Just when I think the medical profession can’t sink any lower, it digs a trench a climbs in.

My previous post was about a new study claiming that surgery reverses diabetes more effectively than diet and drugs – the only problem, of course, was that the diet was the American Diabetes Association’s high-carbohydrate diet.  The study was set up to produce a better outcome for surgery.  That’s sinking pretty low.

Now here’s the new low:  Researchers are giving a diabetes drug to pregnant women, essentially drugging their unborn babies, in an attempt to prevent the babies from becoming obese.  Here are some quotes from an article in the U.K. Daily Mail:

In a world first, dangerously overweight mothers-to-be in four British cities have started taking a diabetes drug during their pregnancy. The doctors behind the controversial NHS trial say that obesity among pregnant women is reaching epidemic proportions and they need to act now to protect the health of tomorrow’s children.

Yes, they do need to act now.  They could start by telling pregnant women that the Eat Well Plate (the UK’s version of our USDA Food Plate) is a crock of @#$%.  Here’s what the official Eat Well site recommends:

• Plenty of fruit and vegetables
• Plenty of potatoes, bread, rice, pasta and other starchy foods
• Some milk and dairy foods
• Some meat, fish, eggs, beans and other non-dairy sources of protein
• Just a small amount of foods and drinks high in fat and/or sugar

So you’re an obese, insulin-resistant British mom-to-be, and you follow the Eat Well guidelines by eating plenty of fruit, plenty of starchy foods, and just a bit of meat and dairy.  Great.  You just sent your blood sugar through the roof.

I swear, every time I see these government goofballs put fat and sugar into the same category, I want to kidnap two of them, stuff a pound of sugar down one’s throat and a pound of lard down the other’s, then have them compare notes on the effects.  They might notice a slight difference.

However, there is likely to be unease about resorting to medication in pregnancy for a problem that can be treated through changes in diet and exercise.

Yes, this problem can be treated through changes in diet.  But not if the diet consists of plenty of fruit and plenty of potatoes, bread, rice, pasta and other starchy foods.

If the strategy is a success, the treatment could be in widespread use in as little as five years, with tens of thousands of overweight but otherwise healthy mothers-to-be drugged each year.

This will be a boon not just for the pharmaceutical industry, but for the paper industry as well.  Doctors will be going through prescription pads like crazy.

The Daily Mail recently revealed the rise of the ‘sumo baby’, with the number of newborns weighing more than 11lb soaring by 50 per cent over the last four years.

Remember the days when a big baby was considered a healthy baby?  Not anymore.  Now more and more babies are big because they’ve already been biochemically programmed to become obese.

The trial involves 400 pregnant women in Liverpool, Coventry, Sheffield and Edinburgh. They have started taking metformin, which has been safely used by diabetics for decades and is cleared for the treatment of diabetes in pregnancy. It costs just pence per tablet.

Okay, maybe not a huge boon to the pharmaceutical industry.  But tens of thousands of prescriptions will still add up to a tidy profit.

The study aims to exploit the ability of metformin to lower levels of the hormone insulin in the bloodstream. Obese women make more insulin than other mothers-to-be and this leads to a greater nutrition supply reaching the baby. It is hoped that lowering levels of insulin will reduce the supply and so cut the odds of babies being born obese.

What, they’re blaming high levels of insulin?  No, no, no .. insulin has nothing to do with becoming obese.  Just ask all those people who are calling Gary Taubes an idiot on their blogs.  The problem here is food reward.  The moms are eating too much palatable food, so their babies are sitting there in the womb thinking, “Dang, that’s good stuff!  Salty, sweet, fatty … delicious!  I’m going to open the spigot on my feeding tube and have another couple of servings!”

Study leader Professor Jane Norman of Edinburgh University said: ‘One of the challenges is that many women feel perfectly healthy but there is very good evidence that women who are obese have an increased risk of pregnancy problems and their babies are at risk, and we’d like to reduce that risk.’

Addressing concerns about unborn babies being medicated for a problem that many would say could be treated by diet and exercise, she said: ‘I absolutely support the improvement of diet and encouraging exercise. ‘But we are increasingly faced with women who start their pregnancy obese. Saying at that stage to eat less and exercise more is not particularly helpful.’

No, we shouldn’t be telling pregnant women to eat less.  We should be telling them to eat differently.  We should be telling them to adopt a diet that doesn’t pump their unborn babies full of insulin.  Giving pregnant women a drug to beat down their glucose and insulin levels when switching to a low-carb, high-fat diet will accomplish the same goal is just nuts.

p.s. — I apologize for going all day without checking comments.  I was juggling projects and just now got around to it.

Time to catch up on some of the interesting news items readers have sent me lately.

Maybe they should just ban the consumption of their own product …

You’re probably aware that some companies are trying to keep their health-care costs down by charging overweight and obese employees more for health insurance.  I think that’s a dumb idea.  It’s based on the (mistaken) belief that the overweight employees know how to lose weight, but just don’t care to make the effort.

But when this company charges unhealthy employees extra, it seems double-stupid:

Four years ago, PepsiCo began rolling out a wellness program that charges its employees $50 a month if they smoke or have obesity-related medical problems such as diabetes, hypertension, and high blood pressure. Workers can avoid the surcharge if they attend classes to learn how to break their nicotine addictions or lose weight. When about 400 unionized PepsiCo bottlers and truck drivers in central New York learned early last year they’d be subject to the fee, they rebelled.

So we’ve got a company producing a sugary drink that can cause obesity-related medical conditions such as diabetes and high blood pressure, and they’re going to levy a sin tax on employees who developed obesity-related medical conditions such as diabetes and high blood pressure.  Why don’t they just send out a memo:

Dear employee,

Please stop drinking our product.  We don’t want to have to charge you extra for insurance.

I’m waiting for a news story describing how cigarette manufacturers are going to charge higher insurance rates for employees who smoke.

The soda maker doesn’t think of its $50 assessment as a sin tax. Says [PepsiCo spokesman Dave] DeCecco: “What company wouldn’t want a healthy, engaged workforce?”

Oh, I don’t know … maybe a company that sells big bottles of sugar-water for less than a dollar apiece?

Truth in advertising

You’ve got to love the name of this new cereal:

Yup, I’m sure lots of kids will krave Kellogg’s Krave.  They’ll probably toss back big ol’ bowls of the stuff before going to school and attending the special classes for kids with ADHD.  But hey, it’s okay … as you can see from the label, Kellogg’s Krave contains fiber and whole grains!

“Johnny, where were you?  You missed Social Studies and English!”

“I’m sorry, Mrs. Worthington.  I had to make a number two.  Again.”

“Well, that shouldn’t take two class periods to accomplish, young man.”

“It does if you fall asleep on the toilet.”

Paleo bagel-eaters

Okay, this isn’t exactly a news item, but a reader who happens to be a teacher sent me a copy of the guidelines she was given to teach 7th graders about the Paleolithic era and the “stone-age” diet.  Here are some quotes from an assignment for the kiddies:

No one expects you to eat raw mammoth brains, or even thistle, twigs, or your hamster. In fact, many species eaten by early hominids are now extinct. To duplicate the same foods our ancestors ate is almost impossible. Imagine trying to find in the local supermarket such foods as reindeer, fox, caribou, giant sloth, flamingos, bear, catmint, grubs, or quail eggs. Nevertheless, many foods exist that are similar to foods eaten during the Stone Age.

Yup … steaks, organ meats, chicken eggs, chickens, fish, a wide variety of vegetables, fruits …

Approved “Stone Age” foods to eat
• fish and seafood
• small game (e.g., rabbit, chicken)
• bison (buffalo meat)
• seeds and nuts (raw, without salt)
• lots of fruits (including figs)
• lots of vegetables (including beans)
• lots of water (eight to 10 glasses per day)
• whole grains such as barley, bulgar, oat bran, corn bran, rice, millet, buckwheat, and rye
• tubers (potatoes and sweet potatoes)
• small amounts of cereal grains
• pita bread and whole grain breads
• honey—the only sweetener allowed in your Stone Age diet!
• berries
• shoots and roots
• edible leaves and flowers
• lean red meats (sparingly)
• whole wheat bagels and rolls
• rice cakes

Whole grains, cereal grains, rice cakes and bagels – in the STONE AGE?!!  Do these goofballs have any idea when farming actually began?

Your goal is to eat an abundance of natural, wholesome food with few or no chemical additives. Keep track of what you eat on the STONE AGE DIET RECORD. Why not do one more thing your ancestors did—exercise by walking or running outside each day. The combination of wholesome, low-fat foods and daily vigorous exercise will make a difference in your life!

Yup, that was life in the stone age:  whole-wheat bagels, rice cakes, cereal and other low-fat foods.   Those paleo hunters were very concerned about saturated fat and cholesterol.

Well, at least the lesson planners probably explained how anthropologists have found that hunter-gatherers spent an average of 20 hours per week obtaining food, then spent their remaining time playing games, telling stories, and engaging in ceremonies.

For 2.5 million years, humans lived nomadic lives of hunters and gatherers. This era of human existence was one of continual scarcity. All human energy had to be devoted to daily securing the food necessary to survival.

Head.  Bang.  On.  Desk.

Yes, let’s get those cholesterol levels even lower!

I just knew that when the patents on statin drugs began to expire, something even (ahem) better would come along.  I’m sorry to say I was right:

A possible revolutionary way to fight cholesterol is expected to cause a big stir among thousands of heart doctors gathering in Chicago starting this weekend for the annual American College of Cardiology meeting.

No doubt. You mention fighting cholesterol, and cardiologists get all stirred up.  Fighting cholesterol makes them feel good about themselves.  That’s because they believe – despite all the contrary evidence – that high cholesterol causes heart disease.

The new drugs in development by top pharmaceutical makers and up-and-coming biotechs are injectable medications that block a protein called PCSK9.

They have shown promise in early clinical trials for slashing “bad” LDL cholesterol further than widely used statins can alone. Their biggest advocates say PCSK9 blockers have the potential to be the next multibillion-dollar class of heart drugs.

I’m sure they will be.  The makers of those drugs will sponsor educational conferences for doctors (in really nice locations) and present some dazzling, highly-manipulated evidence that these new drugs can save millions of lives.

Regeneron Pharmaceuticals Inc last year disclosed that its product slashed levels of LDL cholesterol up to 65 percent beyond reductions seen alone with statins – pills like Pfizer Inc’s Lipitor and AstraZeneca Plc’s Crestor that are today’s standard treatments.

Outstanding!  If we can just get people’s LDL levels down to, say, 20 or 30, we’ll make a fortune!  Granted, the people taking the drugs will be impotent, sore, tired, cranky, too weak to move and suffering from serious cognitive decline, but – here’s the important thing – their lab scores will make doctors feel good about themselves.

“PCSK9 is one of the most exciting targets in cardiovascular drug development today,” Michael Severino, Amgen’s chief medical officer, said in an interview. Severino said a large number of patients – some studies suggest 40 to 50 percent – fail to reach their cholesterol-lowering goals despite being on statins, and that PCSK9 inhibitors could give them the needed extra push.

Yup, right into the home for Alzheimer’s patients.  But – this is the important  thing – their lab scores will make doctors feel good about themselves.

Sure, you’ll lose weight … but then you’ll die

In my recent ORI speech, I listed this as the fifth ingredient for cooking up a crisis in nutrition:

Doctors, researchers, medical industry trade groups, government agencies and other authorities insisting that while the alternative advice may occasionally help some stupid, lazy, or gluttonous people lose weight and get their blood sugar under control, it will also kill them.

We had another example this week.  Take a look at this dramatic headline:

Low carb diets imperil people prone to heart disease

No ifs, ands or buts in that headline, by gosh.  There’s not even a maybe.  If you’re prone to heart disease, going on a low-carb diet is risky, period, end of story.  Surely a bold headline like is the result of a well-designed clinical study of how low-carb diets affect humans.

A low-carb, high-fat diet might help some people lose weight, but it could be deadly to those with a family history of heart disease, according to research presented March 25 at a meeting of the American College of Cardiology in Chicago.

Hey … that would be the same meeting where cardiologists were dazzled by the news that some new drugs can beat down cholesterol levels even more than statins!  I’m starting to see pattern here:  going on a diet that makes you feel great and lose weight will kill you, but the drugs we sell are fantastic and will save your life.  So forget the diet and take your drugs.

Anyway, back to the article:

Researchers from the University of Alabama at Birmingham found that obese rats fed a high-fat, low-carb diet — comparable to what many humans consume — had more damaging and deadly heart attacks than obese rats fed a low-fat diet.

Got that?  Obese rats fed a high-fat diet had more heart attacks than rats on a low-fat diet, so this proves (according to the headline) that low-carb diets imperil people with heart disease.  And you wonder why I think the average media health writer is a flippin’ moron?

I couldn’t find the study online (it may not be published yet) and therefore couldn’t determine what was in that “high-fat” diet the rats consumed, but I did find a spec sheet awhile back for something called the Atkins-Style Diet that’s frequently used in rodent studies.  Here are some of the top ingredients:

• Casein
• Corn Starch
• Milk Fat
• Crisco
• Lard
• Dextrin
• Sucrose
• Soybean Oil
• Corn Oil
• Blue Dye

Boy, that sounds exactly like the average Atkins dieter’s dinner, doesn’t it?  The lard is good, but I urge all of you to avoid basing your meals on corn starch, Crisco, dextrin, sucrose, soybean oil and corn oil.

In other words, don’t eat the typical school lunch, even if the USDA approves.

Quick update on the sciency stuff. I thought maybe Tom would dissect the latest “death by red meat” story when he returns.

Maybe he will, but the most awesomeful Denise Minger, who hit the Fat Head radar with her blistering analysis of The China Study, has done another superb piece on this new assault on real science as a guest post on primal guru Mark Sisson’s blog at marksdailyapple.com.

I took an amatuer stab at the Science for Smart People thing as lots of folks were commenting about the study here, and I felt really good seeing that I caught the main points Denise hit. But if you want to read a breakdown by a real genius, get over there for a good read. Sorry I can’t stick a link in here – I’m pecking away at this on my nook and my finger is killing me!

Cheers,

The Older Brother

Okay, This isn’t really my strong suit, and I don’t usually climb up into the big chair two days in a row, but there’s been several folks asking about the latest study proving that red meat will kill you.

Sigh.

Firstly, keep in mind that these things crop up like spring mushrooms after a rain. Tom just finished debunking one a couple of months ago here.

If you’ve checked out my blog, you know I’m more of an economics nerd.  The equivalent in that realm is every other year or so, some liberal think tank or university releases a dramatic new study proving that increasing the minimum wage actually raises employment.  It’s always trumpeted on the front page.  Once it gets peer review, if they even bother, it gets shredded.  Those stories never seem to make the editorial cut, much less get front page attention:

Startling Review of Study Shows Higher Prices Mean People Buy Less, Even for Labor!!!

The irritating part is if you look at them, it seems like they just took the last one that was discredited, then rerun the same plan, then go to press.

So I figured I’d take a look at this one not because I think I can do an original analysis and takedown ala Tom on a fresh study done by “experts,” but because I guessed we could spot some of the same doo-doo that are the hallmark of bogus science.

I hit paydirt pretty quickly and thought I’d pass some easy observations along.

First of all, this isn’t a new study, it’s a meta-analysis where they cherry-pick some studies that have data they want to use.  It’s also “observational” in the worst way — from the study’s description of its methodology:

“Diet was assessed by validated food frequency questionnaires and updated every 4 years.”

Okay, if you really insist on good science, you could stop reading right there.  Long-term food questionnaires are the hallmark of bogus nutritional science.  How many servings of red meat did you eat last Thursday?  How about January 12, 2010?  You simply can’t invent less reliable information.  And fortunately for hacks, with food questionnaires you don’t have to!

Also:

“Men and women with higher intake of red meat were less likely to be physically active and were more likely to be current smokers, to drink alcohol, and to have a higher body mass index.”

Can anyone say “Confounding Variables?”  The researchers said they adjusted for these.

“We also stopped updating the dietary information after a diagnosis of major chronic disease assuming that participants could have changed their diet after receiving the diagnosis.”

So, instead of actually gathering data, you assume it would’ve changed and stopped asking.  Huh?  I can’t help but wonder what kind of data they would’ve wanted to not include.  Here’s one that popped into my mind:

Meat eater gets diagnosis of chronic disease and, at the insistence of doctor and experts, changes diet to hearthealthywholegrains, avoids arterycloggingsaturatedfat, starts chronic cardio exercise program.  Drops dead two years later.  Wouldn’t want to show he’d changed his diet, would we?  Let’s count him in the red meat column!

Here’s the thing that did it for me.  The authors made a statement that “red meat has been shown to increase diabetes.”  Again, Huh? The reference for this statement was a study the same authors had conducted.  The methodologies and verbiage where the same boilerplate as the current study in question.  Their conclusion on that one was this:

“We estimated that substitutions of one serving of nuts, low-fat dairy, and whole grains per day for one serving of red meat per day were associated with a 16–35% lower risk of [Type 2 Diabetes].”

Here’s the thing, kids.  If you believe people can dramatically drop their incidence of diabetes by swapping grain in for protein, then I say all we have to do is raise the minimum wage to $500 an hour; we’ll all be millionaires and this whole little economic downturn will be solved overnight.

I don’t know what the authors of this study’s motivation or cause or agenda is, but it sure as hell isn’t the pursuit of good science.

The ironic thing is that the reason Tom isn’t here to respond to this latest step on the slow road to idiocracy is because he’s in Washington D.C. on a mission to get bureaucrats to understand why people don’t trust doctors, scientists, nutritionists, government committees and the panalopy of “experts” who’ve been making us fatter, more diabetic, more arthritic, and more lots of bad stuff while making tons of money for their “owners.”

So, please pass that study on to anybody you don’t like.  Then enjoy your bacon and repeat after me,

Scientists are Freaking Liars!

Cheers,

The Older Brother

I’m starting to wonder if the editors of medical journals schedule a yearly Meat Causes Cancer! issue …something like their own equivalent of the Sports Illustrated Swimsuit issue.

Our cover model this year is pancreatic cancer, folks — and as you can see, she’s a hot little topic!  We don’t want to start any rumors, but we have it on good authority she’s often seen in the company of some beefy hunks.

The hot little topic made a splash in the media last week, with headlines and opening paragraphs like these:

Bacon eaters warned of cancer risk

Eating two rashers of bacon or one sausage a day can increase the risk of a deadly form of cancer by almost a fifth, according to a new study.  New research by the Karolinska Institute in Stockholm has found that eating 50g of processed meat a day can increase the risk of pancreatic cancer by 19%.

Processed Meat Could Raise Pancreatic Cancer Risk

Some possible bad news for all the bacon lovers out there.

A new review in the British Journal of Cancer suggests a link between processed meats — like bacon and sausages — and an increased pancreatic cancer risk. In particular, eating an extra 50 grams a day of processed meat — or about a sausage — is enough to raise pancreatic cancer risk by 19 percent, BBC News reported, while an extra 100 grams of processed meat a day could raise the cancer risk by 38 percent.

“The authors of this study have suggested that one of the reasons could be that some of the chemicals that are used to preserve processed meat are turned in our bodies into some really harmful chemicals which can affect our DNA and increase the chance of cancer,” Jessica Harris, health information manager at Cancer Research UK, told Sky News.

Holy jumpin’ jiminy!  A 19% increase in risk – that’s almost a fifth!  Better drop that bacon right now, Mister.  You don’t want to mutate your DNA and roll the dice with a 19% increase in the odds you’ll die of pancreatic cancer.

I tracked down the full study, and it was pretty much what I expected:  a meta-analysis of several other studies, all of them based on food-recall surveys.  So let’s put on our Science For Smart People hats (mine is cone-shaped; you can choose your own) and ask some critical-thinking questions:

Q: Was this an observational study or a clinical study?

A:  It was a meta-analysis of 11 observational studies, the kind where the researchers pool the data and crunch the numbers.

Q:  Did the researchers control the variables?

A:  No, because they couldn’t.  They were dealing with data published by other researchers who may or may not have done a good job controlling their variables.  As the authors of the current study noted:

Our study has some limitations. First, as a meta-analysis of observational studies, we cannot rule out that individual studies may have failed to control for potential confounders, which may introduce bias in an unpredictable direction. All studies controlled for age and smoking, but only a few studies adjusted for other potential confounders such as body mass index and history of diabetes. Another limitation is that our findings were likely to be affected by imprecise measurement of red and processed meat consumption and potential confounders.

Let me put that into plain English:  Our findings are meaningless. The studies we analyzed were based on food-recall surveys that are notoriously inaccurate, and most of them didn’t control for body mass index or diabetes, which essentially means they didn’t control for intake of sugars and refined carbohydrates.

Okay, folks, move along; nothing here to see.

…

What, you’re still here?  Then we may as well continue.

Q:  If A is linked to B, is it possible that they’re both caused by C?

A:  Yes, of course it’s possible.  As the researchers noted above, “All studies controlled for age and smoking, but only a few studies adjusted for other potential confounders.”  Since processed meats are often served with a big wallop of refined carbohydrates – pizza, burritos, deli sandwiches, etc. – it’s entirely possible that people who consume more processed meats have higher rates of pancreatic cancer (if that’s even the case) because they also consume more white flour.

Q:  If A is linked to B, do we see that connection consistently, or are there glaring exceptions?

A:  We can answer that question by looking at the charts from the full study.  This one shows the change in the relative risk of developing pancreatic cancer from consuming an additional 120 grams of red meat per day:

A relative risk of 1.0 is neutral – no change in risk.  Below 1.0 means lower relative risk and above 1.0 means higher relative risk.  The horizontal bars represent the range of values that fell within the “confidence interval,” the black squares represent the average relative risk for each study, and the white diamond in the last row represents the overall average obtained by pooling data from all the studies.

The first thing that jumped out at me is that in four of the 13 studies analyzed, the relative risk of developing pancreatic cancer was lower for the people who (supposedly) eat a lot of red meat.  I wouldn’t call that a consistent result.  If some studies show higher risk and some studies show lower risk, I’d conclude that we’re looking at the wrong variables.

But through the magic of statistical analysis, the researchers pooled the results (from studies that often failed to control the variables) and declared that consuming 120 grams of red meat per day raises your risk of developing pancreatic cancer by 13%.

Now here’s the change in relative risk from consuming an additional 50 grams of processed meat per day:

Nine studies, and in three of them the relative risk of developing pancreatic cancer was lower for people who consumed more processed meat.  Once again, that’s hardly a consistent result, but the researchers pooled the data in order to declare that processed meat raises your risk of pancreatic cancer by 19% — which leads to our final question.

Q:  What was the actual difference?

A:  Almost nothing.  That’s the short answer.  Now for the longer answer:

Scientists like to cite relative risk instead of absolute risk because relative risk sounds far more impressive.  Suppose that when I lived in sunny California, my odds of being struck by lightning were 1 in a million.  But now that I live in Tennessee, suppose the odds are 1.5 in a million.  That’s a 50% increase in relative risk … but a meaningless increase in absolute risk.  The actual difference — the change in absolute risk –  is 0.5 in a million.

According to the National Cancer Institute, the age-adjusted annual incidence rate of pancreatic cancer is 13.6 per 100,00 men and 10.3 per 100,00 women.  We’ll split the difference and call it 12.15 per 100,000 people.  Expressed as a percentage, here are the odds that you’ll be diagnosed with pancreatic cancer this year:

0.0122%

Just barely over one-hundredth of one percent.  Now … let’s set aside the fact that this meta-analysis was 1) based on observational studies that 2) used unreliable food-recall surveys and 3) produced inconsistent results.  Suppose we choose to believe that processed meat really and truly causes pancreatic cancer at the increased rate found by pooling all that data, but we keep on eating our bacon anyway.  Here are the odds, expressed as a percentage, that we bacon-eaters will be diagnosed with pancreatic cancer this year:

0.0145%

And here’s the actual difference between those two numbers:

0.0023%

Well, maybe you’d prefer to deal with lifetime odds instead of annual odds.  Okay, fine.  According the National Cancer Institute, the lifetime odds of developing pancreatic cancer in the U.S. are 1.45%.  If eating 50 grams per day of bacon or other processed meat really and truly (and all by itself) raised the rate by 19%, your lifetime odds would be 1.70%.

Here’s the actual difference between those two numbers:

0.25%

Enjoy your bacon.

Suppose you were reading the health section of a newspaper looking for ideas on how to lose weight, and you came across an article that started like this:

Whether you are just starting a New Year’s diet or struggling to maintain a healthy weight, a provocative new study offers some timely guidance. It isn’t so much what you eat, the study suggests, but how much you eat that counts when it comes to accumulating body fat.

The findings are the latest in a string of studies to challenge claims that the secret to healthy weight loss lies in adjusting the amount of nutritional components of a diet—protein, fat and carbohydrates.

I don’t know about you, but I’d assume that provocative new study involved adjusting the nutritional components of a diet – protein, fat and carbohydrates.  Let’s check:

In the study, to be published in Wednesday’s issue of the Journal of the American Medical Association, 25 young, healthy men and women were deliberately fed nearly 1,000 excess calories a day for 56 days, but with diets that varied in the amounts of protein and fat.

Hmmm  … it appears that the provocative new study which supposedly proves the secret to healthy weight loss isn’t a matter of adjusting the ratio of protein, fat or carbohydrates is

1)  a study of people who intentionally gained weight instead of losing weight

which

2) manipulated the balance of fat and protein, but not carbohydrates.

Let’s read on:

While those on a low-protein diet—about 5% of total calories—gained less weight than those on a normal- or high-protein regimen, body fat among participants in all three groups increased by about the same amount. Typical protein consumption is about 15% of calories, while the U.S. government recommends it make up between 17% and 21% of total daily calories.

The findings suggest that it matters little whether a diet is high or low in fat, carbohydrates or protein, it’s calories that build body fat.

It matters little whether or a diet is high or low in fat, carbohydrates or protein?  I must be missing something here … did the researchers change the ratio of carbohydrates in the diet nor not?

The patients in the Pennington study ranged in age from 18 to 35 and had BMIs between 19 and 30. (Between 25 and 30 is considered overweight.)  They lived at the center’s metabolic unit for between 10 and 12 weeks and were fed the 1,000 extra calories a day for the final eight weeks of their stay. Carbohydrates were held steady at about 41% to 42% of calories while fat levels varied with the protein regimen.

Brilliant.  Study subjects were put on three different diets designed to induce weight gain, the carbohydrate ratio was virtually the same across all three groups, and yet media health reporters are telling us the provocative study proves that manipulating the fat, carbohydrate or protein content of a diet won’t help us lose weight.

After eight weeks, all participants in the study gained weight. The 16 men and nine women made similar gains. The low protein-diet group gained about seven pounds, about half the 13.3 pounds added on by the normal protein participants and 14.4 pounds put on by the high protein group.

If you read the full study (which I did), you’ll learn that the low-protein group didn’t gain as much weight because – despite overeating by 1,000 calories per day – they lost muscle mass.  The other two groups gained muscle mass, with the high-protein group gaining the most.  I’d say that’s an important difference.  Losing muscle mass is a great way to slow your metabolism.  Gaining muscle mass raises your metabolism.  The results listed in the study seem to confirm that point:

The low protein diet had 6% of energy from protein, 52% from fat, and 42% from carbohydrates. The normal protein diet had 15% of energy from protein, 44% from fat, and 41% from carbohydrates. The high protein diet had 26% of energy from protein, 33% from fat, and 41% from carbohydrates.

Overeating produced significantly less weight gain in the low protein diet compared with the normal protein diet group or the high protein diet.  Body fat increased similarly in all 3 protein diet groups and represented 50% to more than 90% of the excess stored calories. Resting energy expenditure, total energy expenditure, and body protein did not increase during overfeeding with the low protein diet.  In contrast, resting energy expenditure and body protein (lean body mass) increased significantly with the normal and high protein diets.

Elsewhere in the study, the researchers provide more details:  the low-protein group lost an average of 1.5 pounds of lean body mass, while the high-protein group gained an average of 7 pounds of lean body mass.  When you overeat by 1,000 calories per day and still lose muscle, you know it’s a lousy diet.

The effects on metabolism may not have produced significant differences in fat accumulation in the short duration (less than two months) of this study, but I suspect that since the low-protein group was losing muscle mass, we’d see more of a difference over time.  Interestingly, the researchers didn’t say exactly how much extra body fat each group gained.  They only told us the difference wasn’t significant:

The overall increase in fat mass for all 3 groups was 3.51 kg (95% CI, 3.06 to 3.96 kg) from baseline and was not significantly different between the 3 groups (P = .89), although the low protein group added on average more than 200 g of fat (about 2000 kcal).

I also found these paragraphs interesting:

With the low protein diet, more than 90% of the extra energy was stored as fat. Because there was no change in lean body mass, the 6.6% increase in total energy expenditure reflects the energy cost of storing fat and is close to the estimate of 4% to 8% for fat storage derived by Flatt. With the normal and high protein diets, only about 50% of the excess energy was stored as fat with most of the rest consumed (thermogenesis).

The extra calories in our study were fed as fat, as in several other studies, and were stored as fat with a lower percentage of the excess calories appearing as fat in the high (25%) protein diet group.

I’m confused … if the low-protein group stored 90% of their extra energy as fat, while the other groups only stored 50% of their extra energy as fat, how did they all end up gaining the same amount of body fat?

Maybe I’m just not getting the math involved, but never mind.  Even if all three groups did gain the same amount of body fat, this study doesn’t really tell us anything about how to effectively lose weight, and it certainly doesn’t prove anything one way or another about the effects of manipulating the carbohydrate content, since the carbohydrate ratios were virtually identical.

Another researcher who commented on the study in a Reuters article put it nicely:

Donald Layman, a food science researcher at the University of Illinois in Urbana, said it’s difficult to see how the findings apply to a general population that isn’t being overfed such a protein-deficient diet, in the case of the low-protein group.

“It’s an interesting scientific study, but from an obesity standpoint, I don’t think it tells us anything,” he told Reuters Health.
Bingo.  Even if the protein ratio made little or no difference on fat accumulation in an over-eating study conducted in a metabolic ward, most of us aren’t trying to get fatter.  We’re trying to get leaner.  And we don’t live in metabolic wards where our meals are prepared for us and every calorie is tabulated.  We live in the real world where we don’t (and can’t) count every calorie, and where the amount of food we eat is determined by our appetites.  Protein is satiating.  When we eat higher-protein foods, we tend to eat less.  When we eat high-carb meals, many of us find our appetites going all out of whack, and we eat more.

The lead researcher for the study was George Bray, who seems to have dedicated his career to proving that the federal government’s dietary guidelines are correct – and if he has to cleverly design studies to achieve that goal, or write conclusions that aren’t backed up by the actual data, by gosh he’ll do it.

It was Bray who conducted the study on salt restriction that I mentioned in my Science For Smart People Speech, the one in which a drastic reduction in dietary sodium produced a whopping two-point drop in blood pressure.  Based on that meaningless result, Bray concluded that sodium restriction is an effective means of controlling hypertension.  (Say what?  Two points is a meaningful reduction in blood pressure?  I don’t think so.)

Here’s Bray offering his conclusion from the latest study:

“If you over-eat extra calories, no matter what the composition of the diet is, you’ll put down more fat.”

Really, Dr. Bray?  If you wanted solid scientific evidence that the composition of the diet is meaningless, why was the ratio of carbohydrates the same in all three groups?  Since you blasted Gary Taubes in your review of Good Calories, Bad Calories, we know you’re well aware of the hypothesis that it’s carbohydrates, not protein or fat, that promote fat accumulation … so why didn’t this provocative study include a group that restricted carbohydrates?  After all, none of the low-carb diet gurus recommend anything close to a ratio of 40% carbohydrates.

I think the answer to that question can be found near the end of the study.

This study was supported in part by the US Department of Agriculture.