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Tuesday, 24 November 2015

My rant about David Katz's double identity and the meaning of consensus.

(I posted the first part of this rant on this RetractionWatch post but the moderator seems to have decided that it doesn't meet their policy. Fair enough as I find it hard to be restrained about such nonsense.)

I don’t care that David Katz wrote the fake review. Fiction about fiction, all very meta.
What I do care about is the Big Lie he repeats in his defenses – that those criticizing the dietary guidelines and the DGAC process “are the very group employing every means at their disposal to scuttle dietary guidance dedicated to public (and planetary) health to serve their own pecuniary interests”.
This is the paranoid underside to the grandiose self-image that Katz displayed in the reviews. Those critiquing the guidelines have few pecuniary interests and I would be surprised if any of them are as wealthy as Dr Katz. That Dr Katz sees fit to call them for “want of qualifications” begs a question – why is it that PHD students, engineers, psychologists, cell biologists, hard-working journalists, and auto-didacts can see and point-out glaring omissions and bias in the way the DGAC selects and interprets evidence, yet someone like Dr Katz, with enough letters after his name to write another novel, refuses to see them? (Indeed, why, with all these qualifications, did Dr Katz get involved with pseudocience in his practice?).
Katz, the CSPI, and the DGAC committee themselves have brought great guns to bear to find a few minor inaccuracies in Nina Teicholz’ long analysis, none of which seem to affect the conclusions. Yet nowhere do we see them addressing the countless accuracies, which surely need to be addressed if the DGAC is to recover its credibility.
Whatever the DGAC may end up recommending in the near future, it will be different from what they currently recommend, meaning that the current recommendations are not supported by current science. If the science is this labile, why were such far-reaching recommendations being made at all? Why not stick to the basics of nutrition – eat foods rich in vitamins and minerals, not refined foods – get enough protein and essential fats, preferably from natural protein-and-fat foods rather than refined foods or grains – and be aware that diabetes and obesity usually indicate an intolerance to carbohydrates, especially refined ones. These are choices that will improve or maintain health in the present. Theories about what will reduce this or that disease at the end of our lives, based on interventions that do not reduce mortality, should never have been allowed to distort nutritional advice.
Nor should unproven theories about what is best for the planet. Someone who wants what is best for the planet won’t tell us to remove the fat from meat and not cook with animal fat – this advice wastes most of the energy produced by raising animals, which then needs to be replaced with energy derived from growing additional plants. In the case of the unsaturated fat energy these experts are so keen on, these nutritionally unnecessary plants need to be processed in an environmentally damaging and industrially hazardous way.
This inane suggestion comes from people who claim to be dedicated to planetary health (another grandiose Sci Fi claim when you think about it). Surely it would be better to leave the effect of diet on planetary health aside until it can be addressed by someone with more information, better sense, and no other axe to grind.

This is why I do not accept the notion of consensus peddled by Katz, Hu, Willett and others after their recent Oldways celebration. It fails to address any of the inconsistencies in the advice given by most of the attendees. In the case of Paleo expert Boyd Eaton's presentation, it is plainly compromise rather than consensus that is being offered. No doubt this is the price Paleo needs to pay to enter the elite plant-based bullshit club, but the idea of "fat-free" dairy replacing whole meat in a future-paleo menu suggests the price is too high, and not even consonant with mainstream nutritional research in the present day.

Perhaps what sticks in the craw most is the call for the media to avoid reporting research with fear-mongering headlines that contradict each other. This is priceless when one of the signatories is Walter Willett, who feeds this stuff to media outlets verbatim.
But not always.

It is really the question of context that bedevils compromise consensus. However you interpret the evidence for phytochemicals, there are people who don't tolerate plants all that well but have no problem with meat. You may think that it's the saturated fat in pizza that makes it artery-clogging, but saturated fat seems to make no difference to metabolic profiles when carbs are restricted (if anything, it makes them non-significantly better). And when you're supplying advice to a population with a high rate of carbohydrate intolerance, you need to take the relative metabolic superiority of fat into account, yet there was no-one at Oldways speaking for LCHF. Saturated fat and whole-grains are the shibboleths, and you still can't enter the hallowed precincts if you can't pronounce their "artery-clogging" and "healthy" prefixes. 

I'm sure there is plenty of room for agreement between all of us - absolutely no-one here thinks that commercially processed food, frequent deep-frying, and a high content of added sugars are a good idea. But people need to eat, and used to cook meals based on meat, eggs, animal fats, and dairy which were easy to prepare using knowledge handed down in families. A media campaign that painted those foods as killers for decades is one factor behind a tragic and damaging decline in basic cooking abillity and increased reliance on a well-and-truly depraved food industry. Industry can place products with added fibre or low in saturated fat as "healthy" with the backing of epidemiological nutritionists, and sell the alternatives as "treats" which are fine in moderation as part of a balanced diet according to the dietitians. With what results we see.

And, seriously, you want to fix this by feeding Americans (and by extension, the English-speaking world) a watered-down but still costly Mediterranean diet, when there are other foods their grandparents ate which will do the job equally as well?

Everyone in nutrition is influenced, more-or-less unscientifically, by their own dietary choices or those of their culture. On the one hand we have a clique of mandarins who were "born on second base and think that they've hit a home run" with regard to diet and metabolic health. On the other hand we have people such as Tim Noakes, on trial for his opinions as I write, who have overcome metabolic disadvantages with the help of diets that have included the prohibited elements. By any objective test, the second narrative should be the more convincing, but perhaps not in a society that worships unearned success. It is obvious enough that the selection and appreciation of evidence in the DGAC process is distorted by unthinking acceptance of the first narrative. We owe a real debt to Nina Teicholz for bringing this out to be debated in the public domain.

What is the right thing to do when this happens? To blame it on "t
he very group employing every means at their disposal to scuttle dietary guidance dedicated to public (and planetary) health to serve their own pecuniary interests”? To call in the sponsors, circle the wagons, and manufacture consensus for the media? 

Or to hold a full and frank investigation into the reasons for the debacle, one which includes the evidence gathered by those who don't think your conduct of operations has met a satisfactory standard?


tess said...

Bravo, George! Well-written indeed!

Elliot Feldman said...

Great article, "the elite plant-based bullshit club" lol. I think Dr. Katz is a vegan or vegetarian which in my mind means he is defending himself not nutritional science. It's very difficult for someone who is in the public's eye to go against something that they are committed to themselves and publically announced. Otherwise it would be like saying, there'e something stupid about myself. I don't see Dr. Katz or Greggor changing their opinion.

Galina L. said...

I especially appreciate your emphasis on the waste of such nutritious component of our food as animal fat as the result of modern dietary guidelines. Supposedly deadly fat just gets trimmed from a meat by a butcher in stores and goes directly into a garbage while environmental activists on all levels whine about resources of mother Earth being wasted on a meat production.
Speaking about independence, Dr.Katz receives substantial financing from government agencies -
"A of October 2014, the Yale-Griffin Prevention Research Center (PRC), based at Griffin Hospital in Derby and affiliated with Yale University’s School of Public Health, will begin a new 5-year cycle of funding from the Centers for Disease Control and Prevention (CDC). For this upcoming 5-year cycle, the CDC has awarded continued funding to 26 of the existing 37 PRCs across the United States."

Puddleg said...

Generally, if someone gets funding from Coca Cola or the Atkins foundation, people feel free to disregard what they come up with. I think this is wrong - there is no Santa Claus handing out money for research and wanting nothing in return. Researchers have always need to go cap-in-hand to those likely to fund them. Louis Newburgh received funding from John Harvey Kellogg and discovered the superiority of the very low carb, high fat diet for diabetes.
However - the CDC seem wedded to the idea that less than 7% SFA is ideal, and it doesn't surprise me that they choose to support someone who is likely to agree with that and not look too hard for contradictions. A Government body will find it harder to change direction than an individual or a business.

I'm curious to know what research Katz himself does as I find it very hard to pin down his exact research findings from his plethoric public statements. Or, for that matter, his diet. Except that he likes plants. Good for him.

Larcana said...

Thanks for the rant. I agree. I keep hoping that evidence will outlay monetary intrusions, but as you pointed out research is costly and comes with a price tag that makes one beholding to the check writer. We will have to press on with our voices.
Plant based diets may work for a few, very few. Those arguing that it is more natural are disregarding the very fact that animals are here with us and are part of the food chain. Like it or not. Plants are here to "get us by" until we find fat and protein to power our bodies.

Galina L. said...

A science used to be an expensive hobby for rich and educated individuals. Times changed. Nowadays a research needs a funding. I just thought that Dr.Katz was not in a position to present himself as an independent researcher with a steady stream of financing coming from US government which is being renewed every 5 years.
I think a current diet advice worships plants too much at the expense of a normal human food. Such advice is very unpractical and creates an unrealistic expectation for a general population. People are advised to pay a lot of money for a food which doesn't keep them satiated, contains very little nutrition (but rich in a new class of important nutrients as mysterious antioxidants), spoils quickly, gets rejected by children. I think most families with a tight budget and several children would be better off not buying fancy vegetables like kale or a purple cauliflower at all, and spending more of their money on a non-lean meat, eggs, butter.

Puddleg said...

That's a good point Galina. Even if the Yale PRC does good independent work with the CDC funding, it is fronted by a highly political scientist (in some sense of the word, probably) who will not present contradictory findings to the media. In terms of prevention, which relies on propagation, that means the work need not have been done at all.
Katz is big on what he doesn't say - that is, he never addresses confounding variables. The conceit is that these have all, or the important ones, been adjusted for, but this is always a bogus claim. In your second paragraph, we have the confounding variables of class, income, and nutritional adequacy. Adjusting for these is very sketchy indeed. and adjusting for exposure to industrial or environmental toxins and air pollution, other than smoking, is just unknown in nutritional epidemiology. Similarly with adverse life events that have major associations with disease, such as violence and neglect. Not a whisper.
This is where RCTs are more reliable, you can randomise these things. RCTs give very little support to the myth of plants over animals.

Galina L. said...

My guess - drinking a very expensive wine should be correlated with a better health for the same reason as eating "your rainbow", caviar could be proven by observational studies to be a healthy food. A good education is correlated with a better health as well - there are a lot of confounding variables here too. When people do not straggle to make ends meet, their life gets better in many ways.