June 10, 2011

Caveman 6, A Summary

The Department of Agriculture, which seems to take the lead in telling Americans how to eat (as opposed to the more natural advisors, the National Institutes of Health, or the Center for Disease Control, or the Department of Health & Human Services) has systematically misinformed the American people about how to eat for about 34 years. The evidence is overwhelming. The Ag Dept. has urged a low-fat, high-carb diet on an unwitting populace as part of its "Heart Healthy" program (in conspiratorial combination with the American Heart Association), which has no scientific basis in fact. Americans have internalized (in more ways than one) the message that eating fat is bad, particularly animal fat, although this advice is more than just wrong. It is 180 degrees out of phase.

As some metabolic scientists have noted, this program is probably the greatest fuck-up in the history of modern medicine. It makes leeches and the bleeding of patients look like cutting edge medical technology. It is such bad advice, as the brilliant and acerbic Wolfgang Pauli said about a physicist who produced useless work, that it is "not even wrong." To be wrong, in the sense Pauli meant, implies that the analysis proceeded on some credible basis, went somewhere awry, but is useful as an elimination of an hypothesis. The low-fat, high-carb diet does not even make it this far. There was never any scientific evidence for recommending it.

Common sense tells you that eating refined cultivated wheat, or sucrose, or corn oil, or high fructose corn syrup, or milled white rice, cannot be a natural diet for homo sapiens because such foods could not have been available to mankind as he evolved over the last four million years. They have been around for at most 10,000 years, and the highly refined milling of flour and rice has only existed since the Industrial Revolution.

The modern mania for eating refined carbohydrates (or starches such as french fries and potato chips) came about because of a complete misrepresentation of the science of cholesterol, particularly (in the truly benighted early days of the science) "total cholesterol." Total cholesterol is essentially irrelevant to a healthy cardiovascular system, except in the sense that cholesterol, particularly for women, can be very beneficial in sustaining a long life. The precise composition of blood lipids is actually the issue; however, if a 50-year old man walks into an internist's office with a total cholesterol of 240, and the doctor, consulting the brochure left by the Lipitor salesman, puts the guy on statins, no jury will find the doctor liable even if the patient dies in a couple of years from liver complications caused by the drug. Not that it's likely to go that far; after all, these are the only noted "side" effects so far: diarrhea, constipation, gas, headache, joint pain, muscle pain, tenderness, or weakness, lack of energy, fever, chest pain, nausea, extreme tiredness, unusual bleeding or bruising, loss of appetite, pain in the upper right part of the stomach, flu-like symptoms, yellowing of the skin or eyes, rash, hives, itching, difficulty breathing or swallowing, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, and hoarseness.

I don't see this list as anything to get worked up about; I doubt that Job would. That's how the system works; that's even how the "standard of care" is defined legally. The standard of care is to commit epidemic negligence. Further, the Department of Agriculture has the doc's back, and Archer Daniels Midland and Lipitor have the Department of Ag's, and the U.S. Congress is not going to do anything that will undermine the monoculture farming of America's Breadbasket.

Thus, to invoke another Old Testament hero, Jeremiah, there are voices crying in the wilderness of American obesity, pointing out that Americans are getting sick and obese from eating all the wrong stuff (people like Robert Lustig, David Ludwig, Gary Taubes, the late John Yudkin, Peter Cleave), but the official position is, well, fat and happy. It's all good.

Anyway, before I fry up some eggs: the one place I would take issue with the Carbo-Jeremiahs has to do with this constant invocation of the "First Law of Thermodynamics." There seems to be an effort, and it may have originated with Taubes, to marginalize the role of exercise in maintaining a healthy weight. This shows up again in the Lustig lecture, where the good doctor chuckles at the idea that a 5'6", 240-pound fourteen year old is going to jog off the excess weight. Well, in the first place, a truly scientific usage of the First Law tells you that it will in fact help to increase physical activity over basal metabolism in the effort to burn calories. Why even imply otherwise? But the greater harm is in the worldview this approach, perhaps unwittingly, supports.

In "Fat Head," a very funny takedown of Morgan Spurlock's "SuperSize Me," the comedian Tom Naughton and wife Chareva have put together a highly informative documentary which you can think of as a cinematic dramatization of the carb vs. fat ideas. His basic premise, which Naughton fulfills, is that a person can eat fast food for a month and lose weight if you avoid sugary drinks and choose wisely, limiting oneself to about 2,000 calories per day. (Naughton also improved his blood lipid profile on his McDonald's/Wendy's/Taco Bell diet.) If you eat at the same places, tank up on 5,000 calories/day, include lots of 32-oz. Cokes, as Spurlock did, you will encounter Spurlock's near-death experience. ("Fat Head" is on streaming Netflix.)

Anyway, not precisely the point I was going to make. Naughton recalls his childhood, which occurred perhaps 15 years after my own, but still in the general ball park, and the ball park is the whole idea. Because it seems to me that the best way not to be obese is never to become obese in the first place. Naughton recalls walking to school, as opposed to the traffic jams so typical in front of modern schools as the closing bell rings. This was my experience. I'm going to guess that my elementary school was about 1/2 mile from the house. Thus, I walked a minimum of one mile every school day; however, it was the usual routine to walk back to the park, which was across the street from the school to play whatever sport was in season. So now we're up to two miles, plus the vigorous physical activity involved in football, basketball or baseball.. We never thought of any of this as "exercise;" it was, as Naughton says, "playing outside."

In this sense, I think the abandonment of physical education programs in schools has been a complete disaster. It wasn't so much the classes in school themselves that were critical; these were frequently taken up with sports we would never dream of playing in our after school hours, games like kickball and getting timed, endlessly, running the 50-yard dash. But the classes inculcated and reinforced the idea of physical activity as a daily habit. The end result was that kids formed a lean body mass which was much more efficient and effective at dealing with the daily onslaught of high-caloric intake. Thus, this is running the "thermodynamic arrow" in precisely the opposite direction from Taubes & Co. They are treating obesity as some sort of State of Nature, when it is really a culturally-reinforced extreme aberration. Maybe it's very difficult to take off one hundred pounds of extra flab through moderate exercise; but it's less likely you'll gain the weight in the first place if you were originally physically active.

In essence, the obesity program for kids which Robert Lustig himself runs recognizes this truth, since it stresses physical activity at "the expense of" video games and watching TV. Lustig also forbids all sugary drinks. These two things are enough to turn things around for his young patients. There's no reason to think it would not work nationally. Anti-sedentarianism, anti-HFCS, and you're halfway there. The rest is simply to spin the Department of Ag's food pyramid through a 180 degree rotation so that fats regain their place in the Caveman's proper diet.

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