The Obesity Epidemic — Is Medicine Scientific?

An anonymous reader writes "An award-winning science author, Gary Taubes, has written a book that pans the medical community's treatment of the obesity epidemic. What is interesting is that it looks like the medical community is behaving in a very unscientific manner. Taubes points out that the current medical orthodoxy — that consuming fat makes you fat and exercise makes you thin — has no basis in research. In fact, all the available research points in quite another, and more traditional, direction. Here's the (excellent) podcast of an interview with Taubes on CBC's 'Quirks and Quarks.' So, has medicine become a non-science? Is it mostly a non-science? Somewhat?"

Comments

He May Be But You're Not Helping

[eldavojohn]

It's done wonders for me. I think that's the number one problem with diet plans these days. People assume that since it worked for them it will work for everyone else. I don't think that's the case.

To answer the questions of the summary, I don't think it will ever be an untainted science so long as the government, businesses & religion stick their noses in it. Couple that with the difficulty of applying the scientific method to humans (average life span of 75 years and ethical problems) and I think you'll see why medicine is a 'non-science.'

Patents, legislation & belief in what is good for you are what ruin medicine. Look at all the Hindu medicine that was ignored by the West for the longest time because it was ... well, Hindu.

Medicine will continue to be a non-science no matter how hard the community tries. The public's assumptions and beliefs that "Since I can eat McDonald's every day and be thin, everyone should be able to" merely exacerbates the situation.

I eat whatever I feel like and I'm in great shape. This is not the case with the majority of Americans.

Perhaps it's worth investigating...

[Spy der Mann]

Not more of this low-carb propaganda bullshit.

I understand your anger, but the issue here is whether the low-carb propaganda is really bullshit or not. It is a matter that should be investigated, otherwise those dismissing it as bullshit would effectively act as anti-low-carb zealots, instead of following the scientific method.

Also, we have to wonder why the US (the country where the Food Pyramid originated) is also where the "fatness" phenomenon originated, and why the countries that start to follow the "american way of life" (fast food, sedentary life, high-calory carb snacks) tend to follow american's fatness. This phenomenon, at least country-wise, behaves like an epidemic.

Re:Perhaps it's worth investigating...

[badasscat]

I understand your anger, but the issue here is whether the low-carb propaganda is really bullshit or not. It is a matter that should be investigated, otherwise those dismissing it as bullshit would effectively act as anti-low-carb zealots, instead of following the scientific method.

Ok, here's your scientific study:

Asians eat carbs with almost every meal (rice, noodles). They are thinner than us. End of story.

Excess calories make you fat. That's a law of physics; I have no idea why some people dispute it. It's like arguing with the law of gravity. The only question is whether calories coming from different sources are absorbed more slowly or quickly, but the end result is the same unless you're exercising to stay in shape. A calorie is a unit of energy and if that energy is not used, it must be stored. Energy doesn't just disappear into thin air; when you consume it, you either use it or you store it.

And I really don't think there are any scientists out there saying otherwise; I don't know of any scientist saying "eating fat makes you fat" or even "eating carbs makes you fat". The only time that's ever said is in the context of certain types of high-fat or high-carb foods generally being higher in calories, which is true. Although again, Asians eat plenty of fatty meats along with their carbs and they're still thinner than we are. The reason is they just eat less. Which means fewer calories.

Not rocket science. And we've got all the knowledge we need.

Re:Perhaps it's worth investigating...

[cbr2702]

"Excess calories make you fat. That's a law of physics; I have no idea why some people dispute it. It's like arguing with the law of gravity. The only question is whether calories coming from different sources are absorbed more slowly or quickly, but the end result is the same unless you're exercising to stay in shape. A calorie is a unit of energy and if that energy is not used, it must be stored. Energy doesn't just disappear into thin air; when you consume it, you either use it or you store it."

This would require human waste to have no caloric value.

Re:Perhaps it's worth investigating...

[sitarah]

"Calories in, calories out. It's so easy!" You are missing the point and the reason all these low-carb, low-fat, low-whatever suggestions exist. Calories in, calories out works in a lab environment where you can measure intake, consumption methods, and waste precisely. You cannot do that with humans. There are too many variables.

1) You don't know what your calories out are.

You have no idea what you are really burning, standing around, unless you get a battery of tests performed to check your metabolism, lung function, and body heat during any given activity.

There are a ton of things that affect your metabolic rate; your core temperature, insulin levels, sugar sensitivity, allergies, your inclination to fidget, whether you are building muscle at a given time, whether you are healing wounds or recovering from sickness. There has even been researching suggesting that 3 months of consistent exercise actually changes your energy consumption at a mitochondrial level. Did you know soy and broccoli reduce the level of iodine in your body and therefore inhibit metabolic function?

2) You don't know what your calories in are.

You know what the government knows about broccoli: that if you light it on fire, it burns at x rate, and it leaves behind x waste. They extrapolate its structure from there. That has nothing to do with how well your body actually digests the food and uses that energy. You could have an extremely acidic stomach, or lock up calories with excess fiber, or drink too much and hurry food through your intestinal track before you can extract all its energy.

You also don't know how well-marbled their test steak was, how saturated with water their chicken breast was (did you know supermarket chicken is injected with saltwater?), or how aerated their whipped cream was. This will all lead to a difference in caloric value. These little differences all add up.

These diet plans that discard certain foods do so with the idea that we might be able to find a diet that works by minimizing a variable; eat fewer carbs to reduce insulin levels, isolate sugar sensitivity, eat less wheat to minimize allergies, eat less meat to reduce hormones, salt, and saturated fat, etc.

Asians are genetically different; they have different musculatures (they might have smaller thighs, for instance, meaning they burn less calories because that's a very large muscle group), different insulin levels, they may produce heat differently than Europeans due to their environment. There's also cultural differences; less dairy, more lean meat, etc. You're just not making an apples to apples comparison.

Yes and no.

[Valdrax]

Calories make you fat, regardless of whether they come from fat, sugars, or starches.

This is absolutely true. You can't dispute the fact of this statement taken in isolation. In isolation.

However, it's a fine example of blinding yourself to the causes. The questions at the heart of the debate between low-carb and low-fat diet proponents are the following:

1. Does eating certain types of food allow for the intake of more calories before being satisfied? (e.g. Pork vs. chicken; fruit vs. Twinkies)
   
2. Do certain foods increase hunger? (i.e. Effects on insulin and other hormones)
   
3. Do certain foods have other health issues than weight? (e.g. Saturated vs. unsaturated fat; sugar-intake & diabetes.)
   

So just saying calories are calories is like saying BTUs are BTUs and putting heating oil in your gas tank in the hopes of getting better MPG.

Re:Ugh...

[NeutronCowboy]

You're like every customer who calls into customer support: they know the symptoms, are vaguely aware of the underpinnings of the machine and are absolutely convinced they know what the issue is.

Do yourself a favor, and treat your next interaction with your doctor like a call with tech support: understand that they know more about how the system is supposed to work than you, understand that you know more about how your system works than them, transfer that knowledge to them, and be patient while they wade through the standard troubleshooting steps (did you reboot your machine? do you get enough sleep/vitamins?).

You'll actually have a chance of getting some use out of them, and live a better life.