received as much critical analysis as it deserves, especially from some of the great thinkers in the vegetarian world. Hopefully this critique has shed some light on the book’s problems and will lead others to examine the data for themselves.

Lastly, since I first wrote this, both my wife and I have fallen head-over-heels with Denise Minger.  This might give you an idea why:

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

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