Dietary Dogma: Tested and Failed

There were two recent studies that looked at diets. One compared the 2010 Dietary Guidelines again the typical American diet. The other compared multiple dietary interventions: Mediterranean diet, low-fat diet, and low-salt diet. This covers the main diets advocated most often by doctors, nutritionists, dieticians, and health officials. Yet neither study found a significant overall benefit to any of the recommended diets. That is shocking, when one considers how official experts and major institutions have pushed these diets for decades. The low-fat diet has been a favorite among dietary technocrats for about a half century (The Creed of Ancel Keys).

What these studies didn’t bother to consider is the benefits of traditional foods diet (Weston A. Price & Sally Fallon Morrell), paleo/hunter-gatherer diet, low-carb high fat diet, ketogenic diet, carnivore diet, etc. Nor any of the related but less well known diets like ketotarian, pegan, etc. Nor related dietary strategies such as fasting, either intermittent or extended, along with calorie restriction. With a narrow focus, the comparisons were limited. Still, it is a powerful judgment that none of the diets that were tested stood out as being all that impressive. What is being brought under doubt represents the key message of authoritative opinion on diet and nutrition. These diets tested (official Dietary Recommendations, Mediterranean diet, low-fat diet, and low-salt diet) are among the best that the collective wisdom of mainstream thought has to offer.

Here is an intriguing point. The first study looked at the 2010 Dietary Guidelines as separate from weight loss, to determine what were the results of the diet itself. This officially trumpeted dietary regime, a fad diet that hasn’t been around long by the way, had no noticeable affect on glucose homeostasis, fasting lipids, or type 2 diabetes. Let’s consider another study, as a comparison and to clarify a point (Parker N. Hyde et al, Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss). As with the above mentioned study, body weight was carefully maintained so as to control for that potentially confounding factor. What were the results?

“Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS [metabolic syndrome, including type 2 diabetes], especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high-carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate.”

Interestingly, these particular two studies demonstrate that obesity by itself is not necessarily the problem. Rather, it is a symptom of the problem. Obesity can even be an attempt by the body to compensate in preventing something even worse (Coping Mechanisms of Health). The fundamental problem is the metabolic syndrome itself and any diet that doesn’t directly deal with that will be ineffective. And only some variation of a low-carb diet can accomplish that end.

It’s time to rethink dietary recommendations and guidelines. There are signs this is already happening. The public is already turning toward low-carb diets (Low-Carb Diets On The Rise). And slowly but surely the official position is shifting in this direction (Obese Military?, Weight Watchers’ Paleo Diet, American Diabetes Association Changes Its Tune, Official Guidelines For Low-Carb Diet, & Slow, Quiet, and Reluctant Changes to Official Dietary Guidelines). The evidence keeps accumulating. These recent two studies add to the growing pile. It’s getting harder and harder to ignore the obvious.

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A randomized controlled-feeding trial based on the Dietary Guidelines for Americans on cardiometabolic health indexes
by Sridevi Krishnan et al

To our knowledge, this is the first controlled-feeding trial to test the effect of a food-based dietary pattern following recommendations of the DGA [2010 Dietary Guidelines for Americans]. We measured cardiometabolic disease risk factors in an at-risk female cohort, while maintaining body weight, with the use of foods that are accessible and acceptable to the consumer. The higher quality of the DGA diet relative to the TAD [typical American diet] was confirmed by HEI scores of 98 and 62, respectively. We found that, in the absence of weight loss, consuming a diet based on recommendations of the DGA did not change glucose homeostasis or fasting lipids in our cohort. The 2015 DGA Advisory Committee report concluded that there was moderate evidence for reduction in type 2 diabetes risk associated with nutrient-dense diets (2); however, the results from our short-term intervention trial did not align with this evidence. By design, the intervention did not lead to significant weight loss, and because changes in body weight and body fat can play a role in the pathogenesis of type 2 diabetes (31), this may also explain why improvements in blood sugar control were not observed despite the improvement in diet quality.

Supplements and Diets for Heart Health Show Limited Proof of Benefit
by Anahad O’Connor

When Dr. Khan and his co-authors looked at various diets recommended for cardiovascular prevention, they found a similar lack of solid evidence.

That was certainly the case for low-fat diets, which health authorities have recommended for decades as a way to lower cholesterol and heart disease risk. Dr. Khan and his colleagues found that the most rigorous randomized trials provided no evidence that eating less fat, including saturated fat, had an impact on mortality or cardiovascular outcomes. Low-fat diets have largely fallen out of favor among health authorities in recent years, though the federal government’s dietary guidelines still encourage people to limit their intake of foods rich in saturated fat, such as butter, meat and cheese.

One diet that remains highly touted by health authorities is the Mediterranean diet, with its abundance of whole grains, beans, nuts, fruits and vegetables and olive oil. While clinical trials have found that it reduces cardiovascular risk, some of the major ones have been flawed, and experts who have scrutinized the evidence for the diet have urged caution.

One of the largest and most publicized Mediterranean diet trials, called Predimed and published in 2013, found that it reduced heart attacks and strokes. But last year it was retracted because of methodological problems. The Predimed authors published a new analysis of their data, claiming their conclusions had not changed. But other Mediterranean diet trials have been embroiled in similar controversies. After analyzing data from all the relevant trials, Dr. Khan and his colleagues found that “the totality of evidence did not favor the Mediterranean diet for cardiovascular outcomes.”

“It’s not favorable or harmful,” he added. “It’s just a neutral diet from a cardiovascular perspective.”

The one dietary intervention that seemed to have the most support from randomized trials was lowering salt intake, though the researchers graded the evidence only as having “moderate certainty.” And there was nuance. Low-salt diets reduced mortality from all causes only in people with normal blood pressure. Among people with hypertension, lowering salt intake reduced deaths from heart disease but not from other causes.

Dr. Topol said that in his own clinic he sees a wide range of responses to salt intake. Some people are very sensitive to salt: A small increase in salty foods can have a pronounced effect on their blood pressure. But others can eat salt-laden meals and their blood pressure will hardly budge.

Dr. Topol said he finds diet studies hard to interpret because they rarely take into account the unique way that different people can have markedly different responses to dietary changes, whether it is cutting back on salt or avoiding fat or carbohydrates.

“The problem we have here is that all these studies essentially treat all people as one,” he said. “I think that all these things are going to turn out to be quite heterogeneous. Maybe salt restriction really is beneficial for some, but we haven’t defined the people yet that would drive that.”

Too Much Protein?

A ketogenic diet is any diet that puts you into ketosis. The issue isn’t only what raises your ketone levels but also what lowers them. It is glucose that keeps you out of ketosis and that generally means restricting carbohydrates. But glucose can come from other sources. This is where protein come in. It has been a common view that too much protein would keep you out of ketosis. The theory was that gluconeogenesis, the process that turns proteins into glucose, could interfere with ketosis. So, some have worried that too much protein was basically no different than too many starches and sugar.

That view has been challenged by more recent research. The newer understanding is that gluconeogenesis is mostly demand-driven, not supply driven. That said, it’s more complicated than that. There are conditions that can alter demand or else signaling. Benjamin Bikman, an insulin researcher, advocates a higher protein ketogenic diet. He says that initially it might matter when someone first goes onto a ketogenic diet, if they have hyperglycemia and hyperinsulinemia, a problem for far too many Americans. But as insulin levels are normalized, which can happen quickly, gluconeogenesis is not a problem.

So, it depends on how healthy you are. With insulin resistance, high protein intake might spike insulin and cause the insulin glucagon/ratio to become imbalanced. Yet for a person with a healthy metabolism, the glucose/insulin ratio might not change at all. As Ben Wagenmaker explains it, “Studies do show that GNG affects obese people and diabetics, in that excess protein produces measurable spikes in blood glucose levels, although this same effect has not been observed and quantified in non-diabetics that are not obese” (Gluconeogenesis, Chocolate Cake, and the Straw Man Fallacy).

Considering that most Americans are obese, diabetic, pre-diabetic or insulin resistant, it might be advisable to limit protein until one has become fat-adapted and metabolically flexible. It’s easy to figure out for yourself, though. You can simply measure such things and see how it is affecting you. Or you can go by an even simpler method. Once your body is regularly in ketosis, fasting should become easy. If you can skip meals or go a day without eating at all and not be particularly bothered by it, then you know you’re body has fully adjusted to ketosis. At that point, protein should no longer be a concern.

This is good to keep in mind, considering most people turn to specific diets later in life. Bikman points out that, as people age, the body requires more protein for health. That is because the body becomes less effective at using protein. And if you don’t get enough protein on a keto diet, the body will cannibalize muscle.  A lack of protein, in general, can be problematic — look at how lacking in musculature are many vegans with limited protein and lower quality protein. Muscle loss is a major health hazard for senior citizens, but muscle loss can begin much earlier in life.

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Dietary Proteins Contribute Little to Glucose Production, Even Under Optimal Gluconeogenic Conditions in Healthy Humans
by Claire Fromentin et al

Dietary Protein and the Blood Glucose Concentration
by Frank Q. Nuttall & Mary C. Gannon

The relationship between gluconeogenic substrate supply and glucose production in humans
by F. Jahoor, E. J. Peters & R. R. Wolfe

More Than You Ever Wanted to Know About Protein & Gluconeogenesis
by Amy Berger

Ketosis Without Starvation: the human advantage
by L. Amber and Zooko Wilcox-O’Hearn

Coping Mechanisms of Health

Carl Jung argued that sometimes what seems like mental illness is in actuality an effective coping mechanism. He advised against treating the coping mechanism as the problem without understanding what it is a response to. The problem itself could be made worse. Some people have found a careful balance that allows them to function in the world, no matter how dysfunctional it may seem to others, from addiction to dissociation. We need to have respect and compassion for how humans cope with difficulties.

There is something similar in physical health. Consider obesity. Is it always the cause of health problems? Or might it be the body’s way of protecting against other health problems? That is what was explored in a recent study mentioned by Gabor Erdosi. It is Friendly Fat Theory – Explaining the Paradox of Diabetes and Obesity by Rajiv Singla et al. The authors write:

“Obesity has been called the mother of all diseases and, historically, has been strongly linked to diabetes. However, there are still some paradoxes that exist in diabetes epidemiology and obesity and no unifying hypothesis has been proposed to explain these paradoxical phenomena. Despite the ever-increasing prevalence of both obesity and diabetes, differential relationships exist between diabetes and the extent of obesity in various different ethnic groups. In addition, people with a higher body mass index have been shown to have an improved survival advantage in terms of chronic diabetes complications, especially cardiovascular complications. This narrative review attempts to explain these paradoxical and complex relationships with a single unifying theory. We propose that adipocytes are actually friends of the human body to prevent the occurrence of diabetes and also help in mitigating the complications of diabetes. Adipose tissue actually acts as a reservoir of free fatty acids, responsible for insulin resistance, and prevents their overflow into insulin-sensitive tissues and, therefore, friendly fat theory.”

L. Amber O’Hearn responded, “Wait, are you saying the body is actually trying to be healthy and that many symptoms we see in connection with disease are functionally protective coping mechanisms? Yes, indeed.” Following that, someone else mentioned that this perspective was argued by Dr. Jason Fung in an interview with Peter Attia, podcast #59. I’m sure many others have said similar things. It’s not difficult to understand for anyone familiar with some of the science.

For example, inflammation causes many problems, but inflammation itself isn’t the fundamental cause since it is a protective response itself to something else. Or as yet another example, there is the theory that cholesterol plaque in arteries doesn’t cause the problem but is a response to it, as the cholesterol is essentially forming a scab in seeking to heal injury. Pointing at cholesterol would be like making accusations about firefighters being present at fires. One could look to numerous other things, as the basic principal is widely applicable. The body is always seeking the healthiest balance under any conditions, even if less than optimal. So, in seeking greater health, we must realize that the body-mind of an individual is a system that is part of larger systems. To get different results, the totality of the situation needs to be shifted into a new balance. That is why something like ketosis can dramatically improve so many health issues, as it completely alters the functioning of gut health, metabolism, immune response, neurocognition, and on and on. That diet could have that kind of impact should not be hard to understand. Think about the multiple links, direct and indirect, between the gut and the brain — multiply that by hundreds of other major connections within our biology.

The failing of conventional medicine is that it has usually been a symptoms-based approach. Diagnosis is determined by patterns of symptoms. Too often that then is used to choose a medication or surgical intervention to treat those symptoms. Underlying causes are rarely understood or even considered. Partly, that is because of a lack of knowledge and the related low quality of many medical studies. But more problematic is that the dominant paradigm constrains thought, shuts down the ability to imagine other ways of doing medicine. The above study, however, suggests that we should understand what purpose something is serving. Obesity isn’t merely too much fat. Instead of being the problem itself, obesity might be the body’s best possible solution under those conditions.

What if so many of our supposed problems operate in a similar manner? What if instead of constantly fighting against what we deem as bad we sought understanding first about what purpose is being served and then sought some other means of accomplishing that end? Think about the short-term thinking that has been observed under conditions of poverty and high inequality. Instead of judging people as inferior, we could realize that short-term thinking makes perfect sense in evolutionary terms, as extreme stress indicates that immediate problems must be dealt with first. Rather than blaming the symptom or scapegoating the victim, we should look at the entire context of what is going on. If we don’t like the results we are getting as individuals and as a society, we better change the factors that lead to those results. It’s a simple and typically overlooked insight.

We aren’t isolated individuals. We are an inseparable aspect of a larger world. Every system within our bodies and minds, every system in society and the environment is integral to our holistic functioning as human beings. Everything is connected in various ways. Change one thing and it will ripple outward.

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Most Mainstream Doctors Would Fail Nutrition

To return to the topic at hand, the notion of food as medicine, a premise of the paleo diet, also goes back to the ancient Greeks — in fact, originates with the founder of modern medicine, Hippocrates (he also is ascribed as saying that, “All disease begins in the gut,” a slight exaggeration of a common view about the importance of gut health, a key area of connection between the paleo diet and alternative medicine). What we now call functional medicine, treating people holistically, used to be standard practice of family doctors for centuries and probably millennia, going back to medicine men and women. But this caring attitude and practice went by the wayside because it took time to spend with patients and insurance companies wouldn’t pay for it. Traditional healthcare that we now think of as alternative is maybe not possible with a for-profit model, but I’d say that is more of a criticism of the for-profit model than a criticism of traditional healthcare.

Diets and Systems

Related to diet, Pezeshki does bring up the issue of inflammation. As I originally came around to my present diet from a paleo viewpoint, I became familiar with the approach of functional medicine that puts inflammation as a central factor (Essentialism On the Decline). Inflammation is a bridge between the physiological and the psychological, the individual and the social. Where and how inflammation erupts within the individual determines how a disease condition or rather a confluence of symptoms gets labeled and treated, even if the fundamental cause originated elsewhere, maybe in the ‘external’ world (socioeconomic stress, transgenerational trauma, environmental toxins, parasites because of lack of public sanitation, etc. Inflammation is linked to leaky gut, leaky brain, arthritis, autoimmune disorders, mood disorders, ADHD, autism, schizophrenia, impulsivity, short-term thinking, addiction, aggression, etc — and such problems increase under high inequality.

There are specific examples to point to. Diabetes and mood disorders co-occur. There is the connection of depression and anhedonia, involving the reward circuit and pleasure, which in turn can be affected by inflammation. Also, inflammation can lead to changes in glutamate in depression, similar to the glutamate alterations in autism from diet and microbes, and that is significant considering that glutamate is not only a major neurotransmitter but also a common food additive. Dr. Roger McIntyre writes that, “MRI scans have shown that if you make someone immune activated, the hypervigilance center is activated, activity in the motoric region is reduced, and the person becomes withdrawn and hypervigilant. And that’s what depression is. What’s the classic presentation of depression? People are anxious, agitated, and experience a lack of spontaneous activity and increased emotional withdrawal” (Inflammation, Mood Disorders, and Disease Model Convergence). Inflammation is a serious condition and, in the modern world, quite pervasive. The implications of this are not to be dismissed.

Essentialism On the Decline

In reading about paleolithic diets and traditional foods, a recurring theme is inflammation, specifically as it relates to the health of the gut-brain network and immune system.

The paradigm change this signifies is that seemingly separate diseases with different diagnostic labels often have underlying commonalities. They share overlapping sets of causal and contributing factors, biological processes and symptoms. This is why simple dietary changes can have a profound effect on numerous health conditions. For some, the diseased state expresses as mood disorders and for others as autoimmune disorders and for still others something entirely else, but there are immense commonalities between them all. The differences have more to do with how dysbiosis and dysfunction happens to develop, where it takes hold in the body, and so what symptoms are experienced.

From a paleo diet perspective in treating both patients and her own multiple sclerosis, Terry Wahls gets at this point in a straightforward manner (p. 47): “In a very real sense, we all have the same disease because all disease begins with broken, incorrect biochemistry and disordered communication within and between our cells. […] Inside, the distinction between these autoimmune diseases is, frankly, fairly arbitrary”. In How Emotions Are Made, Lisa Feldman Barrett wrote (Kindle Locations 3834-3850):

“Inflammation has been a game-changer for our understanding of mental illness. For many years, scientists and clinicians held a classical view of mental illnesses like chronic stress, chronic pain, anxiety, and depression. Each ailment was believed to have a biological fingerprint that distinguished it from all others. Researchers would ask essentialist questions that assume each disorder is distinct: “How does depression impact your body? How does emotion influence pain? Why do anxiety and depression frequently co-occur?” 9

“More recently, the dividing lines between these illnesses have been evaporating. People who are diagnosed with the same-named disorder may have greatly diverse symptoms— variation is the norm. At the same time, different disorders overlap: they share symptoms, they cause atrophy in the same brain regions, their sufferers exhibit low emotional granularity, and some of the same medications are prescribed as effective.

“As a result of these findings, researchers are moving away from a classical view of different illnesses with distinct essences. They instead focus on a set of common ingredients that leave people vulnerable to these various disorders, such as genetic factors, insomnia, and damage to the interoceptive network or key hubs in the brain (chapter 6). If these areas become damaged, the brain is in big trouble: depression, panic disorder, schizophrenia, autism, dyslexia, chronic pain, dementia, Parkinson’s disease, and attention deficit hyperactivity disorder are all associated with hub damage. 10

“My view is that some major illnesses considered distinct and “mental” are all rooted in a chronically unbalanced body budget and unbridled inflammation. We categorize and name them as different disorders, based on context, much like we categorize and name the same bodily changes as different emotions. If I’m correct, then questions like, “Why do anxiety and depression frequently co-occur?” are no longer mysteries because, like emotions, these illnesses do not have firm boundaries in nature.”

What jumped out at me was the conventional view of disease as essentialist, and hence the related essentialism in biology and psychology.

A Century of Dietary and Nutritional Trends

At Optimizing Nutrition, there is a freaking long post with a ton of info: Do we need meat from animals? Let me share some of charts showing changes over the past century. As calories have increased, the nutrient content of food has been declining. Also, with vegetable oils and margarine shooting up, animal fat and dietary cholesterol intake has dropped.

Carbs are a bit different. They had increased some in the early 20th century. That was in response to meat consumption having declined in response to Upton Sinclair’s muckraking of the meat industry with his book The Jungle. That was precisely at the time when industrialization had made starchy carbs and added sugar more common. For perspective, read Nina Teicholz account of the massive consumption of animal foods, including nutrient-dense animal fat and organ meats, among Americans in the prior centuries:

“About 175 pounds of meat per person per year! Compare that to the roughly 100 pounds of meat per year that an average adult American eats today. And of that 100 pounds of meat, more than half is poultry—chicken and turkey—whereas until the mid-twentieth century, chicken was considered a luxury meat, on the menu only for special occasions (chickens were valued mainly for their eggs). Subtracting out the poultry factor, we are left with the conclusion that per capita consumption of red meat today is about 40 to 70 pounds per person, according to different sources of government data—in any case far less than what it was a couple of centuries ago.” (The Big Fat Surprise, passage quoted in Malnourished Americans).

What we forget, though, is that low-carb became popular for a number of decades. In the world war era, there was a lot of research on the ketogenic diet. Then around the mid-century, low-carb diets became common and carb intake fell. Atkins didn’t invent the low-carb diet. Science conferences on diet and nutrition, into the 1970s, regularly had speakers on low-carb diets (either Gary Taubes or Nina Teicholz mentions this). It wasn’t until 1980 that the government began seriously promoting the high-carb diet that has afflicted us ever since. Carb intake peaked out around 2000 and dropped a bit after that, but has remained relatively high.

The inflammatory omega-6 fatty acids combined with all the carbs has caused obesity, as part of metabolic syndrome. That goes along with the lack of nutrition that has caused endless hunger as Americans have been eating empty calories. The more crap you eat, the more your body hungers for nutrition. And all that crap is designed to be highly addictive. So, Americans eat and eat, the body hungering for nutrition and not getting it. Under natural conditions, hunger is a beneficial signal to seek out what the body needs. But such things as sugar have become unlinked from nutrient-density.

Unsurprisingly, Americans have been getting sicker and sicker, decade after decade. But on a positive note, recently there is a slight drop in how many carbs Americans are eating. This is particularly seen with added sugar. And it does seem to be making a difference. There is evidence that the diabetes epidemic might finally be reversing. Low-carb diets are becoming popular again, after almost a half century of public amnesia. That is good. Still, the food most American have access to remains low quality and lacking in nutrition.












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Corporate Media Slowly Catching Up With Nutritional Studies

“The change in dietary advice to promote low-fat foods is perhaps the biggest mistake in modern medical history.”
 ~ Dr. Aseem Malhotra, cardiologist and expert on heart disease

“Fundamental problems were 2-fold. First, acceptance of weak associational epidemiological data as proof of causation. Second promotion of diet-heart hypothesis/lo fat diet to the public ahead of definitive proof of outcomes. Diet-heart hypothesis then became incontestable dogma.”
~ Tim Noakes, emeritus professor, scientist, and expert on low-carb diets

We’re All Guinea Pigs in a Failed Decades-Long Diet Experiment
by Markham Heid, Vice

The US Department of Agriculture, along with the agency that is now called Health and Human Services, first released a set of national dietary guidelines back in 1980. That 20-page booklet trained its focus primarily on three health villains: fat, saturated fat, and cholesterol.

Recently, research has come out strongly in support of dietary fat and cholesterol as benign, rather than harmful, additions to person’s diet. Saturated fat seems poised for a similar pardon.

“The science that these guidelines were based on was wrong,” Robert Lustig, a neuroendocrinologist at the University of California, San Francisco, told VICE. In particular, the idea that cutting fat from a person’s diet would offer some health benefit was never backed by hard evidence, Lustig said.

Just this week, some of Lustig’s colleagues at UCSF released an incendiary report revealing that in the 1960s, sugar industry lobbyists funded research that linked heart disease to fat and cholesterol while downplaying evidence that sugar was the real killer.

Nina Teicholz, a science journalist and author of the The Big Fat Surprise, said a lot of the early anti-fat push came from the American Heart Association (AHA), which based its anti-fat stance on the fact that fat is roughly twice as calorie-dense as protein and carbohydrates.

“[The AHA] had no clinical data to show that a low-fat diet alone would help with obesity or heart disease,” Teicholz told VICE. But because fat was high in calories, they adopted this anti-fat position, and the government followed their lead. Surely the 1960s research rigged by the Sugar Association, which was published in the prestigious New England Journal of Medicine, added to our collective fat fears.

By the 1990s, when Teicholz says the epidemiological data started piling up to show that a low-fat, high-carb diet did not help with weight loss or heart disease—calories be damned—much of the damage was already done. The US public was deep in what nutrition experts sometimes call the “Snackwell phenomenon”—a devotion to low-fat and low-calorie processed snack foods, which people pounded by the bagful because they believed them to be healthy.

“This advice [to avoid fat] allowed the food industry to go hog-wild promoting low-fat, carb-heavy packaged foods as ‘light’ or ‘healthy,’ and that’s been a disaster for public health,” Lustig said.

The stats back him up. Since the US government first published a set of national nutrition guidelines in 1980, rates of obesity and related diseases like diabetes have more than doubled. “Childhood diabetes was basically unheard of, and now it’s an epidemic,” Lustig said.

Overseas, national health authorities followed America’s lead on fat. The results have been similarly grim. Earlier this year, a UK nonprofit called the National Obesity Forum (NOF) published a blistering condemnation of its government’s diet and nutrition policies. […]

Teicholz said it’s hard to overstate the effect of national health authorities’ pro-carb, anti-fat stance. A whole generation of health professionals accepted—and passed on to their patients—the government’s guidance to avoid fat and cholesterol. Many still do.

“Both professional and institutional credibility are at stake,” she said when asked why more doctors and policymakers aren’t making noise about the harms caused by the government’s dietary guidance. She also mentioned food industry interests, the potential for “massive class-action lawsuits,” and the shame of copping to nearly a half-century of bad diet advice as deterrents for USDA and other health authorities when it comes to admitting they were wrong. […]

But one thing is clear: Dietary fat was never the boogeyman health authorities made it out to be.

“I think most of us would be 90 percent of the way to a really healthy diet if we just cut out processed foods,” UCSF’s Lustig said. “We wouldn’t need diet guidelines if we ate real food.”

Physical Health, Mental Health

There is a growing field focused on the relationship between diet, nutrition, neurocognition, and psychiatry. I’ve written about this previously (The Agricultural Mind; Ketogenic Diet and Neurocognitive Health; & Fasting, Calorie Restriction, and Ketosis). But there aren’t many well known experts in this area.

One of the better known figures in this convergence of fields is Dr. Georgia Ede, a psychiatrist with a medical degree and a B.A. in Biology. She has completed a graduate course in nutrition at Harvard where she also completed her residency. Besides psychiatry, her employment includes as laboratory research assistant, psychopharmacologist, and nutrition consultant. Her writings regularly appear in Psychology Today.

Another major expert is Dr. Ann Childers. She is a psychiatric physician for children and adults. Besides being a lecturer and podcaster, she has written chapters for textbooks. She is a member of the American Psychiatric Association, the American Medical Association, the Nutrition and Metabolism Society, Obesity Medicine Association, and Fellow of the American Psychiatric Association.

There is another authority in this area, Dr. Natasha Campbell-McBride. She holds a degree in Medicine and Postgraduate degrees in both Neurology and Human Nutrition. After years working as a neurologist and neurosurgeon, she now practices as a nutritionist and used to run the Cambridge Nutrition Clinic. She is the founder of the widely used Gut and Psychology (GAPS) Diet.

I’ll mention two other names. Carol Simontacchi was a certified clinical nutritionist and hosted a nationally syndicated radio show. She was also a writer, including a book on this topic, Crazy Makers. Last but not least, there is L. Amber O’Hearn. By education, she is a data scientist. In dealing with her own physical and mental health issues, she tried a ketogenic diet and then a carnivore diet. She is a major figure and speaker in the low-carb community.

Heck, while I’m at it, I’ll also give honorable mention to some others: registered dietitian nutritionist Vicky Newman and clinical psychologist Julia Rucklidge. Both support their views with scientific evidence. Newman basically recommends a low-carb diet without ever explicitly calling it that. She also takes a fairly holistic approach with more knowledge that is common in alternative health, such as the importance of pastured and grassfed livestock.

Rucklidge is more conventional in her recommending a Mediterranean diet. From what I can tell, she is unaware of functional medicine, traditional foods, paleo, low-carb, keto, carnivore, etc. On the other hand, she gets extra credit points for talking about how good nutrition improves the psychological and behavioral outcomes among depressives, autistic children, ADHD adults, trauma patients, prisoners, etc.

For good measure, let me also recommend Dr. Eric Berg. He has no particular specialty in psychology, psychiatry, or anything similar. But he is is one of the best presenters on useful medical knowledge for diet and health. His talks are always clear and concise.

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Ketogenic Diets for Mental Health: A Guide to Resources
by Georgia Ede

Your Brain on Plants: Micronutrients and Mental Health
by Georgia Ede

Affects of Diet and Mental Health
by Georgia Ede

Schizophrenia, Depression, and the Little-Known “Mental Heatlh”/DietaryLink
interview with Dr. Natasha Campbell-McBride

A Carnivore Diet for Physical and Mental Health
interview with L. Amber O’Hearn

Failure of Nutritional Knowledge in Science and Practice

“The idea that the same experiment will always produce the same result, no matter who performs it, is one of the cornerstones of science’s claim to truth. However, more than 70% of the researchers (pdf), who took part in a recent study published in Nature have tried and failed to replicate another scientist’s experiment. Another study found that at least 50% of life science research cannot be replicated. The same holds for 51% of economics papers”
~Julian Kirchherr, Why we can’t trust academic journals to tell the scientific truth

“The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue”
~Richard Horton, editor in chief of The Lancet, one of the leading medical journals where nutritional studies are published

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor”
~Dr. Marcia Angell, former editor in chief of The New England Journal of Medicine

“Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias.”
~John Ioannidis, Why Most Published Research Findings Are False

“Possibly, the large majority of produced systematic reviews and meta‐analyses are unnecessary, misleading, and/or conflicted.”
~John Ioannidis, The Mass Production of Redundant, Misleading, and Conflicted Systematic Reviews and Meta‐analyses

“Nutritional epidemiologists valiantly work in an important, challenging frontier of science and health. However, methods used to-date (even by the best scientists with best intentions) have yielded little reliable, useful information.”
~John Ioannidis, Unreformed nutritional epidemiology: a lamp post in the dark forest

“Associations with cancer risk or benefits have been claimed for most food ingredients. Many single studies highlight implausibly large effects, even though evidence is weak. Effect sizes shrink in meta-analyses.”
~Jonathan Schoenfeld & John Ioannidis, Is everything we eat associated with cancer? A systematic cookbook review

“Some nutrition scientists and much of the public often consider epidemiologic associations of nutritional factors to represent causal effects that can inform public health policy and guidelines. However, the emerging picture of nutritional epidemiology is difficult to reconcile with good scientific principles. The field needs radical reform.”
~John Ioannidis, The Challenge of Reforming Nutritional Epidemiologic Research

“Incoming residents to a pediatric residency program appear to be deficient in basic nutritional knowledge. With the ever increasing burden of obesity and its associated co-morbidities on society, it is imperative that medical education focuses on preparing physicians to appropriately counsel all populations on proper nutrition.”
~M. Castillo, R. Feinstein, J Tsang & M. Fisher, Basic nutrition knowledge of recent medical graduates entering a pediatric residency program.

“Many US medical schools still fail to prepare future physicians for everyday nutrition challenges in clinical practice. Nutrition is a dominant contributor to most chronic diseases and a key determinant of poor treatment outcomes. It cannot be a realistic expectation for physicians to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition, and many other conditions as long as they are not taught during medical school how to recognize and treat the nutritional root causes.”
~Kelly Adams, W. Scott Butsch & Martin Kohlmeier, The State of Nutrition Education at US Medical Schools

* * *

I’ve written about this topic before. In some of those earlier posts, I used a few of the above quotes. But I also came across some new quotes that emphasize the point. I decided to gather them all together in one place without analysis commentary, as they speak for themselves. I’ll allow myself to make a single note of significance.

A lot of medical research is done by doctors. In Rigor Mortis, Richard Harris points out that doctors aren’t generally well educated and trained in research methodology or statistical analysis. My cousin who does medical research confirmed this observation. On top of that, doctors when they were back in medical school also weren’t taught much about diet and nutrition — interns right out of medical school get about half the nutritional questions wrong, which would be a failing grade.

So, combine doctors not trained in research doing research on diet and nutrition which they never learned much about. It is not surprising that nutritional studies is one of the worst areas of replication crisis. The following are the prior posts about all of this:

Flawed Scientific Research
Scientific Failure and Self Experimentation
Clearing Away the Rubbish
Most Mainstream Doctors Would Fail Nutrition

* * *

Bonus Video – Below is a speech given by Dr. Aseem Malhotra at the European Parliament last year and another speech by Dr. Michael Eades. Among other things, he covers some of the bad methodologies, deceptive or misleading practices, and conflicts of interest.

Sometimes research is intentionally bad because of the biases of funding and ideological agendas, an issue I’ve covered numerous times before. It can’t all be blamed on the insufficient education of doctors in their doing research. After the video, I’ll throw in the links to those other pieces as well.

Cold War Silencing of Science
Eliminating Dietary Dissent
Dietary Dictocrats of EAT-Lancet
Monsanto is Safe and Good, Says Monsanto

Diets and Systems

Chuck Pezeshki is a published professor of engineering in the field of design theory and high performance work teams. I can claim no specialty here, as I lack even a college degree. Still, Pezeshki and I have much in common — like  me: He prefers a systems view, as he summarizes his blog on his About page, “As we relate, so we think.” He states that, “My work exists at, and reaches far above the micro-neuroscience level, into larger systemic social organization.”

An area of focus we share is diet and health and we’ve come to similar conclusions. Like me, he sees a relationship between sugar, obesity, addiction, trauma, individuality, empathy issues, authoritarianism, etc (and inequality comes up as well; by the way, my favorite perspective on inequality in this context is Keith Payne’s The Broken Ladder). And like me, he is informed by a low-carb and ketogenic approach that was initially motivated by weight loss. Maybe these commonalities are unsurprising, as we do have some common intellectual interests.

Much of his blog is about what he calls “structural memetics” involving value memes (v-memes). Even though I haven’t focused as much on value memes recently, Ken Wilber’s version of spiral dynamics shaped my thought to some extent (that kind of thing being what brought me to Pezeshki’s blog in the first place). As important, we are both familiar with Bruce K. Alexander’s research on addiction, although my familiarity comes from Johann Hari’s writings (I learned of the rat park research in Chasing the Scream). A more basic link in our views comes from each of us having read the science journalism of Gary Taubes and Nina Teicholz, along with some influence from Dr. Jason Fung. He has also read Dr. Robert H. Lustig, a leading figure in this area who I know of through the work of others.

Related to diet, Pezeshki does bring up the issue of inflammation. As I originally came around to my present diet from a paleo viewpoint, I became familiar with the approach of functional medicine that puts inflammation as a central factor (Essentialism On the Decline). Inflammation is a bridge between the physiological and the psychological, the individual and the social. Where and how inflammation erupts within the individual determines how a disease condition or rather a confluence of symptoms gets labeled and treated, even if the fundamental cause originated elsewhere, maybe in the ‘external’ world (socioeconomic stress, transgenerational trauma, environmental toxins, parasites because of lack of public sanitation, etc. Inflammation is linked to leaky gut, leaky brain, arthritis, autoimmune disorders, mood disorders, ADHD, autism, schizophrenia, impulsivity, short-term thinking, addiction, aggression, etc — and such problems increase under high inequality.

There are specific examples to point to. Diabetes and mood disorders co-occur. There is the connection of depression and anhedonia, involving the reward circuit and pleasure, which in turn can be affected by inflammation. Also, inflammation can lead to changes in glutamate in depression, similar to the glutamate alterations in autism from diet and microbes, and that is significant considering that glutamate is not only a major neurotransmitter but also a common food additive. Dr. Roger McIntyre writes that, “MRI scans have shown that if you make someone immune activated, the hypervigilance center is activated, activity in the motoric region is reduced, and the person becomes withdrawn and hypervigilant. And that’s what depression is. What’s the classic presentation of depression? People are anxious, agitated, and experience a lack of spontaneous activity and increased emotional withdrawal” (Inflammation, Mood Disorders, and Disease Model Convergence). Inflammation is a serious condition and, in the modern world, quite pervasive. The implications of this are not to be dismissed.

I’ve been thinking about this kind of thing for years now. But this is the first time I’ve come across someone else making these same connections, at least to this extent and with such a large context. The only thing I would add or further emphasize is that, from a functional medicine perspective (common among paleo, low-carb, and keto advocates), the body itself is a system as part of the larger systems of society and the environment — it is a web of connections not only in which we are enmeshed but of which forms everything we are, that is to say we aren’t separate from it. Personal health is public health is environmental health, and think of that in relation to the world of hyperobjects overlapping with hypersubjectivity (as opposed to the isolating psychosis of hyper-individualism):

“We shouldn’t personally identify with our health problems and struggles. We aren’t alone nor isolated. The world is continuously affecting us, as we affect others. The world is built on relationships, not just between humans and other species but involving everything around us — what some describe as embodied, embedded, enacted, and extended (we are hypersubjects among hyperobjects). The world that we inhabit, that world inhabits us, our bodies and minds. There is no world “out there” for there is no possible way for us to be outside the world. Everything going on around us shapes who we are, how we think and feel, and what we do — most importantly, shapes us as members of a society and as parts of a living biosphere, a system of systems all the way down. The personal is always the public, the individual always the collective, the human always the more than human” (The World Around Us).

In its earliest meaning, diet meant a way of life, not merely an eating regimen. And for most of history, diet was rooted in cultural identity and communal experience. It reinforced a worldview and social order. This allows diet to be a perfect lens through which to study societal patterns and changes over time.

* * *

Relevant posts by Chuck Pezeshki:

Weight Loss — it’s in the V-Memes
Weight Loss — It’s in the v-Memes (II)
Weight Loss by the V-Memes — (III) What’s the v-Meme stack look like?
Weight Loss by the V-Memes (IV) or Channeling your Inner Australopithecine
Weight Loss by the v-Memes (V) – Cutting out Sugar — The Big Psycho-Social-Environmental Picture
The Case Against Sugar — a True Psychodynamic Meta-Review
Quickie Post — the Trans-Cultural Diabolical Power of Sugar
How Health Care Deprivation and the Consequences of Poor Diet is Feeding Contemporary Authoritarianism – The Trump ACA Debacle
Quickie Post — Understanding the Dynamics of Cancer Requires a Social Structure that can Create Cellular Dynamics
Finding a Cure for Cancer — or Why Physicists May Have the Upper Hand
Quickie Post –A Sober Utopia
Rat Park — Implications for High-Productivity Environments — Part I
Rat Park — Implications for High-Productivity Environments — Part II
Leadership for Creativity Isn’t all Child’s Play
Relational Disruption in Organizations
The Neurobiology of Education and Critical Thinking — How Do We Get There?
What Caused the Enlightenment? And What Threatens to Unravel It?

* * *

Relevant posts from my own blog:

It’s All Your Fault, You Fat Loser!
The World Around Us
The Literal Metaphor of Sickness
Health From Generation To Generation
The Agricultural Mind
Spartan Diet
Ketogenic Diet and Neurocognitive Health
Fasting, Calorie Restriction, and Ketosis
Like water fasts, meat fasts are good for health.
The Creed of Ancel Keys
Dietary Dictocrats of EAT-Lancet
Eliminating Dietary Dissent
Cold War Silencing of Science
Essentialism On the Decline

There is also some discussion of diet in this post and the comments section:

Western Individuality Before the Enlightenment Age

And related to that:

Low-Carb Diets On The Rise

“It has become an overtly ideological fight, but maybe it always was. The politicization of diet goes back to the early formalized food laws that became widespread in the Axial Age and regained centrality in the Middle Ages, which for Europeans meant a revival of ancient Greek thought, specifically that of Galen. And it is utterly fascinating that pre-scientific Galenic dietary philosophy has since taken on scientific garb and gets peddled to this day, as a main current in conventional dietary thought (see Food and Faith in Christian Culture ed. by Ken Albala and Trudy Eden […]; I made this connection in realizing that Stephen Le, a biological anthropologist, was without awareness parroting Galenic thought in his book 100 Million Years of Food).”

* * *

Mental health, Psychopathy, Addiction, Inflammation, Diet, Nutrition, etc:

Dark triad traits and health outcomes: An exploratory study
by Jasna Hudek-Knezevic et al

Brain chemical is reward for psychopathic traits
by Ewen Callaway

Psychopaths’ brains wired to seek rewards, no matter the consequences
from Science Daily

Psychopathic traits modulate brain responses to drug cues in incarcerated offenders
by Lora M. Cope et al

Links Between Substance Abuse and Antisocial Personality Disorder (ASPD)
from Promises Behavioral Health

Antisocial Personality Disorder and depression in relation to alcoholism: A community-based sample
by Laura C. Holdcraft et al

More inflammation but less brain-derived neurotrophic factor in antisocial personality disorder
by Tzu-Yun Wang et al

High Neuroticism and Low Conscientiousness Are Associated with Interleukin-6
by Sutin, Angelina

Aggressive and impulsive personality traits and inflammatory markers in cerebrospinal fluid and serum: Are they interconnected?
by S. Bromander et al

Inflammation Predicts Decision-Making Characterized by Impulsivity, Present Focus, and an Inability to Delay Gratification
by Jeffrey Gassen et al

Could Your Immune System Be Making You Impulsive?
by Emma Young

Impulsivity-related traits are associated with higher white blood cell counts
by Angelina R. Sutin et al

Dietary long-chain omega-3 fatty acids are related to impulse control and anterior cingulate function in adolescents
by Valerie L. Darcey

Diabetes Risk and Impulsivity
by David Perlmutter

Experimentally-Induced Inflammation Predicts Present Focus
by Jeffrey Gassen et al

Penn Vet researchers link inflammation and mania
by Katherine Unger Baillie

Anger Disorders May Be Linked to Inflammation
by Bahar Gholipour

Markers of Inflammation in the Blood Linked to Aggressive Behaviors
from University of Chicago Medical Center

Anhedonia as a clinical correlate of inflammation in adolescents across psychiatric conditions
by R. D. Freed et al

From Stress to Anhedonia: Molecular Processes through Functional Circuits
by Colin H. Stanton et al

Mapping inflammation onto mood: Inflammatory mediators of anhedonia
by Walter Swardfager et al

Understanding anhedonia: What happens in the brain?
by Tim Newman

Depression, Anhedonia, Glutamate, and Inflammation
by Peter Forster et al

Depression and anhedonia caused by inflammation affecting the brain
from Bel Marra Health

Inflammation linked to weakened reward circuits in depression
from Emory Health Sciences

Depression in people with type 2 diabetes: current perspectives
by L. Darwish et al

The Link Between Chronic Inflammation and Mental Health
by Kayt Sukel

Emory team links inflammation to a third of all cases of depression
by Oliver Worsley

Brain Inflammation Linked to Depression
by Emily Downwar

The Brain on Fire: Depression and Inflammation
by Marwa Azab

Inflammation, Mood Disorders, and Disease Model Convergence
by Lauren LeBano

High-inflammation depression linked to reduced functional connectivity
by Alice Weatherston

Does Inflammation Cause More Depression or Aggression?
by Charles Raison

A probe in the connection between inflammation, cognition and suicide
by Ricardo Cáceda et al

What If We’re Wrong About Depression?
by Anna North

People with ‘rage’ disorder twice as likely to have parasitic infection
by Kevin Jiang

Rage Disorder Linked with Parasite Found in Cat Feces
by Christopher Wanjek

Maternal Inflammation Can Affect Fetal Brain Development
by Janice Wood

The effects of increased inflammatory markers during pregnancy
from Charité – Universitätsmedizin Berlin

Inflammation in Pregnancy Tied to Greater Risk for Mental Illness in Child
by Traci Pedersen

Inflammation may wield sex-specific effects on developing brain
by Nicholette Zeliadt

Childhood obesity is linked to poverty and parenting style
from Concordia University

The Obesity–Impulsivity Axis: Potential Metabolic Interventions in Chronic Psychiatric Patients
by Adonis Sfera et al

The pernicious satisfaction of eating carbohydrates
by Philip Marais

Your Brain On Paleo
from Paleo Leap

The Role of Nutrition and the Gut-Brain Axis in Psychiatry: A Review of the Literature
by S. Mörkl et al

Emerging evidence linking the gut microbiome to neurologic disorders
by Jessica A. Griffiths and Sarkis K. Mazmanian

New Study Shows How Gut Bacteria Affect How You See the World
by David Perlmutter

The Surprising Link Between Gut Health and Mental Health
from LoveBug Probiotics

Nutritional Psychiatry: Is Food The Next Big Frontier In Mental Health Treatment?
by Stephanie Eckelkamp

Ketogenic Diets for Psychiatric Disorders: A New 2017 Review
by Georgia Ede

Low-Carbohydrate Diet Superior to Antipsychotic Medications
by Georgia Ede

Gut microbiome, SCFAs, mood disorders, ketogenic diet and seizures
by Jonathan Miller

Can the Ketogenic Diet Treat Depression and Anxiety, Even Schizophrenia?
by Rebekah Edwards

Fat Doesn’t Mean Not Fit

Eric “Butterbean” Esch, having weighed 425 lbs at his heaviest, was one of the best boxers of the 1990s. He regularly knocked out his competitors in under a minute. He didn’t look impressive, besides being obese. He wasn’t the best trained nor did he fight with much style. But he was a powerhouse. He could take punches and give them in return. And when he landed a punch, it was devastating.

As with many others, Butterbean’s obesity was not an indicator of a lack of muscle, stamina, and aerobic health. Even in later fights when his power was decreased, he still could hold his own for many rounds. In 2002, he remained on his feet for 10 rounds with one of the greatest fighters of all time, Larry Holmes, before finally knocking him back against the ropes with the fight ending after the referee did a standing 8 count. He expanded his career into professional wrestling and MMA matches, winning many more fights. As late as 2011 in his mid-40s, he was still knocking out opponents and he was still fat.

This is why so few people can lose weight through exercise alone. All that more exercise does for most, specifically on a high-carb diet, is to make them hungrier and so leading to them eating more (exercise on a ketogenic diet is a bit different, though). And indeed, many athletes end up focusing on carbs in trying to maintain their energy, as glucose gets used up so quickly (as opposed to ketones). Long-distance runners on a high-carb diet have to constantly refuel with sugary drinks provided along the way.

Americans have been advised to eat more of the supposedly healthy carbs (whole grains, vegetables, fruit, etc) while eating less of the supposedly unhealthy animal foods (red meat, saturated fats, etc) and the data shows they are doing exactly that, more than ever before since data was kept. But telling people that eating lots of carbs, even if from “whole foods”, is part of a healthy diet is bad advice. And when they gain weight, blaming them for not exercising enough is bad advice stacked upon bad advice.

Such high-carb diets don’t do any good for long-term health, even for athletes. Morally judging fat people as gluttonous and slothful simply doesn’t make sense and it is the opposite of helpful, a point that Gary Taubes has made. It’s plain bullshit and this scapegoating of the victims of bad advice is cruel.

This is why so many professional athletes get fat when they retire, after a long career of eating endless carbs, not that it ever was good for their metabolic health (people can be skinny fat with adipose around their internal organs and have diabetes or pre-diabetes). But some like Butterbean begin their athletic careers fat and remained fat. Many football players are similarly overweight. William Perry, AKA The Fridge, was an example of that, although he was a relative lightweight at 335-350 lbs. Even more obvious examples are seen with some gigantic sumo wrestlers who, while grotesquely obese, are immensely strong athletes.

Sumo wrestlers are also a great example of the power of a high-carb diet. They will intentionally consume massive amounts of starches and sugars in order to put on fat. That is old knowledge, the reason people have understood for centuries the best way to fatten cattle is to feed them grains. And it isn’t as if cattle get fat by being lazy while sitting on the couch watching tv and playing on the internet. It’s the diet alone that accomplishes that feat of deliciously marbled flesh. Likewise, humans eating a high-carb diet will make their own muscles and organs marbled.

I speak from personal experience, after gaining weight in my late 30s and into my early 40s. I topped out at around 220 lbs  — not massive, but way beyond my weight in my early 20s when I was super skinny, maybe down in the 140 lbs range (the result of a poverty diet and I looked gaunt at the time). In recent years, I had developed a somewhat protruding belly and neck flabs. You could definitely tell I was carrying extra fat. Could you tell that I also was physically fit? Probably not.

No matter how much I exercised, I could not lose weight. I was jogging out to my parent’s place, often while carrying a backpack that sometimes added another 20-30 lbs (books, water bottle, etc). That jog took about an hour and I did it 3-4 times a week and I was doing some weightlifting as well, but my weight remained the same. Keep in mind I was eating what, according to official dietary guidelines, was a ‘balanced’ diet. I had cut back on my added sugars over the years, only allowing them as part of healthy whole foods such as in kefir, kombucha, and fruit. I was emphasizing lots of vegetables and fiber. This often meant starting my day with a large bowl of bran cereal topped with blueberries or dried fruit.

I was doing what Americans have been told is healthy. I could not lose any of that extra fat, in spite of all my effort and self-control. Then in the spring of last year I went on a low-carb diet that transitioned into a very low-carb diet (i.e., keto). In about 3 months, I lost 60 lbs and have kept it off since. I didn’t do portion control and didn’t count calories. I ate as much as I wanted, but simply cut out the starches and sugars. No willpower was required, as on a keto diet my hunger diminished and my cravings disappeared. It was the high-carb diet that had made me fat, not a lack of exercise.

On Health or Lack Thereof

Millennials’ health plummets after the age of 27: Study finds the generation has unprecedented rates of diabetes, depression, and digestive disorders
by Natalie Rahhal

  • After age 27, all major measures of health start to decline sharply for millennials, according to a new Blue Cross Blue Shield Report
  • Millennials have higher rates of eight of the top 10 most common health conditions by their mid-30s than generation X-ers did at the same age
  • As their health continues to decline, millennials stand to cost the American health care industry and economy steep sums

It's all downhill from here: A depressing graph shows steep health decline that begins after age 27 and continues until death for millennials
It’s all downhill from here: A depressing graph shows steep health decline that begins after age 27 and continues until death for millennials

Effect of Dietary Lipid on UV Light Carcinogenesis in the Hairless Mouse
by Vivienne E. Reeve, Melissa Matheson, Gavin E. Greenoak, Paul J. Canfield, Christa Boehm‐Wilcox, and Clifford H. Gallagher

Isocaloric feeding of diets varying in lipid content to albino hairless mice has shown that their susceptibility to skin tumorigenesis induced by simulated solar UV light was not affected by the level of polyunsaturated fat, 5% or 20%. However a qualitative effect of dietary lipid was demonstrated. Mice fed 20% saturated fat were almost completely protected from UV tumorigenesis when compared with mice fed 20% polyunsaturated fat. Multiple latent tumours were detected in the saturated fat‐fed mice by subsequent dietary replenishment, suggesting that a requirement for dietary unsaturated fat exists for the promotion stage of UV‐induced skin carcinogenesis.

Therapeutic benefit of combining calorie-restricted ketogenic diet and glutamine targeting in late-stage experimental glioblastoma
by Purna Mukherjee, Zachary M. Augur, Mingyi Li, Collin Hill, Bennett Greenwood, Marek A. Domin, Gramoz Kondakci, Niven R. Narain, Michael A. Kiebish, Roderick T. Bronson, Gabriel Arismendi-Morillo, Christos Chinopoulos, and Thomas N. Seyfried

Glioblastoma (GBM) is an aggressive primary human brain tumour that has resisted effective therapy for decades. Although glucose and glutamine are the major fuels that drive GBM growth and invasion, few studies have targeted these fuels for therapeutic management. The glutamine antagonist, 6-diazo-5-oxo-L-norleucine (DON), was administered together with a calorically restricted ketogenic diet (KD-R) to treat late-stage orthotopic growth in two syngeneic GBM mouse models: VM-M3 and CT-2A. DON targets glutaminolysis, while the KD-R reduces glucose and, simultaneously, elevates neuroprotective and non-fermentable ketone bodies. The diet/drug therapeutic strategy killed tumour cells while reversing disease symptoms, and improving overall mouse survival. The therapeutic strategy also reduces edema, hemorrhage, and inflammation. Moreover, the KD-R diet facilitated DON delivery to the brain and allowed a lower dosage to achieve therapeutic effect. The findings support the importance of glucose and glutamine in driving GBM growth and provide a therapeutic strategy for non-toxic metabolic management.

Writer’s block
by Dr. Malcolm Kendrick

Anyway, to return to the main issue here, which is that medical science may now be incapable of self-correction. Erroneous ideas will be compounded, built on, and can never be overturned. Because of a thing called non-reproducibility.

In most areas of science, there is nothing to stop a researcher going back over old research and trying to replicate it. The correct term is reproducibility. In every branch of science there is currently an acknowledged crisis with reproducibility.

‘Reproducibility is a hot topic in science at the moment, but is there a crisis? Nature asked 1,576 scientists this question as part of an online survey. Most agree that there is a crisis and over 70% said they’d tried and failed to reproduce another group’s experiments.’ 2

This is not good, but in medical research this issue is magnified many times. Because there is another in-built problem. You cannot reproduce research that has been positive. Take clinical trials into statins. You start with middle aged men, split them into two groups, give one a statin and one a placebo. At the end of your five-year trial, you claim that statins had a benefit – stopped heart attacks and strokes and suchlike.

Once this claim has been made, in this group, it becomes unethical/impossible to replicate this study, in this group – ever again. The ethics committee would tell you that statins have been proven to have a benefit, you cannot withhold a drug with a ‘proven’ benefit from patients. Therefore, you cannot have a placebo arm in your trial. Therefore, you cannot attempt to replicate the findings. Ever.

Thus, if a trial was flawed/biased/corrupt or simply done badly. That’s it. You are going to have to believe the results, and you can never, ever, have another go. Ergo, medicine cannot self-correct through non-reproducibility. Stupidity can now last for ever. In fact, it is built in.

When Evidence Says No, but Doctors Say Yes
by David Epstein

Even if a drug you take was studied in thousands of people and shown truly to save lives, chances are it won’t do that for you. The good news is, it probably won’t harm you, either. Some of the most widely prescribed medications do little of anything meaningful, good or bad, for most people who take them.

In a 2013 study, a dozen doctors from around the country examined all 363 articles published in The New England Journal of Medicine over a decade—2001 through 2010—that tested a current clinical practice, from the use of antibiotics to treat people with persistent Lyme disease symptoms (didn’t help) to the use of specialized sponges for preventing infections in patients having colorectal surgery (caused more infections). Their results, published in the Mayo Clinic Proceedings, found 146 studies that proved or strongly suggested that a current standard practice either had no benefit at all or was inferior to the practice it replaced; 138 articles supported the efficacy of an existing practice, and the remaining 79 were deemed inconclusive. (There was, naturally, plenty of disagreement with the authors’ conclusions.) Some of the contradicted practices possibly affect millions of people daily: Intensive medication to keep blood pressure very low in diabetic patients caused more side effects and was no better at preventing heart attacks or death than more mild treatments that allowed for a somewhat higher blood pressure. Other practices challenged by the study are less common—like the use of a genetic test to determine if a popular blood thinner is right for a particular patient—but gaining in popularity despite mounting contrary evidence. Some examples defy intuition: CPR is no more effective with rescue breathing than if chest compressions are used alone; and breast-cancer survivors who are told not to lift weights with swollen limbs actually should lift weights, because it improves their symptoms.

A separate but similarly themed study in 2012 funded by the Australian Department of Health and Ageing, which sought to reduce spending on needless procedures, looked across the same decade and identified 156 active medical practices that are probably unsafe or ineffective. The list goes on: A brand new review of 48 separate studies—comprising more than 13,000 clinicians—looked at how doctors perceive disease-screening tests and found that they tend to underestimate the potential harms of screening and overestimate the potential benefits; an editorial in American Family Physician, co-written by one of the journal’s editors, noted that a “striking feature” of recent research is how much of it contradicts traditional medical opinion.

That isn’t likely to change any time soon. The 21st Century Cures Act—a rare bipartisan bill, pushed by more than 1,400 lobbyists and signed into law in December—lowers evidentiary standards for new uses of drugs and for marketing and approval of some medical devices. Furthermore, last month President Donald Trump scolded the FDA for what he characterized as withholding drugs from dying patients. He promised to slash regulations “big league. … It could even be up to 80 percent” of current FDA regulations, he said. To that end, one of the president’s top candidates to head the FDA, tech investor Jim O’Neill, has openly advocated for drugs to be approved before they’re shown to work. “Let people start using them at their own risk,” O’Neill has argued.

So, while Americans can expect to see more drugs and devices sped to those who need them, they should also expect the problem of therapies based on flimsy evidence to accelerate. In a recent Stat op-ed, two Johns Hopkins University physician-researchers wrote that the new 21st Century Cures Act will turn the label “FDA approved” into “a shadow of its former self.” In 1962, Congress famously raised the evidentiary bar for drug approvals after thousands of babies were born with malformed limbs to mothers who had taken the sleep aid thalidomide. Steven Galson, a retired rear admiral and former acting surgeon general under both President George W. Bush and President Barack Obama, has called the strengthened approval process created in 1962 the FDA’s “biggest contribution to health.” Before that, he said, “many marketed drugs were ineffective for their labeled uses.”

Striking the right balance between innovation and regulation is incredibly difficult, but once remedies are in use—even in the face of contrary evidence—they tend to persist. A 2007 Journal of the American Medical Association papercoauthored by John Ioannidis—a Stanford University medical researcher and statistician who rose to prominence exposing poor-quality medical science—found that it took 10 years for large swaths of the medical community to stop referencing popular practices after their efficacy was unequivocally vanquished by science.

Science institute that advised EU and UN ‘actually industry lobby group’
by Arthur Nelson

An institute whose experts have occupied key positions on EU and UN regulatory panels is, in reality, an industry lobby group that masquerades as a scientific health charity, according to a peer-reviewed study.

The Washington-based International Life Sciences Institute (ILSI) describes its mission as “pursuing objectivity, clarity and reproducibility” to “benefit the public good”.

But researchers from the University of Cambridge, Bocconi University in Milan, and the US Right to Know campaign assessed over 17,000 pages of documents under US freedom of information laws to present evidence of influence-peddling.

The paper’s lead author, Dr Sarah Steele, a Cambridge university senior research associate, said: “Our findings add to the evidence that this nonprofit organisation has been used by its corporate backers for years to counter public health policies. ILSI should be regarded as an industry group – a private body – and regulated as such, not as a body acting for the greater good.”

The New Faces of Coke
by Kyle Pfister

Of the 115 individuals Coca-Cola admitted to funding, here’s a breakdown:

By sector, 57% (65) are dietitians, 20% (23) are academics, 7% (8) are medical professionals (mostly Doctors), 6% (7) are fitness experts, 5% (6) are authors, 3% (3) are chefs, and 1% (1) are food representatives. I was not able to identify sectors for two of the funded experts.

Kellogg Paid ‘Independent Experts’ to Promote Its Cereal
by Michael Addady

Kellogg paid council experts an average of $13,000 per year, according to emails and contracts obtained by the Associated Press. The payment was for expert to engage in “nutrition influencer outreach” and refrain from offering their services to products that were “competitive or negative to cereal.”

Outreach usually meant one of two things: Experts would claim Kellogg was their favorite brand on social media, or they would tout the cereal during public appearances. Kellogg’s spokesperson Kris Charles told Fortune in a statement that the experts’ association with the company was disclosed at public appearances.

Additionally, the experts’ connection to the company may have affected some of their published work. For example, an independent expert was involved in publishing an academic paper in the Journal of the Academy of Nutrition and Dietetics that defined a “quality breakfast.” Kellogg had the opportunity to edit the paper and even asked that the author remove a suggestion about limiting added sugar (something the sugar industry has also been accused of doing with heart disease research).

FDA: Sampling finds toxic nonstick compounds in some food
by Ellen Knickmeyer, John Flesher, and Michael Casey

A federal toxicology report last year cited links between high levels of the compounds in people’s blood and health problems, but said it was not certain the nonstick compounds were the cause.

The levels in nearly half of the meat and fish tested were two or more times over the only currently existing federal advisory level for any kind of the widely used manmade compounds, which are called per- and polyfluoroalykyl substances, or PFAS.

The level in the chocolate cake was higher: more than 250 times the only federal guidelines, which are for some PFAS in drinking water.

Food and Drug Administration spokeswoman Tara Rabin said Monday that the agency thought the contamination was “not likely to be a human health concern,” even though the tests exceeded the sole existing federal PFAS recommendations for drinking water.

Why smelling good could come with a cost to health
by Lauren Zanolli

About 4,000 chemicals are currently used to scent products, but you won’t find any of them listed on a label. Fragrance formulations are considered a “trade secret” and therefore protected from disclosure – even to regulators or manufacturers. Instead, one word, fragrance, appears on ingredients lists for countless cosmetics, personal care and cleaning products. A single scent may contain anywhere from 50 to 300 distinct chemicals.

“No state, federal or global authority is regulating the safety of fragrance chemicals,” says Janet Nudelman, policy director for Breast Cancer Prevention Partners (BCPP) and co-founder of the Campaign for Safe Cosmetics. “No state, federal or global authority even knows which fragrance chemicals appear in which products.”

Three-quarters of the toxic chemicals detected in a test of 140 products came from fragrance, reported a 2018 BCPP study of personal care and cleaning brands. The chemicals identified were linked to chronic health issues, including cancer.