NuSI, NuSI ... What to make of NuSI
|Boy Wonder Attia has called off his|
war on insulin, but his character lives on
Well Gary Taubes and Peter Attia -- or, if there was ever a time to refer to them by their superhero Asylum names, Fatman and Glucagon -- have launched their project, NuSI, the Nutritional Science Initiative.
Finally! Some real proper science will get done, free from the stranglehold of bias inherent in the evil entanglements of government and industry -- oh, and idiot scientists operating with suboptimal intelligence..
Why any scientist would even apply for a grant from an organization headed by a man with such disdain for them is really beyond me, but ...
Well on to NuSI. It's mission -- to fix science, to do it "right", yada yada. To finally answer that burning question -- was Dr. Atkins right all along? (Oh wait, that's been answered ...) It should come as no surprise that yours truly has basically no hope for this venture other than providing material to blog on from time to time - grin.
NuSI can cloak their mission any way they like, its sole purpose is to fund studies to support TWICHOO. Gary Taubes is incapable of directly addressing the fatal flaws in his alternate hypothesis, or do I need to remind folks just how many proverbial teeth had to be pulled and whatnot to get Taubes to admit -- never in writing! -- that the lynch pin of his hypothesis was not as he claimed. I'm talking about glucose-3-phosphate, aka alphaglycerol phosphate. That "interesting argument" Taubes put forth in GCBC and every single lecture until some bunny eared annoyance came along and forced his hand. That "interesting argument" he wanted so badly to keep in WWGF, but ultimately had to leave on the cutting room floor. The notion that you couldn't store fat without dietary carb. Remember that one?
Just a few more details are necessary to understand why we get fat. The first is that the amount of glycerol phosphate available to the fat cells to accumulate fat—to bind the fatty acids together into triglycerides and lock them into the adipose tissue—also depends directly on the carbohydrates in the diet. Dietary glucose is the primary source of glycerol phosphate. The more carbohydrates consumed, the more glycerol phosphate available, and so the more fat can accumulate. For this reason alone, it may be impossible to store excess body fat without at least some carbohydrates in the diet and without the ongoing metabolism of these dietary carbohydrates to provide glucose and the necessary glycerol phosphate.
“It may be stated categorically,” the University of Wisconsin endocrinologist Edgar Gordon wrote in JAMA in 1963, “that the storage of fat, and therefore the production and maintenance of obesity, cannot take place unless glucose is being metabolized. Since glucose cannot be used by most tissues without the presence of insulin, it also may be stated categorically that obesity is impossible in the absence of adequate tissue concentrations of insulin…. Thus an abundant supply of carbohydrate food exerts a powerful influence in directing the stream of glucose metabolism into lipogenesis, whereas a relatively low carbohydrate intake tends to minimize the storage of fat.”
The science -- good science -- some from the very references cited in GCBC -- had already been done that refuted Gordon's simplistic proclamation of almost 50 years ago. That should be the end of the story, but Gary soldiers on. BTW, anyone besides me see the inherent problem with slamming modern science while relying on relatively ancient science from long before we had the ability to accurately measure the vast majority of things we can today?
But let's take Stephan Guyenet's optimistic view and presume that NuSI is just going to operate as a funding mechanism that will only influence matters on the level of picking and choosing which impeccably designed studies to fund. What would such studies look like?
Let's look at NuSI's smear of existing science.
Point 1. Studies are free living:
Among the list of studies that are presumably "bad science" in NuSI's eyes, we find Shai et.al. 2008. Sound familiar? Shai is *the* study that Taubes formulated TWICHOO 2.0 out of when he was forced to drop the G3P schtick. I suppose free living studies are bad science until some hack science journalist comes along and "analyzes" two-thirds of the data to support his version of science? Taubes uses this "bad science" in his lectures still ... I blogged on this here and here, for those newer readers who are unaware of my greatest sin of spelling his name with a $.
True, there are inherent flaws in free living studies. Haven't we been pointing this out all along? Makes no nevermind to those constructing lists of studies that supposedly demonstrate LC diets are superior. And Taubes' likes to cite science when it's convenient to him ... oh does he like to cite it!
Point 2. Studies are Small and Short:
True, many metabolic ward studies are too small or too short to have sufficient statistical power or demonstrate an effect. But most of these studies are crossover types where the subjects act as their own controls in different phases. Making their list of such flawed studies is Young et.al. 1971, and while it gets mentioned later, Grey & Kipnis, also 1971, was not included. I'll address that in a future post.
"Because of the lack of statistical power with such a small sample size, and because of the inability to measure fat loss specifically over such short durations, these studies were unable to detect the modest differences in fat loss that may have been present during the study, or attenuated with a longer study or a greater sample."
I find it interesting that NuSI is calling some of the studies most heralded by TWICHOOB's inferior science. The sacred Kekwick & Pawan? Say it ain't so!
OK ... I have additional commentary on the remaining points in their review of the literature. But let's cut to the chase on just these two points. NuSI is characterizing existing science as inferior. Their mission is to improve the quality of the science. Given the two talking points above -- both valid short-comings of existing science -- what exactly is NuSI proposing to do to revolutionize science? The points they make are simply pointing out the problems that practicality bring into such studies in humans. Most studies are free living because of cost and practicality. The cost to house and monitor subjects 24/7 for any length of time is prohibitive. Thus metabolic ward studies do tend to be smaller and shorter than one might desire.
So what exactly do they propose to do to fix this? Are they planning on funding year long metabolic ward studies on 35+ subjects per group? That's what would need to be done and hope to at least have groups of 30 remaining at the end. The cost of ONE such study would be enormous ... which is why it hasn't been done. And imagine what sort of pathetic lying cheating dregs of society one might expect to participate in such a study (I'm channeling Dr. Eades here, who in his "debate" with Anthony Colpo resorted to characterizing metabolic ward study subjects in an unfavorable light, implying that those studies is where the real cheating goes on ... well before he totally spun out and resorted to insensible water weight losses).
Any reasonable person understands why such studies probably won't ever be done, even if NuSI can amass a small fortune to divvy out to scientists. They are impractical and darned near impossible. That larger existing studies tend to be free-living, and existing metabolic ward studies tend to be small and short in duration is NOT the fault of the scientists. These are just limitations they must acknowledge and work within. Some do a better job than others of making the best of both worlds. The recent Ebbeling et.al. study comes to mind, where they went to great expense and detail to do a semi-ward study with all foods provided, food diaries, etc. Unfortunately not all of this data was reported.
But we've discussed here, and innumerable other bloggers have discussed elsewhere, literally thousands of studies where true "bad science" was done. Bad science is not working within one's means and acknowledging the limitations of interpreting one's outcomes.
Bad (nutritional/obesity/etc.) science IS:
- No control group
- No randomizing
- Ignoring wide disparities in dropout rates
- Failure to collect critical data
- Failure to address body composition
- Failure to make significant efforts to ensure compliance and assess compliance
- Failure to control for obvious confounders (e.g. protein, calories)
- Failure to quantify and/or address instrument/measurement error
- Study designs where bias is evident (e.g. it is obvious the design was to elicit the result)
- Drawing conclusions that are not supported by the results
- Statistical tampering
- Distorted graphs and figures
- Incomplete reporting of data, even in supplemental materials
- etc. ...
I see NOTHING to indicate that NuSI is interested in improving the quality of existing science. Somehow "philanthropic funding" will magically fix the problems. I don't see how. Speaking of philanthropy, that "non-profit" label is misleading -- the organization may not be in the profit making business, but you can be damned sure many of its officers and even minions are well compensated for their "good deeds". One reason to look forward to September in my area is that I will no longer be bothered by college kids with clipboards showing up at my door to get me to sign some idiotic petition or another for the non-profit group they are paid by. I have it down to 30 seconds to dismiss them, but every now and then I like to toy with them and pretend I'm the naive middle aged housewife they assume I am. Hummana huh manna ... you want me to explain my cause rather than reciting the talking points they are paying me up to $20/hr to memorize and regurgitate? (I know the rates, I see the flyers on the bulletin boards each Spring). These same students would be lucky to make that working a "real job" at a for-profit business in their field of study, and actually working a relatively unskilled job? Minimum wage. It will be interesting to see just how philanthropic NuSI really is ...
I'll address the rest of their points of contention with existing science in a future post.