RA Guest Blog: Review of “The Science and Politics of How Nutrition Got It Wrong on Fat and Cholesterol” with Nina Teicholz

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Last week, DiSH RA Emma Schopp attended a talk called “The Science and Politics of How Nutrition Got It Wrong on Fat and Cholesterol” with investigative journalist Nina Teicholz and host Dr. Aaron Blaisdell of the UCLA Psychology Department. Here’s what Emma had to say about the talk:

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Last Wednesday, investigative journalist Nina Teicholz visited UCLA to give a talk about the politics and science that led to the villainization of fat by public health officials, as discussed in her controversial book, The Big Fat Surprise. As I am very interested in public health and the multitude of effects that food can have, I was excited to hear directly from someone who had delved so deeply into the research, policy, and history of this field.

Teicholz did not disappoint, providing a fascinating history of the creation and implementation of national nutritional guidelines that entirely contradict current research. She described the actions of politicians and scientists, like Ancel Keyes, who, amidst panic over rising rates of heart disease in the 1950s, was able to convince leaders at the American Heart Association that saturated fats and cholesterol led to heart disease. Although his hypothesis was backed only by biased, correlational studies such as the Seven Countries Study, his conclusions led to the first ever dietary guidelines released by the USDA in 1980, which advised a diet low in fat and coincided with the beginning of a sharp increase in obesity rates in the US, which we are still experiencing today.

Teicholz explained that these guidelines had widespread effects, such as determining the food served in the military (an organization which today has an enormous obesity issue), changing the available food supply to comply with new “healthy” demands, and embedding into the minds of Americans that fat is unhealthy, despite experimental evidence to the contrary, such as the 1960s Minnesota Coronary Heart Study. This study, and others like it that showed that high fat diets had no detrimental effects, were ignored and buried by the scientists and leaders in nutrition policy, whose views these studies did not support.

Teicholz ended her discussion by sharing some of the information that has been supported by reliable, NIH-funded studies in the past decade, including that saturated fat and cholesterol don’t cause heart disease, low fat diets are ineffective, and that fat does not cause cancer. She discussed some preliminary research supporting the Carbohydrate-Insulin Hypothesis, which posits that increased carbohydrate consumption has led to obesity, possibly because of the way that carbohydrates are metabolized in the body.

Teicholz’s presentation emphasized the importance of ensuring that all fields remain transparent and open to contributors challenging and testing all findings. A strength of the scientific community is its ability to check itself, and to remain impartial and skeptical until enough supporting evidence has supported a hypothesis. By conducting research objectively in the DiSH Lab, we can be confident that our contributions to the field of health psychology are evidence based and will benefit society.

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We’re glad to hear that you enjoyed the talk, Emma!

Stop Using BMI to Determine Health – DiSH research featured in NPR & LA Times!

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Check out the NPR Interview & LA Times articles!

Last week, Dr. T, DiSH Collaborator Jeff Hunger, DiSH Lab Manager Jolene Nguyen-Cuu, and UCLA statistician Christine Wells published a really important paper in the International Journal of Obesity; as it turns out, one of the most common measures of population health, Body Mass Index (BMI), actually misclassifies millions of Americans as unhealthy when they’re not! In many cases, people had healthy measures of blood pressure, insulin resistance, triglycerides, cholesterol, and other factors, but fell into “overweight” or “obese” BMI categories and were therefore classified as “cardiometabolically unhealthy.” On the flip side, many Americans who fell into the “normal” BMI category were actually cardiometabolically unhealthy, even though they were assumed to be healthy based on their BMI.”

In Dr. T’s words: “There are healthy people who could be penalized based on a faulty health measure, while the unhealthy people of normal weight will fly under the radar and won’t get charged more for their health insurance. Employers, policymakers, and insurance companies should focus on actual health markers.”

Of course, BMI is popular because it’s so easy to obtain – all you need is a person’s height and weight! However, Dr. T. argues that getting a more accurate measure of cardiovascular health, like blood pressure, can be easy too, saying “it takes maybe 20 seconds if you have the machine. And so I really think focusing on better health markers like blood pressure is a better way to go about it — particularly when we’re talking about financial penalties.”

To U.S. News, Jeff Hunger explained that “the bigger picture we want to draw from our findings is that the dominant way of thinking about weight — that higher-weight individuals will always be unhealthy — is flawed,” and, that “the general public should try to focus on improving their health behaviors — eating well, staying active and getting enough sleep — and forget about the number on the scale.”

Ultimately, Dr. T emphasized that “we have this laser focus on weight, when this measure of body size doesn’t get under the skin of what healthy markers are. We need to focus on actual health markers, rather than this outdated, very broad measure called BMI.”

This paper has been picked up left & right by the media, check out some of its coverage here!

NPR Interview & Article

Los Angeles Times

Science Daily

U.S. News

UCLA Newsroom

One Size Does Not Fit All -The need for tailoring in obesity treatment

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Researchers from the University of Sheffield once again showed that the too commonly proposed “one-size fits all” paradigm for weight-loss falls short when it comes to providing successful treatment for obesity. The authors of the study observed that obese individuals are currently all treated the same, regardless of how healthy they are, where they live, their behavioral characteristics, and so on. This led them to propose a new approach: dividing the participants into subgroups that would receive tailored treatment according to the group’s characteristics.

The study divided participants who had a BMI of 30 or over into six subgroups: young males who were heavy drinkers, middle aged individuals who were unhappy and anxious, older people who despite living with physical health conditions were happy, younger healthy females, older affluent healthy adults, and individuals with very poor health.

The researchers found that tailored treatment was far more successful in tackling weight loss than the “one-size-fits-all” approach, which again highlights the importance of recognizing individual differences in obesity.

Dr. Green, one of the lead researchers in the study, said: “Policies designed to tackle obesity and encourage healthier lifestyles often target individuals just because they are obese. But a focus on just the group as a whole is not very efficient. We are all different and different health promotion approaches work for different people”.

For those with the poorest health, advise surrounding exercise might not be reasonable, and more modest goals may be needed than in the group of affluent healthy adults. Middle aged adults who were anxious and unhappy benefitted from psychosocial counseling, which would not have made sense to provide to the happy older adults. “Our research showed that those in the groups that we identified are likely to need very different services, and will respond very differently to different health promotion policies,” Dr. Green states.

Read more about how this study suggests tackling obesity here!

Boxing up on obesity -Too much too cheap?

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Recent research from the National Bureau of Economic Research investigating external forces influencing obesity has found that two particular factors that may be highly influential: Big-box stores and the proliferation of restaurants.

In light of the skyrocketing obesity epidemic, much effort has been made in order to reveal some of the external and internal causes of obesity. Plenty of environmental factors have been highlighted, including food deserts and desk jobs. The aim of these four researchers was to analyze as many as possible of these notions in order to identify the sources that seem to have the greatest effect on the rise of obesity.

The researchers examined 27 factors associated with obesity and analyzed them in what they called a “statistical horserace”, meaning that they inspected each element and held everything else constant, such as demographic or economic changes.

Two factors stood out as significant drivers of the obesity epidemic: the rise of big-box stores, like Costco, and the proliferation of restaurants. Interestingly, regular supermarkets actually had a negative effect on the obesity rate, suggesting that the underlying reason is not that food has become more accessible, but that the extremely low prices and large quantities at big-box stores seem to be the underlying factor.

Moreover, the time-efficiency of just stopping by a restaurant in an environment where restaurants are everywhere seems to be highly influential as well.

Courtemanche, one of the researchers, explains that this does not imply food should be more expensive, but rather that this knowledge should be taken into account by governmental policy and nutritional guidelines supporting subsidization of healthy food and taxation of junk food.

The researchers point out that it may be a depressing reality that one of our nation’s most costly problems may actually be partly due to food being too cheap. “We’d all like something to be all good or all bad,” Courtemanche said, “and the reality is that often there are things that are mostly good but have some adverse consequences.”

Read the full article here!

An insider’s peek into the ultra elite IOM meeting on “Solving Obesity”

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On January 7th the Institute of Medicine (IOM) held a roundtable discussion workshop with the topic “The current state of obesity solutions in the United States”. Among the high-level speakers was James Hamblin, the senior editor of The Atlantic, who gave a speech about the role of media in obesity. He reports back an intriguing discussion regarding the pressing issue of obesity interventions, and how the general public’s perception of the root causes of obesity makes this particularly hard.

Three years ago the IOM agreed that the obesity crisis has been pushed by complex environmental circumstances, and called on public awareness to catalyze change. There is plenty of coverage about obesity in the media, but is it the right one? Ultimately, it is the general public’s view of what obesity is that will determine how we go about solving the obesity crisis. In sum, the media might be more inclined to depict obesity as a personal affliction, and a moral and biological failing, rather than a social disease. In fact, recent research from Yale University found that more than two thirds of news stories about overweight people portray them in a “negative and stigmatizing manner”.

Although most people agree that obesity is a serious national problem, only 27% of Republicans (and 87% of Democrats) believe the federal government should intervene to address this issue. Why? Because only 18% of Americans identify external factors such as food deserts, lack of opportunity to play outside and so on, as the primary cause of childhood obesity. Most people blame “overeating” and “watching too much television” and thus think that the best and most effective solutions can only be made by the person himself.

But what if these factors are only symptoms – not causes – of what the real problem is, Hamblin asks? Can you really separate personal choices from structural factors such as community planning, food packaging and marketing, and media stigmatization? Hamblin says that his role as opinion former in the news industry is one of public health as well. In sum, messages from the media are critical for the way people see obesity, and ultimately how they feel about government policies. Read the rest of his argument, as well as some of what other IOM speakers said in his article here.

Dr T says: “If shaming reduced obesity, there would be no fat people”

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Back in December, Daniel Callahan published his piece “Obesity: Chasing an Elusive Epidemic” where he made the controversial suggestion that stigmatization of the overweight/obesity will ease the “obesity epidemic”. As you may know, the DiSH Lab strongly promotes weight acceptance, and much of our current research investigates the detrimental physical and psychological effects of exposure to weight stigma. So Dr. T and Traci Mann (from the University of Minnesota) put together a strong rebuttal to Callahan’s claims in their piece “If shaming reduced obesity, there would be no fat people.” You can read each piece on our publications page, but here are some highlights:

Callahan Says:

“Those who are overweight hardly notice anymore:

it is just the way ordinary people look. We need them to notice.”

Dr. T replies:

“The same survey [that Callahan uses to make this claim] found that

67 percent of the sample described themselves as weighing over

their ideal weight… they are aware of their weight.” Maybe this discrepancy

arises from “people being reluctant to describe themselves as overweight…

consistent with the view that obesity is stigmatized.”

Callahan identifies his solution:

“The most promising strategies, I believe, fall into three categories:

strong and somewhat coercive public health measures, childhood

prevention programs, and social pressure on the overweight.”

Dr. T says:

“If stigmatizing fat people worked, it would have done so by now.

Obese people are already the most openly stigmatized individuals in

our society, with published data showing that weight stigma

is more pervasive and intense than racism, sexism, and other forms of bias.

Weight-based discrimination is one of the few legal forms of

discrimination that remain in America.”

Callahan suggests:

“I would couch the social pressure in the following terms, finding ways

to induce people who are overweight or obese to put some uncomfortable

questions to themselves.” These include questions like: “If you are overweight

or obese, are you pleased with the way you look?” and “Fair or not, do you know

that many people look down upon those excessively overweight or obese,

often in fact discriminating against them and making fun of them…”

Dr. T refutes this suggestion:

DiSH Lab research asked Callahan’s questions to a sample of

overweight and obese individuals and found that 91% said yes to

whether they knew that “many people look down upon those

excessively overweight or obese…” and 88% said they were not

pleased with the way they looked.

Callahan’s justifies these questions:

These questions aim “to make people acutely aware of pervasive

stigmatization, but then to invoke it as a danger to be avoided:

don’t let this happen to you! If you don’t do something about yourself,

that’s what you are in for.”

Dr. T’s Response:

DiSH Lab research asked a randomized sample of 372 individuals

either Callahan’s six questions or a set of neutral questions.

They then saw an array of food and chose any and all foods they

would like to eat in that moment. “Those who answered Callahan’s

questions selected items amounting to a statistically significantly

higher amount of sugar foods… as well as more calories.

This does not bode well for his strategy.”

Callahan claims:

“It will be necessary to make just about everyone strongly

want to avoid being overweight and obese.”

Dr. T cites:

“People already want to avoid being obese more than they want

practically any other thing. In a survey of patients who had lost

one hundred pounds after having gastric bypass surgery,

nearly every patient agreed that he or she would rather be

deaf, blind, have heart disease,or lose a leg than gain

back the weight… They all said they would give up being a

multimillionaire to be normal weight.”

Callahan says:

People who are overweight or obese are “beyond help”.

Dr. T concludes:

“It would be unconscionable for the medical community

to give up on over 200 millions Americans including

2.4 million children. Using the word ‘edgy’ does not disguise

what his cynical and unscientific strategy truly is:

mean-spirited.”

Is Dieting Worth the Trouble?

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Just posted today, Dr. T collaborated with Britt Ahlstrom and Traci Mann on this article in the Huffington Post, “Is Dieting Worth the Trouble?” Their op-ed piece talks about the failure of the recent large dieting study, and what it exactly means for a diet to “succeed” or “fail.”

New formula for weight loss – losing it is twice as hard

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Dr. Kevin Hall presented new findings indicating that the mathematical formula that the US government uses to calculate weight loss doesn’t account for a slow-down in your metabolism. It looks like weight loss is harder than we initially thought. Click here for the paper that describes the new, adjusted guidelines.

Diet books dumped outside of UK Parliament

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In a movement called Ditching Dieting, last month protesters dumped hundreds of dieting books into a toxic waste bin outside the United Kingdom parliament. It’s related with an ongoing parliamentary inquiry into body image in the UK.

Here is the Washington Post’s coverage of the story, and you can find information on Ditching Dieting here.

Mystery Meat, Tater Tots, and Pizza! Oh My!

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Mystery meat, tater tots, pizza, chicken nuggets, and french fries…sound like a familiar menu?  If this rings a bell, you may be no stranger to the standard lunch offered in a typical American school cafeteria.  Potato-rich and nutritionally-poor, these meals continue to be a great source of debate among government officials, nutritionists, and parents, especially given the rising rate of obesity.  In fact, our government is proposing changes to the $11 billion school-lunch program in hopes to reduce childhood obesity.  According to our government, 40 percent of the daily calories consumed by children happens during school lunch periods, so it is no surprise that a third of American children are obese or overweight.  While serving fresh fruits and vegetables seems like a logical answer, some argue that lunch prices would rise only to leave children with meals they simply will not eat.  If you think you have the solution, or would just like to learn more about the issue, click here…