Gary Taubes is a Blowhard

Imagine if you will that you make a living by selling an idea. You are a merchant in the marketplace of ideas, and you sell an idea that we will call Idea X. You sell books that promote Idea X, you give lectures across the country extolling the virtues and benefits of Idea X, etc. Turns out that Idea X is somewhat controversial but quite lucrative. You tried selling other stories and ideas in the past, but none have been nearly as profitable to you as Idea X. Espousing this idea has afforded you the ability to provide your spouse and children a comfortable living in these tough economic times. Imagine also that a scientific study was recently conducted by prominent researchers and the results are published in a prestigious scientific journal. As it happens the results of the study are pretty devastating to Idea X and contradict some of its main points. In the following days the study results are much-discussed in various media outlets, and some people begin to doubt the idea that you’re selling. The study results have left the more loyal adopters of your idea confused as to what to believe, and they beg you to respond to the study.

What do you do?

There are probably a few different choices you could make in this case.

  1. You could ignore the study and hope this bad news blows over soon. Then after the media gets bored of discussing the study results and moves on, you can try to resume preaching your idea to the people still adhering to your idea. As time goes on you can try to re-convert those who left Idea X.
  2. You could follow where the evidence leads and come out and say “I don’t want to mislead anybody. It looks like Idea X is not supported by the evidence. I was wrong, and I’m sorry.” Then you face the very tough challenge of trying to find another idea that is both as profitable as your last idea with the caveat that it is also evidence-based and grounded in reality. If you don’t find another profitable idea then you’ll have to move your family out of your nice neighborhood and into a lousier one while you work unappealing jobs to put food on the table.
  3. You could denounce the study and the scientists who conducted it. You could try and poke holes in the evidence and muster your greatest argument for why no one should believe the results. It may not be intellectually honest, but the truth must be an unfortunate casualty when you and your family’s quality of life is at stake.

Gary Taubes has chosen #3, except he takes it even further and denounces not only the specific study and the researchers that conducted it, but the field of epidemiology as a whole. This is actually pretty shrewd since most epidemiological evidence is against him anyway. Taubes’s Idea X in this analogy is the assertion that, contrary to popular belief, foodstuffs like red meat, saturated fat, and cholesterol are actually healthy and pose no threat of disease while just about any and all carbohydrates are unhealthy.

Mr. Taubes recently wrote a blog post responding to a recent study titled Red Meat Consumption and Mortality published in Archives of Internal Medicine. The study concludes “red meat consumption is associated with an increased risk of total, CVD, and cancer mortality.”1 If I had to summarize Mr. Taubes entire blog post it would be something like: Epidemiology is a pseudoscience. Well, not all epidemiological research, just any research suggesting that eating red meat for every meal might not be healthy. Any scientist or nutrition researcher claiming that is practicing a junk science. Those that come to other conclusions are the real scientists, the good scientists. Also, I will never accept any scientific claim unless there are randomized, placebo-controlled clinical trials to back it up. Except for the claim that smoking causes lung cancer. I will accept that one without RCTs.

Let’s Break it Down

To start things off Taubes does not refute any specific thing in the actual paper. He leaves that job to someone else.

Zoe Harcombe has done a wonderful job dissecting the paper at her site.

Taubes prefers instead to respond to the paper’s general tone and the tone of some of the researchers involved with the paper, notably Dr. Walter Willett and Dr. Meir Stampfer.

Who is this Zoe Harcombe and why should I trust her judgment? The biography on her webpage does not tell me much about her credentials other than she is a

[Q]ualified nutritionist with a Diploma in Diet & Nutrition and a Diploma in Clinical Weight Management, but she is first and foremost an obesity researcher.

A “qualified nutritionist”? What does that even mean? Who “qualified” her and gave her “Diplomas”? Were these actual universities or did she just pay 30 bucks (or pounds perhaps, since she’s from the UK) for some shady online certification that means nothing? We are not told, and I suspect for good reason.

She is also an obesity researcher, huh? A quick Google Scholar search of her name came up with no publications. Is she actually a researcher or does she just call herself one? I suspect the latter. I love how Taubes apparently thinks she is some sort of authority on the matter but the Harvard School of Public Health is full of incompetent boobs.

Here is one of her “key problems with this study”

1) This study can at best suggest an observed relationship, or association. To make allegations about causation and risk is ignorant and erroneous.

Nowhere in the study did the authors claim to have a causal relationship. It is always stated as an association. Harcombe misrepresents the results.

Eventually her “key problems” devolve into irrelevant and unverifiable ad hominem

[O]ne of the authors (if not more) is known to be vegetarian and speaks at vegetarian conferences

It is like the author is a communist or something!  As if being a vegetarian would have any bearing on the results of the study. Are vegetarians not supposed to conduct nutrition research now, only omnivores? What about Jews or Muslims? If they do research involving meat should their results not be published? What’s more is this claim isn’t even verified. She has a citation but it takes me to this page that tells me nothing. I also went to the page with the 2013 speakers but none of them authored the study in question.

Okay, back to Taubes now.

The problem with observational studies like those run by Willett and his colleagues is that they do none of this [testing hypotheses]. That’s why it’s so frustrating. The hard part of science is left out and they skip straight to the endpoint, insisting that their interpretation of the association is the correct one and we should all change our diets accordingly.

You mean like how you do, Taubes, with your books and lectures? Except that you are not a scientist and have no medical training or research experience like Willett et al. I don’t want to engage too much in tu quoque, but pointing out hypocrisy is so much fun. Let me get in one more jab, and then I’ll move on.

I’m no expert in Taubesian hermeneutics, but I think he meant to say The problem with observational studies like those run by Willett and his colleagues is that they are so devastating to my position that everyone should eat truckloads of meat. Okay now I’ll get to the substance of his point.

Mr. Taubes seems to be accusing Willett et al. of laziness despite the fact that they churn out hundreds of studies that take decades to complete and are peer-reviewed and published in top-tier journals.2 The reason for this is because, according to Mr. Taubes, epidemiology is not a true science, and if Willett and his colleagues really wanted to study certain dietary aspects and their link to colon cancer mortality or cardiovascular disease mortality they have to conduct randomized, double-blind, placebo-controlled human clinical trials (I will abbreviate as RCTs). Anything less is not “good science.”

I’m not about to give you a lecture on what epidemiology is and why it is important. It may be a good subject for a future post, but for now I will say that it is a useful field when studying large populations, incidence and prevalence of disease, or when RCTs would be unethical or impossible.

Here is a visual reference to help understand the hierarchy of evidence a little better. At the top of the triangle you have the most rock-solid evidence that we have on a given subject and the bottom is the least valuable evidence.

As you can see, the cohort studies in question are not quite as good as RCTs, but they are as close as you can get. They are not meant to replace RCTs in evidence-based medicine, but they can be a good proxy when conducting a RCT would be impossible. Here’s another visual that explains each method.

Mr. Taubes asserts that the experts are wrong and red meat does not lead to any kind of mortality. He asserts this with barely any evidence and zero RCTs to back up his assertion, yet if anyone would disagree he demands they provide RCTs because Taubes will not accept cohort studies. Conveniently for him the RCTs he demands will  almost certainly never take place. Let me explain.

Mr. Taubes seems to think that RCTs examining specific dietary constituents and their roles in disease mortality are low-hanging fruit. I’d like to see Taubes design one for, say, red meat and colon cancer. It would be worth a read just to see how he deals with the problem of blinding alone. Furthermore, what would be a good placebo? I get that one group would be assigned red meat every meal, but how do you get the control group to eat placebo meat without the subjects really knowing if they are in the meat-eating group? Surely people can tell the difference between a tofu steak and a genuine ribeye. Plus cancer is not something that you get only a few weeks into a feeding study. It takes decades to arise, so it would mean that a RCT would also have to take as much time. There are many more difficult study design issues Mr. Taubes would need to tackle before he could begin.

This is all assuming of course that the study would be funded (it almost certainly wouldn’t because it would be the single most costly RCT in history) and that it would pass IRB approval (it wouldn’t because the study itself would be unethical considering there is a fair amount of evidence that red meat does in fact lead to colon cancer3, Red Meat Consumption and Mortality notwithstanding).


Throw it Against the Wall and See if it Sticks

If you don’t buy into his Epidemiology Sucks theory Taubes also hurls some other arguments against the study hoping at least one of them will stick. One is that the increase in mortality from red meat eaters is only an increase of 0.2 so it’s basically nothing and you should just forget about it. Of course another way to present that increase is 20%. An increase of only 0.2 seems like such a small number compared to 20%, doesn’t it? What if I told you that drinking Generic Beverage That You Sort Of Enjoy everyday increases your risk of developing esophageal cancer by twenty percent? My guess is you would cut down on Generic Beverage That You Sort Of Enjoy, even if you enjoyed it.

Another argument Taubes uses is admitting the following:

[T]he people who avoided red meat and processed meats were the ones who fundamentally cared about their health

If I may paraphrase: Okay, sure, vegetarians are healthier than meat-eaters. But is it because of the meat? I say it’s because vegetarians are just generally healthier than meat-eaters. They are more health-conscious and they smoke less. It has nothing to do with meat! It’s simply the “healthy cohort effect”!

Are you sitting down? I hope so because I’m about to rock your world: I agree with Taubes here. This is a legitimate concern with epidemiological studies. If you are not careful with your study design and statistical analysis these kinds of things can bias your results. However, there are many ways you can adjust for things like this, and I think it goes without saying that if you have a poor study design or no adjustments then you don’t get published in the top tier journals in which Willett and Stampfer get published. Furthermore, sampling biases like the healthy cohort effect are stronger in smaller cohorts of 10 or 20, but when you increase sample size to 100 or 1,000 the effect becomes negligible. In the case of Red Meat Consumption and Mortality the authors use cohorts of 37,698 men and 83,644 women, so if they did their due diligence with the statistical analysis (and I’m not about to check their math, that’s what the peer-review process is for) if the effect is even present it should be so weak as to be nonexistent.

As it stands the authors of the paper in question did in fact adjust for smoking status as well as a host of other lifestyle factors.4

Watch now as Taubes removes any possible hope you might have about his scientific literacy.

So do an experiment to see which is right. How do we do it? Well you can do it with an N of 1. Switch your diet, see what happens.

The ol’ do-it-yourself randomized controlled trial. The very pinnacle of oncological research. Have you switched to a high-beef, low-carb diet? Check. Have you died from colon cancer and/or cardiovascular disease? No? Well then the experts were wrong! Help yourself to some more mutton. Take note future lawyers: this is special pleading at its finest.

Credit Where Credit is Due

Although completely irrelevant to a discussion of Red Meat Consumption and Mortality Taubes does cite one randomized trial (not placebo-controlled) that kind of shows some benefits in a low-carb Atkins diet over other somewhat popular diets such as Zone or Ornish. It is totally a red herring, but let’s touch on it anyway. The study takes premenopausal women that are either overweight or obese and assigns them to one of several diets. They all receive instructions on how to follow their assigned diets and are followed-up on after one year. Turns out the Atkins people lost more weight than the other people. They also had a slightly more favorable lipid profile (i.e. higher HDL levels lower triglyceride levels) but elevated LDL levels compared to the other diets.5

A few things to note:

  • I think it is hilarious that earlier in his post Taubes criticizes the Red Meat Consumption and Mortality study because he claims “they use questionnaires that are notoriously fallible” to collect dietary information.6 Meanwhile he praises this “A to Z” study for its design without mentioning that the authors use telephone-administered dietary recalls, which are not bad per se but chosen mainly for their efficiency rather than robustness.
  • One could make an argument that simply giving people some instruction on the diets in the beginning and then coming back in a year to measure outcomes is not the best study design. For example, many nutrition labs in the Fred Hutch (including mine) will actually provide all of the meals to be eaten during the study free of charge. This accomplishes a couple things: 1) It increases compliance with the diet7 and 2) It allows the researchers to strictly control the calories, vitamins, fat content, etc. I don’t think the above study was a poor design, but there are stronger (albeit more costly and time-consuming) feeding designs one could use when studying diet.
  • I was not surprised that the Atkins group lost more weight. There are actually good and interesting reasons for why low-carb diets are very effective in that area, but I won’t get into that now. What did surprise me at first was that the Atkins group had lower triglyceride levels. But then I remembered that weight loss in general will produce that effect, especially if subjects are overweight at baseline. If the other diets produced as much weight loss as Atkins I would expect a similar reduction of triglycerides.8
  • This study uses exclusively disease-free, non-diabetic, non-pregnant or lactating (etc…9) overweight and obese premenopausal women, so to extrapolate these results and suggest that the general population would be healthier if they adopted this diet is certainly dubious.
  • This is a diet study that examines carbohydrates and weight loss and lipid profiles after 12 months. The Red Meat Consumption and Mortality study in question deals with red meat and cancer, CVD, and other mortalities after 28 years. The former does not and cannot refute the latter. They are almost unrelated. You can eat meat three times a day and have the bulk of your calories come from carbohydrates. You can be a vegan that eats a ton of fat and protein but very few carbs. They are not mutually exclusive.

Stunning Hypocrisy

Now you may be thinking that this is a guy who simply demands the highest levels of evidence. Sure Taubes may miss out on a ton of great knowledge obtained from epi studies but the man takes a hard line on evidence. He will only accept findings from human randomized controlled trials and you can’t fault him for that.

Except that he doesn’t.

If you take a look at some of Taubes’s other posts you will see he makes other controversial claims that run contrary to mainstream science.10 In other posts he conveniently uses epi studies to bolster his narrative while impugning the RCTs that run contrary to his point.

Some examples of this are his posts on sodium. He cherry-picks cohort studies and case-control studies as evidence that the sodium-hypertension link is one big hoax. He even cites ecological and cross-sectional studies which are among the least substantial types of studies not just in epidemiology but in all of science (they would be blue or green-ish on the above pyramid), and he misrepresents their results to claim that sodium does not cause hypertension. Cross-sectional and ecological studies literally cannot show causation; they are not designed to do so.

Meanwhile, Taubes tries to downplay one of the strongest and most-lauded RCTs on the subject (The DASH trials) saying that blood pressure change was only “modestly lower.” If you call nearly a ten-point decrease in blood pressure by only manipulating sodium intake11 “modest” then sure. I suppose I can’t argue with such vague wording.*  He also says that while the researchers measured blood pressure, they failed to measure other things such as lifespan. Big deal, right? Let’s just forget about that stupid study that completely contradicts me. He says basically the same thing about the Cochrane reviews that do not support his position on the subject. Sure the reviews state that cutting back on salt will lower blood pressure, but it doesn’t prove that cutting back will make you live longer so who cares, amiright? By the way, Cochrane reviews are at the very tip of the aforementioned evidence pyramid.

At least he doesn’t sink to the level of anecdotal evidence and personal testimony to prove a point. I take that back; he does:

All I knew was that I had played high school football in suburban Maryland, sweating profusely through double sessions in the swamplike 90-degree days of August. Without salt pills, I couldn’t make it through a two-hour practice; I couldn’t walk across the parking lot afterward without cramping.

You know what? Of all the evidence on the subject that story of Taubes in high school is the smoking gun we have all been waiting for, so I take it all back. You were right all along Taubes. Go collect your Nobel Prize. You have earned it, my friend.


In Conclusion

Mr. Taubes takes the position that red meat does not contribute to cancer or CVD mortality.  He took this position without any evidence from RCTs since, as he said, they have never been done.12 Moreover, he claims that any epidemiological evidence against his position is meaningless because the epidemiology field itself is meaningless.13 The only evidence Mr. Taubes is willing to accept are those of RCTs which are nearly impossible when it comes to things like diet and cancer mortality. So Mr. Taubes has set things up to where he cannot be proven wrong even if he is wrong.

You know what? I can do that, too! I contend that parachutes are not beneficial and life-saving when it comes to falling out of the sky. Prove me wrong. Oh and you can’t point to instances where groups of people have jumped out of an airplane and the parachute has slowed their velocity toward earth allowing a safe landing while those who had a malfunctioning parachute or no parachute at all suffered major trauma or death. Those would have to be either cohort or case-control studies and therefore meaningless. There have been zero RCTs studying the effect of parachutes and gravitational challenge.14 The basis for parachute use is purely observational, and its apparent efficacy could potentially be explained by a “healthy cohort” effect. My contention stands!

If Mr. Taubes had any intellectual consistency he would have to agree with that point. At best he would have to remain neutral on parachutes, since there are no RCTs to prove they do anything.

Some Additional Nit-Picky Stuff

Nutritionists and public health authorities have gone off the rails in their advice about what constitutes a healthy diet.

Wow, that’s painting with a pretty broad brush now isn’t it? It’s like saying “Government bureaucrats are wrong.” Much like government bureaucrats there are quite a few “nutritionists and public health authorities” in the world and they hold a variety of positions on a variety of topics. You mind picking one, telling me what it is, and why it is wrong? Or do you just want to construct a straw man that grossly misrepresents what a few people may or may not be saying so you can more easily refute it?

Are you talking about the advice of dietitians? What specific piece of advice do you object to? Do you have a problem with the following statement that I took off the AND website: “A well-balanced diet filled with whole grains, fruits, vegetables, healthy fats, low-fat dairy and lean protein is important for health and wellness.” Is that advice “off the rails”? Here’s a statement I copy-pasted from “Limit the amount of foods and beverages with added sugars your kids eat and drink.” Is this bad advice? If so, why?

I first wrote about the pseudoscience of epidemiology in Science back in 1995, “Epidemiology Faces It’s Limits”[sic]… my Science article has since been cited by over 400 articles in the peer-reviewed medical literature…

Over 400 citations? Wow! Congratulations Mr. Taubes. You should be proud of yourself. Although I’m confused as to why you put that bit of self-aggrandizement in your post. Is it to imply that because your article has so many citations your thesis (Epidemiology is a bogus science) is correct? If citations = truth then I’m afraid that Willett (the villain in your narrative) is right and you are wrong. Why? Because Willett has actually published far more papers than you have, many of which have well over 1500 citations each. Furthermore, Willett’s papers are actual peer-reviewed scientific studies as opposed to simply lay commentary.

One last (petty) thing.

I’m writing this post with a little more haste than is my wont.

What are you doing Taubes? How about you quit pretending to be an 18th century British aristocrat and start acting like a 21st century American, you pretentious windbag. You are not Christopher Hitchens. Knock it off.

Way down at the bottom of the blog post Taubes admits a correction to an earlier version of the post. Evidently he instructed Dr. Willett to go read a chapter in a textbook titled Modern Epidemiology and learn how the “best epidemiologists” conduct real research. As it turns out Dr. Willett actually wrote the chapter in question. I won’t add any commentary here. Just let that bit of delicious schadenfreude wash over you like a warm bath.

*EDIT: This sentence originally said “more than ten-point decrease.” As it was pointed out to me by a commenter the more than 10 point decrease in blood pressure was between a low-sodium DASH diet compared to a typical high sodium diet. The data where ONLY sodium is manipulated resulted in decreases of 6-7 points.

  1. Pan A, PhD, Sun Q, MD, ScD, Bernstein AM, MD, ScD, et al. (2012) Red Meat Consumption and Mortality Results from 2 Prospective Cohort Studies. Arch Intern Med. 172(7):555-563.
  2. The number of studies published by Willett is currently at 1279 according to Pub Med
  3. WCRF/AICR (2007) Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global perspective. Second Expert Report. London, UK: World Cancer Research Fund; 280-288
  4. From the article: “The results were adjusted for age (continuous); body mass index (calculated as weight in kilograms divided by height in meters squared) category (<23.0, 23.0-24.9, 25.0-29.9, 30.0-34.9, or ≥35); alcohol consumption (0, 0.1-4.9, 5.0-29.9, ≥30.0 g/d in men; 0, 0.1-4.9, 5.0-14.9, or ≥15.0 g/d in women); physical activity level (<3.0, 3.0-8.9, 9.0-17.9, 18.0-26.9, or ≥27.0 hours of metabolic equivalent tasks per week); smoking status (never, past, or current [1-14, 15-24, or ≥25 cigarettes per day]); race (white or nonwhite); menopausal status and hormone use in women (premenopausal, postmenopausal never users, postmenopausal past users, or postmenopausal current users); family history of diabetes mellitus, myocardial infarction, or cancer; history of diabetes mellitus, hypertension, or hypercholesterolemia; and intakes of total energy, whole grains, fruits, and vegetables, all in quintiles.)”
  5. Gardner CD, Kiazand A, Alhassan S, et al. (2007) Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women the A to Z Weight Loss Study: a Randomized Trial. JAMA. 297(9):969-977.
  6. By the way the food frequency questionnaires used in Red Meat Consumption and Mortality as well as many other studies certainly have their limitations. No one disputes that. But they have been repeatedly verified for validity and reproducibility in many other studies, especially when looking at overall dietary patterns.
  7. something that the authors of this study were concerned with by stating: “limitations included the lack of a valid and comparable assessment of individual adherence to the 4 different diets”
  8. In fact the authors mentioned exactly that: “[T]he trajectories of weight change between 6 and 12 months suggest that longer follow-up would likely have resulted in progressively diminished group differences.”
  9. “Women were excluded if they self-reported hypertension (except for those whose blood pressure was stable using antihypertension medications); type 1 or 2 diabetes mellitus; heart, renal, or liver disease; cancer or active neoplasms; hyperthyroidism unless treated and under control; any medication use known to affect weight/energy expenditure; alcohol intake of at least 3 drinks/d; or pregnancy, lactation, no menstrual period in the previous 12 months, or plans to become pregnant within the next year”
  10. Omigosh! I did not see that coming (/sarcasm)
  11. Sacks FM, Svetkey LP, Vollmer WM, et al. (2001) Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 344:3-10.
  12. and in this author’s estimation won’t be done in our lifetimes, if at all
  13. unless we’re talking about smoking, of course
  14. Smith GC, Pell JP. (2003) Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ. 20;327(7429):1459-61.

Tom Naughton is a Fat Head

Link to the episode [mp3]

There is an amazing amount of misinformation in the world today. Some of it is unintentional and is simply repeated so often people assume it’s true. These are misconceptions or myths such as you only use 10% of your brain or Jesus was born on December 25th.1 However, there is other misinformation in the world that is more sinister. Misinformation of this sort is usually designed to manipulate you into buying a product, or it could be used as propaganda to convert you to a certain belief system.2 Unfortunately we are a trusting species and most of this manipulation works surprisingly well! That’s why the less scrupulous among us have used quack medicine and scams and cons to get rich quick at the expense of the more trusting among us.

I don’t consider Fat Head to be on the level of a scam, but it is filled with quite a bit of misinformation, manipulation, and disingenuous statements. In fact, most of the “experts” involved with this film have a vested interest their version of reality being true. That is to say, if you end up believing the main thrust of the movie then they can directly profit off that belief by selling you their books, supplements, DVDs, etc.

Why do I care so much about what other people believe? Usually I don’t. If Scientologists want to form a club of celebrities that believe in stuff like thetans and Xenu and engrams and other such nonsense I could not care less. Go nuts, I say. Other things, however, don’t sit well with me. I don’t exactly know why, but if it’s demonstrably false it really gets under my skin… especially if it is in my field of education and training.

Let’s get to the actual meat and potatoes of the movie, shall we? If I had to sum up the thesis of this movie it would be this: There is a large conspiracy in this country and it involves the media, scientists, the government, and non-governmental organizations. You should eat more meat because it’s actually really good for you; anyone that says otherwise is either brainwashed or in the pocket of Big Vegetable. Vegetarians are radical nutjobs. I hate the government. I hate Morgan Spurlock. Do you think I am exaggerating this? You must not have seen the movie. It breaks down like this: You know those studies that claim cholesterol and saturated fat are bad for you? Well it turns out they are all bogus. Every. Single. One. There was a dude named Ancel Keys some years ago that published a fake study linking cholesterol to heart disease. Then every other research scientist ever decided to piggyback off of his data and published studies that showed the same link even though it was false.3 Why would they do this?? Because the government said to. Yeah, see we actually live in a fascist state where you can’t get any funding for research unless you promise to publish more fake studies that promote eating more fruits and vegetables. Why would the government do such a thing? I dunno, maybe Del Monte bought all the politicians. Did I mention I hate our government? I really do. I’m not a big fan of Morgan Spurlock or CSPI, either.

It just cannot be believed by any rational, thinking person. There is a conspiracy against the public to make us unhealthy? Why? Just because the government hates us? First of all can you imagine the effort needed to carry this out? Picture 99% of all the scientists and medical doctors being involved, plus all (or at least most) of the US government. That would be some X-Files level operation right there, and we’re just scratching the surface! What about other countries? They also have research scientists. What do their studies show? As it turns out essentially every study around the world supports the FACT that circulating levels of cholesterol and intake of saturated fat play a huge role in atherosclerosis. So there goes that little conspiracy theory, unless you want to go even further and claim it’s not just a US conspiracy but a global conspiracy!!!

Meet the Experts

Michael and Mary Eades

According to their own website, they appear to be kind of a husband and wife team that both received MDs from the University of Arkansas. Now I respect anyone that has the brains and patience to get a medical degree. No doubt they take time and an incredible discipline. I will say, though, that the University of Arkansas is not exactly Harvard Medical School or Johns Hopkins University. In fact it’s as pretty far from them as you can go while still remaining an accredited medical school. All things being equal I’d rather take medical and/or dietary advice from someone that went to a more elite university rather than one located in the Ozarks. Also, I looked for any published studies by the aforementioned doctors Eades and was able to only find one that was co-authored by a Dr. Loren Cordain of my old alma mater Colorado State University. It’s nothing ground-breaking, just a review article detailing why you don’t want a ton of circulating insulin in your blood. Why do I bother to bring this up? The Eadeses style themselves as nutrition experts but have only been involved in authoring one review article back in 2003. This makes me skeptical of their claims about being nutrition experts and their pursuit of “research into metabolic and nutritional medicine,” as they put it on their website. What is a review article? Basically  it’s a summary of one particular area of research. That means there are not any actual scientific experiments conducted on the part of the author(s).

If you visit their website you will notice that they also sell several pop diet books that promote low-carb diets, so I don’t know if they are exactly a source of objective and unbiased information. Remember what I said earlier about a vested interest? Whaddya know! You can also buy a ton of nutritional supplements from them, too. Who would have thought? You can also get something called Metabosol for $209.95. If you are too pressed for cash not to worry, they have a “value pack” of Metabosol for $149.00. I’m sure they would tell you it’s a steal at that price.4

Al Sears

Dr. Sears is also a MD who got his degree at the University of South Florida, according to his website. Remember when I said that the University of Arkansas is about as far from Johns Hopkins as you can get? I lied. It’s actually the University of South Florida. Dr. Sears also sells a myriad of books including one that claims the sun will actually prevent cancer! He will also sell you a metric shit-ton of supplements. Seriously  a BOATLOAD. Everything from anti-aging to detox to plastic bio-shields. What are bio-shields?* They protect you from your own cell phone, of course. I’ll let the good doctor explain:

This new breakthrough, which is nearly invisible, neutralizes the waves that come out of your cell phone.

It doesn’t try to block them, weaken them, or deflect them.

It simply turns them into natural waves… waves that don’t cook your head.

By sending out small pulses of energy, it changes the wave pattern your cell phone sends out, neutralizing the heating effect.

But of course, it doesn’t interfere with your cell phone reception. You don’t even notice this is happening.

What’s the secret?

Natural electro-magnetic fields of energy.

Now that’s just good science. I don’t think this shield even takes batteries to send out the small pulses of energy – that’s how advanced it is. It’s yours for the low, low price of $59.95 plus shipping. I really need to get into this racket of selling “wellness” products. Seriously. I bet he makes a killing.

As an aside I was unable to unearth any peer-reviewed publications by this nutrition expert. If you have any feel free to send them my way.

Eric Oliver

Here’s a guy who got his PhD from UC Berkeley and is now a professor at the University of Chicago. Those are some serious credentials. Only thing is he got his doctorate in political science and now teaches political science. He has absolutely no education or training in the nutritional sciences, or any field of biology for that matter, at least according to his CV. I would not mind grabbing a beer with this guy and talking politics, but if I made a doc about nutrition I would not put him in as an expert. But hey, that’s just me.

Mary Enig

Finally we have an expert who has actually been involved in scientific experiments and has published articles in actual scientific journals! No joke. I can’t believe it.

Sally A. Fallon

I really don’t know what she is doing in this movie either. She has degrees in English and is the president of this organization called the Weston A. Price Foundation. We are never told what it is in the movie or why we might want to hold this foundation in any kind of esteem. Some simple Googling can remedy any ignorance, though. Evidently it is a bit of a fringe group that promotes high animal fat, high animal protein, low-vegetable diets. In addition to meat they also promote raw milk and… something… oh yeah homeopathy!!  They claim to be against fluoridation as well. Oh, but CSPI are the real radicals, right? Because they push for nutrition labeling. Whatever. Quackwatch has some info about the foundation’s namesake, and as far as I know Quackwatch is unimpeachable.

Jacob Sullum

Who is this asshat and why do I care what he says? Oh, he’s a professional libertarian and writes for a magazine that no one has heard of. A perfect addition to the panel of experts.

Tom Naughton

The filmmaker himself. According to the bio on his website he was going to be a doctor but was not a fan of science so he did something else. He puts it like this:

After two years of pre-med, Tom switched to a self-directed major called “Random Courses That Do Not Involve Studying Organic Chemistry.” By creating his own major, Tom enjoyed the rare distinction of graduating at the top and bottom of his class simultaneously. His valedictorian speech was very short, as he was the only one in attendance.

Oh Tom you’re such a card! Did he drop out of school? Major in something else? We do not know. But apparently he went on to try his hand at freelance writing, and then he tried to make it big in Hollywood as an actor on sitcoms. During the filming of Fat Head he seems to be employed as a computer programmer of some sort. C++? Python? HTML? It is unclear. What is clear (if his bio is even partially true) is the he likes the limelight more than he likes science, and he is going to lecture you about the etiology of heart disease5 because a) he read a pop science book once, and b) he wants to be on the silver screen.

He also seems to spend quite a lot of time blogging. The last time I visited his personal blog he had published the 14th iteration of an email debate he was having with one of his “leftist friends.” After giving that post a cursory glance I discovered two things: 1) Naughton thinks these email debates are so riveting that the world must see them, and 2) Naughton thinks he knows more about economics than a Nobel laureate and professor of economics at Princeton.

I almost forgot! Naughton sells homemade T-shirts, too.

You can pick one of these beauties up on his website if you have a PayPal account. Looks like they were freshly plucked off the racks at a Paris fashion boutique, amiright?

It appears that the bulk of Fat Head ideology comes from a book called Good Calories, Bad Calories by a guy named Gary Taubes. Mr. Taubes holds degrees in applied physics from Ivy League universities. That’s pretty impressive! However, Taubes has about as much authority expatiating on nutrition as I would have expatiating on string theory, which is to say none. Alrightythen, picture this if you will:  I have taken absolutely zero classes on any kind of physics. I have no education on such matters beyond reading Richard Feynman’s autobiography. Yet I decide to write a book about how everything we have been taught about Einstein’s mass-energy equivalency was wrong. I’ll go tour the country lecturing for no less than $5,000 per appearance and say “Hey guys, Einstein was wrong! Really. There is no link between the mass of an object and its energy content. It’s all a big hoax perpetuated by stupid scientists and the media. I did some Googling one night and unraveled the hell out of it. E=MC2 is the greatest lie of our generation. My book is on sale in the back. I accept cash, Visa, and MasterCard.”

The Actual Science

Although it is exceedingly easy with this panel of experts, I don’t want to engage exclusively in ad hominem attacks.

Modern humans (defined as Homo Sapiens) have not been around for millions of years like the filmmaker claims. Conservative estimates have placed the origins of humanity at about 100,000 years ago. More liberal estimates say we arose 250,000 years ago. I’ve even seen reports of up to 400,000 years, but I know of no legitimate anthropologist that would claim that humans have been around for millions of years. Why would I nitpick about something so seemingly insignificant? If someone is going to tell you what you should and shouldn’t eat based on what he/she assumes the first humans ate, yet are off on the origins of humanity by orders of magnitude then I would ask “Why should I trust their interpretations of the actual diet and its supposed benefits?”

Which brings me to another thing: Where did they get their information on the diets of early humans? I certainly did not see or hear any evidence that supported their version of a Paleolithic diet. Just assertion from the “experts” that for millions of years humans ate almost exclusively saturated animal fat.

The facts: Every nutrition professor I ever had – in addition to any literature I have read on the topic6, 7, 8, 9, 10, 11 – has stated that early humans subsisted on a diet of mainly foliage and seeds with periodic access to meat and a good amount of this meat was in the form of fish. There are of course debates on exactly how much saturated fat and unsaturated fat and fiber and total calories and cholesterol and what-have-you were in the diet of early humans or human ancestors. It’s difficult to come to a definitive number in terms of grams of any particular macro or micronutrient. To be honest it is probably quite variable, depending on which particular ecological niche of East Africa you want to study. However, the preponderance of evidence points toward a diet that was highly diverse, more total calories than we consume today (probably due to the fact that they were way more physically active than we are today), very high in fiber, included both terrestrial meat and seafood, included a lot of foliage, and included seeds, pulses, legumes, and tubers. In any case I can tell you what the “Paleolithic” diet DID NOT include, and that’s fried chicken, hamburgers, butter, French fries, and basically everything you see Naughton eating in the movie.

A Note on Diets and the Lipid Profile

A couple of things to note: both exercise and weight loss significantly affect cholesterol levels. In the film Naughton mentions that he walks in his spare time for a bit of exercise, but I don’t think he ever mentions how much. However, Naughton is interviewed by Jimmy Moore on his Livin’ La Vida Low Carb podcast shortly after the film’s release and (if memory serves) says he walked 15-20 miles per week while filming his documentary. This exercise alone could have caused the modest improvements in his lipid profile, especially if he was more-or-less sedentary prior to filming.

Moreover, although Naughton claims in the beginning of the film that the whole calories-in-calories-burned paradigm for weight loss is a “load of balogna,” if you look at his dietary records you’ll notice that he keeps his daily calorie intake below 2000 kcals/day on most days. Now I don’t know much about Mr. Naughton, but I know quite a bit about my own caloric needs. I’ve performed just about every physiology/metabolic analysis available to me over the years (from DEXA scans, glucose clamps, REE, respiratory quotient, Harris-Benedict, indirect calorimetry, etc, etc…) and I require about 3000-3500 kcals/day for zero wight loss or weight gain. I am almost certainly taller than Naughton (I’m 6’6″) and probably slightly more active as well, but I imagine that both our caloric needs are not too dissimilar. At the risk of spoon-feeding you the obvious conclusion here (pardon the pun): this effectively ensured weight loss during his pseudo Super Size Me diet.

Speaking of the Super Size Me diet, if you have seen both films you will notice that despite what Mr Naughton would have you believe the diets are in fact quite different from each other, and therefore not comparable. For instance, if you look at Naughton’s food record he doesn’t eat buns, he doesn’t drink sodas (unless they are diet), and eats fries only 3 out of the 28 days (Spurlock goes 30 or 31 days I think, but that’s not too important). If you have seen Super Size Me you will notice this is very contrary to what Spurlock ate and drank. Moreover, towards the end of Super Size Me you may also recall that Spurlock devotes a fair amount of screen time pointing out that it wasn’t the Big Macs and burgers that caused his weight gain and subsequent health problems, but in fact the sugary sodas and the fries that were mostly to blame. This would have helped Naughton make his carbs-are-bad point, but instead Naughton decides to shit all over Super Size Me and call Spurlock a liar.

Naughton also does a bonus fat-binge diet toward the end of his movie. He does not tell us what his daily caloric intake is during the month of his fat binge, but if it’s near his previous month and his energy requirements are in the neighborhood of 2500 kcals/day then he is definitely losing weight during his binge. Like I said earlier this will also beneficially affect his lipid profile.

Now what about his diet? You can also manipulate your cholesterol levels via the diet. Most notably, saturated fatty acids can lead to an increase in LDL, HDL, and of course total cholesterol, but not all saturated fatty acids do this. Even though he makes the argument in the film that vegetable oils are bad for you, the coconut oil that you see him adding to his food is one such example of a saturated fat that has a neutral effect on cholesterol because of how it is packaged and transported through the blood vessels. Eggs also don’t have a huge effect on cholesterol. The steak and the cheese and the cream, sure. But clearly that was not enough to override his exercise and weight loss.

Something To Think About

Let’s pretend for a moment that all these nutrition “experts” are right. That early humans and/or human ancestors had a diet consisting of ridiculous amounts of fat.  Just nothing but animal protein and animal fat with nary a vegetable or a grain passing their lips. Just imagine that humans were the ultimate carnivorous predator on the African savannah, so much so that lions would shit themselves and gallop away at the sight of us. Can you imagine it? Okay good. Now dig this vibe: that would have absolutely no bearing on whether such a diet would be healthy. That’s right. As my philosophy friends might say “you cannot derive an ought from an is” (although in this case it would be a was).

More facts: It is claimed in the film that early humans were taller. This is untrue. Here’s a recent graph of European height over the past few decades.12

As you can see it’s a steady growth. But what about really early humans? Maybe we (or our ancestors) used to be really tall, then we got short, and now we’re getting tall again. Okay let’s look at the skeletal remains of Australopithecus, shall we? Lucy was 3 ft 7 in tall for Christ’s sake! Incredibly short. You’ve seen that Evolution of Man image, right? Did any of those proto-humans look taller than the human? Nein.

In the podcast I mentioned some studies that refuted the claim by Fallon that “corn oil was a disaster” and that beef tallow prevented cancer (in rodents anyway).13, 14, 15 I made a sincere attempt to find any studies that backed up her claim. The best I could find was a study claiming there was not much difference in rodents fed high amounts of beef fat and rodents fed high amounts of corn oil regarding tumor incidence. Although that same study stated that rodent populations that were fed low-fat diets had markedly less carcinogenesis than their high-fat counterparts, which would undermine the claims of “more fat is better for you.” If anyone can find links or PDFs of those studies she’s talking about please send them to me. I don’t have any kind of religious devotion to any particular diet, and I will go where the evidence leads me.**

Even More Facts

Remember in the film when Naughton mentioned Dr. Kilmer McCully as token proof of the global conspiracy about heart disease because Dr. McCully had a theory about what might cause heart disease and it wasn’t cholesterol and he allegedly got fired for it but Naughton never mentions what the theory was? Do you also recall in the podcast episode when I say that it is deliciously ironic what Dr. McCully’s theory actually was because it turned out to be hyperhomocysteinemia which is caused by too much animal protein and not enough B vitamins, something even the good doctor himself called “[animal] protein intoxication”? Great! Here’s the New York Times article that I plucked the information from if you wanted to read it for yourself.

The rest of my critique of this awful, awful movie is in the podcast. I would still like to know about any federal mandate stating that kids cannot walk to school and must take the bus instead. Please inform me so I can write a strongly worded letter to the Obama administration about how I vehemently disagree with such a federal mandate. Then I’ll write a second letter to Mr. Naughton thanking him for bringing this travesty to the attention of the public. Or maybe that little tidbit was just some Grade A bullshit that was utilized to rile up the audience in favor of his libertarian cause against the nanny state.

Fun Facts

The Paleo Diet was recently ranked dead last in the US News & World Report Best Diets. Here are the experts that reviewed all the diets. What do they know anyway, with their fancy Ivy League degrees and RD accreditations from the Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association)? It’s all a big hoax anyway.

I also found a section in a nutrition textbook focusing on low-carb diets. Instead of linking to several photocopied pages I am just posting a table summarizing the current science regarding this trend.16

Bonus Picture

Here is a graph showing global web traffic of “paleo diet.”

As you can see it is growing almost exponentially. However, I imagine that around 2015 or maybe sooner the novelty will wear off just like the Atkins diet and it will be just another blip in the history of fad diets.

*It appears as if the good Dr. Sears has since removed the Bio-Shields from his catalog. You can see it archived on the wayback machine and here. Nevertheless, he is still hawking ridiculous stuff at absurdly high prices. For instance he is selling 2 anti-aging DVDs for $199.00! Please tell me no one has actually spent two hundred dollars on that. Please?

**EDIT: I think I may have found the study she was talking about. It seems like a strange study, but I’ll try to summarize it as best I can. So apparently the researchers were investigating the effects of conjugate linoleic acid (CLA, a polyunsaturated fatty acid) that has been shown in other studies to have anticarcinogenic properties with rodents. They fed all mice high fat diets, but the diets differed in fat composition. The experimental diets were a vegetable fat blend, a vegetable fat blend + CLA, a vegetable fat blend + CLA + beef tallow, a vegetable fat blend + corn oil, and a vegetable fat blend + corn oil + CLA. After four weeks they took the rodents and injected them with tumor cells in the mammary area and the tail.  Then they sacrificed the mice and measured tumors. Evidently they got some data on the tumors showing no significant differences between the diets but declined to include that data in the study (the authors mentioned this). However, they were able to find that if 0.05% CLA was added to the diets the vegetable fat blend + beef tallow diet showed a significant decrease in “lung tumor burden” over the other diets. Furthermore, if you were to add 0.1% CLA to the diets then the vegetable fat blend only and the vegetable fat blend + beef tallow diet showed a significant decrease in “lung tumor burden.” Do you see what I mean about being strange? I was tempted to wonder why one would conduct such an odd study…. Then I saw it. Did you see it, too? At the bottom of the first page:

Funded by beef and veal producers and importers through their $1-per-head checkoff and was produced for the Cattlemen’s beef board and state beef councils by the National Cattlemen’s Beef Association

It doesn’t mean that the study is exactly bogus, but it suggests that there were probably quite a few of these studies done with the NCBA actively looking for any hint that beef might be sort of almost healthy so they could take the findings and trumpet them to the skies. So…. There you go. Proof that under the exact right circumstances a little bit of beef tallow can be slightly chemopreventive in rodents.

  1. You should take an hour or two to peruse the Wikipedia page on common misconceptions if you haven’t already. It will blow your mind. I guarantee you believe at least one thing in that list that is patently false.
  2. although the ultimate goal there is likely financial anyway
  3. except for the handful of scientists that agree with us – they are brave, brave souls
  4. Looks like a glorified multivitamin to me, though.
  5. among other diseases he never studied
  6. Kay RF. Dental Evidence for the Diet of Australopithecus. Ann. Rev. Anthropol. 14, 315-41 (1985)
  7. Broadhurst CL, et al. Brain-specific lipids from marine, lacustrine, or terrestrial food resources: potential impact on early African Homo sapiens. Comparative Biochemistry and Physiology Part B 131, 653–673 (2002)
  8. Hockett B and Haws J. Nutritional Ecology and Diachronic Trends in Paleolithic Diet and Health. Evolutionary Anthropology 12, 211–216 (2003)
  9. Marean CW, et al. Early human use of marine resources and pigment in South Africa during the Middle Pleistocene. Nature 449, 905-909  (2007)
  10. Konner M and Eaton SB. Paleolithic Nutrition. Nutr Clin Pract 25, 594-602 (2010)
  11. Don’t pay any attention to these studies, of course, or any other studies for that matter because we all know the researchers are in cahoots with Big Soy. Unless they show something that might be interpreted as pro-meat or pro-saturated fat, in which case those researchers should be heralded as torchbearers of truth and light.
  12. Taken from this study: McEvoy BP and Visscher PM. Genetics of human height. Economics and Human Biology 7, 294–306 (2009)
  13. Morei T, et al. Beef Tallow, but Not Perilla or Corn Oil, Promotion of Rat Prostate and Intestinal Carcinogenesis by 3,22-Dimethyl-4-aminobiphenyl. Jpn. J. Cancer Res 92, 1026–1033 (2001)
  14. You can read the rest of them yourself here and here because they are not available online, or at least not at my institution of higher learning. I personally scanned them. You’re welcome.
  15. This one is not about cancer, but it’s still pertinent to this discussion: Shimomura Y, et al. Less Body Fat Accumulation in Rats Fed a Safflower Oil Diet Than in Rats Fed a Beef Tallow Diet. J Nutr. 11, 1291-1296 (1990)
  16. Sizer F and Whitney E. (2007) Nutrition: Concepts and Controversies, 11th Edition. Brooks Cole, pp 342. Here is the context if you reeeeeally wanna see it.