How Nutrition “Science” Made the US and Other Countries Fatter

In November, many major news outlets published stories describing how the sugar industry buried research from 1967 that showed a that higher consumption of sugar led to increased incidence of heart disease.

This effort to depict the sugar industry as using the same playbook that the tobacco industry did to hide mounting evidence of the damage done by its products. But this image lets the group most responsible for the fattening of America off the hook: so-called nutrition scientists.

Reader Nicholas D flagged a must-read article by Ian Leslie from 2016: The Sugar Conspiracy. It’s a compelling account of how the now-discredited idea, that saturated fats cause of heart disease, became established. Leslie also seeks to draw lessons about the shortcomings of science, that it is a far more human and social enterprise than any practitioners want to admit. While I agree with his overarching concern, I think he misses an important issue in his extremely important report: that nutrition “science” was ripe for malpractice because it was eager to wrap itself in the mantle of “science” when it would be well-nigh impossible to reach that standard.

I strongly urge you to read this important piece in full; it has lots of detail about important studies, the cherry-picking of samples and failures to test alternative hypothesis, and most important, about how protecting the reputations of the incumbents has led them to vilify researchers and outsiders who have mustered evidence that counters their long-established “Fats are bad for you” thesis.

As heart disease rates rose rapidly in the post World War II era, the medical establishment searched for answers. Diet, which had been only a marginal area of inquiry, suddenly became a high priority. A consensus developed in the 1960s that restricting fats, particularly saturated fats, was healthy.

British nutritionist scientists, led by John Yudkin, doubted this view. Humans have been meat and therefore saturated fat eaters for hundreds of thousand of years. Breast milk is full of saturated fat. By contrast, human have been eating grains only about 10,000 years ago, which is recent in evolutionary terms, and sugar, only in the last 300 years.

Leslie quotes Ludkin’s 1972 book, Pure, White, and Deadly:

“If only a small fraction of what we know about the effects of sugar were to be revealed in relation to any other material used as a food additive,” wrote Yudkin, “that material would promptly be banned.” The book did well, but Yudkin paid a high price for it. Prominent nutritionists combined with the food industry to destroy his reputation, and his career never recovered. He died, in 1995, a disappointed, largely forgotten man.

Leslie’s article incorporates the work of Nina Teicholz in her book The Big Fat Surprise. She identified the prominent, arguably seminal role that University of Minnesota’s Ancel Keys playing in turning his “fat hypothesis” into gospel truth despite its thin evidentiary foundation. Keys was also a charismatic and aggressive self-promoter who made vilifying the meticulous, retiring Yudkin a top priority. And because Yudkin was ruined professionally for being willing to assign dietary blame to sugar, no one would consider the sugar hypothesis for decades. Even when spreading waistlines, continued high levels of heart disease, and the explosion of diabetes screamed that something was wrong with what and how people were eating, these “scientists” would attack skeptics with a harpy-like viciousness that looked decidedly un-scholarly.

In my view, the fact that nutritionists depicted themselves as scientists is a big part of the problem. Nutrition is a backwater in medicine, and medicine is vastly less scientific than the medical-industrial complex would like you to believe. As a colleague who once worked for the National Institutes of Health said, “Medicine is a medieval art.”

Nutrition had barely existed as a discipline before the panic over heart disease led it to be seen as a possible solution to a burgeoning health crisis. And it is hard to see how studies into nutrition could yield anything other than tentative conclusions. The results of dietary choices play out over months, and more often, years. People lie about what they eat. Unless you have subjects in a controlled environment, it is also hard to be sure how well they are complying with intake restrictions. The most credible long-term data sources are diet records kept by nurses, who are far more likely to be consistent and keep accurate records than other study subjects would presumably be. But there is perilous little high caliber high quality data like that.

Another sorry result of the Keys v. Yudkin battle is that the wing of the field with the more questionable methods became ascendant. Keys and his followers used epidemiological models, which are in contemporary terms, big data exercises where the most you will find are correlations. They had managed to marginalize European researchers who had been investigating since the 1920s. They were biochemists and endocrinologists, far more obviously related disciplines than epidemiology.

But Lesile warns, with a supporting discussion, that the nutrition “scientists” are typical of how science operates, that it is a social enterprise, where dominant personalities, group-think, pressures to conform, fear of admitting to mistakes, create intellectual inertia. The difficulty of holding science to truly scientific standards, the pressure on young researchers to produce (and therefore over-hype or even fabricate) important findings, and in recent decades, the too-often successful efforts of industry groups to pay for flattering studies, all have eroded the image of science in the public eye, even before you get to attacks by corporate interests when scientists announce results that they see as harmful to their commercial interests.

Thus when a “science” that barely deserves the name like nutrition science spectacularly blows up, and drug “research” that barely deserves the name because it is so badly manipulated by Big Pharma deservedly tarnishes the image of science, it makes it all the easier for the likes of Big Oil to foster doubt in the scientific basis of climate change. So the cost of decades of bad dietary advice is even higher than it seems.

Again, please read The Sugar Conspiracy. It has a great deal of detail on an important and costly case of malpractice.

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