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In this thread, I will tell you my plan for tackling obesity and diet-related disease and explain why it involves STOPPING nutrition research as we know it. Start with this excellent @ceboudreau & @hbottemiller story on nutrition research issues. https://www.politico.com/news/agenda/2019/11/04/why-we-dont-know-what-to-eat-060299
Here’s the problem with nutrition research: the tools are inadequate to the job. We have observational research, which has 2 big problems:
1. People can’t report what they eat accurately
2. All we get are correlations
I wrote about that here: https://www.washingtonpost.com/lifestyle/food/heres-what-the-governments-dietary-guidelines-should-really-say/2019/03/25/69f86e12-4beb-11e9-93d0-64dbcf38ba41_story.html
1. People can’t report what they eat accurately
2. All we get are correlations
I wrote about that here: https://www.washingtonpost.com/lifestyle/food/heres-what-the-governments-dietary-guidelines-should-really-say/2019/03/25/69f86e12-4beb-11e9-93d0-64dbcf38ba41_story.html
We also have controlled trials, and just today @davidludwigmd wrote about the problems with them in the @NYTimes. While we can do a couple easy things (pre-register!) to improve tools, much of their limitations are inherent. https://www.nytimes.com/2019/11/13/opinion/diet-research-nutrition.html
But here’s the thing. We KNOW what a healthful diet is. It’s a variety of whole-ish foods, in amounts consistent with a healthy weight. We have to eat less CRAP - the calorie-dense, nutrient-sparse, cheap convenient delicious stuff that’s everywhere. EVERYONE KNOWS THIS.
We all know this, yet we’re talking about spending bazillions pitting a prudent low-carb diet against a prudent low-fat diet? Don’t do it! The operative word isn’t CARB or FAT. It’s PRUDENT. And we already know what prudent looks like.
Even so, we get study after study showing that a prudent diet (of any kind) leads to better outcomes than a stupid diet. Just last week, we had this one. Surprise surprise, prudent correlates with better outcomes than stupid! https://academic.oup.com/jn/advance-article-abstract/doi/10.1093/jn/nxz270/5613096?redirectedFrom=fulltext
This is where we, the nutrition science and media people, have failed. We know what people should NOT EAT, but we have given them ZERO HELP not eating it when it’s in their face 24/7. Nutrition research has to shift from WHAT not to eat to HOW not to eat it.
It's BEHAVIOR and ENVIRONMENT, not CARBS and FAT.
Ludwig makes my point. He says we can’t study diets properly because subjects can’t adhere to them long enough to be studied properly. But a diet is USELESS if people can’t stick to it, and spending huge money to lock people up and force them to stick to it won’t help.
To tackle obesity, STOP studying diet. START studying how re-engineering environments and re-wiring habits can make it easier to stick to whatever prudent diet tastes good to you.
Done now, except I'm working on a book in case any EDITORS want to bite. https://www.washingtonpost.com/lifestyle/food/to-lose-weight-dont-just-avoid-temptation-remove-it/2018/10/26/eeb48238-d87f-11e8-a10f-b51546b10756_story.html
Done now, except I'm working on a book in case any EDITORS want to bite. https://www.washingtonpost.com/lifestyle/food/to-lose-weight-dont-just-avoid-temptation-remove-it/2018/10/26/eeb48238-d87f-11e8-a10f-b51546b10756_story.html
