Editor’s Note: We are pleased to present this guest post by Vik Khanna.
Last summer, I lambasted the fitness industry on this blog for being an utter failure at improving anything except its bottom line (while failing to keep Americans’ bottoms from expanding). It’s time for the nutrition industry to take its turn in my woodshed. Let’s start with this little gem: The federal Bureau of Labor Statistics projects that there are almost 70,000 people working as nutritionists and dietitians—and this number is increasing by 14 percent per year—at an average annual salary of just under $60,000.
In addition, in the last five years, the nutrition establishment has churned out 34,818 published papers with the phrase “weight loss” in the title or abstract. Under the beneficent umbrella of this vast expertise, we remain the fattest culture in the history of Western civilization … a puffy, pusillanimous pod of sheeple waiting for so-called experts to tell us how to figure out breakfast, lunch, and dinner. Are you kidding me?
The nutrition industry’s lack of productivity should gall everyone about as much as the fitness industry’s ineptitude. To put this in broader economic terms, it’s akin to saying that Ford keeps adding workers, factories, and suppliers, but now they make fewer and poorer quality cars.
This not-so-small army of nutritionists, dietitians, dietetic assistants, and all the other half-baked, self-absorbed, and self-serving diet whack-a-doodles thrive by making something as natural as eating seem as complex as rocket science. It is the sure path to riches and influence: Make people think they need YOU to do something that humans have done quite successfully for, oh, I don’t know, maybe about 200,000 years. If we weren’t good at eating, we would not be here. Literally. (I’ve covered some of this ground before.)
As a case in point about how deranged the contemporary nutrition conversation is, I want to focus on just one thing: the popular gnashing of teeth against dairy. Humans have probably been drinking cow’s milk for about 10,000 years (we’re going to stick to cow’s milk, even though people drink the milk of all kinds of mammals around the world, and milk consumption is a sign of status in many cultures). In fact, in my 43 years of vigorous and relentless pursuit of strength and fitness, milk has been a mainstay. Except for the fact that it contains neither fiber nor vitamin C, it is very nutritious food, with a bolus of all three macronutrients, vitamins A and D (added) and essential minerals, including calcium, potassium, magnesium, and phosphorous.
Let’s start our little walk down diet-drivel lane with a story. In 1986, just two years out of graduate school at Johns Hopkins, I took a position with the Maryland attorney general’s office as Director of the Health Education and Advocacy Unit. It was the very first explicit formal education and advocacy program for health-care consumers, and it opened the door to assertively inserting consumer interests and needs into health, health-care policy and market matters. We took on everyone, from health plans that would not cover contractually required items to doctors and hospitals that billed patients and insurers for things they never did. One of our first and most interesting initiatives was in the arena of nutrition claims.
In the mid-1980s, the Mid-Atlantic Milk Marketing Association (MAMMA) ran an aggressive and ubiquitous ad campaign in which it encouraged people to drink more whole milk … a low-fat food. This is accurate marketing if you live in a parallel universe where science, math, and logic don’t apply. My colleagues and I told MAMMA that its campaign violated Maryland’s consumer protection law by promoting a product in a false and deceptive manner.
First, MAMMA responded by saying that it—a Maryland corporate entity running ads in Maryland—was exempt from state authority because it was chartered into existence by that great dietary think tank, the U.S. Congress. After we finished laughing, we reiterated to MAMMA that it needed to either stop the campaign or we’d bring an enforcement action to stop it. Then, incredibly, they took the position that whole milk was a low-fat food because it was 3.25 percent fat, which it is … by mass. Great, except whole milk is also 88 percent water, which is non-caloric. Hence, in terms of energy, which is the relevant metric when making claims about fat content, fat accounts for 48 percent of the calories in whole milk.
In the span of a couple of weeks of jawing back and forth, we made it pretty clear to MAMMA that it probably would not like to show its math to a judge. We arrived at a settlement agreement with MAMMA in which it ceased promoting the sales of whole milk under bogus pretenses (remember, this was in the 1980s when most of us—even the smart ones—had fallen for the government’s emerging “fat is bad for you” fairy tale). Like many miscreants in civil action settlements, MAMMA stopped its campaign without admitting any wrongdoing.
Fast-forward to the age of the interweb of all things, and I was utterly astounded to find a supposedly highly qualified and august nutritionist/dietitian (Linda Foster) proclaiming in the U.K.’s Mirror Online that, “Milk is a low-fat food.” You would think that someone who is supposedly expert in nutrition would refrain from an assertion that hit the trifecta of being simultaneously untrue, illogical, and just downright idiotic.
In the U.S., the labeling of milk falls under the authority of the Food and Drug Administration. A good summary of the requirements for dairy labeling is available from the Dairy Research Institute. Skim milk is non-fat; 1% milk is low-fat; 2% milk is reduced fat; and, whole milk is, well, milk. Thus, the assertion that whole milk is a low-fat food is 100 percent wrong, logically, mathematically and legally. By definition, 1% milk is a low-fat food because it has less than 3 grams of fat per standard serving (8 fluid ounces). Whole milk, on the other hand, has almost 8 grams of fat per serving.
Why does this matter? Because it goes to the heart of my thesis that we have allowed eating to become complex, and therefore, something that we think requires the guidance of experts. More often than not, those experts and the organizations they front (very much like organized criminal enterprises) make money by cultivating dependence.
Outside of broad guidelines (you need all three macronutrients from a broad array of foods and sufficient hydration), there is no right way to eat. There is no long-term controlled feeding trial of any kind done anywhere on Earth that can show—dispositively—that one pattern of eating leads to better health outcomes or improved mortality compared to another. The overwhelming majority of nutrition research is garbage-in-garbage-out, short-term, recall-based nonsense. It proves nothing except what the study authors determined a priori what they wanted to prove.
Ms. Foster apparently believes—wrongly—that it is still important to get people to embrace the concept of low-fat because, you know, shearing the fat from your diet is so important to health. Not. Substituting poor quality carbohydrates (the whites: white flour, white [or any] sugar, and white rice) for dietary fats (i.e., naturally occurring fats, but not added or highly processed fats) is one of the great dietary boondoggles of all time, brought to you by your government and the medical industrial complex, which doesn’t want you to be healthy … they want you to be either a patient or a long-term paying customer.
Moo Goes There?
The milk-is-bad-for-you meme gets sent around a lot on social media. On Facebook, I’ve seen a widely circulated post of some quack who calls himself a doctor (of who knows what) proclaiming that humans should not consume the product of the mammary glands of another species. We are the only species on the planet that eats virtually every other species we can get our hands on. Even more laughable is the image of any predatory animal—such as a bear—taking down lactating prey and then refusing to consume the mammary glands and milk therein. I am guessing the predator eats up the fat and laps up the milk with gusto.
The anti-milk crowd has also long found its footing in the China Study, a carefully spun piece of chicanery published in 2005 by Cornell academic T. Colin Campbell, an anti-meat and anti-dairy crusader, and based on research Campbell performed with Junshi Chen, a Chinese public health official who doubles as the leader of several Coca-Cola proxy groups. The essence of the China study is this: Animal-based foods are bad for you and lead to heart disease, cancer, and premature mortality, based on data from the study of tribal cultures in the Third World. Because that’s so generalizable to the United States. You can find lots of articles debunking and rightfully bashing this piece of detritus, but most of them missed the obvious.
Recall-based survey data is, mostly, garbage-in-garbage-out, because no matter how hard you try, there is no such thing as controlling for all the variables you’d like to think you can control for. It never establishes causality unless the relationship is overwhelmingly positive and you can replicate the results in multiple populations. Second, data on lifestyle diseases in the Third World in the 1970s has almost zero cross-cultural applicability to the West. Indeed, the mean life expectancy in China in 1975 was 63.5, while it was roughly 73 in the U.S. You know what the number-one risk factor is for heart disease, stroke, cancer and the corresponding premature mortality? Age. The closer you are to death, the more likely you are to get one of these big three life enders. After all, you gotta die of something.
Further, according to the World Bank, prior to 1980, almost all Chinese people lived below the poverty line; and, in 1990 (as far back as I could find), about one-fourth of China’s population was malnourished. So, the thesis of T. Colin Campbell’s takedown of eating patterns that include meat and milk is this: Americans should aspire to eat like the denizens of a totalitarian Third World country at a time when poverty was endemic, malnutrition not far behind, and average lifespan was 14 percent shorter than average lifespan in the U.S. Importantly, this also means that the Chinese people relied upon for these data likely died well before the age at which they were mostly at risk for either cancer or heart disease by U.S. standards (late 60s to early 70s for both). And this guy won awards for this.
Instead of surveys of discrete population groups, like poverty-stricken Third World tribes, I prefer to draw inferences on population health from, you know, population data—that is, the biggest picture data points I can find. For the purposes of nutrition, I focus on longevity, total calories consumed per capita, and per capita consumption of major food items. For the purposes of this discussion, we’ll stick to the countries of the Organization for Economic Cooperation and Development (OECD), which are mostly industrialized modern democracies, but which includes enough developing countries to show some very interesting patterns.
Data sources: Life expectancy and poverty rates — CIA World Fact Book; calories consumed — UN Food and Agriculture Organization; dairy consumption — Canadian Government Dairy Information Center; physical activity — OECD data via Statista.com.
Stop Making Sense
Now, I’m not an elite academic who thinks cheese is our problem, but I am a pretty good data sleuth, in part because I start by looking at the obvious instead of seeking out the obscure to make my point. Looking at the table of 30 OECD nations, the U.S. (highlighted in blue; maroon means no data available), what I deduce is this:
Eighteen modern, industrialized nations have higher life expectancy than the U.S., all of them in the West except Japan and South Korea.
Of those 18 nations, only five get less voluntary physical activity than we do; only three have a poverty rate worse than ours.
Nine consume substantially more dairy than we do, while another four are in the same range.
Only one of the 18 nations has average daily caloric consumption greater than the U.S.; amazingly, the Japanese live half a decade longer and eat 25 percent fewer calories on average.
The Danes live just six months less than Americans while consuming 10 percent fewer calories, about 50 percent more dairy, and being more physically active than we are.
What can a reasonable person conclude from this rough-cut data? Total caloric intake, poverty rates, and physical activity appear to be key drivers of longevity, but dairy intake certainly looks like a net positive contributor. Is that borne out by other data analysis? Indeed, it is.
Multiple studies (see here, here, here and here), including large prospective cohorts, intimate a relationship between the consumption of full-fat dairy and reduced incidence of Type 2 diabetes (T2D). Does correlation prove causation? Let’s answer all together now … NO. But, the more you reduce T2D risk, the more you reduce the risk of cardiovascular disease and cancer.
Should you drink whole milk? I don’t know. Do you like milk? Does it cause GI upset for you? Can you afford it? I love fresh, ice cold whole milk. It’s the basis for my homemade yogurt (the best yogurt you will ever taste), and the foundation of nearly every post-workout protein smoothie I’ve made since 1977 (milk+peanut butter+bananas+protein powder). You don’t like milk? Don’t believe the data? Who cares? Don’t drink it. Just stop telling people that your personal dislike or enmity is data-based—because it isn’t, unless you are also willing to disclose that your data is the based on dietary intake in poor Chinese communities circa 1977.
I took human nutrition in college during the 1978-79 school year. My professor, whose names eludes me, was a kindly older woman, who taught me six critical points that are just as true today as they were then:
Eat the foods you like, but do your best to pull from a broad range of minimally processed whole, fresh, frozen, and canned foods. (Keep in mind that freezing and canning processes have only gotten better since then.)
Count calories because calories count. Imperfect? Yes, but like American democracy, it’s better than every other system you can think of.
Drink what you need to not be thirsty. (The insanely stupid 8-glasses-of-water-a-day advice, which she would have laughed at, came later.)
Carbohydrates and fats are protein sparers and the source of many essential vitamins, minerals and micronutrients, some of which we almost certainly don’t understand well (she said that in 1978-79, and it’s still true). This is why you need all three macronutrients; we know now, after a 40-year experiment in bad eating habits, that it is essential for you to choose your carbohydrates wisely.
The only right way for to you to eat is unique to you, and you will learn it over time, through trial and error. The point from which you begin this journey will be imprinted on you by your family and community. If that’s unhealthy (i.e., abundant fast food), you’ll have some work to do, but you can do it.
Supplementation, in the absence of disease or malnutrition, is also known as pissing your money away.
In the intervening 40 or so years, nutrition science has added almost nothing meaningful to this succinct list. For most people most of the time, moving more and eating less is the right formula for weight loss. In my experience, the people most inclined to disbelieve this are the same folks who refuse to do either.
There are no superfoods. There are no perfect eating patterns. And, no one … I mean, literally, no one will ever be able to tease out the complex interactions that influence health and longevity: genetics, epigenetics, diet, exercise, smoking, alcohol, sleep, income, education, work satisfaction, stress, substance abuse, social groups, social media (AKA poison), temperament, attitude and philosophy. There are only two things in that list over which you have virtually no control. For the other 15, you do the best you can; you’ll hit some strategies and goals, and you will fail with others. That’s life. You do the best you can when you can and with what you have. And, you don’t listen to the nutrition peanut gallery whose goal in life is to confuse you, make you feel like fool and then convince you that they are your path to salvation. Nothing could possibly be further from the truth.