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.

June 08, 2011

Caveman Diary, 5: Civilization's Food and Its Discontents

Since I'm not actually a metabolic scientist or a biochemist (although I play one on this blog), I derive part of my satisfaction in exploring this whole subject of food from the power of the pathway it affords into what you could call macrosocial analysis.

I hold this truth to be self-evident: it's freakin' weird when a modern Western democracy is composed of 300 million people, 200 million of whom are overweight; 100 million of whom are clinically obese; 75 million of whom suffer from metabolic syndrome or Syndrome X (pre-diabetic, with high blood glucose, high blood pressure, high triglycerides, fatty liver and atherosclerosis); and 27% of all citizens over 60 have Type II diabetes. And while all these things are going on, the "debate" about the viability of Medicare, the necessity of reforms, the manageability of its future costs, hardly mentions any of the astounding list of particulars at the top of this paragraph. This critically ill cohort of oversized humans is considered simply the state of nature, what we must work with, the unalterable status quo ante.

I mean...you know? Here's what else makes it completely whacked: the general trend toward the condition of epidemic obesity (and epidemic high blood pressure and related ailments) has obviously been proceeding at an alarming rate since not later than the mid-1970's. We've watched it happen. The Department of Agriculture posts its yearly "Dietary Guidelines for Americans," and Americans get fatter and fatter and fatter, until we are now the fattest people on the face of the Earth.


I commend unto you this linked UCSF lecture by Dr. Robert Lustig, endocrinologist and pediatrician at the university. It's 90 minutes long, but worth watching in its entirety, maybe even if you're not as obsessed as I am in my nocturnal pastime of unlettered biochemist. An astounding 1.4 million people have apparently viewed it so far. In line with what I've written before, I would say that Dr. Lustig has presented a refined refined carbohydrate analysis; specifically, I think what he's arguing (the controversial part) is that the actual culprit behind the obesity epidemic is high fructose corn syrup. Period. Its toxic effects on the liver give rise to insulin resistance through complicated metabolic pathways, and predispose a big consumer of HFCS to fat deposition.

While fructose does not itself elicit an insulin response, the way we consume fructose (other than at low levels when eating actual fruit) is in combination with glucose, either as sucrose (table sugar, 50/50 glucose-fructose) or as HFCS (55% fructose, 45% glucose). Thus, when we consume fructose this way, in the presence of equally high levels of glucose, we eat fructose in the presence of the strong insulin response elicited by the glucose. The importance of this associated fact is that the insulin response, in effect, disables the "satiety feedback loop," and the poor family of four knocking back the Happy Meals may deserve a break today but they don't get one, because they remain hungry even as they ingest humongous piles of crap.

Morgan Spurlock, in his movie "Supersize Me," did not really prove his thesis about McDonald's, as an eminent physiologist from a great Southwestern university explained to me. What Morgan proved was not that there was something inherently and uniquely fattening or sickening about McDonald's food. When his internist told him he was getting sick as well as huge, that his liver was being damaged, that he ran the risk of dying of heart disease if he kept this up, Spurlock was unintentionally (and in an uninformed way) proving Dr. Lustig's points. It is true that Spurlock gained weight because he ate so damn much (the caloric intake was stupendous over his 30-day experiment). But he was able to eat so much, well past the point of reasonable satiety, because of all the sugars he was consuming as part of the diet. The liver damage was a direct result of the high fructose corn syrup that finds its way into practically everything McD's serves. Spurlock became insulin resistant, he laid on fat as a result, and it would have occurred anywhere that he followed such a regime of eating, Arches or no, with or without the Clown. The movie was based on junk science about junk food.

Dr. Lustig refers to the work of the uncannily prescient John Yudkin, the British metabolic researcher, who wrote "Pure, White and Deadly," and was perhaps the first to systematically describe the "saccharine disease." Yudkin was not dealing with the ubiquitous problem of high fructose corn syrup, but he was writing about sucrose, with its 50/50 load. What gives Lustig's analysis strong credibility is the sheer timing of the American obesity epidemic. The average adult American now weighs 25 pounds more than he/she did 25 years ago. Did we just suddenly get hungrier and decide to eat more than we really felt like eating? If it's a sedentary lifestyle, did we stop moving?

No doubt this is one of those multivariate situations. Yet to account for those astounding statistics up there in the lede, something unique and new must be going on. It is true that the Department of Agriculture, beginning in 1977, gave Americans precisely the wrong advice in urging a diet which was 60 to 65% carbohydrate, and in fomenting all the hysteria about the dangers of saturated fat. The researchers knew at the time (as reproduced in hearing transcripts in Gary Taubes's Good Calories, Bad Calories) that it was far more likely that the obesogenic food sources in the American diet were the "easily digestible" carbohydrates, meaning sugars and starches, because they were aware of Yudkin's work (and that of Peter Cleave). Nevertheless, the Founding Fathers of our misbegotten diet coalesced around this low-fat stuff, condemning generations of Americans to the demeaning horrors of margarine. And despite the overwhelming evidence that they were dead wrong, the federal government essentially sits by while high fructose corn syrup, sweetening and "preserving" half the stuff in the grocery store, poisons and fattens the American people.

To go on a bit longer than usual: the parabolic take-off of American obesity appears to dovetail nicely with the introduction of high fructose corn syrup into the American diet in about 1975. We certainly had fat people before 1975, people with beer guts, people with "glandular abnormalities," as we used to say in grade school. But let's face it: we did not have the race of Elephant People that we have today. It's qualitatively different. Something specific is going on, and all the talk about "will power" and "American-ness" is simply clouding the issue. Dr. Lustig himself goes so far as to suggest a political reason: the federal government is not going to blow the whistle on corn growing or its offshoot industry, the use of corn stalks to brew high fructose corn syrup. It's big business and big money. Maybe lots of 400-pound Americans are going to keel over in the streets at the age of 55, but HFCS is good for the balance of trade.

Leading me finally to Waldenswimmer's Five Stages of Collapse of modern capitalist democracy (to match up with Dmitry Orlov's list of five, but mine are not oil-dependent). This is how it seems to me:

1. The society suffers from pandemic existential problems of an obvious nature. These can be fiscal (national debt), environmental (pollution, fracking, mountain-top removal, global warming), health-related (epidemic obesity and its related ailments), among other problems, such as a persistent state of war and imperial overreach.

2. The solutions to these problems are equally obvious. A rational philosopher king, in the Platonic tradition, who had the best interests of his subjects at heart could solve them all in the course of a few months.

3. The existing leadership, however, refuses to implement such solutions because of corruption in favor of legacy industries and institutions which work to the advantage of the economic and power elites.

4. The commoners of the population, through a deliberate program of impoverishment and mal-education foisted upon them by elites, lack the analytical ability to rescue themselves through the democratic process. Thus, the Tea Party and similar futile gestures which simply play into the hands of the Powers That Be, or the election of stooges, such as George W. Bush and Barack Obama.

5. The elites finally overplay their hand through their concentration of wealth and sponsorship of unlivable conditions for the great mass of commoners (the bottom 90%). At this point, the commoners react through what can be called undemocratic channels, viz., America in 1776, France in 1789, Russia in 1917.

As the Chinese say, it is a curse to live in interesting times.

June 07, 2011

In Re: Representative Anthony Weiner

My only comment on this non-issue:

Dear Representative Weiner:

I hope you do not resign your position because of this Twitter nonsense. It's typical of the mainstream media and other politicians to get all worked up about something like "sexting" while the thousands of crimes emanating from Wall Street because of the financial crisis go unprosecuted, or even investigated, and the nation is embroiled in three unnecessary wars we can't afford so that war profiteers can keep syphoning off federal money. You have been a sane voice on all these issues, and on the inadequacies of the Obama health care plan as well, and we need you. I am willing to grant you the right to a private life if the government will respect mine.


June 06, 2011

Caveman Diary 4: Paleolithic Eater by Day, Intrepid Dietary Researcher by Night

I have now made myself curious about this possible connection between (a) the rise in food stamp (SNAP) use by the American population, and (b) the perceived fall in the rate of increase in obesity in the United States (or even a slight decline in total obesity). Certain family members will recognize this as a possible symptom of a mania for getting to the bottom of things. It can't be helped.

Our story so far:

(A) Food stamp usage in the United States has, along with obesity itself, reached epidemic proportions: 40 million people and counting, and on a steep upward slope. About 14% of the total population, in fact, is now enrolled in the SNAP program. Essentially, the eligibility rules follow the federal poverty threshold guidelines, where gross income is allowed at 130% of the threshold (currently about $22,000 per year for a family of four) and net income is fixed at 100% of the threshold.

(B) Conveniently, and certainly not by coincidence, the U.S. Department of Agriculture busies itself, when it is not cutting deals with corn growers or giving bum advice about how to eat the wrong foods, in conducting surveys of what Americans eat. These studies are collected as part of the NHANES series, which sounds like a Michael Jordan commercial but refers to National Health Assessment...(et cetera) . These surveys and statistical tables specifically cover, among many other subjects, the percentage of total energy (kcals) and food by group which Americans eat away from home. Further, these surveys are broken down by income group, including those at, or within 130%, of the poverty threshold.

(C) A major caveat of SNAP use is that they are not convenient for buying crap at a fast food "restaurant," since their usage is forbidden for (i) hot foods or (ii) foods eaten on the premises where they are purchased. I imagine that someone could still use food stamps to buy a 40-oz. barrel of flavored water laced with caffeine, salt and, most important of all, high fructose corn syrup at a McDonald's or Taco Bell, but somehow I think this would be only occasional compared to previous, non-SNAP use. A major feature of our fast food culture is that places like McDonald's are used by the poor as family dining restaurants; the statistics on food intake strongly suggest this behavior. Indeed, the Department of Ag admits that eating out in such places is a big part of the obesity problem:

"Studies examining the relationship between the food environment and BMI have found that communities with a larger number of fast food or quick-service restaurants tend to have higher BMIs. Since the 1970s, the number of fast food restaurants has more than doubled. Further, the proportion of daily calorie intake from foods eaten away from home has increased, [29] and evidence shows that children, adolescents, and adults who eat out, particularly at fast food restaurants, are at increased risk of weight gain, overweight, and obesity. The strongest association between fast food consumption and obesity is when one or more fast food meals are consumed per week. As a result of the changing food environment, individuals need to deliberately make food choices, both at home and away from home, that are nutrient dense, low in calories, and appropriate in portion size."
The above pablum, by the way, is from the current version of the "Dietary Guidelines for America," that yearly document which was promulgated by the McGovern subcommittee in 1977 and has provided misguidelines for Americans ever since. It's beyond lame and stupid, which you would expect, and well into counterproductive territory. It does not take into account that the massive doses of high fructose corn syrup, sucrose and other carbs we allow Americans to consume "away from home" in effect disable the ability of individuals "to deliberately make food choices." As the legendary French polymath and metabolism researcher Jean-Francois Le Magnen stated the problem (and it sounds so much better in French): "L' app├ętit vient en mangeant." The appetite comes in eating. Thus, eating a large bag of popcorn at the movies, which contains 1,100 calories, seems easy, particularly if washed down with a 32-oz. Coca-Cola. The spiking insulin levels engendered by all that carbohydrate suppress the leptin and other feedback mechanisms that tell the poor eater he's full. He doesn't feel full; he wishes he had another bag of popcorn, because he's only halfway through the 12 previews before the movie starts.

But who is Tom Vilsack, Democrat of Iowa, going to blame? Those lazy layabouts at McD's swilling all that HFCS and gobbling up Big Macs (the buns heavily fortified with HFCS as well, so they'll stay "fresh") because they lack "will power" and self-control and "wisdom" to "deliberately" make good food choices that are "appropriate;" or the Corn Refiners Association, who are poisoning us in the first place? Tom, grinning at you up there, will have to get back to you on that. Suffice it to say that the "Dietary Guidelines," beyond a passing reference to "sweetened soft drinks," never betrays any anti-corn sentiment. On the contrary, it suggests that Americans really ought to give Iowa a try.

(D) Thus, if high fructose corn syrup is indeed the culprit, and if a major purveyor of HFCS is the fast food industry (which it is), then the inability of the poor, in particular, to buy humongous portions of HFCS-doctored foods (and most foods at fast food restaurants contain the sweetener, but particularly oversized soft drinks), might suggest a reason for the decline in obesity. And if this is the case, then an important forensic clue as to the origin of the obesity epidemic (at least in part) might be at hand, because the poor of America, those wretched of the Earth, are at the highest risk of obesity and obesity-related diseases, so they make a dramatic cohort for research purposes. And they were knocking back about 34% of their total sugars from "eating out" up to about 2008, and Americans on average are eating about 141 pounds of sugar per year, and it's higher yet among the poor. So if the obesity epidemic is easing up...

I believe this is one of those situations best considered through what is called a multivariate linear regression analysis, but I wouldn't be surprised if at least a suggestive clue is in there someplace. I don't think Secretary Vilsack's number-crunchers are going to tell us, because I doubt they really want to know. They just want you to eat a "balanced meal," wherever you eat it, with at least half the plate covered by fruits and vegetables. God, that sounds good: my steamed broccoli right there next to a big pile of peaches, strawberries and grapes. This is just crazy enough to work!

June 05, 2011

Midnight in Paris


I have a very old two-album set of Woody Allen's standup routines called "The Nightclub Years," the actual vinyl discs, which I must confess I haven't listened to in years because, well, I've committed all the routines to memory so the jokes cannot be fresh. The classics are all there: Shooting the Moose; the kidnapping story where the FBI agents surround the house, realize they don't have any tear gas, and so stage the death scene from "Camille," with the result: "Tear-stricken, my abductors gave themselves up." And all the rest.

You can hear in these old routines a lot of the ideas that Woody subsequently used in his movies and short stories. The whole setup for "Take the Money and Run" is in one monologue where convicts on a chain gang escape captivity "disguised as an immense charm bracelet." In another Woody interacts in a fantasy with the Lost Generation ex-patriots living in Paris in the 1920's. There are a lot of references to Ernest Hemingway's boxing (people keep getting punched in the mouth), and the best line is kind of a throwaway: "Scott and Zelda returned from a New Year's Eve party. It was April."

He uses the ex-pat-in-Paris material in his new movie "Midnight in Paris." Beyond that, I won't say too much of a spoliation nature, because the developments caught me by surprise and that's most of the fun. The movie doesn't quite make it, unfortunately, and probably won't on re-viewing, if that ever happens. Sometimes I find that Woody's movies are better when seen a second time, years later. That happened with both "Celebrity" and "Stardust Memories," which I think are both very interesting movies. So arty you could even call them "films."

I understand that his movies almost never make any money. The stars work for Screen Actors Guild scale in exchange for a chance to take a leading role in a Woody Allen movie, and this usually pays off for them. They are given more interesting, and lucrative, roles after this rite of passage. I'm thinking specifically of Evan Rachel Wood, who plays the southern ingenue in "Whatever Works," another recent Woody effort with Larry David, and Wood went on to a big role in the HBO series "Mildred Pierce." And then Rebecca Hall, in "Vicki Christina Barcelona," which was in fact a very good movie and served as a launching pad for later starring roles for her. I first became aware of how good Will Farrell could be as a semi-serious, yet still very funny, actor in Woody's "Melinda and Melinda," another almost movie.

I've read that Woody Allen writes his screenplays long-hand in his East Side apartment, start to finish, on yellow lined tablets. Sounds about right. Most modern screenplays, "written" for 15 year old boys, are comprised mainly of three words: two have four letters, and one is a compound word with 12 letters, built on an extension of one of the four-letter words. That's pretty much it, for 90 minutes. Woody is still mentally in the 1930's and 1940's, as his soundtracks always suggest, and so his dialogue is slow, stately, precise and sometimes kind of stilted and mannered. His characters don't always sound like actual people talking, but then Bruce Willis in the Die Hard movies doesn't really sound like anyone I know, either. Over the years his writing has become more the language of stage than screen, sort of a modern Noel Coward adapted for the movies.

It wasn't always so. The movies with Diane Keaton were more spontaneous and improvisational, but he's gotten away from that. A character like Owen Wilson in "Midnight" doesn't talk like a contemporary man, but then the movie's theme is a literal anachronism, so it works. It's very clever the way he has coached various actors to be him: Will Ferrell in the "Melinda" movie, Kenneth Branagh in "Celebrity," and now Owen Wilson in "Midnight." Whether they look the part of the nerdy shlemiel or not (and they don't), they bring it off: insecure, neurotic, self-analyzing. The only problem is that no one can really play Woody the way Woody did, and that now includes Woody himself. If the Woody of 30 years ago could have been the time traveler in "Midnight in Paris," instead of Owen Wilson, the movie might have been brilliant, and I suspect Woody Allen knows that. Must be kind of frustrating.

I've often thought that Woody Allen is about the only serious cinematic artist working in modern America. He's vastly underrated, in my opinion, and his true depth is usually overlooked. He works the existential themes of the great European intellectual artists, such as Camus, Sartre, Tolstoy, Dostoevsky and Ingmar Bergman; it's just that he does so in a comedic framework, so his movies are always evaluated on the basis of how many laughs they get. But all modern art has gravitated toward one essential theme (the only one left after the illusions of religion have faded away), the meaning of life or the absence thereof, and this motif runs through all of Allen's work. It's the subject of my favorite scene from his "serious" movies, the "Is life worth living?" monologue toward the very end of "Manhattan" (link above). He lays it all out there, what he's doing: the plot, the complications, the emotional dramas, are all created by his characters (these pampered, over-educated, Manhattanite sophisticates) in order to distract themselves from basic questions of mortality and existence. What really keeps one going, he tells his tape recorder, are just a few of the heart's delights, and Woody recites his. I can't think of another American movie maker who does scenes like that.

It's one of the reasons I think he's more at home in Europe now, where audiences will sit still for something other than the latest Kate Hudson/Anne Hathaway/Jennifer Anniston/Seth Rogen/Ed Helms schlock. Movies made in America aren't supposed to mean anything or clarify anything about life; they're simply sitcoms of about three times the normal length, and since many of them are now animated, they can be regarded as very long Saturday morning cartoons. At the marketing level, this works best for an uneducated populace. I tend to throw away a few hundred dollars a year watching these lousy movies, these cliche-filled scripts built on contrived situations replete with barf and fart jokes. I should probably reconsider that; I could probably support a family of four in West Africa with the money I'm spending watching movies like "Paul Blart: Mall Cop." (No, I haven't seen it.)

Now that I think of it, it's probably true that a lot of contemporary Americans don't know who the American ex-pats in Paris in the 1920's were, and are unprepared to get any of the gags or references in the movie. Yet still Woody writes the script. He works on the assumption that some people will understand some of what he's trying to say, and that's apparently enough for him.