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The Obesity Epidemic — Is Medicine Scientific?
Posted by
kdawson
on Tue Nov 20, 2007 03:05 PM
from the paradigm-takeover dept.
from the paradigm-takeover dept.
An anonymous reader writes "An award-winning science author, Gary Taubes, has written a book that pans the medical community's treatment of the obesity epidemic. What is interesting is that it looks like the medical community is behaving in a very unscientific manner. Taubes points out that the current medical orthodoxy — that consuming fat makes you fat and exercise makes you thin — has no basis in research. In fact, all the available research points in quite another, and more traditional, direction. Here's the (excellent) podcast of an interview with Taubes on CBC's 'Quirks and Quarks.' So, has medicine become a non-science? Is it mostly a non-science? Somewhat?"
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Taubes is a quack. (Score:5, Informative)
He May Be But You're Not Helping (Score:5, Insightful)
To answer the questions of the summary, I don't think it will ever be an untainted science so long as the government, businesses & religion stick their noses in it. Couple that with the difficulty of applying the scientific method to humans (average life span of 75 years and ethical problems) and I think you'll see why medicine is a 'non-science.'
Patents, legislation & belief in what is good for you are what ruin medicine. Look at all the Hindu medicine that was ignored by the West for the longest time because it was
Medicine will continue to be a non-science no matter how hard the community tries. The public's assumptions and beliefs that "Since I can eat McDonald's every day and be thin, everyone should be able to" merely exacerbates the situation.
I eat whatever I feel like and I'm in great shape. This is not the case with the majority of Americans.
Parent
Re:He May Be But You're Not Helping (Score:5, Insightful)
Medicine is complex. But that doesn't stop or discourage scientists. The world is complex. Science has always, and will always, face this issue. Medicine is a perfect subject for the application of science. Do physicists give up because certain things are not directly observable? Those working in public health have to work with what they're given.
I would much rather my doctor give me advice based on years of compounded peer-reviewed research than an opinion based on anecdote. Because, without science-- that's what you're talking about.
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Nutrition, yes. Exercise, no. (Score:5, Interesting)
But to say that Exercise has no effect on weight loss is just plain wrong. Exercise changes the way your body processes the food you put into it (or, more accurately, your body adapts to the amount of exercise that you get). Building muscle causes you to require more calories in your diet to support that muscle. And building stamina causes you to burn a lot of calories in the process. And if you want to venture into the unscientific realm, consistent exercise helps to stabilize your mood and makes you less prone to food cravings (the cravings for sugary foods and for fatty foods are based in imbalances in Serotonin and Dopamine levels).
There is a dire need to re-examine everything we know about a healthy diet. People get so worked up about things like trans fats while completely ignoring the elephant in the room (high-fructose corn syrup). Everyone I know who's given up corn syrup, to the extent that it's possible in the US, has lost a minimum of 10 lbs.
But to suggest that exercise isn't a vital part of a healthy lifestyle is wrong, and potentially very dangerous.
More olive oil, more cream-- less weight (Score:5, Interesting)
In the mean time, I added a gallon of olive oil every 60 days and a pint of cream a week.
Tho fit already (sports twice a week, regular walking and exercise) I started developing diabetes (of course my mom and grandparents had it so I'm kinda doomed there). Despite cutting out enormous amounts of carbs and sugars (I was previously drinking 1,000 calories of soda a day), I continue to slide in the bad direction on my blood sugar. It's not diabetic yet but it is just a matter of time.
My diet consists of large amounts of vegetables, meat courses, almost no grains (2-3 ounces a day tops).
I think people have different needs based on their genetic history.
I agree that a lot of "science" these days is opinion, hysteria, or someone's hidden agenda.
moderation (Score:5, Insightful)
The recommended amount of exercise is 30 minutes per day -- it's actually a fair amount, if you're biking or jogging 30 minutes per day, and eating in moderation, i.e. let's say within the FDA guidelines for diet, and you're still overweight, then you might have a medical need for weight treatment. Otherwise, try all of those things first.
strawman logic (Score:5, Insightful)
Um, hardly. This kind of sentence attempt to draw the reader into a sense of agreement from their most-remembered anecdotes so that the rest of the premise is seen as new. But in reality, fad dieting advice is all over the map and has been since it was part of pop culture, which goes back a *long* way. Spoonful of mercury, anyone?
The only good dieting advice has been through a good understand of one's own body. Allergies, lifestyle, location, education, economics, etc all play roles in what chemicals you put in your and how you burn energy.
This book's position is just another in the lineup of positions taken about the human GI system and energy usage. There are many strategies, both workable and not. Unless you know yourself well, no change is a worthwhile change - its all so much guessing.
Additionally, one has to ask the philosophical question...is the goal to eat yummy/available food or live [potentially] longer lives? There's no one answer, really.
High glycemic carbs (Score:5, Interesting)
I believe there is a relationship between high glycemic carbs, blood glucose spikes, and insulin, which will cause certain body chemistries to convert and store much of that intake as fat.
Wish I had discovered this 15 years ago.
I follow the pysics diet (Score:5, Interesting)
It has to work, because it's physics.
Just finished Taubes' book this morning (Score:5, Interesting)
He notes that the application of the first law of thermodynamics (the slogan is "A Calorie is A Calorie") to a homeostatic dissipative system like the human body is beyond simplistic. It is simply wrong.
The core of his thesis is that a cellular-level metabolic disorder caused over time by consumption of concentrated and rapidly available carbohydrates, and the insulin spikes they provoke, is the cause not only of obesity but also of type II diabetes. Briefly, fat cells become too good at extracting glucose from the blood and storing it. This results in cellular-level semi-starvation in other body tissues, expressed at the organismic level by eating more and exercising less.
He depicts the high level of investment in the competing "gluttony & sloth" model of obesity which exists in our medical establishment and in our culture. Indeed, from his portrayal this viewpoint is very close to being an ideology rather than a theory, in that dissenters are cast into outer darkness rather than refuted.
He discusses the personalities and politics involved in the alleged disastrous wrong turn, and points up some interesting coincidences involving what research gets funded, and what research doesn't get funded, by for example sugar producers.
I'm intentionally being very brief. If you have a personal stake, read this book and form your own conclusions.
--
phunctor
Advice on nutrition from the 1970s (Score:5, Interesting)
The recommended advice of replacing fats with carbohydrates was repeated so often and so forcefully by everyone, that it's now printed on the back of almost every box of food in the country, in the form of the "USDA food pyramid". It was so often repeated that when I was a child (in the 1970s) things like wonder bread with a bit of margarine were considered health foods (lots of carbs, no saturated fat).
I had always assumed that the medical community had done large-scale long-term studies demonstrating that such a diet led to an increase in lifespan, a reduction in disease, and a loss of unhealthy pounds. Apparently, such studies were never done.
But then the massive Harvard Nurses Heatlh Study [harvard.edu] was performed, ending in the mid-1990s. In that study, researchers followed 40,000 nurses for decades, in what was the largest and most comprehensive study on human nutrition ever. The study found that replacing fats with carbohydrates had absolutely no effect on longevity or disease. Furthermore, replacing butter with margarine (the standard dietary advice for decades) led to no benefit either. IIRC, the only nurses who lived longer and had less disease were those who ate nutrient-dense monounsaturated fats like almonds and cashews.
As a result of the Harvard Nurses Health Study, researchers in nutrition quietly dropped their assumptions about dietary fats causing disease.
I still can't believe it. The standard dietary advice from 1960 to 1990 must have been the single largest pseudoscientific load of crap in modern history. What a colossal embarrassment. If the USDA publicly admits that it was mistaken then it will be a long time before people trust it again.
after having read the majority.... (Score:5, Funny)
Re:Ugh... (Score:5, Informative)
Parent
Perhaps it's worth investigating... (Score:5, Insightful)
I understand your anger, but the issue here is whether the low-carb propaganda is really bullshit or not. It is a matter that should be investigated, otherwise those dismissing it as bullshit would effectively act as anti-low-carb zealots, instead of following the scientific method.
Also, we have to wonder why the US (the country where the Food Pyramid originated) is also where the "fatness" phenomenon originated, and why the countries that start to follow the "american way of life" (fast food, sedentary life, high-calory carb snacks) tend to follow american's fatness. This phenomenon, at least country-wise, behaves like an epidemic.
Parent
Re:Perhaps it's worth investigating... (Score:5, Insightful)
Ok, here's your scientific study:
Asians eat carbs with almost every meal (rice, noodles). They are thinner than us. End of story.
Excess calories make you fat. That's a law of physics; I have no idea why some people dispute it. It's like arguing with the law of gravity. The only question is whether calories coming from different sources are absorbed more slowly or quickly, but the end result is the same unless you're exercising to stay in shape. A calorie is a unit of energy and if that energy is not used, it must be stored. Energy doesn't just disappear into thin air; when you consume it, you either use it or you store it.
And I really don't think there are any scientists out there saying otherwise; I don't know of any scientist saying "eating fat makes you fat" or even "eating carbs makes you fat". The only time that's ever said is in the context of certain types of high-fat or high-carb foods generally being higher in calories, which is true. Although again, Asians eat plenty of fatty meats along with their carbs and they're still thinner than we are. The reason is they just eat less. Which means fewer calories.
Not rocket science. And we've got all the knowledge we need.
Parent
Re:Perhaps it's worth investigating... (Score:5, Insightful)
This would require human waste to have no caloric value.
Parent
Re:Perhaps it's worth investigating... (Score:5, Informative)
The palate in America is very sweet. Granted, I only have a few weeks in Spain to base my opinion on, but it seemed quite conclusive and corroberates with what I've heard from some family members who've traveled more than I have.
Take a churro. In America, it's a deep-fried dough stick rolled in sugar and cinnamon. In Spain, it's a deep-fried dough stick. It's savory by our standards. You get a cup of hot chocolate, and it tastes almost like coffee. You get ham, and it's not the artificially sweetened ham we're used to, it's just a big hunk of organically-fed pig that's been sitting in a barrel of salt for a few years. Even bread in America has high fructose corn syrup in it. Now, most of the food in Spain except for the ham, seafood and churros is bordering on objectively disgusting, but everyone I saw over there is very thin.
Parent
Yes and no. (Score:5, Insightful)
This is absolutely true. You can't dispute the fact of this statement taken in isolation. In isolation.
However, it's a fine example of blinding yourself to the causes. The questions at the heart of the debate between low-carb and low-fat diet proponents are the following:
So just saying calories are calories is like saying BTUs are BTUs and putting heating oil in your gas tank in the hopes of getting better MPG.
Parent
Re:Ugh... (Score:5, Interesting)
It's not really a "diet" in the traditional weight-watchers sense. It's a change in eating habits, and I really think it could benefit a lot of people. Besides the weight loss, I feel like I have more energy and things like heart burn, which I suffered from regularly, are nearly eliminated.
Parent
Re:Ugh... (Score:5, Insightful)
My mother has been overweight for some time. She has a medical condition which caused it. She ate well and exercised and she was still overweight. She just couldn't do anything about it. Doctors prescribed her some medication to help the issue, but itcaused all kinds of problems, so she went off it. She gained the weight back. People like that are pretty much the only ones I feel sorry for when it comes to weight.
Hell, I could stand to lose a good 30lbs myself. And ya know what, I'm the one to blame? I'm a computer programmer that sits around eating crap all day. That's my fault. I also used to be very fit, and that was also my doing. I ate well, actually, more than I eat now, and did a little bit of exercise.
It just takes a little effort and common sense. Most people want the magical easy solution...
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Re:Ugh... (Score:5, Funny)
I agree with my tribal elder's wisdom from the ages. (aka Citation needed.)
Parent
Re:Ugh... (Score:5, Funny)
Why only eating? Why not acting? Chase down those animals yourself (with no tools); that'll improve your body.
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Re:Ugh... (Score:5, Informative)
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Re:Ugh... (Score:5, Insightful)
Do yourself a favor, and treat your next interaction with your doctor like a call with tech support: understand that they know more about how the system is supposed to work than you, understand that you know more about how your system works than them, transfer that knowledge to them, and be patient while they wade through the standard troubleshooting steps (did you reboot your machine? do you get enough sleep/vitamins?).
You'll actually have a chance of getting some use out of them, and live a better life.
Parent
Re:What's the mystery? (Score:5, Interesting)
I can raise my burn rate for several days by playing hard sports for three hours. People comment that I feel like I have a fever.
My friend who has developed problems after a life time of being thin has low thyroid and other hormone feedback systems. And she is always hungry- constantly. Even when she eats, she will be hungry again a while later. And not eating does not cause the hunger to fade like it does for me- it just gets stronger.
I have another friend who has the *reverse* problem. He is slowly losing weight (like a pound a year) despite eating heavily and it is getting kinda critical. He has a messed up endocrine system too.
Some people are messed up so that any exercise just destroys muscle (they do not get stronger).
I wish people would not be so judgmental about these things.
Some people eat because they are sad- some were raised and trained on bad food- some were never trained to enjoy physical activity. Some people have hyper metabolisms that allow them to eat heavily and still remain thin.
And there is some evidence recently that fat people die less of many diseases. The anti-fat attitudes stink of group-think gone bad.
Parent