Is it Possible? "Smarter Science" worse than "Good" Science Journalism?

I'm really disgusted folks.  I'm sorry, but I get a whole heckuhlot of criticism for checking the references of one Gary Taubes.  I must be some obsessed, hermit crab stalker type to spend my time and a few dollars to actually look into what he says his references say, vs. what they actually say.  Nah, rather that I just accept what he says at face value.  Taubes' misuse of the Pima as an example of his carbs-make-you-fat-and-diabetic garbage is one where you don't even need to try to understand the science.  He flat out misrepresents this "poster population" for his hypothesis to have people believe their's was a lower carbohydrate diet back when.  But, in fact, it was far higher in carbohydrate than the SAD, to the tune of 80+%.  Still ... no program has approved GCBC for their curricula to the best of my knowledge.

Well, Jonathan Bailor is giving The Master a run for his money when it comes to misinterpreting/misrepresenting studies in his Smarter Science of Slim book.  Only since Taubes explicitly avoided modern peer review research, while Bailor likens his "research" to meta-analysis of same, Bailor is far more insidious.  Even as a "review" of the research it is turning out to be horribly misleading and inaccurate time and again.  How then did this happen?

Endorsed by the world-wide scientific community including top doctors at the Harvard Medical School, Johns Hopkins, and UCLA, and approved as curriculum for registered dieticians (RDs) by the Academy of Nutrition and Dietetics

I've already discussed how his highlighted study -- comparing his "Smarter" eat-more-move-less approach to the conventional ELMM "Harder" plan -- distorted the truth.  The Smarter group ate less and moved more than at baseline (albeit moved less than the conventional cardio group), and ate comparable calories to the Harder group.  Not to mention their diet was low fat (20%) and 40% each carb and protein.  But now in a guest post on Mark's Daily Apple, Bailor has highlighted another study he misrepresents.  He writes:

... My research confirms this by digging into the endocrine and neurological signals of the metabolic regulatory system that control how much we eat, how many calories we burn, and how much body fat we store. It also shows that when we “eat poisonous things,” this system gets clogged up and begins to regulate us around a higher set-point weight. Thus, long-term fat loss has nothing to do with counting calories and everything to do with restoring our body’s natural ability to regulate our weight appropriately.

Consider a study done at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona. Researchers examined both heavy and thin people to see how their metabolism behaved when they were given no calories. As expected, everyone’s system slowed down and everyone burned body fat, but here’s the kicker: Thin people burned off nearly 50% more body fat than heavy people.

Think about that for a second. Despite having more body fat, the heavy people burned less body fat. In the words of the researchers, “Obese patients could not take advantage of their most abundant fat fuel sources but have to depend on the efficient use of…the breakdown products of body protein [muscle].”

The heavy people needed to burn body fat, but did not burn body fat effectively. This is just one of many clinical examples of losing our natural ability to regulate weight appropriately. The researchers put the problem like this: “Profound metabolic disturbances exist in the obese state that constantly interfere with normal hormonal responses [the ability to burn body fat].”

Now it sounds like the St. Joseph's study was a weight loss study, right?  Where they fasted a bunch of obese and lean people for several days at least to ascertain how they partitioned which tissues they catabolized as they lost weight.   Well, not really so much.  This study is:  Obesity and the metabolic response to severe multiple trauma in man.  Severe multiple trauma??  

Abstract:

In the obese state profound metabolic disturbances exist and it is not known how this disrupted metabolism in obese subjects (body mass index > 30) may change their ability to respond to the superimposed, injury-induced stress. Understanding the mechanisms that modify the metabolic parameters in traumatized obese patients is essential in their nutritional assessment and further treatment. We have investigated in 7 obese and 10 nonobese multiple trauma patients, on a whole-body level, the energy metabolism, protein kinetics, and lipolysis in the early catabolic "flow phase" of severe injury when they were receiving maintenance fluids without calories or nitrogen. Traumatized obese patients mobilized relatively more protein and less fat compared with nonobese subjects. A relative block both in lipolysis and fat oxidation is experienced by injured obese patients that results in a shift to preferential use of proteins and carbohydrates. Reduced endogenous protein synthetic efficiency observed in obese patients implies increased protein recycling. Thus obese patients could not effectively use their most abundant fat fuel sources and have to depend on other fuel sources. The nutritional management of obese trauma victims should therefore be tailored towards provision of enough glucose calories to spare protein.

Discussion:

Major features of the posttraumatic response include enhanced metabolic rate, accelerated net protein breakdown, alterations of lipid and carbohydrate metabolism with associated changes in hormonal environment. The magnitude of these metabolic responses depends partly on the severity of injury and partly on the preinjury status of the patient.  .... Mobilization of protein sources is apparently accelerated mainly to provide substrates for the synthesis of glucose in the obese trauma victim.

C'mon!  Yes, this is interesting and of importance of treating obese victims of traumatic injury.  Given their dependence on carbohydrate in the post-trauma state, glucose is recommended as a supplement to prevent excessive protein breakdown.  But for Bailor to extrapolate this study -- subjects 2-4 days post traumatic injury, stabilized on non-caloric fluids and on ventilators --  and even insinuate it is somehow relevant to long term significant weight loss is deceptive.  For what reason??  To convince obese people that if they eat less they'll just break down their muscles anyway?   I would note that he's so into the "eating less slows your metabolism" meme he apparently makes up that all subjects metabolisms slowed, despite the blue highlighted statement (above) that leads off the Discussion section of the paper.  

He's even a bit more misleading, IMO, in the book (pardon the repetition).

More importantly, the need to burn body fat does not mean body fat is burned. If you are clogged, the need to burn body fat is not enough. Your fat metabolism system does not have the ability to burn body fat, and you do not burn body fat efficiently. From researcher J.M. Friedman at the Rockefeller University: “The implication is that something metabolically different about [overweight] individuals results in obesity independent of their caloric intake.” [22] Consider a study done at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona. Researchers examined both heavy and thin people to see how their fat metabolism systems behaved when they were given no calories. As expected, everyone’s system slowed down. Because these people were on zero-calorie diets, everyone burned body fat, but here’s the kicker. Thin people burned off nearly 50% more body fat than heavy people.{22}[23] 

same graphic 

Think about that for a second. Despite having more body fat, the heavy people burned less body fat.  In the words of the researchers, “…obese patients could not take advantage of their most abundant fat fuel sources but have to depend on the efficient use of…the breakdown products of body protein [muscle].”{23} [23] 

That finding is depressing. The heavy people burned what relatively little muscle tissue they had rather than burning the excess body fat they were drowning in. They needed to burn body fat, but did not burn body fat effectively. This is where the idea of a clog comes into play. The researchers put the problem like this: “Profound metabolic disturbances [clogs] exist in the obese state that constantly interfere with normal hormonal responses [the ability to burn body fat].” [23]  As long as you and I are clogged, our ability to burn body fat will be severely compromised.{24} 

Note the blue numbers in {} are how Bailor references this portion of his text.  The red [ ] are how it should be referenced.  What is reference 24?  As he does quite often, it's is a number of references presented as follows:    {24} A sampling of supporting research:

- Goldberg M, Gordon E. Energy Metabolism In Human Obesity. Plasma Free Fatty Acid, Glucose, And Glycerol Response To Epinephrine. JAMA. 1964 Aug 24;189:616-23. PubMed PMID: 14162576.

- E.A. Newsholme and C. Start. Regulation of Metabolism. 173 ISBN: 0471635308

- Frayn, K. N. Metabolic Regulation: a Human Perspective. London: Portland, 1996. Print.

Note to Bailor:   textbooks are not "research".  I have both of these books, not because they are easy to come by, or up-to-date seminal texts, but because they are cited by Taubes in GCBC.  What ... not even a chapter number, let alone page numbers?   When I learned how to reference term papers in junior high school, they were pretty specific that you provide page numbers (this was back before different electronic versions can make it almost impossible depending on the format, so in this day and age chapters may be more practical).  To assert that these two books support his "clog" theories is absurd on its face.  I'm going to go out on a limb here and guess that Bailor has never even seen a copy of Newsholme & Start.  And what's with referencing the 1996 version of Frayn's book in a 2012 publication?  Frayn came out with an updated version in 2010.  Why not just cite GCBC?

As to Goldberg and Gordon (you can download full PDF at that link):  1964!  This is almost half a century old.  This is anyone's idea of "thorough research", how?  

ABNORMALLY HIGH fasting levels of plasma free fatty acids (FFA) and decreased responsiveness of this lipid fraction to various lipolytic stimuli in obese humans and animals have now been documented by several investigators.1-5 Whether such alterations in FFA metabolism relate to obesity as cause or effect, however, remains speculative.

We have previously reported the failure of the plasma FFA to rise significantly during periods of prolonged fasting in certain patients with longstanding, therapeutically resistant obesity.1 In contrast, a normal FFA response to fasting has been observed in patients whose obesity seems clearly the result of compulsive overeating.

In the present investigation, the plasma FFA response to the more potent lipid-mobilizing action of epinephrine is compared in obese subjects and normal weight controls in two separate experiments: an initial study in which plasma FFA and glucose levels were determined before and 30 minutes after epinephrine administration, and a subsequent (cut off here)

This study also looked at the response to epinephrine, although there is some evidence presented that obese respond to mobilizing fatty acids when needed more poorly in general.    But here I thought insulin was the bad guy in the hormonal clog?!   I ask again:  How does something like this get accepted for use in RD training?  Tis interesting that in 1964 they were still asking a lot of questions -- the presumed answers to which one might find in the four plus decades of peer reviewed inquiry into.  One such ambiguity caught my eye (wonder why - grin):

The finding of an abnormally elevated FFA/glycerol molar ratio therefore suggests either a relative inability to oxidize FFA at the peripheral level, or alternately, failure to re-esterify FFA due to insufficient supplies of a-glycerophosphate.

The sort of misrepresentations Bailor makes undermine his credibility.  A little later in the book he states emphatically (under a quote from the evil anti-Taubes George Bray)

Eating less does not create the need to burn body fat. It creates the need for the body to slow down.  Contrary to popular opinion, the body hangs on to body fat. Instead, it burns muscle tissue, and that worsens the clog problem. Only as a last resort, if the body has no other option, it may also burn a bit of body fat.{48}

Now, there are actually 14 separate papers in reference 48, which represent again a "sampling of the research" ...  Bailor has gone out of his way to obscure his sources and employed another Taubesian tactic:  List lots of references, hope readers confuse quantity with thoroughness or exhaustive or comprehensive research, make it difficult/time consuming for anyone to fact check.  This is NOT an academic work, but it is being lauded as one.

Why does the body hang on to body fat and burn muscle? To answer that question, let’s look at it another way. What does our fat metabolism system want more of when it thinks we are starving?  Stored energy. What is a great source of stored energy? Body fat. So when our fat metabolism system thinks we are starving, does it want to get rid of or hold on to body fat? It wants to hold on. Next, what does our fat metabolism system want less of when we are starving?  It wants less tissue which burns a lot of calories. What type of tissue burns a lot of calories? Muscle tissue. So when our fat metabolism system thinks we are starving, it gets rid of calorie-hungry muscle tissue.   Studies show that up to 70% of the weight lost while eating less comes from burning muscle—not body fat.{49}

Reference 49 is another dozen studies --  well including yet another text, this time the 1966 3rd Edition of the classic Textbook of Medical Physiology by Guyton.  I've not seen anywhere near 70% lean losses in any of the hundreds of studies I've actually read where body composition was examined.  Ahh, but speaking of Guyton, I'm looking at page 905 of my 6th Edition from my college days and wondering why someone who was probably born around the time of publication (1981) would be citing a 1966 edition.  This tells me he just gathered citations, but didn't actually read any of them.  The graph at right is from p. 874 of the 2006 11th Edition ... seems our intrepid researcher never read Guyton?   It's the exact graphic from my 1981 hardcopy, just snazzed up a bit (in mine it's Figure 73-2).  

I'm sorry, this just compounds my disillusion with what passes for "science-based" nutritional advice.  Forget that Bailor's plan is hardly the "mild ketosis" "fat burning beast" schtick Mark Sisson has revamped his franchise into selling.  Why, WHy, WHY do these people need to resort to this shit?  Shit it is and I won't hold my tongue.

I plan to do at least one more installment on Jonathan Bailor's mangling of science for fun and profit, because he resurrects the whole G3P and fat and insulin crap, and this is just unacceptable in this day and age.  It's one thing for a science journalist to cling with his fingernails to a failed hypothesis that should never have been, it's quite another for a young up-and-comer to put forth this GARBAGE as scientific proof and "fact".