Interesting items from my inbox and elsewhere …
Let’s not rush in to regulate sugar.
I was already a fan of Nina Teicholz because of her book The Big Fat Surprise and her critique of the U.S. Dietary Guidelines that appeared in the British Medical Journal (which upset The Anointed very, very much). I gained even more respect for her after reading a recent piece in The Atlantic titled The Limits of Sugar Guidelines: Is there a danger in governments offering too-specific advice on sugar consumption?
I’d recommend reading the entire article, but here’s the gist of it: Yes, many of us now believe sugar is the main driver of obesity and other metabolic diseases. But let’s not jump the gun on imposing new guidelines and regulations. We’ve made that mistake before.
Here are some quotes:
While the evidence to date shows zero benefit from sugar and a clear signal of harm, there hasn’t been enough time to fund and conduct definitive trials. Meanwhile, governments naturally feel they can’t wait. Facing panic over the continued, relentless climb in obesity and diabetes rates with no solution in sight, they’ve gone ahead and passed sugar guidelines pinned to exact thresholds, of 10 percent or 5 percent of calories. This advice is clearly well-intentioned. Yet if, as the Annals paper concludes, experts are skirting scientific norms by passing guidelines based on weak evidence, the whole process of guideline-making is effectively watered down.
Government officials, of course, are driven by a belief that no problem will ever be solved unless they by gosh DO SOMETHING! It’s the old problem of when you’re holding a hammer, everything looks like a nail. Government’s hammer is regulation. More government officials should heed the advice Lee Marvin’s first acting teacher gave him: don’t just do something, stand there.
As Americans well know, there have been many reversals in our guidelines in recent years—on dietary cholesterol, on total fat, on whether to eat breakfast to maintain a healthy weight. These were all official guidelines based on weak evidence that, when actually tested in clinical trials, were found to be unjustified. It turned out that people had been avoiding egg yolks, lobster, and fat, generally, to no avail, and that skipping breakfast altogether might actually be the best option for weight loss.
Instances of flip-flopping on nutritional advice not only erode the public trust, but make people think that the basic science itself is flawed—which, for the most part, it’s not. Instead, the central problem has been that experts and policy makers have passed judgment before that good science was done. And once a judgment is codified as policy, it’s hard to repeal. This was the case, for instance, with the low-fat diet, which although adopted as a U.S. guideline in 1980, wasn’t actually studied in trials for another decade-plus. This kind of mistake, at its very worst, is potentially deadly: Indeed, the low-fat advice, by shifting consumption to carbohydrates such as grains and sugar, is now regarded as a probable cause of the obesity and diabetes epidemics.
I’d bet dollars to donuts (and you can keep the donuts) Teicholz believes sugar is driving obesity and diabetes. So it takes integrity to urge waiting for solid proof before taking action.
Of course, taking action doesn’t always work so well anyway …
Soda Taxes failing to reduce consumption.
Here are some quotes from a Reason magazine online article:
If 15 major cities adopt a sugary drink tax of just 1 cent per ounce, diabetes could be slashed, more than 100,000 cases of obesity prevented and 3,683 deaths averted according to a new report from Harvard’s T.H. Chan School of Public Health.
The report claims extraordinary health benefits for close to zero cost except that of administering the tax. So just how do the eminent researchers at Harvard find so many health-related benefits from just a 1 cent per ounce tax?
The answer is what Healthy Food America, who asked the researchers to conduct the study, call an “evidence-based, peer-reviewed computer model.” Unfortunately for soda tax advocates, the model collides head-on with the cold hard reality that there is not yet a single real world example of a soda or sugar tax reducing obesity.
Mexico, which was hailed by public health activists and the editorial pages of The New York Times as an example to follow, has so far proved a huge disappointment to anti-obesity campaigners.
Mexico slapped a 1 peso per liter tax on sugar-sweetened beverages in 2013, with health benefits promised to follow. The tax took effect in 2014 and after an initial decline in the average purchases of taxed sugary beverages of six percent, sales are on now on the up again.
The article goes on to cite examples of the same cycle: a tax on sugar is imposed, consumption dips for a bit, then goes back up. According to classical economic theory, we’d expect a higher price to mean lower sales. So why doesn’t it work that way with sugar?
Because as books like Predictably Irrational explain, classical economic theory assumes people are rational — and they usually are when making decisions like which insurance policy or TV to buy. But when it comes to things that tickle our reward centers — sex, drugs, and perhaps rock ‘n’ roll – dopamine overrides rational thinking. People feed their addictions even when it makes no economic sense. That means the people who are most likely to overindulge are also the least likely to be discouraged by sin taxes.
Not only did the tax have close to zero impact on calorie consumption, but those homes with an obese head of the household were actually the least likely to cut back on soda.
I suspect many of The Anointed in government know soda taxes don’t actually change behavior. But I suspect they also know this:
The one area the tax has achieved its goal is in the area of revenue. The Mexican government raked in more than $2 billion in soda taxes from January 2014. But since soda taxes hit those with the lowest incomes hardest, one would think this is hardly something to celebrate.
“There is no real world evidence that they have the slightest effect on calorie consumption, let alone obesity. They are stealth taxes which allow governments to pick the pockets of the poor,” says Christopher Snowdon, head of lifestyle economics at the Institute of Economic Affairs.
But sometimes the taxes aren’t so stealthy. Case in point …
Philly mayor outraged by basic laws of economics.
Some quotes from another Reason magazine article online:
After driving up the cost of soda and other sugary drinks with a new tax, the mayor of Philadelphia is now trying to blame businesses for charging higher prices (and for the outrage those prices have generated).
Mayor Jim Kenney, who proposed the soda tax and championed its passage through city council last year, told reporters on Tuesday it’s not the new 1.5-cents-per-ounce tax that’s making it more expensive to buy a can of Coke in Philly. No, according to the mayor, those higher prices are caused by city businesses price gouging their customers in order to stir up opposition to the tax.
Note to Mayor Kenney: buy a book on basic economics and read it. Or perhaps just be honest with the public. I know it’s popular among politicians to promise people goodies and insist those bad old business will pay the bill, but that’s not how it works in the real world. Businesses pass the bill along to their customers in the form of higher prices. Here’s why:
Newswork’s Katie Colaneri visited Carbonator Rental Services in Philadelphia to break down the math.
The distributors sells five-gallon boxes of syrup that can be used in soda fountains, and each box costs a retailer about $60. Thanks to the city’s new tax, though, retailers have to pay $57.60 in taxes for each of those boxes of syrup.
“We’re not talking about a couple of bucks on a $60 item,” Andy Pincus, who owns Carbonator Rental Services, told Newsworks. “We’re talking about $57.60 on a $60 item. It’s too big not to pass on.”
Pincus says he can’t absorb the tax because he makes less than $20 in gross profit—the difference between how much he paid for the box of syrup and how much he sells it for—on each box. Out of that money, he has to pay all his employees, buy gas for delivery trucks, and cover all the other costs of doing business. So, he increased the price he charges to retailers buying syrup from his business. Those retailers, who are operating under similarly small margins, are doing the same thing and increasing prices charged to consumers.
This is why I hate observational studies.
Over the years, we’ve been told all kinds of foods might be the key to a longer life. Now chili peppers – yes, chili peppers – might join the list. Here are some quotes from an article titled Eat hot peppers for a longer life?
Like spicy food? If so, you might live longer, say researchers at the Larner College of Medicine at the University of Vermont, who found that consumption of hot red chili peppers is associated with a 13 percent reduction in total mortality — primarily in deaths due to heart disease or stroke — in a large prospective study.
If so, you might live longer, say researchers … Head. Bang. On. Desk.
Did the researchers conduct a carefully controlled, long-term study in which eating chili peppers was the only variable? Of course not.
Using National Health and Nutritional Examination Survey (NHANES) III data collected from more than 16,000 Americans who were followed for up to 23 years, medical student Mustafa Chopan ’17 and Professor of Medicine Benjamin Littenberg, M.D., examined the baseline characteristics of the participants according to hot red chili pepper consumption. They found that consumers of hot red chili peppers tended to be “younger, male, white, Mexican-American, married, and to smoke cigarettes, drink alcohol, and consume more vegetables and meats . . . had lower HDL-cholesterol, lower income, and less education,” in comparison to participants who did not consume red chili peppers. They examined data from a median follow-up of 18.9 years and observed the number of deaths and then analyzed specific causes of death.
“Although the mechanism by which peppers could delay mortality is far from certain, Transient Receptor Potential (TRP) channels, which are primary receptors for pungent agents such as capsaicin (the principal component in chili peppers), may in part be responsible for the observed relationship,” say the study authors.
No, I’ll explain the mechanism: First, highly unreliable data on what people eat was gathered. Then it was compared to medical records. Then, as chance would have it, the researchers found a meaningless association between chili peppers and mortality. Then they high-fived each other and ran off to write up the study results. Then they probably proposed doing further research. In fact, I’m sure they did.
“Because our study adds to the generalizability of previous findings, chili pepper — or even spicy food — consumption may become a dietary recommendation and/or fuel further research in the form of clinical trials,” says Chopan.
I’m reminded of the tongue-in-cheek paper Dr. John Ioannidis wrote in which he demonstrated that 80% of the ingredients in a common recipe book have been linked to higher rates of cancer. Or lower rates of cancer. Or both. It just depends on which observational study you dig up.
And that’s the state of nutrition science.