Thoughts on the Proposed Nutritional Label Changes

The announcement for updating the labeling of nutritional info came out a little while ago, and there was some discussion in social media, etc.  But I thought I'd make a few comments here on the blog.  

So here are the current and proposed labels:

I think the new labeling would be a definite improvement, but I think we can do better.  

To Bean or Not To Bean ... Why is That Even a Question?

True confession:  I ate beef in a stew last night and I'm in that dangerous age range for doing so according to the latest study that came out.  Finally, a study the paleo community can finally agree on about and rally around!  Paleo for the win!  If you don't know what I'm talking about, you can get a dose of sanity here.

But before mass media hysteria gifted the paleo community with the great unifier -- another meat is bad study -- it was all up in arms over another media circus:  Paleo on the Dr. Oz show!!

That was truly an odd spectacle.  There you had Paleoista, Nell Stephenson, who in her own practice and through her blogging is about as puritanical "paleo" as one could imagine, and Chris Kresser, someone who was at best loosely associated with paleo, but almost from the get-go seemed to be "beyond paleo".

Bull(sh)it Poop Cough-kee

Oh my lordie, last night I went to bed feeling like I had just spent the day in some alternate land of Woo Woo.  I was puttering about the house doing chores most of the day, checking in on the laptop (more than I should have!) from time to time in between.  Every corner I turned it seemed mangled science, marketing schtick and woo woo popped up like some hydra monster determined to relegate me to Grain Brain status. 

And then I awoke this morning to find this in my Facebook newsfeed.  It's a link to Dave Asprey's article in some online BeMore magazine article.  You'll want to type 33 in the top middle to go to the article.  I think we need a new award for cramming the most scientific crapola into the fewest number of words or something.  This guy would win, along with scam artist of the year.   Since I'm way under the weather today, let me take a few moments of convalescence to address this shiz.

Lessons from Diet RCTs II: Randomizing, Blinding, and perhaps even Controlling, is Futile

You hear it all the time -- the randomized controlled trial is the "gold standard" for clinical research.  Unfortunately, just because something is an RCT doesn't make it a good study, not by a long shot.  I blogged recently calling for an end to diet comparison RCTs because I don't believe this model is productive in identifying what a healthful non-obesigenic diet is for humans.  All of the foods that have been blamed have been around for far longer than this problem has, so, frankly it really isn't the food.  There's no magical macronutrient ratio, no superfoods that will impart you with superhuman powers, and no foods that are inherently fattening or slimming ... even butter and celery, but please no buttered celery.

The Optimal Diet for Type 2 Diabetes

Now that I have your attention ...

Guess what?  There is no single optimal diet to treat/manage the disease.  I don't often do short bookmarking posts here much anymore, but I thought this paper that I found down a PubMed rabbit hole the other day was worthy of more than just a link in the library.  

Is there an optimal diet for patients with type 2 diabetes? Yes, the one that works for them!

Most importantly there is evidence that adherence to any given dietary approach is more important than the macronutrient prescription. So the best diet for those with type 2 diabetes is the one that works for them, and critically the one that they can maintain in the long term.

How many times, tucked somewhere in the discussion of the latest diet comparison clinical trial, or mumbled by the researcher in the press conference, have we heard that in the end, adherence was the single best predictor of whatever-the-heck-health-weight-measure-improvements regardless of assigned intervention.

The Paleo Fad-Wagon Rolls On!

Chris Kresser got in with the right publisher!  How else do you get quite such a book tour and to present "paleo" when up relatively recently you didn't even call yourself that?   But there he was on Monday, the latest to make that always-panned-as-pseudosci-hype-unless-you-get-on-it show:  Doctor Oz.  When the paleo diet last made the "big time" it was with Paleoista Nell Stephenson and capital T, The Paleo Diet® author Loren Cordain PhD Exercise Science.   I blogged on that previously.  

Now, anyone who has ever skimmed more than two blog posts of Paleoista knows that Nell is one of the remaining few hard core purists.  She has taken to calling this True Paleo, or as she said on the first episode:

... there are no inflammatory foods so there is no dairy, no grains, no legumes, no refined sugars. 

She again went on the Oz show with her "Cheater Plan" whereby you eat strict paleo per this screenshot compilation.   But if you're good on that, you get 3 cheat meals a week!

Calorie Needs & Expenditure

Hello all!

Just a quick follow on post to my previous one on caloric needs inspired by a recent diet comparison RCT.  

In comments there, Yoni Freedhoff of Weighty Matters blog (and author of the new book The Diet Fix: Why Diets Fail and How to Make Yours Work) made the following comment:

The Journal of the American Dietetic Association (I believe) once had a study looking at all of the various calculators (not including Hall's) and it crowned the Mifflin-St Jeor the best as compared with indirect calorimetry results.

Lessons from Diet RCTs I: Calories

Researchers in Sweden have just published the results of a two year dietary intervention involving obese postmenopausal women.   The results and implementation leave much to be desired in terms of providing any useful information vis a vis the diets tested.  I blogged on this HERE.  But if one looks past the diet comparisons, I believe there is some useful information to be had.  I would like to highlight this in this post and however many more I have the time for or choose to break it up into.  

The study began with 70 mildly obese women as assessed by BMI.  Here's the tabulation:

Rules for Diet Advocacy and Clinical Trials

1. Get the full text of the study and at least skim it

(hint: start with the tables and graphs in the results section, then work your way back through the methods, etc.)  before taking to social media or your blog to tout it.   Don't have access?  Here are my tips to get it:

1. First check if it is free.  Sometimes it is!  NO excuses there!  
2. Use scholar.google.com to search on the title.  Look in the column on the right  See that [PDF]?  Click on that link ... someone is already sharing it.
3. Ask the person who Tweeted, messaged, blogged, etc. for it.
4. Ask a friend who might have access.  (I have an extensive network at this point.  Cultivate your own, but if you consider me a friend and I you, well ... you know the drill).
5. Email the corresponding author and ask.  It will usually land in your Inbox shortly.  I reserve this as a last resort because I don't want to take up researchers' time, but the few times I have done this have been fruitful.

2.  If Using a Clinical Trial to Promote the Diet You Advocate:

• Make sure the diet implemented is the diet you actually advocate
• Make sure the subjects followed the diet
• Make sure the results are worth mentioning

3. If Using a Clinical Trial to Criticize a Diet You Oppose:

• Make sure the diet implemented is the diet you actually oppose
• Make sure the subjects followed the diet
• Make sure the results are worth mentioning

That is all.

The Rise & Fall of Soy & Gluten in the Low Carb World

Random Bump & Flashback!

Because someone just asked me about this Eco-Atkins vegan vs. Ovo-lacto vegetarian study on Twitter:  

Effect of a 6-month vegan low-carbohydrate (‘Eco-Atkins’) diet on cardiovascular risk factors and body weight in hyperlipidaemic adults: a randomised controlled trial

Pretty much all of the paleo, WAPF and Weizen Wampe dick und krank demon foods included!!  Veggie oils ... check!   Gluten ... check!   Soy ... check and check!   Heck, even 21 Day Sugar Detox no nos ... those sugar habit triggering cashews!  

As with the previous metabolic study, participants were encouraged to eat only 60% of their estimated caloric requirements in order to continue the body weight reduction started on their metabolic phase.38–40 The prescribed test diet was a low-carbohydrate vegan diet containing 26% of calories from carbohydrate, 31% of calories from vegetable proteins and 43% from fat (primarily vegetable oils).