I recently received an email from a nutrition researcher who works behind the The Ivy Wall.  He offered to give me occasional insider information about how nutrition research is conducted, but on the condition that I not reveal his name.  He suggested I refer to him in my posts as “Fat Throat.”  (As Dave Barry would say, I am not making this up.)  He also asked that I not reveal the organization that employs him and said to refer to it as The Committee to Re-Erect The Pyramid, a.k.a. CREEP.  (He is making that up.)

Last week, I wrote about the two-year study that compared low-fat and low-carb diets. Low-carb won the comparison as far as raising HDL, but other than that, the results were the same — at least according to the researchers. I noticed right away that the Atkins dieters essentially went on a maintenance program within the first year, but it was Fat Throat who confirmed that the researchers included the drop-outs in their final numbers to even up the weight-loss score for the low-fat diet.

Fat Throat also believes the researchers included the drop-outs in their calculations to help even up the cardiovascular scores.  As he told me, “Follow the triglycerides.” (Okay, he didn’t use those exact words, but the meaning is the same.)

Here’s what he’s talking about.  At the beginning of the study, these were the average triglyceride levels:

Low Fat: 124
Low Carb: 113

Now look at the change in triglycerides over the course of the study:

Diet Group 3 Mos. 6 Mos. 12 Mos. 24 Mos.
Low Fat -17.99 -24.3 -17.92 -14.58
Low Carb -40.08 -40.06 -31.52 -12.19

Within three months, the low-carb group had reduced their triglycerides by a whopping 40 points.  That result held up at six months.  At the one-year mark, the low-carb group was backsliding but still had a much more impressive reduction in triglycerides.  And then, wouldn’t you know it, by the time the study ended, the low-fat group actually had an edge — because the reduction in triglycerides for the low-carb group had dwindled from 40 points to just 12 points.

As Fat Throat explained during a follow-up phone call, it’s highly unlikely a group of people sticking to a low-carb diet would experience a 20-point rise in triglycerides in the last year of the study, and even less likely they’d end up with a smaller drop in triglycerides than low-fat dieters over the course of two years.  I believe his words were something like, “It’s not biochemically plausible.”

In my own experience, triglycerides are remarkably stable on low-carb diet. I’m not on a zero-carb diet by any means, but I probably keep my carb intake below 60 grams on most days. Every time I’ve had a checkup in the past three years, my triglycerides were right around 70.  The people in the Atkins group reached that level, then averaged nearly 30 points higher by the two-year mark.

So I’m guessing either they weren’t on much of a low-carb diet by the end of the study, or we’re seeing the results of creative calculations performed on the estimated end-points for the drop-outs. Perhaps a bit of both.

If we could just take a peek at the actual food intake for both groups of dieters, we could clear up this mystery. That would also address my suspicion that the low-carb dieters reached maintenance level within the first year. But as I noted in the previous post, the full text of the study (slipped to me by Fat Throat in a plain manilla email) doesn’t list any food-intake figures.

This weekend, I received another email from Fat Throat to explain why:  There aren’t any food-intake figures.  The researchers didn’t track or record anyone’s actual diet.  Yes, you read that correctly.  Their reasoning apparently goes like this:  food journals are often inaccurate, so we won’t ask the study subjects to keep them. Instead, we’ll just counsel them regularly about the importance of sticking to their diets, then assume both groups stayed within their fat-and-calorie or carbohydrate limits … then estimate data for the drop-outs.

In a two-year, $4 million study with “weight loss” listed as the primary outcome, there’s no recorded information about food intake … and yet I’m supposed to believe this study actually tells us something?

I’m starting to wonder if this group of researchers — all with long histories of praising low-fat diets in their previous works — didn’t track the data for fat, calories and carbohydrates because they were afraid they wouldn’t like the results. Perhaps they didn’t want us to see that the low-carb dieters — with no restrictions on calories — would only regain weight after increasing their carb intake to, say, half of what the government recommends.  (This was a government-funded study, by the way.)

Or perhaps they intended to test the results of dietary advice instead of actual diets.   If so, those Low-Fat, Low-Calorie Diets Equally Effective For Weight Loss headlines are looking pretty shaky.

All I know is, something doesn’t pass the smell test here.  Fat Throat probably has an opinion on that, but he didn’t say.  Next time, I may offer to meet him in an underground garage so I can ask more questions.

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28 Responses to “Inside Information From ‘Fat Throat’”
  1. Lee says:

    I was going to post about how sorry I am in a way that I ever started reading and studying about nutritional science, since all the BS has resulted in seriously lowering my opinion of all scientists. Happily, I then remembered that Gary Taubes pointed out that there are hardly any ‘scientists’ in the field of nutrition. Guess I can stop worrying about physics, and chemistry, and you know – science.

    Physicists and chemists may not be immune to bad science, but the there seems to be much more rigor in those fields.

  2. John hunter says:

    Very good info and a great post. Once again, I don’t know whether to laugh or cry.

    A little of each may be appropriate.

  3. Alex says:

    Oh Noes! Fat causes Teh Diabeetus in 6 hours!

    http://www.youtube.com/watch?v=4pmRtztGsoU

    Oh my god, that is SO going into a post! More bologna there than I can cover in a comment.

  4. TonyNZ says:

    “There aren’t any food-intake figures. The researchers didn’t track or record anyone’s actual diet.”

    Peer… reviewed… literature…?

    When I was working in academia, to get a paper published you needed to put exactly how you did your experiments in excruciating detail, down to where you obtained your reagents and what equipment you used to measure data. The most basic requirement of any peer reviewed experiment is that there is enough information for someone to repeat the experiment. That would not seem to be the case here. Something here seems very awry.

    My tax dollars at work.

  5. Patz says:

    People are doing studies to prove or disprove something or to check a possible result. It’s bad when the final result is known before the study is even made . Most of those studies are given the task to prove that low-carb is the real deal. No real science.

    No, it’s not real science when they’ve decided the result ahed of time.

  6. Barbara says:

    So after reading this we’re still presuming the subjects of this study actually exist and aren’t figments of the researchers collective imaginations? :-D Great post as usual Tom!

    Perhaps the whole study was computer-simulated.

  7. Dan says:

    Thats really interesting. It does tend to debunk that study. However, one quick question I would like to ask, do you know how much weight the low carbers lost, when you don’t include the drop outs, compared to the low fat group?

    Nope, the researchers haven’t made that information available.

  8. Hilary Kyro says:

    Alex, that link is hilarious! For the next experiment protocol on this guinea pig, I’d like to see the effect of deadly salmon, cigars, cocaine, puffed wheat and skim milk! Go science go!

  9. Jane says:

    I am an academic and a health researcher (Ph.D.) as well. And yes, it’s hard to call health research “real science”.

    Good reading on the subject is Richard Smith’s — Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies

    (Richard Smith is a former editor of the BMJ)

    http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020138

    The more you know — the scarier it gets.

  10. Rocky says:

    I once dated an NIH researcher. She was employed there while in grad school. She was one of the brightest people I know, having a real passion for pure science and the pursuit of exacting knowledge. She frequently commented to me that what they’re doing at the NIH is by no means science. The organization itself is more geared to politics than anything else. Even the scientists there are more interested in politics and chasing funding than they are about science. She once remarked that anyone within their ranks who was interested in pure truth and unbiased research was quickly ostracized and shut out by the other researchers.

    She didn’t stay there much longer.

    I don’t blame her. I hope she ended up doing real science somewhere.

  11. Amy Dungan says:

    Just horrible. And the poor public trust blindly that these results come from honest we-want-what’s-best-for-you science. Self education is all we really have.

    That’s why you and I do what we do.

  12. Jeanne says:

    Alex, the good news is that the comment show that he didn’t fool anyone.

  13. seyont says:

    They tracked triglycerides to the hundredth and did not track food intake at all? Impossible to be that ignorant of science unless, perhaps, this came from the East Anglica Caloric Research Unit…?

    Could be. If so, we’ll eventually discover emails in which they suggest ways to hijack the peer-review process and express frustration over their inability to make the results match their hypothesis.

  14. chmeee says:

    This is almost certainly just another version of the ITT ( Intention To treat ) fraud. Dr Eades did a truly excellent debunking of this a while back on his blog. Here’s the link: http://www.proteinpower.com/drmike/bogus-studies/the-fraud-of-intention-to-treat-analysis/.

  15. Mallory says:

    odd he researchers arent giving out the information peopel are intestered in, well actually not so odd. this is about as annoying as the new margarine omega 3 diet results!!

  16. Ronald Pottol says:

    Well, I do see the point about not tracking their eating, their are two questions, what works, and how to get people to do what works, if you look at this as seeing what works in the world (vs locking them in a lab environment), it is reasonable say we gave them instruction, and we looked at outcomes. But it is still odd. And it would be useful to see what they found easy and hard about the diets.

    But making up numbers for the drop outs is crazy.

    I’d vote for tracking their diets, then making compliance part of the analysis. It would be useful to know, for example, if low-carb diets are difficult to maintain, but highly effective for weight loss and cardiovascular improvements if you stick to it.

  17. Matt says:

    Metabolic.

    Ward.

    Research is a tough business. It’s easy to read a study and say “the researchers screwed up here, here and here.” I should know, I do it all the time :) The scientific community, especially in the health field, has a lot of work to do to improve the quality of the research they churn out, but how do you make sure money doesn’t skew research? We apparently can’t count on companies to fund honest research that may or may not support their agenda and we apparently can’t count on governmental quality regulation or control.

    So, what do we do?

    Eat meat and plants and forget about research!

    Definitely a tough business, but they don’t help their cause any when they’re sloppy and decide to include drop-outs in their numbers.

  18. Larry says:

    I came across this quote years ago while reading Stephen Hawking’s A Brief History of Time, “Any physical theory is always provisional, in the sense that it is only a hypothesis: you can never prove it. No matter how many times the results of experiments agree with some theory, you can never be sure that the next time the result will not contradict the theory. On the other hand, you can disprove a theory by finding even a single observation that disagrees with the predictions of the theory… Each time new experiments are observed to agree with the predictions the theory survives, and our confidence in it is increased; but if ever a new observation is found to disagree, we have to abandon or modify the theory.”

    I think what’s happened is that in the “health” sciences, people are no longer looking to test their theories, to look for anything that disagrees. How many observations have been made just this year that make the saturated fat intake/heart disease hypothesis look completely wrong? And rather than say, “Hmmm. This data disagrees with our theory, perhaps it’s time to tweak the theory or toss it out altogether,” they tweak the disagreeing data or toss the data out altogether. It’s the exact opposite of how science is supposed to work, isn’t it? In the above quote, Hawking is looking for “a single observation that disagrees with the predictions of the theory,” surely health science has been given enough ‘single observations’ to start to question their own work.

    Karl Popper referred to it as the Black Swan. If your theory is that all swans are white, as soon as I find a black swan, your theory is wrong, even if you can point to 99 white swans.

    That’s what I was trying to explain (knowing full well I was wasting my time) to the vegan evangelists: I don’t care if you can quote a few studies linking animal fats to heart disease and cancer. Those are the white swans. There are a helluva lotta black swans out there too.

  19. Be says:

    I can not WAIT for you to attack the video! What a bunch of lunch meat!

    Anyhoo….

    The bottom line here is that you simply can’t trust many (if any) dietary studies – they are inherently flawed by their nature and since they are funded in large part by pharmaceutical companies mostly suspect. I am about sick of reading studies as the empirical, historical and logical evidence abounds for anyone with a half functioning frontal lobe.

    A final word of warning for you my friend – burn the tapes!

    Burn ‘em? I was going to ask my wife to accidentally erase 20 minutes in the middle.

  20. PHK says:

    wow, this is so surreal (the study)

  21. Laurie says:

    George Box, Ph D. Statistics
    ” All models are wrong, but some are useful”
    Karl Popper. Set out a testable, falsifyable hypothesis and experiment to see if you can DISprove it. If you disprove it, toss it out and create a new hypothesis that is testable and falsifyable. Lather rinse repeat.
    It’s counterintuitive and a bit frustrating (and a slow process) that you cannot prove an hypothesis. Knowledge and science does lurch along though, really, by the acts of disproving hypotheses.!

    If only the anti-fat hysterics had any interest whatsoever in disproving their hypothesis …

  22. Dan says:

    The whole area of health research smacks of scandal, as in your references to Watergate. Of course, one day you hear that something is bad for you and the next day you hear that it’s good for you. That should blow their credibility.

    “Health science” is just geared to making $$$$ for the medical establishment, big pharma, and big processed food.

  23. JimS says:

    The beat goes on, Tom.

    Peter, over at Hyperlipid, has just posted the demolition of a study by Axel & Axel that was micrometrically crafted to ‘prove’ that high fat low carb causes insulin resistance in rats. Except, of course, it doesn’t.

    As someone above said, eat meat and plants. It’s as simple as that.

    So they proved eating hydrogenated Crisco is a bad idea for rats. I’d go so far as to apply that to humans as well. Sure makes you wonder why they didn’t try lard, doesn’t it?

  24. I don’t know what your *problem* is, Tom… Isn’t guessing always more accurate than actual data?

    I can see the advantages of guessing. Say I’m looking at a pepperoni pizza. I could guess the whole thing contains maybe 20 carbs and then eat it.

  25. Richard Tamesis, M.D. says:

    I just finished reading Gary Taubes’ book Bad Science: The Short Life and Weird Times of Cold Fusion. The behavior, lack of skepticism and absence of adult supervision of the people involved in the cold fusion fiasco in Utah back in the 1980′s is actually pretty routine stuff for nutrition scientists and for what goes on in medical research. Little wonder why Taubes didn’t think many of those involved in nutrition research are fit to be called scientists.

    After he wrote that book, some in the nutrition field told him if he really wanted to see some bad science, he should dig into nutrition and health studies. The rest is history.

  26. Bob Kaplan says:

    Hi Tom,

    I was just as outraged as you about the study and wrote the LA Times and amazingly they ran it:

    http://www.latimes.com/health/la-he-my-turn-atkins-20100823,0,6783467.story

    They gave me about 1,000 words, but I have closer to 50,000 (sleep-inducing) words to offer so I started posted and found we seem to be on the same wavelength (I actually did a diet study of fast food around 2004 that was similar in design to your fantastic doc):

    http://www.nerdsafari.com/4/post/2010/08/bad-science-diet-wars-low-carb-vs-low-fat-part-ii-triglycerides.html

    Keep up the great work!

    Excellent job on both. I’m pleased to see the L.A. Times airing more criticism of conventional wisdom lately.

  27. anand srivastava says:

    @Lee
    Don’t assume that physics are immune to bad science. The only issue is that it is difficult to fudge anything that was already discovered till 1930s. If you look at it, after that point there has been very limited improvement in fundamental understanding on physics. The improvements have mostly been in applied physics.

    Ever heard of Dark Matter, Dark Energy, String Theory. These are all mechanisms to obtain grants. They don’t work in reality. The theory of relativity does not work beyond our solar system, where gravity is very weak. It is a very well kept secret. But yes normal people are not affected by it. Except thinking that the universe is actually 13.7 billion years old.

    The whole problem is the research grants, where governments decide, or rather those in power decide who gets the grant.

  28. Fat Throat sounds like a great source. I know that there are a lot of insiders who are pretty upset about the state of nutritional research. I would ask him or her about the latest low-carb thing from Hu and Willett. You should get a graphic of a red flag in a pot of flour to post so we know when something is coming in from Fat Throat.

    Great idea.

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