Science, Pseudoscience, Nutritional Epidemiology, and Meat

 

I’m writing this post with a little more haste than is my wont. I’ve received dozens of e-mails asking me to comment on the recent news — ala the the New York Times — that meat-eating apparently causes premature death and disease. So this post is likely to contain more than my usual number of typos, egregious spelling mistakes, grammatical errors, etc. Bear with me. Rather than spend a week rewriting and editing, as I usually do, I’m going to do my best to get this up and out in a few hours.

Back in 2007 when I first published Good Calories, Bad Calories I also wrote a cover story in the New York Times Magazine on the problems with observational epidemiology. The article was called “Do We Really Know What Makes Us Healthy?” and I made the argument that even the better epidemiologists in the world consider this stuff closer to a pseudoscience than a real science. I used as a case study the researchers from the Harvard School of Public Health, led by Walter Willett, who runs the Nurses’ Health Study. In doing so, I wanted to point out one of the main reasons why nutritionists and public health authorities have gone off the rails in their advice about what constitutes a healthy diet. The article itself pointed out that every time in the past that these researchers had claimed that an association observed in their observational trials was a causal relationship, and that causal relationship had then been tested in experiment, the experiment had failed to confirm the causal interpretation — i.e., the folks from Harvard got it wrong. Not most times, but every time. No exception. Their batting average circa 2007, at least, was .000.

Now it’s these very same Harvard researchers — Walter Willett and his colleagues — who have authored this new article claiming that red meat and processed meat consumption is deadly; that eating it regularly raises our risk of dying prematurely and contracting a host of chronic diseases. Zoe Harcombe has done a wonderful job dissecting the paper at her site. I want to talk about the bigger picture (in a less concise way).

This is an issue about science itself and the quality of research done in nutrition. Those of you who have read Good Calories, Bad Calories (The Diet Delusion in the UK) know that in the epilogue I make a point to say that I never used the word scientist to describe the people doing nutrition and obesity research, except in very rare and specific cases. Simply put, I don’t believe these people do science as it needs to be done; it would not be recognized as science by scientists in any functioning discipline.

Science is ultimately about establishing cause and effect. It’s not about guessing. You come up with a hypothesis — force x causes observation y — and then you do your best to prove that it’s wrong. If you can’t, you tentatively accept the possibility that your hypothesis was right. Peter Medawar, the Nobel Laureate immunologist, described this proving-it’s-wrong step as the  ”the critical or rectifying episode in scientific reasoning.” Here’s Karl Popper saying the same thing: “The method of science is the method of bold conjectures and ingenious and severe attempts to refute them.” The bold conjectures, the hypotheses, making the observations that lead to your conjectures… that’s the easy part. The critical or rectifying episode, which is to say, the ingenious and severe attempts to refute your conjectures, is the hard part. Anyone can make a bold conjecture. (Here’s one: space aliens cause heart disease.) Making the observations and crafting them into a hypothesis is easy. Testing them ingeniously and severely to see if they’re right is the rest of the job — say 99 percent of the job of doing science, of being a scientist.

The problem with observational studies like those run by Willett and his colleagues is that they do none of this. That’s why it’s so frustrating. The hard part of science is left out  and they skip straight to the endpoint, insisting that their interpretation of the association is the correct one and we should all change our diets accordingly.

In these observational studies, the epidemiologists establish a cohort of subjects to follow (tens of thousands of nurses and physicians, in this case) and then ask them about what they eat. The fact that they use questionnaires that are notoriously fallible is almost irrelevant here because the rest of the science is so flawed. Then they follow the subjects for decades — 28 years in this case. Now they have a database of diseases, deaths and foods consumed, and they can draw associations between what these people were eating and the diseases and deaths.

The end result is an association. In the latest report, eating a lot of red meat and processed meat is associated with premature death and increased risk of chronic disease. That’s what they observed in the cohorts — the observation.  The subjects who ate the most meat (the top quintile) had a 20 percent greater risk of dying over the course of the study than the subjects who ate the least meat (the bottom quintile). This association then generates a hypothesis, which is why these associations used to be known as “hypothesis-generating data” (before Willett and his colleagues and others like them decided they got tired of their hypotheses being shot down by experiments and they’d skip this step). Because of the association that we’ve observed, so this thinking goes, we now hypothesize that eating red meat and particularly processed meat is bad for our health and we will live longer and prosper more if we don’t do it. We hypothesize that the cause of the association we’ve observed is that red and processed meat is unhealthy stuff.

Terrific. We have our bold conjecture. What should we do next?

Well, because this is supposed to be a science, we ask the question whether we can imagine other less newsworthy explanations for the association we’ve observed. What else might cause it? An association by itself contains no causal information. There are an infinite number of associations that are not causally related for every association that is, so the fact of the association itself doesn’t tell us much.

Moreover, this meat-eating association with disease is a tiny association. Tiny. It’s not the 20-fold increased risk of lung cancer that pack-a-day smokers have compared to non-smokers. It’s a 0.2-fold increased risk — 1/100th the size. So with lung cancer we could buy as a society the observation that cigarettes cause lung cancer because it was and remains virtually impossible to imagine what other factor could explain an association so huge and dramatic. Experiments didn’t need to be done to test the hypothesis because, well, the signal was just so big that the epidemiologists of the time could safely believe it was real. And then experiments were, in effect, done anyway. People quit smoking and lung cancer rates came down, or at least I assume they did. (If not, we’re in trouble here.) When I first wrote about the pseudoscience of epidemiology in Science back in 1995,  “Epidemiology Faces It’s Limits”, I noted that very few epidemiologists would ever take seriously an association smaller than a 3- or 4-fold increase in risk. These Harvard people are discussing, and getting an extraordinary amount of media attention, over a 0.2-fold increased risk. (Horn-blowing alert: my Science article has since been cited by over 400 articles in the peer-reviewed medical literature, according to Thomson Reuter’s Web of Knowledge.)

So how can we explain this tiny association between the risk of eating a lot of red and processed meat — the 1/100th-the-size-of-the-lung-cancer-cigarette effect–compared to eating virtually none? Again, we have an observation — or an association, two or more things happening in concert; let’s think of all the possible reasons that might explain why these two variables, meat-eating and disease, associate together in our cohorts of nurses and physicians.  Here’s how the great German pathologist Rudolph Virchow phrased this in 1849: How, he said, can we “with certainty decide which of two coexistent phenomena is the cause and which the effect, whether one of them is the cause at all instead of both being effects of a third cause, or even whether both are effects of two entirely unrelated causes?” This is the hard part.

The answer ultimately is that we do experiments, which is what Virchow went on to discuss. But we’ll get back to this in a minute. Before we get around to doing the experiments, we must rack our brains to figure out if there are other causal explanations for this association beside the the meat-eating one. Another way to think of this is that we’re looking for all the myriad possible ways our methodology and equipment might have fooled us.  The first principle of good science, as Richard Feynman liked to say, is that you must not fool yourself and you’re the easiest person to fool. And so before we go public and commit ourselves to believing this association is meaningful and causal, let’s think of all the ways we might be fooled. Once we’ve thought up every possible, reasonable alternative hypotheses (space aliens are out on this account), we can then go about testing them to see which ones survive the tests: our preferred hypothesis (meat-eating causes disease, in this case) or one of the many others we’ve considered.

So let’s think of reasonable ways in which people who eat a lot of meat might be different from people who don’t, looking specifically for differences that might also explain some or all of the association we observed between meat-eating, disease and premature death. What else can explain this association, which might have nothing to do with whatever happens when we consume meat or processed meat?

Zoe Harcombe made this point beautifully using the Harvard data. The obvious clue is that as we move from the bottom quintile of meat-eaters (those who are effectively vegetarians) to the top quintile of meat-eaters we see an increase in virtually every accepted unhealthy behavior — smoking goes up, drinking goes up, sedentary behavior (or lack of physical activity) goes up — and we also see an increase in markers for unhealthy behaviors — BMI goes up, blood pressure, etc. So what could be happening here?

If you go back and read my New York Times Magazine article on this research, you’ll see that I discussed a whole host of effects, known technically as confounders  — they confound the interpretation of the association — that could explain associations between two variables but have nothing to do biologically with the variables themselves. One of these confounders is called the compliance or adherer effect. Heres’ what I said about it in the article:

The Bias of Compliance

A still more subtle component of healthy-user bias has to be confronted. This is the compliance or adherer effect. Quite simply, people who comply with their doctors’ orders when given a prescription are different and healthier than people who don’t. This difference may be ultimately unquantifiable. The compliance effect is another plausible explanation for many of the beneficial associations that epidemiologists commonly report, which means this alone is a reason to wonder if much of what we hear about what constitutes a healthful diet and lifestyle is misconceived.

The lesson comes from an ambitious clinical trial called the Coronary Drug Project that set out in the 1970s to test whether any of five different drugs might prevent heart attacks. The subjects were some 8,500 middle-aged men with established heart problems. Two-thirds of them were randomly assigned to take one of the five drugs and the other third a placebo. Because one of the drugs, clofibrate, lowered cholesterol levels, the researchers had high hopes that it would ward off heart disease. But when the results were tabulated after five years, clofibrate showed no beneficial effect. The researchers then considered the possibility that clofibrate appeared to fail only because the subjects failed to faithfully take their prescriptions.

As it turned out, those men who said they took more than 80 percent of the pills prescribed fared substantially better than those who didn’t. Only 15 percent of these faithful “adherers” died, compared with almost 25 percent of what the project researchers called “poor adherers.” This might have been taken as reason to believe that clofibrate actually did cut heart-disease deaths almost by half, but then the researchers looked at those men who faithfully took their placebos. And those men, too, seemed to benefit from adhering closely to their prescription: only 15 percent of them died compared with 28 percent who were less conscientious. “So faithfully taking the placebo cuts the death rate by a factor of two,” says David Freedman, a professor of statistics at the University of California, Berkeley [who passed away, regrettably, in 2008]. “How can this be? Well, people who take their placebo regularly are just different than the others. The rest is a little speculative. Maybe they take better care of themselves in general. But this compliance effect is quite a big effect.”

The moral of the story, says Freedman, is that whenever epidemiologists compare people who faithfully engage in some activity with those who don’t — whether taking prescription pills or vitamins or exercising regularly or eating what they consider a healthful diet — the researchers need to account for this compliance effect or they will most likely infer the wrong answer. They’ll conclude that this behavior, whatever it is, prevents disease and saves lives, when all they’re really doing is comparing two different types of people who are, in effect, incomparable.

This phenomenon is a particularly compelling explanation for why the Nurses’ Health Study and other cohort studies saw a benefit of H.R.T. [hormone replacement therapy, one subject of the article] in current users of the drugs, but not necessarily in past users. By distinguishing among women who never used H.R.T., those who used it but then stopped and current users (who were the only ones for which a consistent benefit appeared), these observational studies may have inadvertently focused their attention specifically on, as Jerry Avorn says, the “Girl Scouts in the group, the compliant ongoing users, who are probably doing a lot of other preventive things as well.”

 

It’s this compliance effect that makes these observational studies the equivalent of conventional wisdom-confirmation machines. Our public health authorities were doling out pretty much the same dietary advice  in the 1970s and 1980s, when these observational studies were starting up, as they are now. The conventional health-conscious wisdom of the era had it that we should eat less fat and saturated fat, and so less red meat, which also was supposed to cause colon cancer, less processed meat (those damn nitrates) and more fruits and vegetables and whole grains, etc. And so the people who are studied in the cohorts could be divided into two groups: those who complied with this advice — the Girl Scouts, as Avorn put it — and those who didn’t.

Now when we’re looking at the subjects who avoided red meat and processed meat and comparing them to the subjects who ate them in quantity, we can think of it as  effectively comparing the Girl Scouts to the non-Girl Scouts, the compliers to the conventional wisdom to the non-compliers. And the compliance effect tells us right there that we should see an association — that the Girl Scouts should appear to be healthier. Significantly healthier. Actually they should be even healthier than Willet et al. are now reporting, which suggests that there’s something else working against them (not eating enough red meat?). In other words, the people who avoided red meat and processed meats were the ones who fundamentally cared about their health and had the energy (and maybe the health) to act on it. And the people who ate a lot of red meat and processed meat in the 1980s and 1990s were the ones who didn’t.

Here’s another way to look at it: let’s say we wanted to identify markers of people who were too poor or too ignorant to behave in a health conscious manner in the 1980s and 1990s or just didn’t, if you’ll pardon the scatological terminology, give a sh*t. Well, we might look at people who continued to eat a lot of bacon and red meat after Time magazine ran this cover image in 1984 — “Cholesterol, and now the bad news”. I’m going to use myself as an example here, realizing it’s always dangerous and I’m probably an extreme case. But I lived in LA in the 1990s where health conscious behavior was and is the norm, and I’d bet that I didn’t have more than half a dozen servings of bacon or more than two steaks a year through the 1990s. It was all skinless chicken breasts and fish and way too much pasta and cereal (oatmeal or some other non-fat grain) and thousands upon thousands of egg whites without the yolks. Because that’s what I thought was healthy.

So when we compare people who ate a lot of meat and processed meat in this period to those who were effectively vegetarians, we’re comparing people who are inherently incomparable. We’re comparing health conscious compliers to non-compliers; people who cared about their health and had the income and energy to do something about it and people who didn’t.  And the compliers will almost always appear to be healthier in these cohorts because of the compliance effect if nothing else. No amount of “correcting” for BMI and blood pressure, smoking status, etc. can correct for this compliance effect, which is the product of all these health conscious behaviors that can’t be measured, or just haven’t been measured. And we know this because they’re even present in randomized controlled trials. When the Harvard people insist they can “correct” for this, or that it’s not a factor, they’re fooling themselves. And we know they’re fooling themselves because the experimental trials keep confirming that.

That was the message of my 2007 article. As one friend put it years ago to me (and I wish I could remember who so I could credit him or her properly), when these cohort studies compare mostly health advice compliers to non-compliers,  they might as well be comparing Berkeley vegetarians who eat at Alice Water’s famous Chez Panisse restaurant once a week after their yoga practice to redneck truck drivers from West Virginia whose idea of a night on the town is chicken-fried steak (and potatoes and beer and who knows what else) at the local truck stop. The researchers can imply, as Willett and his colleagues do, that the most likely reason these people have different levels of morbidity and mortality is the amount of meat they eat; but that’s only because that’s what Willett and his colleagues have to believe to justify the decades of work and tens, if not hundreds, of millions of dollars that have been spent on these studies. Not because it’s the most likely explanation. It’s far more likely that the difference is caused by all the behaviors that associate with meat-eating or effective vegetarianism — whether you are, in effect, a Girl Scout or not.

This is why the best epidemiologists — the one’s I quote in the NYT Magazine article — think this nutritional epidemiology business is a pseudoscience at best. Observational studies like the Nurses’ Health Study can come up with the right hypothesis of causality about as often as a stopped clock gives you the right time. It’s bound to happen on occasion, but there’s no way to tell when that is without doing experiments to test all your competing hypotheses. And what makes this all so frustrating is that the Harvard people don’t see the need to look for alternative explanations of the data — for all the possible confounders — and to test them rigorously, which means they don’t actually see the need to do real science.

As I said, it’s a sad state of affairs.

Now we’re back to doing experiments — i.e., how we ultimately settle this difference of opinion. This is science.  Do the experiments.  We have alternative causal explanations for the tiny association between meat-eating and morbidity and mortality. One is that it’s the meat itself. The other is that it’s the behaviors that associate with meat-eating. So do an experiment to see which is right. How do we do it? Well you can do it with an N of 1. Switch your diet, see what happens. Or we can get more meaningful information by starting with your cohort of subjects and assigning them at random either to a diet rich red meat and processed meat, or to a diet that’s not — a mostly vegetarian diet. By assigning subjects at random to one of these two interventions, we mostly get rid of the behavioral (and socio-economic and educational…) factors that might associate with choosing of your own free will whether to be a vegetarian (or a mostly-vegetarian) or a meat-eater.

So we do a randomized-controlled trial. Take as many people as we can afford, randomize them into two groups — one that eats a lot of red meat and bacon, one that eats a lot of vegetables and whole grains and pulses-and very little red meat and bacon — and see what happens. These experiments have effectively been done. They’re the trials that compare Atkins-like diets to other more conventional weight loss diets — AHA Step 1 diets, Mediterranean diets, Zone diets, Ornish diets, etc. These conventional weight loss diets tend to restrict meat consumption to different extents because they restrict fat and/or saturated fat consumption and meat has a lot of fat and saturated fat in it. Ornish’s diet is the extreme example. And when these experiments have been done, the meat-rich, bacon-rich Atkins diet almost invariably comes out ahead, not just in weight loss but also in heart disease and diabetes risk factors. I discuss this in detail in chapter 18 of Why We Get Fat, ”The Nature of a Healthy Diet.” The Stanford A TO Z Study is a good example of these experiments. Over the course of the experiment — two years in this case — the subjects randomized to the Atkins-like meat- and bacon-heavy diet were healthier. That’s what we want to know.

Now Willett and his colleagues at Harvard would challenge this by saying somewhere along the line, as we go from two years out to decades, this health benefit must turn into a health detriment. How else can they explain why their associations are the opposite of what the experimental trials conclude? And if they don’t explain this away somehow, they might have to acknowledge that they’ve been doing pseudoscience for their entire careers. And maybe they’re right, but I certainly wouldn’t bet my life on it.

Ultimately we’re left with a decision about what we’re going to believe: the observations, or the experiments designed to test those observations. Good scientists will always tell you to believe the experiments. That’s why they do them.

 

 

Egregious (and embarrassing) error correction: In an early version of the post, I suggested that if you read the chapter on nutritional epidemiology in the textbook Modern Epidemiology, you’d see that the best epidemiologists agree that this pursuit is pathological. A reader from my institution — a UC Berkeley grad student — pointed out that the chapter on nutritional epi in the textbook was actually written by Walter Willett and that, not surprisingly, it does not agree with this position. Here’s how Willett ends that chapter:

The last two decades have seen enormous progress in the development of nutritional epidemiology methods. Work by many investigators has provided clear support for the essential underpinnings of this field. Substantial between-person variation in consumption of most dietary factors in populations has been demonstrated, methods to measure diet applicable to epidemiologic studies have been developed, and their validity has been documented. Based on this evidence, many large prospective cohort studies have been established that are providing a wealth of data on many outcomes that will be reported during the next decade. In addition, methods to account for errors in measurement of dietary intake have been developed and are beginning to be applied in reporting findings from studies of diet and disease.

Nutritional epidemiology has contributed importantly to understanding the etiology of many diseases. Low intake of fruits and vegetables has been shown to be related to increased risk of cardiovascular disease. Also, a substantial amount of epidemiologic evidence has accumulated indicating that replacing saturated and trans fats with unsaturated fats can play an important role in the prevention of coronary heart disease and type 2 diabetes. Many diseases—as diverse as cataracts, neural-tube defects, and macular degeneration—that were not thought to be nutritionally related have been found to have important dietary determinants. Nonetheless, much more needs to be learned regarding other diet and disease relations, and the dimensions of time and ranges of dietary intakes need to be expanded further. Furthermore, new products are constantly being introduced into the food supply, which will require continued epidemiologic vigilance.

The development and evaluation of additional methods to measure dietary factors, particularly those using biochemical methods to assess long-term intake, can contribute substantially to improvements in the capacity to assess diet and disease relations. Also, the capacity to identify those persons at genetically increased risk of disease will allow the study of gene–nutrient interactions that are almost sure to exist. The challenges posed by the complexities of nutritional exposures are likely to spur methodologic developments. Such developments have already occurred with respect to measurement error. The insights gained will have benefits throughout the field of epidemiology.

Now the reason I made this mistake is because I was rushing (no excuse, despite the warning up front) and so working from memory about a chapter that the UCLA epidemiologist Sander Greenland, one of the editor/authors of Modern Epidemiology, sent me when I was writing the New York Times Magazine article in 2007. The chapter Greenland was discussing and that he had sent me at the time was one he had authored, chapter 19 — “Bias Analysis” — and it was discussing observational epidemiology in general.

Here’s Greenland on the problem with all these studies — nutritional epi included — and how they’re interpreted:

Conventional methods assume all errors are random and that any modeling assumptions (such as homogeneity) are correct. With these assumptions, all uncertainty about the impact of errors on estimates is subsumed within conventional standard deviations for the estimates (standard errors), such as those given in earlier chapters (which assume no measurement error), and any discrepancy between an observed association and the target effect may be attributed to chance alone. When the assumptions are incorrect, however, the logical foundation for conventional statistical methods is absent, and those methods may yield highly misleading inferences. Epidemiologists recognize the possibility of incorrect assumptions in conventional analyses when they talk of residual confounding (from nonrandom exposure assignment), selection bias (from nonrandom subject selection), and information bias (from imperfect measurement). These biases rarely receive quantitative analysis, a situation that is understandable given that the analysis requires specifying values (such as amount of selection bias) for which little or no data may be available. An unfortunate consequence of this lack of quantification is the switch in focus to those aspects of error that are more readily quantified, namely the random components.

Systematic errors can be and often are larger than random errors, and failure to appreciate their impact is potentially disastrous. The problem is magnified in large studies and pooling projects, for in those studies the large size reduces the amount of random error, and as a result the random error may be but a small component of total error. In such studies, a focus on “statistical significance” or even on confidence limits may amount to nothing more than a decision to focus on artifacts of systematic error as if they reflected a real causal effect.

 

 

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Comments

  1. Morgan M says:

    After reading this – and both of your books on nutrition – I’m amazed that I used to follow Michael Pollan’s word as if it were gospel. It felt like he was preaching to me: “Eat food. Not too much. Mostly Plants.” Eat what your grandma used to eat! No need for this “science,” just eat what healthful and traditional, it’s all so very obvious, he said! We know in our souls what is healthy (like grandma!). And I ate it up.

    Now I see Pollan’s work for what it is: a denunciation of science. And while he is right to criticize what passes for science in the field of nutrition as you do here, his message–that we don’t need science–is so, so wrong. Pollan’s little mantra only “feels” right (he presents so little proof) because it fits within a dogma that we’ve all embraced, one that has never been held to any degree of scientific rigor.

    I’m so glad you’re out there–the anti-Pollan–reminding us that nutrition needs to be treated like a proper science if we’re ever going to make progress. Science, not gospel. Experimental evidence, not feelings or anecdotes. We can’t rely on common sense. Science never does, and only science can save, improve, and lengthen our lives. Bravo, Gary!

    • js290 says:

      Other than Food Inc and a few of his lectures, I don’t know Pollan’s work that well. However, it should be noted that the purpose of science is to explain nature. And, if science hasn’t figured it out yet, it may be safer (at least nutritionally) to default to nature.

      • Brian says:

        Great point. I follow Pollan’s writing often and he doesn’t preach an agenda i.e. vegetarianism. Most of what he puts out there is honest and true regarding food etc. I agree with him that we don’t need nutritionism to figure out what is healthy, in nature it’s clear: whole fresh foods, grown locally, sustainably, unprocessed etc.

        However, when Big Media comments on flawed studies, it’s important to address the bias in the study like GT and Zoe Harcombe have done.

        • Jack says:

          You claim that whole, unprocessed, fresh food is obviously healthier. But I suggest that it’s not obvious at all. Just yesterday I was at the supermarket and I noticed that a bunch of apples that were imported from Chile looked much fresher, crisper, and more vibrant than a bunch of organic apples that had been grown in the US. Counterintuitive though it may be, I wouldn’t be surprised if the apples shipped from overseas had higher levels of nutrients in this case.

          Ketchup has been shown to have much higher levels of bioavailable lycopene than fresh, unprocessed tomatoes, yet according to your conjecture, the fresh tomatoes would necessarily be healthier. Raisins have shown to have higher levels of antioxidants than grapes after the dehydrating process. Onions have more quercetin after being sauteed than raw. Is unprocessed food always worse than processed food, then?

          Science is most definitely necessary for us to figure out the true nature of healthy foods. We can’t rely on gut feelings that whole and natural and leafy is always better. It’s a pleasing sentiment, but closes us off from a whole world of potential knowledge.

          • Steph says:

            Science is also highly limited, however — as I think Gary makes the point. Behind all science are scientists, who have budgetary constraints, intellectual constraints, and, unfortunately, their own biases (more often than not linked to their funding sources).

            My perspective is, we have to maintain a balance between what we read from science or hear from our doctors, and what makes us feel healthy. Use it, but don’t expect a definitive answer on everything from nutritional science. Part of the problem is our faith that nutrition science can tell us everything. It’s a great tool, but like any, it has its limits. It is a far cry from being able to tell every single person on the planet what is exactly right for their body. There are too many variables involved to isolate them all.

            And to advocate for the other side, there is a lot of knowledge within traditional cultures about how to eat (cooking, fermentation, additives). The older the tradition the better, generally, as it is “time-tested”. It wouldn’t survive on without conveying some benefit to the practitioner. Interestingly, science many times – though not always – confirms the basis for this traditional knowledge.

            We need to keep in mind that due to the mechanization of agriculture and rise of technology, the amount and variety of food we produce now is unparalleled to previous years of human existence. Right now we’re kind of part of a huge experiment, that has barely even started, if you consider that processed foods have only really been around for maybe 100 years, 60 years if you consider really processed foods. But even good science is not a panacea. We also need our own intuition, our personal experience and observation, and to listen to our bodies telling us what’s working and what’s not.

          • tordeu says:

            “Ketchup has been shown to have much higher levels of bioavailable lycopene than fresh, unprocessed tomatoes”.

            Besides the fact that it’s the higher amount is no surprise, I would still say tomatoes are healthier by far. It’s too simple to just look at the amount of one nutrient and ignore all others.
            You can’t pretend that 30mg of a Vitamin mixed with 100g of sugar is healthier than 10mg of the Vitamin alone, just because there is more vitamin in the first case.
            The sugar content of ketchup alone outweighs the higher level of lycopene by far, in my opinion. If I thought I need more lycopene I would go for tomato juice/paste or try to find a gac, which has 20x the amount of lycopene in comparison to ketchup.

            I would also argue that we probably don’t need to eat more of any nutrient than real food can provide us with. It does not make sense that our body needs more of a single nutrient than we could give it by eating real food. (Although food of course has become less nutrient dense, because everyone is trying to increase the amount of water and to decrease the amount of time it takes etc.)

            It’s also a big problem that nutritionists focus too much on single nutrients instead of combinations of nutrients. We have absolutely no clue in most cases how the different things in vegetables and fruits and whatnot work together. That’s why all those processed foods that are essentially sugar with added vitamins don’t seem to make anyone healthier. The vitamins are taken isolated instead of in the “package” the nature delivers them in and the benefits the vitamins might have is destroyed by the amount of sugar.

          • Vic says:

            I couldn’t agree more on what was written above about ketchup being full of sugar (not to mention other nefarious ingredients. I also agree with this notion that isolated vitamins, minerals, aminos, etc. are somehow more healthful than what is provided in nature’s whole foods. Reductionist thinking leads to side effects. Now, if you made your own ketchup, minus the deleterious ingredients, then you’d have a better comparison to make with tomatoes.

          • Chris says:

            Apples from Chile in April are essentially fresh-picked. Apples from the US in April are around 6 months old. Even with proper storage, 6-month-old apples don’t “look” as good as fresh-picked ones.

    • Pamela says:

      Of course, Pollan fails to understand that some French Canadian grandmas ate food like pigs feet, blood sausages and poutine! I follow his advice to eat like my Grandma (albeit not too much poutine) and buy humanely-raised meat, but ditched the rest.

    • Marc Brazeau says:

      Pollan’s take is that the science of nutrition is so rudimentary in what we actually know, that traditional foodways provide a more reliable algorithm to answer the question of how to eat healthfully. He says that the science is important and needs to be done, but in its current form it doesn’t provide a useful guide for the average lay person.

    • Charly says:

      If I ate what my grandma ate, I would eat very little in plant based foods. She grew up in Norway, where the diet is heavy in fish, dairy, meat, eggs and only seasonal fruits and vegetables. Vegetables and fruits in the winter were preserved with salt, vinegar, as were out of season animal products, and sugar, lots of it. Lamb, goat meat, chicken and fish, butter, sour cream, contributed the most calories. Cheese extremely important. She never heard of Michael Pollan, probably would have shrugged her shoulders and ignored him, or called him an elitist fool. My grandmother lived to be 100, was only in the hospital once in her life, and only for a day and a half. She introduced me to my favorite breakfast treat – pumpernickel rye bread topped with brown-sugar-sweetened sour cream. Yum.

      • Jennifer says:

        Hey Charly,
        From your description, your Grandmother ate large quantities of protein and quality fat. Were we living in paleolithic times and more primally in the forests and caves, hunting and gathering, that’s what humans would eat. Animals and their byproducts (organ meats, etc) and as much fat as possible for survival (think of a wolf, or lion eating the fattiest part of their prey first for the biggest nutritional bang). Those are the keys to good health and longevity…nutritional optimization. Fat is good for you and when eaten WITHOUT sugar in the diet, your body knows exactly what to do with it (store some for health, repair cells, keep body processes running smoothly, get rid of the rest).

        Your Grandma’s food preservation techniques saved her from having to hunt as often (salt/vinegar, etc). Also your Grandmother’s sugar intake was probably less than you realize. With sugar in EVERY MEAL on the standard American table (potatoes, bread, pasta, rice, corn, carrots, etc) and added to all popular snack foods (cookies, ice creams, sodas, chips, crackers, etc. etc. etc) the average American cannot get away from sugar. Your Grandma ate unadulterated sugar (not HFCS, fructose, sucrose and all the additive incarnations of sugar found in our processed foods) and probably burned it trying to stay warm in Norway. Cold weather leads to a higher metabolism: we burn fat for fuel in order to shiver, keep our core temperature warm, etc. People in colder climates can get away with more calories. Think about it this way: animals try to fatten up before the winter. Fat insulates us and keeps us warm and some body fat is very healthy. Especially brown adipose tissue which helps with keeping the body warm.

        I’ve often seen immigrants to this country gain weight simply by eating the American diet (even though they ate MORE food back home). This can be attributed to our mild climates (mostly…Northan States in the winter excluded), sedentary lifestyle, processed foods (your body doesn’t know what to do with POTASSIUM BROMATE, PROPYL GALLATE, SODIUM NITRATE, etc. etc.) and increased consumption of sugar, sugar, sugar, sugar. Don’t even get me started on Genetically modified foods and conglomerate farm raised meats. There is little wonder why we are dying of disease in this country.

        Kudos to your Grandma. Old-world eating had less tampering and less plastic (seriously, McNuggets have the same ingredient as rubber tennis-shoe soles…we eat plastic, how awful) and overall, much less sugar.

    • My reaction upon first reading GCBC was that it was the first time anybody had actually applied the scientific method to the relationship between diet and health. It makes apparent that all the claims and assurances of the authorities before then were (and are, sadly) insane gibberish.

    • England says:

      I just started rereading Omnivores Dilemma when the NYT article came out. I noted in Pollan’s Introduction he gives Dr. Atkins a backhanded slam by mentioning him with the phrase, “…the formly discredited Dr. Atkins…” Then on the next page he says that we are surprised by the “French paradox” for how could the French eat foie gras and triple cream cheese and stay slim. Well, to me, Atkins clearly explained why the French or anyone could do that.

    • Mike says:

      OMG – have you read all of Pollan’s work – He never states “ignore the science” – he is saying from my reading something similar to the above – trying to break down nutrition into its essence and then make broad statements about a specific nutrient is simply not accurate – not at this moment in science.

    • Carin says:

      Lets not be too hard on Pollan – he is the reason that many people have started exploring nutrition and [sustainable] eating for themselves by providing a seemingly logical and emotional lens through which to view both. Even if people’s journeys end at his writing – they, and the planet, will be marginally better for it. If their journey continues through to more indepth articles like this one – great! Grassroots education will never mean that everybody is at the same place at the same time.

      • anna says:

        I have to agree with Carrin. The first nutrition/food related book I read was Pollan’s. That was the beginning of an obsession that led me to Gary Taubes, and many other writers in the real food/ low-carb/ paleo realm.

        I didn’t see if anyone else commented about this but it seems to me it’s kind of crazy (and bad science) for any study to lump together regular meat and processed meat. Processed meats contain nitrites, which are a known carcinogen. That’s like doing a study on vegetable consumption, sprinkling carcinogens on all the vegetables and then concluding that vegetables cause cancer. It’s ridiculous.

        • Robert Speirs says:

          Where’s the study that shows nitrites are a “known carcinogen”? Such a statement is utterly unscientific without formal, detailed evidence. That is what G Taubes was trying to get across in his article.

        • Victoria says:

          Nitrites are a known carcinogen? No, they’re not. They’re not even sure if they’re dangerous at all. Besides, how could anyone possibly control the amount of nitrogen vegetables get, when it is by far the most abundant element in the world, let alone CARE how much is in anything when it isn’t actually a bad thing. This natural cure they use for bacon and stuff these days? Celery juice. Why? Because it’s LOADED with natural nitrates. Stop eating vegetables if you want to get rid of the bulk of nitrates in your diet.
          Good things about nitrites:
          lowers blood pressure, supports heart function, promotes wound healing, destroys harmful gut bacteria.
          You want to avoid that? I don’t.

          Here are just two websites, one’s a study and one’s by a dietician with references.
          http://ajcn.nutrition.org/content/90/1/11.full
          http://www.coopfoodstore.coop/content/good-or-bad-nitrates-and-nitrites-food

    • Steph says:

      Nutrition science is definitely necessary, but only insofar as the funding exists to do it well, and excluding as much as possible the reductionism that Gary talks about. Unfortunately, too many people (*cough* corn industry, junk food industry, sugar industry) have a vested interest in making sure that the right research doesn’t get done. That lack of funding severely limits scientists from doing good work.

      And let’s not forget that we’re in trouble BECAUSE of the food science that has brought us an abundance of mass-produced industrial soy and corn that later led to High Fructose Corn Syrup, corn oil, soybean oil, and a cheap base for a myriad of junk foods — which science has used to provide a blank slate on which to add the perfect balance of natural/artificial flavorings (all flavorings are artificial, actually), fat, and sugar to make us crave more. Even though we’re only eating 70% corn in any snack food, they know exactly how to get us to eat more — which in high-sugar, high-fat foods — will make us fatter. They also know exactly what to feed us when we’re trying to lose weight, and they probably know it won’t work. Look at all the “diet” foods on the market!

      I guess what I’m seeing here is that while people with an interest in real nutrition and human health are going back and forth arguing over the benefits of meat-eating and the benefits of vegetarianism or veganism, the major companies continuing pushing sugar, fat, soy, corn, and refined carbs on the public . Maybe we’re missing the central point?

      As Denise Minger points out, if we look at all diets that have produced long-term health benefits for people (including Campbell’s, regardless of the flaws in his study): they tend to emphasize whole foods, avoid processed grain products, avoid omega-6 oils, and cut out processed sugar entirely.

      If we can all agree that processed grain products and processed sugar are harmful, why don’t we band together to spread that message?

      Until we see a randomized-controlled trial — which to my knowledge does not exist — there’s not much evidence that I can’t eat my whole grain quinoa with beans and veggies and be happy. There’s also not much evidence you can’t eat grass-fed meat with veggies. Any argument to the contrary is an intuition based on our reading (of other scientists or lay authors with their own biases), our observations of others and ourselves, and at the deepest level, our dogma about eating animals. Not exactly a scientific finding.

      (In my experience people tend to have an intuition that falls along the spectrum from “Eating animals is wrong and no one should do it” to “Eating animals is my right and no one’s going to tell me I can’t/everyone should do it.” But certainly there are many people who fit into the grey areas! And I would certainly agree that the medical profession is entrenched in an anti-red-meat dogma that many doctors do not question for themselves.)

      “Eat like your ancestors” is not bad advice — and I don’t see how that diverges from either the spirit of Gary’s message nor that of Michael Pollan.

    • tordeu says:

      I actually don’t think that Pollan is that far away from low carb/paleo. What I took away from “In Defense Of Food” are actually two things:
      1. The “science” of looking at single nutrients and then just adding them to “foodlike substances” does not work.
      2. The well known “Eat food. Not too much. Mostly plants”
      He is against processed “foods”, which is also a big component in low carb (especially because of the high carb content of most processed foods) and especially in paleo and he advocates eating more plants, which is also found in low carb (especially vegetables) and paleo (vegetables + fruits).

      I actually think that Pollan was a step in the right direction, because it favors avoiding simple carbohydrates and eating more nutrient-rich plants. There are things I do no agree with, but he has some good points and I don’t see Michael Pollan as standing on the opposite side (from us). I think he’s more in the middle between low/paleo on “our” side and the traditional diet on the other side.

      • Rober says:

        You “think” Pollan was on the right track? So another personal opinion with no facts or research to back it up. I think you demonstrated Mr. Taubes’ point quite well, thank you.

    • sante cerini says:

      my father was italian and ate lunch meats every single day of his life tons of pork and meats and made a desert out of pure cream every week and lived too the age of 90 only because he was in a car accident not his fault a drunk driver . and had 3 girlfriends at the time put that in your pipe and smoke it low fat dummys ..lol

  2. Ben Atlas says:

    Thank you very much for this post, I was waiting for it. I find it peculiar that they lumped together meat with the processed meat. What if the additives in the processed products account for the entire variable?

    • Warren Dew says:

      The study actually provides separate numbers for processed and unprocessed meat. There are a lot of things wrong with the study, but that’s not one of them this time around.

      • Sam Mackrill says:

        Only if you classify hamburgers as unprocessed meat. And you think that people can accurately assess this when filling-in dietary questionnaires every four years (four!)

  3. George Henderson says:

    Lucid as always (not bad for a vomit draft). All this low-risk stuff, if you take it seriously, is a form of gambling.
    Gambling with health, as opposed to investment in it.
    One quibble; you called the paper a trial – too kind, as nothing was trialed. I’d call it a study.
    The problem I have with processed meats is that vegetable contaminants often creep into them, especially that filthy soy, and that rat gluten.

    • George Henderson says:

      “Eat Animals. Mostly fat. Enjoy”
      - the anti-Pollan

      • Galina L. says:

        I just started to use the Fitday after more than 4 years of being on a weight-loss diet. It is almost amazing how little veggies add to the nutritional content when listed. It is mostly fiber and a some carbs, also a lot of flavor and texture.
        I personally think there is something strange in human interest in strong favors. Why wild life attacking my garden can’t stand orange jest and rosemary essential oils, but I gladly put it on my food? Why raccoon thinks it is a poison, but it makes food more rewarding and palatable for me? It is boring to eat only meat, of course, but from nutritional perspective it looks less questionable than veggies.

        • Tony P. says:

          When it comes to veggies, remember that much of their benefit (not that fiber isn’t good) comes from micronutrients. I can’t speak for Fitday but a lot of the online databases I’ve seen focus on the macronutrients and often ignore the vitamins, minerals, etc. Especially when content is user generated,people who are interested in weight loss just tend to enter in fat, protein, carbs, calories, and maybe fiber. People just trying to lose weight probably aren’t overly concerned about hitting their vitamin k or folate goals :)

      • Margaretrc says:

        Love that, @ George Henderson. Think I’m going to use it in the future. I’m not totally anti Pollan–he has done a lot to steer people away from factory farmed meat and monocultured crops. And he is right that, in the absence of scientific information, what Grandma ate is a good guide–if one’s metabolism has not been broken. But we have scientific information–from GT, Atkins, Phinney, Wortman, etc. So we don’t need to use Pollan as a guide.

      • Tim H. says:

        lol couldn’t agree more :)

      • Priest says:

        Your posting is aboslutely on the point!

    • Sam says:

      I Wonder why they don’t give the same coverage to this “study”;

      http://www.sciencedaily.com/releases/2012/03/120315225751.htm

      White Rice Increases Risk of Type 2 Diabetes

      ScienceDaily (Mar. 15, 2012) — The risk of type 2 diabetes is significantly increased if white rice is eaten regularly, claims a study published today on bmj.com.

      • gman3164 says:

        I like it, Sam – thanks for the article. They made one huge blunder at the end of it, however. They recommend that we eat whole grains to avoid type II diabetes. That’s a D- grade in my book.

        • jamesghd says:

          funny how they do that. the problem isnt the carbs… its that youre not eating carbs with the stuff that counteracts the effect of carbs. its like, bro, you didnt fly through your windshield because you were goin 110 mph, you just didnt have your seat belt on!

      • Dianekjs says:

        Paul Jaminet of “Perfect Health Diet” addresses that study here:
        http://perfecthealthdiet.com/?s=white+rice.

        The Jaminets’ research has led them to believe that small additions of “safe starches” to an overall low carb, high fat, moderate protein diet is beneficial for many. White rice (not brown) and sweet potatoes are their preferred choices for this purpose.

  4. I’ve been waiting to see what you’d say about this one. And I’m not disappointed.

    I’m hoping you might have pointers to some good references for diet compliance. I’ve been searching for weeks and can’t find any good statistics for how many people stick with different diets, how often the diets are effective, and total weight loss.

    The A TO Z addresses the outcomes; are you aware of any that address compliance and effectiveness in a non-clinical setting?

    • Bawdy says:

      I’ve been wondering about this, too. I just finished reading Primal Body, Primal Mind by Nora Gedgaudas. In the foreword written by Brent Pottenger is a reference to the psychological concept of “overshadowing.” He writes that overshadowing “occurs when the initial stimulus is so strong that it blocks the perception of a second, downstream effect. For example, when people drink a soda, the initial stimulus from the sugar is so great that it overshadows the energy crash and feelings of poor health that follow shortly after consumption. In this way, overshadowing inhibits people from responding appropriately to the poisons they ingest and inhibits their ability to learn via conditioning degrade as a result.”

      Unfortunately, I can’t seem to find the discussion of this in the book. I was hoping to learn some new coping mechanisms or something that would help me make better choices. I don’t have an issue avoiding sugars, starches, or grains, but I do like a “wee nip o’ the Irish” in the evenings. If I have one, I’m fine. If I have two, I’ll fall asleep with no problem but then wake up at 1:30 or 2:00 am and not be able to fall asleep again until around 4:30 am.

      And yet, does knowing this stop me from having that second drink? Uh, no. It’s the classic example of the initial stimulus blocking perception of the second, downstream effect.

      As I said the other day to someone, “Why do I do what I do when I know what I know?” It’s the ultimate disconnect.

      • Joyce R. says:

        Bawdy,
        I learned alot from Nora’s book. Did you read the part were she discusses the idea that alcoholism may be a severe carbohydrate addiction? 1-2 drinks a night does not sound like an alcoholic, but taking that second drink when you KNOW the consequences, does. Perhaps it’s as she suggests, more of a carboholism than an alcoholism? Ever try giving up alcohol for a month, like she suggests for dairy?

  5. Thanks Gary, I hope one day the Nobel crowd will acknowledge your efforts and contribution to the world of science and obesity research!

    • Elenor says:

      The heck with Nobel (well, okay, in *addition* to the Nobel….), Gary should get a McArthur Genius Grant! (Higher prize money…. and does he ever deserve it!)

      Bravo Gary — excellent, amazing, wonderful essay — as always!

      • jake3_14 says:

        Not to criticize Gary; he’s worthy of the award. I just think Gary should share it with other intellectual giants: Denise Minger, Dr. Uffe Ravnskov, Dr. Richard Fineman, Dr. Jeff Volek, Dr. Stephen Finney, and probably a few others I can’t think of at the moment.

        • Paula says:

          Hi jake3_14! Just so people don’t miss him due to the spelling error, I have to point out it’s Richard Feiman – Richard D. Feinman no less with a great blog at rdfeinman.wordpress.com. He is very funny. Also, tho it will dilute the award monetarily, let’s divvy up a bit for the Drs. Eades (Mike and Mary Dan) and Mark Sisson. And what about Richard Bernstein?

          • Joyce R. says:

            Yeah! Bernstein is great. He was wayyyy ahead of his time. Back in the olden days when he was trying to get doctors interested in his method of blood sugar control by doing testing, he was told that they (docs) didn’t see any value in controlling blood sugar!
            OMG! Some things never change!

        • Sue says:

          Speaking of intellectual giants, make sure to read what Denise Minger wrote about this study on Mark’s Daily Apple (dated March 14), too–eye-opening, funny, witty.

  6. Mary says:

    Thanks for the post Gary. When I heard the NPR story on this article I thought — sounds like a bunch of epidemiologists published a paper. Then, I kept hitting your blog looking for your commentary. The work you have done to shed light on the poor science around nutrition is having an effect — I have anecdotal evidence. ;-D The commercial from a local supermarket that is going to label shelves for carb-smart food. The people in my daily life I run into who are avoiding carbs. The number of low or no carb choices in the supermarket or at a restaurant. It will be interesting to see what the “recommended diet” is in 5 or 10 years…

    • Sam says:

      Thanks Gary for another great post; Just another biased “study” meat is evil; from the usual suspects. Making scientific inferences from large retrospective studies using the p-value is not the best way to evaluate the evidence. Steve Goodman, professor of biostats and oncology at Johns Hopkins makes that point in this paper:

      http://www.annals.org/content/130/12/995.abstract

  7. G-man says:

    I’m currently reading Robb Wolf’s book, “the Paleo Solution, the Original Human Diet.” Much of what he says coincides with your findings. My one concern/question is whenever he mentions meat, he specifically states “lean” meat. He states to stay away from eggs if you have autoimmunity issues. What is your take on this and in general, Mr. Wolf’s approach and recommendations?

    • Robert M says:

      You should listen to Robb Wolfs latest pod cast. He goes into the reasons he suggests lean meats in his book. It basically boils down to not wanting to scare people off, he wants to reach as many people as possible and get them hooked before they’re introduced to the suggestion that fatty meat is not something to avoid. Not sure I agree with the approach tbh.

      • Margaretrc says:

        I like Robb Wolfe, but I think he’s wrong on this one. Rational people can be very easily and quickly persuaded to lose their fear of fat when presented with the proper scientific evidence. I was. On the other hand, eating lean meat, even if you’re eating Paleo, is an invitation to either get too much protein or continue to eat too many carbs from potatoes and such. There are non grain sources of carbs. And if you go low carb and low fat, that’s dangerous and the very people whom he is trying to convince to go Paleo may soon quit because they don’t feel good/have enough energy with all that protein.

    • Steak & eggs says:

      Robb wolf using the term “Lean Meats” is just a ploy. He doesent want to scare off fat fobic people who have been following the SAD. Listen to his latest podcast and he explains it better than I. bacon = awesome

    • Todd says:

      G man, go to Robb’s website and listen to his latest podcast. Or read the transcript. He addresses this issue in question number 7. He actually doesn’t have a problem with fatty cuts of meat. But, his main objective is to get people off of grains, vegetable oils, sugars, packaged food, etc. He fears that if he also tells people (at least in the beginning) that eating fat is healthy, it will be too much of a “shock” for people to accept and they won’t give it a try. Here are some quotes:

      “it’s so easy to disseminate information that it’s
      easy to then create the firewall that is so complex that then people just
      bail and they’re done. That’s where the lean meat part comes in. People
      in the beginning need to hear lean meat. They just do because if they
      don’t, they’re going to freak out. They’re going to be like, “Oh, it’s
      Atkins,” and they’re gone.
      So what this is, is just learning over the course of time to tell people what
      they need to hear so that we get them bought in long enough so that
      their life is transformed. Then we can say, “Oh, by the way, the real story
      is this.” Like, “You don’t have to worry so much. You can have bacon with
      breakfast, and it’s not going to be the end of the world. That’s all cool.” If
      we lead with that, we’re not going to get any type of buy in. We’re going
      to peel people out and it’s not going to serve them in the long run.”

      “That’s why I still say lean meat because when you think about
      the people entering the site, they need to hear these things because they
      need to be pacified long enough to be able to buy in enough. To be able
      to make some progress and it kind of sucks. I’m definitely iconoclastic
      about some things, but I’ve just learned over the course of time that
      you’ve got to tell people what they want to hear long enough to actually
      get them what they want. Even though the route that they used to get
      there isn’t necessarily the one that they thought it was going to be.”

      • Todd says:

        Doh! Beat me to the punch too!

      • elton says:

        I don’t know anything about Robb, but there is a danger of getting too much protein if you only consume large amounts of Lean Meat. I would be careful as a lot people may have issues with too much protein and not enough fat.

      • G-man says:

        Thanks to all who replied to my inquiry. Makes me feel better about having my bacon with eggs. LOL Seriously, I’m sold on what Gary Taubes has to say and so far (if any of you have read Robb Wolf’s book) I like what Mr. Wolf has to say as well and good to see they’re not in contradiction. It appears Mr. Wolf too talks about the influence of carbs on hormones. He does take it a step farther with the exercise component and seems to be even a bit more restrictive diet-wise than Gary.

    • David Pryor says:

      I’m sorry I cannot remember the exact quote, or source, but I think there is another reason Robb Wolf discusses “lean” red meats. If you are not buying grass-fed meat, the FAT of the feed-lot animals you are eating is going to have a less-than-optimal content of “bad” fats, hormones, and other dietary hazards. Under those conditions, you are better off getting your fat calories from things like coconut oil, avocadoes, etc.

  8. Mloader says:

    This type of work is having an effect, no doubt. Ten years ago all fat was bad now they are hanging on to saturated fat as a killer. We have “healthy picks” food labels at our cafeteria at work and the hard boiled eggs are tagged. Ten years ago, you would never have seen that.

    It is interesting to me that many people who are champions of dietary fat, and are also interested in science, cite so much of Gary’s work. And they will say they became enlightened in mid 2000′s right around the time Gary started getting the word out.

    I think the reason Gary’s work isn’t having a larger impact is he offers information, not a product. People want to work 40 hours a day and use the money they earn to solve other issues. He isn’t selling a box or a diet plan, nor should he. Every time I evangelize his work, people always say ‘what can I eat?’ and I tell them the most important part is knowing why, not what or how. If you only know the how without the why, it really is not meaningful.

    On the other hand, this kind of stuff is useful, it is inspiring to see all the responses. One quote I saw on Twitter was great:
    @terrysimpson:
    @MloaderGraphics the only way red meat will kill you is if it is alive and bigger, faster and hungry – oh, and also eats red meat

  9. J. Stanton says:

    I hope it’s not pedantic to point out that, in addition to all the other problems of epidemiology Gary has mentioned, the reported food intake data from the Nurses’ Health Study is not just suspected to be shaky — it’s been studied, validated, and found to be almost completely unrelated to actual food intake.

    Specifically, for unprocessed animal meat, the data is anywhere from 1.5% to 15% accurate…i.e. worthless. Furthermore, the intake of foods thought to be healthy was dramatically exaggerated, and the intake of foods thought to be unhealthy was dramatically underreported.

    “Always Be Skeptical Of Nutrition Headlines: What Pan et.al Really Tells Us”

    JS

    • jake3_14 says:

      I don’t understand what this “Food-based validation of a dietary questionnaire” analysis was comparing the FFQ to — was it another self-reporting mechanism (“recorded their food consumption for seven consecutive days, four times during the one-year interval”)? If so, why would we expect the second questionnaire to be an accurate benchmark?

      • J. Stanton says:

        Yes, the verification is still self-reported — the subjects themselves measured the foods they were eating. This is clearly far more accurate than simply mailing in a survey once every four years that asks “On average, what did you eat last year?” However, you’re correct that the act of self-reporting still changes one’s habits, usually for the better: if we know we’ll have to write down that we ate a whole tub of ice cream, we’re less likely to actually do it. And, of course, we might just fudge the numbers or lie completely.

        In conclusion, yes, a tiny 1.4%-15% correlation is the best possible case. The reality is probably even worse.

        JS

        • FrankG says:

          J Stanton writes:

          This is clearly far more accurate than simply mailing in a survey once every four years that asks “On average, what did you eat last year?”

          We could only wish that the food frequency questionnaire (FFQ) was that open-ended and even-handed… Denise Minger supplied a link to the FFQ http://www.channing.harvard.edu/nhs/questionnaires/pdfs/NHSI/2002.PDF and what ;lea[t straight out at me were leading questions like “What brand and type of cold breakfast cereal do you usually eat?” and “What form of margarine do you usually use?”… not even do you eat these items but straight to what brand?!?

  10. Stipetic says:

    Attaboy, Gary.

  11. Alan Sausse says:

    Gary – an outstanding article. I think you’ve pretty much put this one to bed, and plenty of other nutrition-based scare stories with it. Thanks and best wishes from Merrie England.

  12. mark glen says:

    Rhetorical question: Is it more likely a study will be swayed in favor of a meat diet by the 99% of the population and industries that stands to gainfrom meat consumption OR is it more likely a study wlil be swayed against meat because someone cares about animals or wants to gain attention?

  13. Lanie says:

    Nice post, Gary. Thanks for your quick response to this media hype.

  14. Mike says:

    Great job on the interview with Tom Woods. Thanks!

  15. Alas, it would be more convenient for me as a healthcare provider making nutrition recommendations if I could just go with the crowd.
    Instead I will tweet your article and hope my colleagues read it and do not make a complaint against me to my Board.
    Thank you!

  16. Thor Falk says:

    Great article! You forgot two points though (or were you just being nice?)
    (1) The people at Harvard are not generally stupid, and what you have explained here is really statistics and scientific reasoning 101 – there is no way this did not come up in their own studies (and if it did not, someone would by now have explained it to them); on the other hand there is “publish or perish” – who would accept a paper that says “there is an association between red meat and mortality, but we think it is because of the Girl Scout effect
    (2) if you throw enough hypothesis at a given set of data, some will always be statistically significant; by definition, if you test 100 “random” hypothesis, then 5 out of them will be “statistically significant (at the 95 level)”, meaning five papers that can be written

    • Dana says:

      Answer to #1: There was barely any association between red meat and mortality. There’s more association, frankly, between being born and mortality. A lot, lot more.

      And that should take care of #2.

      Criminey, man… there’s more of a connection between wheat and mortality, as shown in the China Study data (see also Denise Minger). How many Harvard experts do you see telling us all to ditch wheat?

    • John Miklavcic says:

      Re: point 2.

      When significance is set at 95% (alpha = 0.05), it is a statement regarding type I error; that is, rejecting the null hypothesis when it should not be rejected.

      More accurately, when the SAME hypothesis is tested 100 times, the true relationship will be divulged about 95 times and a false conclusion will be made about 5 times.

      ie.
      hypothesis: smoking causes lung cancer
      therefore, null hypothesis: smoking is not the cause of lung cancer
      (for the purposes of this example, let’s say the true relationship reflects our hypothesis: smoking causes lung cancer)
      when the same study is repeated 100 times, the true relationship (causative) will be concluded about 95 times and the false relationship (not causative) will be concluded about 5 times.
      It is not practical to repeat an experiment 100 times, so in any ONE study that (correctly) concludes that smoking causes lung cancer, it is understood that there’s a 5% chance that the conclusion is incorrect.

      Not all significant research is published. Specifically, research performed in industry as opposed to academia.

  17. Chris Beeby says:

    Hi Gary
    I’ve long been a fan of yours.
    It occurred to me some years ago that our current “obesity epidemic” started at approximately the same time that high-carb, low-fat diets became the orthodoxy.
    It also occurs to me that a cheapish experiment could be conducted with pigs rather than humans as the subjects. Am I not right in thinking that pigs (like humans) are omnivores and in many ways biologically very similar to humans – so much so that (if memory serves) heart valves from swine were once considered possibly suitable for transplantation into people? The results of feeding high-carb diets to one group of porkers and high animal fat diets to another might be instructive, though not, of course, conclusive.
    Keep up the good work!
    Chris

    • Margaretrc says:

      I believe that experiment has been done, though not exactly in a laboratory, @Chris. They used to feed pigs coconut oil in the hopes of fattening them up. Instead, they got lean and now they feed them coconut oil when they want a source of lean meat for all the fat phobes. When they want to fatten them up, they feed them corn and soy.

  18. Tracy says:

    Thank you for this, Gary. My local news reported on this ‘study’, and interviewed 2 nutritionists for the supporting side – and not one for the dissenting view. For that, they interviewed people on the street about how much they liked meat (and eating crap from food trucks)… basically, making it seem like scientists etc know the truth, but regular folk are rebellious know-nothings who are going to do what we want regardless, and that’s why we’re all so damn fat and unhealthy.

    My n=1 tells me otherwise. :)

  19. So glad you decided to put out this article, Gary. This is exactly what I was waiting for. I’ve been telling everyone I’ve talked to that this “study” holds no water and is nothing to be concerned about. Finally I have a legitimate resource to reference. Thanks again!

  20. Mark Weaver says:

    Exactly right, Gary, thank you! And right on about the “no amount of ‘correcting’ for BMI and blood pressure… can correct for this.” Nassim Taleb said “Multiple regression is plain, dressed up bullsh*t.” As a PhD-level statistician (but one who actually understands the true values of randomization), I completely agree. And if multiple regression is bad, “time-dependent proportional hazards” regression is even worse. If people knew the assumptions behind this method, they’d realize how insane these models are, coupled with the fact that they’re almost always, *virtually 100% of the time*, done incorrectly! Sheesh.

    • Mark Weaver says:

      Sorry, should have made it clear that the time-dependent PH models are what were used in the Willet paper.

      • Agentzero says:

        Do the authors of these papers ever make their underlying calculations available? Shouldn’t they have to, so that other statisticians can examine their work? If they don’t, should we give their conclusions any more weight than “because I said so”?

        • Mark Weaver says:

          Agentzero,

          Great questions, here are my personal answers: not often, yes, and it wouldn’t really matter too much because it’s still an observational study… regardless of who does the calculations, hypothesis generation should be the name of the game.

          • Another statistician chiming in here, and to add that it really depends on the type of work being done, but most statisticians aren’t that interested in retracing the steps down someone else’s black-hole/cul-de-sac. They are usually too busy trying to get their own real data. Early on in their career they usually realize how difficult it is to climb their way out of a pile of accumulated data, and unless they are obsessed like Denise Minger (which I certainly understand) and have all sorts of time, they try to avoid it in the future. There is always one more idea to try, or one more term in the model, and one more meeting where someone pleads to take one more look.

    • jake3_14 says:

      Mark,
      You should team up with Denise Minger to co-author more critiques. It’s always wonderful to have people who can explain the statistics to those of us who don’t have the training to understand the raw information.

  21. BlueEyesSf says:

    This is great GB but the elephant in the room is Marion Nestle’s new book “proving” CI/CO. No one has th guts or ability to take that one on. These bad studies are easily attacked. Marion’s the real deal. Can anyone take her down? If not, the insulin hypothesis will truly be dead.

    • Adam says:

      BlueEyes,

      You’re right. CI/CO is the enemy not only of the insulin hypothesis but also of humankind. Unless/until the Calorie Wizards’ spell is broken, America is doomed.

      It’s high time that all of us who care about good health and justice coalesce around Taubes’ idea that our problem is Overstoring not Overeating. It’s a simple mantra. Arguably as simple as “Eat less exercise more.”

      We need “simple smart” to fight “simple stupid.” So say it with me now, everyone!

      It’s Overstoring, Not Overeating
      It’s Overstoring, Not Overeating
      It’s Overstoring, Not Overeating

      IONO not CICO!

      • Chris H says:

        Adam,

        Spot on. Very much agree we need a snappy response and this is great.

      • Margaretrc says:

        I like it Adam. ONO!

      • Margaretrc says:

        Oops. I mean IONO.

      • jocko271 says:

        Jimmy Moore thought he was as smart as you too. Here’s how he looks now on your diet, without raising his insulin:

        http://ancestralizeme.com/2012/03/17/great-photos-from-paleofx/#wpcom-carousel-471

        http://ancestralizeme.files.wordpress.com/2012/03/img_6822.jpg

        Can your insulin theory explain it (without copping out and saying his body is just “broken”)?

        • James D. says:

          first, why dont you explain how he would look off of his diet? answer: much FATTER. fyi. he probably ruined his body with hfcs–it does permanent damage.

          • jocko271 says:

            Yes but according to the insulin theory of obesity, he should be skinny now since he never raises his insulin. That’s my point. He’s been on this diet for years now! Shouldn’t it have worked?

          • FrankG says:

            It’s a pretty sorry state of affairs when bloggers and commentators turn to personal attacks in order to discredit others .

            If you have a strong position that will hold up to scrutiny and critical thinking, it will hold up regardless of the personalities promoting it.

            To my thinking, anyone who resorts to this kind of character assassination in an attempt to undermine the credibility of those they view as their “opposition”, is simply suggesting to me that their own position must be pretty weak.

            As an example of “how to do it right”: the blog post here by Gary, points out the flaws in the methodology of the study and they way it has been interpreted by its authors, without any need to personally attack those authors.

          • jocko271 says:

            Uh Frank, didn’t I do away with your stupidity in the last post? Both you and Jimmy are overweight. This means low carb is not working for you.

            Those are not attacks, they are facts. You want to deflect and confuse this point by saying it’s a “character assassination” again? Then this will degenerate into the same argument we had last post.

            You cannot deny the facts Frank, no matter how hard you try. The insulin theory has broken down.

          • FrankG says:

            When have I ever said that I am overweight? I have said that I lost over 100lbs and have kept that off for over 3 years AND that my BG control is on par with a non-Diabetic. In what strange world is that “low carb NOT working for me”..?

            I would be surprised if insulin is the only hormone involved (in fact I’m pretty sure that it isn’t) but until I learn something to convince me otherwise a diet high in sugars and refined carbs leads over time to chronic high insulin levels and IR which in most results in excess fat mass due to the energy partitioning effects of insulin currently provides me with the best working hypothesis for why I and so many others gained excess fat mass.

            BTW ranting, insults, sarcasm and name-calling will NOT work to convince me or any rational person that you are right.

          • jocko271 says:

            So you lost 100 lbs and now you’re ripped on low carb? Is that, like Jimmy Moore kinda ripped? How many lbs do you have to go before you’ll consider yourself skinny? I suspect it’s a lot, since you said you were “happy with your body now”. That’s another cop-out way of saying “I’m still pretty fat, just not as fat as before”.

            Look up low fat diets, they control BG too. What’s so special about low carb?

            And who is ranting? I start with questions and you get very defensive, aside from the fact that you conveniently dodge the questions I throw at you every time. Signs of a weak argument to me.

          • Martin Levac says:

            @jocko271, you ask “why is Jimmy still fat when his insulin is back to normal”?

            It’s a valid question. Part of the answer is that you probably misunderstand or oversimplified the “insulin theory of obesity”. First, it’s called the Carbohydrate Hypothesis or CHO hypothesis for short, as opposed to the Positive Caloric Balance Hypothesis or PCB hypothesis for short. The CHO hypothesis is not merely about insulin, but about all hormones and enzymes. Insulin is not the only regulator of fat tissue. There’s growth hormone, epinephrine, glucagon, lipoprotein lipase, ASP, etc. Any of which can affect fat accumulation. GH deficiency for example will cause excess fat accumulation, just like an excess of insulin will. Gary explains all that at length in GCBC. So even if Jimmy got his insulin in check, he may still have to take care of the other hormones and enzymes that regulate his fat tissue.

            And then there’s the idea that obesity is not just a function of how much fat is inside fat cells, but also of how many fat cells there are. This is also regulated by hormones and enzymes but unlike regular obesity, it can’t be fixed just by eating less carbs. And that would explain in part why Jimmy can’t get as lean as the next guy even he eats the same amount of carbs. Jimmy used to be fat, really fat. It’s reasonable to assume that he now has many more fat cells than a guy who was never fat. If he wanted to get just as lean, he’d have to reduce the number of fat cells on top of cutting carbs. The phenomenon here is called lipohypertrophy.

            Finally there’s the idea that non-caloric substances or even pathologies can also affect fat accumulation. Certain drugs for example contain no calories yet still make us fat or lean as the case may be. Infections can also affect fat accumulation either way. If Jimmy consumes any of those substances or suffers from a chronic infection, then that may explain further why he’s still fatter than the next guy.

            And so if Jimmy took care of all the other hormones and enzymes, the extra fat cells, stopped consuming obesogenic substances and treated any infection, he would probably become just as lean as anybody else. This is true for everybody who’s ever been fat.

        • FrankG says:

          It *has* worked… here is a before shot of Jimmy for comparison… http://farm2.static.flickr.com/1088/1388595899_102d90a0d4.jpg?v=0

          It is not t a “cop out” to suggest that a body subjected to multiple years, or decades of chronically high insulin levels, insulin resistance, excess fat mass etc… can be metabolically damaged possibly beyond repair and that some of us will never see the waistline we had in our teens again.

          On the other hand I have lost significant excess fat mass (over 100 lbs – maintained now for over 3 years) and improved every other health marker. I don’t reasonably expect a complete return to my youthful figure and vigour but I’m pretty much satisfied with where I am now.

          • FrankG says:

            In my own case: it is evident that the beta cells in my pancreas (where insulin is secreted — an essential part of human metabolism) are damaged. So despite my much improved health overall and despite Blood Glucose (BG) levels comparable to someone who does not have Diabetes (due to my diet), I still *do* have Diabetes and will do for the rest of my life. Thanks for rubbing it in… so thoughtful of you ;-)

            The effect of damaged beta cells are apparent but no doubt there is comparable long-term metabolic damage that is not so easily measured.

            Another consideration are the fat storage cells… they can grow to store more but only so much, after which the body starts to create new fat storage cells. These “extra” cells do not go away if you then shed those excess pounds. Same with excess skin around the belly for example.

            So yes there may be some who have not lived with obesity for as long as others who can return closer to perfect health than others, but we are not all the same. Your Mileage May Vary.

          • Sam says:

            Frank what some people don’t understand is that in any intervention, even potent pharmacologic ones you have a great spread of responder to non responder. Even something like aspirin that works for a lot of people will make some sick, not work as good for others. When you are dealing with a wide variety of genetic and metabolic damages the response to diet will also vary a lot.

            I know of many eating a lot more calories, with the same exercise on VLC losing weight. Good example is Peter Attia http://waroninsulin.com/how-i-lost-weight he is consuming near 5,000 calories more that he did before and lost weight. Expecting everyone to have the same results is just silly it doesn’t happen in any type of intervention. Depending on genetics, how damage our on metabolism is the easier or harder it will be to get back to normal if possible. What is of no doubt is that insulin plays a big role and that the best and easiest to follow to fix those metabolic problems is Low Carb.

          • jocko271 says:

            Oh now it’s the “genetics” and “I’m just broken” excuses??? I like those.

            Your Mileage May Vary doesn’t cut it, Frank. If insulin is what determines your bodyfat levels, then those who don’t raise insulin should be skinny.

            Blaming genetics and the fact that you are somehow “damaged” is just another route to “it’s not my fault” nirvana, which is why you are all here.

          • FrankG says:

            You may dismissively like genetics and metabolic damage all you bloody well please… but until you offer some evidence based proof to refute them you are just so much blather.

            Are you saying that my pancreas is 100% fine? Or that my energy regulation mechanisms are 100% fine, so all it really comes down to is what I put in my mouth today? Does the fact that my Endocrinologist has diagnosed me (and many many others) with “Metabolic Syndrome” lead you to assume that my metabolism is working 100%? Hint – there’s a clue in the name of the diagnosis ;-)

            Your simplistic “reasoning” is absurd. Carbs are not the only thing to raise insulin… look up the Chinese restaurant effect.. protein also raises insulin… we have a basal level of insulin at all times in the body BUT in a person with insulin resistance (IR) we can expect even the basal level to be higher than in an healthy person — let alone the amount needed to control the BG after a meal.

            I should have realised that any attempt to “engage” you in discussion was futile — lesson learned and I hope others will similarly ignore your ranting from here on in.

            p.s. this is the bit where you have to have the last word and rather than even discuss the “engaging” part of my comment you will simply focus on the “deflection”.

            p.p.s. you seem to know why we are all here… so why exactly are YOU here? You can’t possibly think that your comments will be taken seriously by anyone?

          • jocko271 says:

            Frank, I’m here to make you question this stupid hypothesis and to use your OWN brain, not follow some half-truths from a science writer who wants to get famous. I think I made that pretty clear last time.

            First of all, MY “simplistic reasoning”??? That’s funny coming from someone who thinks all health is related to insulin swings, which are in fact completely natural after a meal.

            Even when you’re fasting you can raise insulin without eating a bite. Just the smell of food, or even thinking about it, raises insulin. So shouldn’t we all get fat and metabolic syndrome just by thinking about insulin? Exercise raises insulin too temporarily. Shouldn’t that make you fat? According to your theory it does.

            And BTW, Jimmy lost 100 lbs on low carb too, and he is still quite obese. Are you telling me you are ripped on over 3000 kcals/day? I’d like to see before and after pics if so.

            Because I notice you going on and on here acting like you know all the answers, answering other people’s questions, etc., but by your own admission you aren’t in any kinda shape to be giving sick people advice. Why should your comments be taken seriously by anyone either??

            Lots of diets can regulate your BG: even low fat can do that. You people conveniently forget so many things in your efforts to convince people you have the One True Answer to health.

          • gman3164 says:

            OK, jocko – explain the biochemical mechanism of how a low-fat diet, which is by definition high-carb (and thus high glucose), will keep blood glucose in the normal range? It doesn’t make logical sense. Type II Diabetics struggle with elevated blood glucose. So your cure? Add even more glucose to their blood. And that argument is convincing to you? “Negative, Johansenn!” Clint Eastwood.
            And once again you provide zero evidence for your opinion. Any primary literature references to back up your claims? The answer is “No.”

        • Random.Passerby says:

          I just wanted to point out that jocko271 is a mean person.

          • jocko271 says:

            LOL. Because truth hurts…

          • Random.Passerby says:

            Because of the way you correspond with other people.
            You are writing very disrespectfully.
            I don’t know why you have so much venom in the way you write.
            It looks bad to an outsider looking in. This is on the Internet and is read by a lot of people. I think the way you say things discredits what you are saying. It hurts your arguments. In other words, you are helping the people you are debating against.

            I have a two year old son. I wish I could explain to him that he would more likely get the results he wants by being respectful, calm, courteous. But he is two years old, so he doesn’t have the capacity to engage in that kind of discussion. Instead he says “no daddy! Go away!”

            On the other hand there are times when he is so obedient and sweet, when he puts his arm around my neck and says “love you too!” At those times I am compelled to let him stay up a little later, or get just one more snack.

            I hope he comes to understand that kindness gets you further. I hope you do, too.

            I’m not saying lighten up; be as serious as you please, but soften up. Understand that you are dealing with human beings, not devils or monsters.

            Present your arguments respectfully like you would to someone you really care about.

          • Craig N says:

            Far more concerning his inability to apply rational thought. I am much less bothered by “meanness” in an argument than in its “stupidity”. You can always convince a rational person with evidence eventually (a-hole or not). But with stupidity, you’re SOL . Focusing so much time on the results of one person’s anecdotal experience with a diet is truly assinine. He clearly doesn’t understand the nature of science.

            For once in your life Jocko, try engaging the rational part of your brain. You’ll thank me later. Then you can direct that “meanness” where it belongs… at brain-dead people such as yourself.

      • FrankG says:

        @Adam: I just listened to your podcast with Jimmy Moore — well done! http://livinlavidalowcarb.com/blog/the-llvlc-show-episode-559-adam-kosloff-says-its-time-to-move-beyond-caloriegate/13678

        And I especially appreciated the detailed response in comments to Kelly.

        I agree wholeheartedly that first we need to make the paradigm shift away from focusing on overeating to one of overstoring before we can really make any headway. Then we can really start to tackle questions like “why are we storing excess fat?’. And the answer may be different for different people.. or it may be the same… I don’t know yet. Insulin as a primary agent makes the best sense of it for me so far but as Gary Taubes is quick to point out this is an hypothesis worthy of further testing.

        Progress is often about asking the right questions; as in one of my favourite quotes from Jacob Bronowski, “That is the essence of science: ask an impertinent question, and you are on the way to a pertinent answer. “

        • Adam says:

          Hi Frank,

          Thanks much for the shout-out. I appreciate the support! Gotta practice doing the whole interview thing to avoid stammering and such :]

          Love your comments on this thread, btw.

          • FrankG says:

            You are welcome Adam and thank-you.

            I know that you and Jimmy touched on the fact that there seem to be some who simply like to spread dissent and confusion without really helping anyone — we seem to have our fair share on this blog ;-)

            I could go all conspiratorial and wonder what their real agenda is — they can’t possibly think they are helping can they? — and I even start to wonder who is funding them to spend all day writing endless blog posts while watching and commenting on hundreds of others? There is big money at stake if people move away from processed packaged food and re-embrace local, seasonal sources… not to mention the money in drugs used to treat the multiple ailments resulting from the garbage too many eat.

      • Eating in Orlando says:

        Brilliant!

        I’ve been slammed 100 times by friends and relatives: “all that meat is bad for you, you are over eating”. Of course, i have lost 30 pounds, but they ignore that. I try to explain, in detail and with scientific references, why my diet makes sense. But they shut down and close their ears. So a good slogan is what I need! If the glove does not fit, you must acquit!

    • Dana says:

      Marion’s a human being with letters after her name. I don’t care about human beings with letters after their names. I care about the words said human beings are speaking. If the words can be independently tested and verified, fine. If not, no amount of alphabet soup after one’s name ought to save one’s career.

      Marion’s gone around telling people it’s fine to be vegan if you’re an adult. I can think of four vitamins off the top of my head that you absolutely positively cannot get on a vegan diet, which should have laid veganism to rest a long, long time ago, but some people can’t let go of the notion that a diet *requiring* vitamin supplementation to avoid *death from deficiency* could be anything but healthy.

      That’s pretty much becoming my gold standard. If veganism is OK with you (and by “OK with you” I mean you’re going around saying it’s healthy, *ever*–I wouldn’t outlaw veganism, if you want to adopt a dumb diet then that’s your business) then I pretty much dismiss anything else you’ve got to say unless you can back it up with good science. You could tell me the sky’s blue at noon on a cloudless day and I think I’d have to go outside and see for myself.

    • Jim Bowron says:

      GT does not dispute that you will gain weight if you input more calories than you expend- his issue is that you have to go to the next step, and find out why you are inputting more calories. His basic position, as I understand it, is that because insulin blocks export of fat stores from cells, when your body burns all the ‘fuel’ from the carbohydrates that you just ate, it goes looking for more energy sources. Since it can’t access fat stores, your cells demands more fuel, and thus you overeat.

      • Margaretrc says:

        Yes, @Jim Brown, and Marion Nestle doesn’t do that next step. She thinks that it doesn’t matter where the calories come from–at least according to her blog. I haven’t read the book. Yet. Don’t know that I won’t, but if I do, I will read it with skepticism engendered by reading the works of GT, Drs. Eades, Phinney, Wortman, Attia, and others.

    • Stephen Harris says:

      What’s CI/CO?

    • Martin says:

      What are Marion Nestle’s arguments? You should give us more details.

      If CI/CO is the determinant modulator of fat % in the human body I guess George Bray would have jumped on the occasion to bury the insulin hypothesis when he did his recent overfeeding study.

      He bashed GT when Good Calories Bad Calories came out, saying CI/CO is all that matters, then last year he started his overfeeding study officially to measure how protein affects the fattening process but all of his study groups were kept at 40% carbohydrates. And after that he tells the media that CI/CO is all that matters as if his experiment proved that. He could have tried fattening a group at 5 or 10 % carbs to see what happens. He’s aware of the arguments against the calorie balance but he just ignored them and went into his confirmation bias mode.

      Those who want to bury the insulin hypothesis first need to try to fatten a group of thin people on a high calorie / low carb diet compared to a high calorie / high carb diet in a controlled environment to see what happens. That kind of experiment should have been done decades ago.

      • gman3164 says:

        @ Martin,
        Well put. I couldn’t agree more. I think Taubes and Attia are trying to get funding to do exactly what you suggest. Hopefully it will happen sooner than later.

  22. mhanch says:

    Thanks for the write-up Gary. This has been a hot-button issue and it, as always, is great to hear your take on the issue.

  23. I appreciate the both sides offered on this topic. I enjoyed reading the depth of this.

  24. Fritz Ziegler says:

    Thank you for this, Gary. I feel better. The popular reporting about nutritional received wisdom is so against low-carb-high-fat eating that I need constant reminders, even though my personal N=1 experiment has been going so well since I read “Good Calories, Bad Calories” more than three years ago.

    What distinguishes your work is the lack of nihilism. You point out the problems with nutritional “science” while showing the way to good science. It’s like the difference between PBS NewsHour and all the network news shows. You and Jim Lehrer give me hope.

    Fritz

  25. Matt Taylor says:

    This flawed observational epidemiology remind me of the scene in Monty Python and the Holy Grail where Sir Belvedere teaches the villagers how to tell if a women is a witch:

    Sir Bedevere: There are ways of telling whether she is a witch.
    Peasant 1: Are there? Oh well, tell us.
    Sir Bedevere: Tell me. What do you do with witches?
    Peasant 1: Burn them.
    Sir Bedevere: And what do you burn, apart from witches?
    Peasant 1: More witches.
    Peasant 2: Wood.
    Sir Bedevere: Good. Now, why do witches burn?
    Peasant 3: …because they’re made of… wood?
    Sir Bedevere: Good. So how do you tell whether she is made of wood?
    Peasant 1: Build a bridge out of her.
    Sir Bedevere: But can you not also build bridges out of stone?
    Peasant 1: Oh yeah.
    Sir Bedevere: Does wood sink in water?
    Peasant 1: No, no, it floats!… It floats! Throw her into the pond!
    Sir Bedevere: No, no. What else floats in water?
    Peasant 1: Bread.
    Peasant 2: Apples.
    Peasant 3: Very small rocks.
    Peasant 1: Cider.
    Peasant 2: Gravy.
    Peasant 3: Cherries.
    Peasant 1: Mud.
    Peasant 2: Churches.
    Peasant 3: Lead! Lead!
    King Arthur: A Duck.
    Sir Bedevere: …Exactly. So, logically…
    Peasant 1: If she weighed the same as a duck… she’s made of wood.
    Sir Bedevere: And therefore…
    Peasant 2: …A witch!

  26. Mike says:

    Epidemiology studies smell a lot like looking for Bible codes or stock-picking schemes. Past results are not indicative of future returns.

    • They aren’t bad for starters. The problem is that they’ve been cranking out lots of papers that sound like there is more to them, and then building nutritional policy on top of that.

  27. Jose Marti says:

    Great post.A lot of the problems with these Studies is that they always fail to isolate an independent variable,in this case meat eating,and then test it.I wonder how difficult or costly would be to do an experiment like the one done on Stefansson in 1928.Pick 50 subjects,preferably with Metabolc Syndrome,measure all Health Indicators and then put them in a controlled environment eating meat and fat only for say six months.Experiments like that would go a long way to shed light upon all these nutritional issues.And the cost would certainly be within the range of the Major Universities and Research Centres.

    • jake3_14 says:

      “I wonder how difficult or costly would be to do an experiment like the one done on Stefansson in 1928.”
      Very difficult and extremely costly. In addition, there would be political penalties and a loss of future funding for reporting the truth. That’s why no major institution does experiments like these. Gary and Dr. Peter Attia are trying to get funding for their NuSi Institute, which will do good experiments on a smaller scale.

      • FrankG says:

        In Stefansson’s case didn’t he get backing from the Meat Packers? Along with the strict caveat that they would have no say in the study design etc… ?

  28. tess says:

    It occurs to me that, by Medawar/Popper standards, Guyenet is NOT “DOING” SCIENCE AT ALL. He certainly isn’t paying attention to arguments which knock holes in his HYPOTHESIS (because it hasn’t been tested properly, it can’t be the “theory” that so many people label it)….

    • Martin says:

      What Guyenet is doing is confirmation bias at 200 mph. There’s a big ego underneath his PhD and it didn’t like being rubbed the wrong way at the AHS conference.

      • FrankG says:

        Hi latest blog post is an appeal to “scientific consensus” and I’m also noticing a disingenuous playing down of the brain controlled “fat set-point” part of the food reward hypothesis (FRH). I don’t know if this is a deliberate ploy to garner wider support but I thought FRH was about more than just we eat more of something because it is hyper-rewarding without being satiating — Pringles for example..?

        I can see the common-sense appeal of the idea that we eat more of something because it is hyper-rewarding without being satiating — although it fails to explain WHY the food is not satiating, so we keep eating it — perhaps the peripheral effect of insulin is involved? And I can see a broad -buy-in to that idea BUT how many researchers take the next step and talk about such food raising a “fat set-point” in the brain which signals the body that we need to store more fat mass? Have I misunderstood what FRH means?

        He also tells me in comments that “Dr. Lustig is solidly on board with the food reward hypothesis.” I wonder what Dr Lustig would have to say about that?

        I have asked on both Stephan and Richard Nikol;ey’s blog sites for examples of “hyper-rewarding” foods that do NOT contain sugar and/or refined starch… so far none have been offered. Meantime I can think of plenty which are ONLY sugar or refined starch without any fat.

        It is amazing how these ideas get conflated in people’s minds.. There was a recent BBC Horizon show “The Truth about Fat” — which had a skinny presenter who was quite open about her prejudices towards overweight people; although she did somewhat come around during the show. During the show she would talk about “fatty food” (it almost sounded as if she was spitting the word out) at which they would show pictures of donuts, cakes, hamburgers with buns, ketchup and fries. Fatty foods…. right ;-)

        • Sam says:
        • Martin says:

          FranG: “I have asked on both Stephan and Richard Nikoley’s blog sites for examples of “hyper-rewarding” foods that do NOT contain sugar and/or refined starch… so far none have been offered.”

          I think you’re wasting your time. Many people whom I thought were independent minds seemed to have jumped on the Guyenet bandwagon like a bunch of teenagers fawning over the latest rock star. That was not a rational move. It makes me want to re-read Seth Godin’s book ‘Tribes’.

          You know once you get it, once for example you read The Primal Blueprint, once you know what kind of foods to avoid to be healthy, you don’t need to follow 60 blogs, 30 twitter accounts, post stuff in 10 forums, or participate in “debates” over the writings of a big headed researcher who desperately wants to “win” an intellectual fight against a science reporter. Don’t these people have lives?

          and also, he and some others seem to cling on to the Kitavans as one example of why the insulin hypothesis is wrong, even though:

          a) they eat at most 2 times a day, small breakfast little or no lunch then one big dinner around the fire
          b) they don’t eat a lot, from memory they average something like 2,200 kcals/day
          c) even though it’s technically a high carb diet it’s not a high glycemic diet
          d) they have never been damaged by modern industrial food

          When you take into account meal frequency, calorie intake, glycemic load and the fact their whole lineage has never been exposed to toxic food products unlike most white westerners, it turns out the Kitava study isn’t the blow to the carbs-insulin hypothesis that they make it out to be.

      • FrankG says:

        …His* latest blog post…

  29. Donna E says:

    Terrific arguments, Gary, as always. But I sure would like to know what you think of Ajit Varki et.al.’s research on neu5gc: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2596253/?tool=pubmed

  30. Uh oh, I am going to probably drop dead soon, I haven’t been all that good about listening to my doctor lately. He wants me to eat less, move more, and cut out the saturated fats! Thank you!

  31. John Bailey says:

    Gary, I am a N=1 experiment. In March 2011 I beagen to reduce carbs and increased red meats.
    During this last year, there were no other key lifetsyle changes. Due to back pain, overall I exercised somewhat less. Here are the results one year later:
    Weight: From 199 lbs to 176 lbs; my doctor says I should be no more than 185 lbs. Average since 2000 was 193 lbs.
    Blood Pressure: 130/85, normal, same as since 2000;
    HDL: up to 2.17 from 1.63 ; report says that ideal HDL is more than 1.6.
    LDL: 1.91, unchanged;
    Triglycerides; decreased signficantly , from 1.87 down to 0.54, half the level of the average since 2000.
    My doctor’s report says that “cardiac aerobic exercise and certain medications increase HDL”. I had neither.
    I believe your book indicated that fatty meats may increase good cholesterol – HDL. This is what happened to me. I also believe many think that waist size for men and HDL are two strong indicatos of healthiness. All of my wieght loss was from my gut, and I have dropped 4-5 inches in waist size.
    I hope my experiment can help your arguments about red meats and carbs.

  32. Katie P says:

    We eat mostly red meat in our house. My husband recently had his blood work done and his cholesterol is 110, triglycerides are on the very low end of normal/healthy, his blood pressure is right where it needs to be and his doctor says he has the healthiest heart he’s ever seen! My numbers are similar to his. We don’t eat fast food, however, don’t smoke, drink rarely and exercise every day. The red meat we do eat is lean and we always balance our meals. Lots of fruits and vegetables too. We don’t eat any synthetic food or processed food. Just what nature gives us, including copious amounts of red meat. :)

  33. Stephanie says:

    Or, as I put it:
    surveys+statistics NOT=science.

    Interesting post as always. I wish the media would report that these same “scientists” were the ones who told us to take HRT to prevent heart attacks! WTF Harvard, get some standards!

  34. Sue says:

    Thanks for your tell it like it is insights! Over the years I’ve worked for a couple of marketing research companies and I can tell you first hand that studies that have people filling out lengthy questionnaires are notoriously flawed! Especially the kind that are done at home and mailed in over long periods of time. I could spend the next several hours stating all the ways these studies are flawed and still wouldn’t even scratch the surface.

    You need to keep reminding people that these studies are based on just such questionnaires. Until people really get it drummed into their heads that THIS ISN’T SCIENCE, they will keep being led like sheep to believe almost anything an observational study tells them to believe….as long as it’s in the media of course, because if it’s in the media it must be true!!!! Keep telling it like it is Gary!

  35. fred hahn says:

    Good one Gary.

  36. Greg says:

    Thanks for a great post Gary. I do have some issue with your assertion that seems to imply that the only good science comes from a type of Popperian falsification. Granted, the study in question is BAD science, but it is a form of science nonetheless. As you say, even an N=1 offers some form of data that adds knowledge. We just must understand its limits–as the authors of the Harvard study did not!

  37. Stabby says:

    Brilliant article, thanks for this. And the first part of Good Calories Bad Calories. Debunking bad methods as it pertains to nutrition research is where you shine. Possible confounding factors that Walter Willet would agree absolutely influence mortality:

    Trans fat intake. Is the meat coming from a grass-fed rancher or from Mcdonalds? The latter has partially-hydrogenated oils. But these studies don’t even try to control for trans fats and I’m skeptical of their ability to do it even if they tried.

    Cooking intensity: Meat that is cooked too much is carcinogenic. Is it reasonable to believe that those eating the most red meat are also going to have the highest intake of heat-formed mutagens and toxins, which can probably be tied to any degenerative disease? I’d say so. But this isn’t a criticism of meat, per se. Just the technique used to prepare it.

    Drug use: Okay it’s not polite to talk about it but isn’t it a factor in mortality? Is this controlled for at all? Sure it is probably associated with non-compliance to the government-knows-best program but to try to say that it is accounted for when we control for whole grains and exercise is going to be inaccurate.

    I’m sure we could sit around and come up with more. But will we ever be able to accurately control for all of this? If you think people are inaccurate about their meat intake (which they are) then just think of how much they will tuck their drug intake into the back of their minds.

    Oh well, we do have controlled trials and actual knowledge. And we have Gary Taubes and some other good minds :-)

    • Dana says:

      Until they control for every other factor that is known to lead to early mortality I’m not even going to try to surmise what in red meat could be cutting lifespans short. We’ve been eating red meat for a good couple million years now and, until the advent of agriculture, it was accidents and infections killing us early, not our diets.

      By the way, because you’ll hear this at some point and it might freak you out, there are trans fats in red meat whether it’s cooked at McDonald’s or not. Trans fats that occur naturally in beef and dairy are actually good for you. Conjugated linoleic acid is one of them and there’s another whose name I have not yet committed to memory. But the press is reporting that they are implicated in *decreasing* heart disease and type 2 diabetes risk–which is *odd*, given their other brash statement that red meat kills you.

      As for nitrates in processed meat, those exist in vegetables too. They’re thought to be one reason vegetable-eating reduces your blood pressure. Uncomfortable implications for eating processed meats, if so. I just don’t worry about it, especially given that processed meats are more likely to contain organ meats, which most of us don’t eat at all anymore and which have been keeping human beings healthy for a very long time now.

      • Stabby says:

        Yep I’m familiar with CLA. It does seem to combat cancer and heart disease in the lab, although that isn’t necessarily an argument for red meat if this association actually represents the truth. It could be that the CLA in meat is beneficial but just not as good as red meat is bad. I doubt it, though. Grassfed meat has a lot more of it so whether or not the beef that most Americans eat is protective or not, grassfed meat would be expected to be better.

        Nitrites are indeed present in vegetables, however I think that there is an important distinction but an easy solution. Vegetables have vitamin c which if present facilitates the reduction of nirites to nitric oxide rather than what they would end up otherwise, the damaging nitrosamines. http://www.ncbi.nlm.nih.gov/pubmed/1860156

        Thinking about it we might be able to say that bacon + an orange is a more heart-healthy breakfast than an orange alone!

        • Kris says:

          Well said. Vegies are not isolated to just nitrates (or nitrites). Any time you eat a whole food, odds are in your favor of it being healthier.

      • Margaretrc says:

        Actually, I think it’s nitrites that exist in vegetables, more than nitrates.

  38. Josef Boberg says:

    Wi have to eat “real food” to feel good – as I see it.

  39. Melinda S says:

    Another plausible explanation, that goes along well with your point about not being able to compare the groups well, would be that many people who eat the standard American diet eat almost no vegetables and little fruit. Compared to vegetarians, they might actually fare worse. But that is not necessarily the meat’s fault.

    • Dana says:

      The Inuit also ate almost no vegetables or fruit on their traditional diet. I don’t think the lack of plant foods is the problem. It *is* worth noting that people who eat red meat are also very likely to eat more refined carbs such as hamburger buns, French fries and potato chips. They’re probably also more likely to smoke.

      • LowCarbGran says:

        Yes indeed Dana. And Cokes, 7Up and sweet sauces. To not measure these burger-variables means they cannot be controlled for. To then say that “..we have controlled for all other variables..” is outrageous. This “study” stinks. Because 50% of red US meat is consumed as burgers the study actually measured the (diluted) effect of junkfood on health. Junkfood, the worst known offender was not controlled for or even mentioned in spite of it significant prevalence in possibly 50% of the red meat consumed.
        But to mix variables is a well used trick by so called “scientists” that produced this study, or its conclusions. I call them charlatans.

      • mezzo says:

        And why are they more likely to smoke and have other unfortunate habits? Because as long as red meat is demonized only people who like to misbehave will eat substantial quantities of. People who try to lead a so-called “clean” life usually try to eat mostly vegetarian, will not smoke and try to exercise regularly. Had this study been conducted in, say, Argentina, where a meal without red meat is not seen as a proper meal the outcomes might have been mighty different.

  40. Tony M says:

    Gary – this is exactly what you shuld be doing more of on your blog. I get it that you want to be careful and considered, but it’s a blog, not an academic paper. It’s invaluable to have you delvier your insight when the discussion is current. Thank you.

  41. Nathan Ton says:

    Gary Tabes thanks for the informative email Ive had lots of Co-worker telling me I’m going to DIE! I’m hardcore Meat Eater I eat almost exclusivley meat/fat/cheese in that order. I’m a machine lean strong could not feel better Thanks for your books I wish I could pass on the message as you have….. Almost nobody wants to listen its very sad state we live in.

  42. Tom Bunnell says:

    “I have found the “devil”. Genuinely. — I know that you don’t believe that. Nobody does. — It’s the “adrenaline like effects” of sugars and hybrid carbohydrates”. This is the devil, for sure and for true. — My discovery, I share with you. Thank you.
    -Tom Bunnell

  43. Lolly McIver says:

    I’m so thankful that you are obsessive about this issue.

  44. Emily says:

    Awe Gary!
    Your writing makes it look like an epidemiologist ran over your dog.
    In case you haven’t read it, the original article is here: http://archinte.ama-assn.org/cgi/content/full/archinternmed.2011.2287 . I think your issue is with the media portrayal of the study, which gave it a causal spin (nowhere in the article does it claim causality). Epidemiologists are well aware of the strengths and limitations of their tools, and discussion is generally restricted within those confines. Often the interpretation of results can be confused/sensationalized by people external to the field. I think you might have meant to aim your lengthy diatribe towards them.
    ….but wait, that sounds very familiar. Someone who is external to the field but who communicates broadly with the public, putting their spin on things…..ah now I see why you’ve chosen to criticize the scientists rather than the media.

    • Agentzero says:

      Emily,

      Perhaps you did not read the article. For your convenience, I excerpt below the phrases in which the authors let slip that they have confused correlation with causation:

      “the adverse effect of red meat intake on mortality risk;” “we could not assess whether lean meat has the same health risks as meat with higher fat content;” “the additional harm of processed meats;” “replacement of red meat with alternative healthy dietary components may lower the mortality risk.”

      In other words, while the authors (mostly) speak in terms of correlation, they are not consistent about it, and I have no doubt that they believe — and want their readers to believe — they have identified a causal link.

      Did you notice the paragraph in the article in which the authors state that they have only observed a correlation and that experiments would be warranted to attempt to determine whether there is a causal relationship? Me neither … it isn’t there.

    • GT says:

      Hi Emily,
      Regrettably, and not surprisingly. I disagree with you. Here’s the last line of the abstract: “We also estimated that 9.3% of deaths in men and 7.6% in women in these cohorts could be prevented at the end of follow-up if all the individuals consumed fewer than 0.5 servings per day (approximately 42 g/d) of red meat.” If that isn’t an implication of causality, I don’t know what is. Yes, they’re not saying this would happen, only that it could, but they shouldn’t even be doing this. At best they should be suggesting that tests be done to check this hypothesis. And, yes, the journalists are to blame as well, but if the journals didn’t put out press releases, if the universities didn’t put out press releases, and if the researchers refused to speak to the journalists, the journalists would not be able to over-interpret the data and would have little motivation to do so. I discussed this point in my Science article back in the mid-1990s. The epidemiologists would like to blame it on the press coverage, but they’re pushing this stuff as well. So, yes, I’m external to the field, but that doesn’t make my criticisms invalid. And when I do criticize in these articles, I’m only echoing the better researchers in the field and giving voice to their criticisms.
      A last note, after I wrote the NYT Magazine article in 2007, I was invited out to Berkeley to lecture at the School of Public Health and also to meet with the epidemiology doctoral students for two hours, no other faculty present. The students gave me a list of questions they were going to ask in advance about the NYTM article. One of them, perhaps the only serious criticism of the article, was why did I focus the article on the Nurses’ Health Study and the Harvard group because “everyone knows they’re terrible.” (This is being recalled from memory after four-plus years, so that quote may not be verbatim but it’s certainly close.) My response when I met with the students in Berkeley was that it’s not good enough in a functioning field of science to know other researchers are terrible. Researchers have to police their own fields. They have to weed out the, well, weeds. And so they had to expose the bad science of the Harvard group and get them out of the field. I don’t know how that would be done, but I think about it a lot.
      gt

      • CRoman says:

        I am a nutritional epidemiology doctoral student. I read the article, read this entire thread and I am 100% with Emily. I have also read GCBC and Willett’s Nutritional Epi text. I will say this. Willett is clearly the expert in nutritional epidemiology. Taubes is a journalist. Epidemiology is a very useful form of pseudo-science, involving human behavior, taught in schools of public health – not in labs. Most epidemiologists are drawn to the field because intuition is welcome and necessary for making progress in public health. Results are presented and in spite of all the bias and confounding factors that epidemiologists are well aware of, it’s still good to publish these findings. It’s also good that they are examined critically. I just think Taubes takes it too far by criticizing an entire field of science, rather than adding useful commentary to an interesting article.

        I think the the most beneficial outcome (in terms of public health) for this situation would be for epidemiologists to continue presenting results the way they are expert in doing, and then for the media and journalists to make fair and thoughtful criticism or commentary that does not lead the public to believe that a Harvard expert doesn’t know what he’s doing, and it’s better to trust a blogger/author/journalist.

        Epidemiologists love knowledge and answer questions with more questions (and can’t wait to test them). Journalists love controversy and recognition more than knowledge. Where do you suppose truth is found? We are imperfect humans striving to make perfect sense (with numbers and stats) out of life. Is that possible? Of course not. But if we acknowledge it will never be perfect and we are actually happy about that because it lets us continue to ask questions and discover little bits at a time, shall we pursue it anyway? Of course! Welcome to the joy of Epi.

        I’ll also take gt’s follow up, defensive, block paragraph, rant as further evidence against his willingness to admit that he might be pointing his finger in the wrong place (at scientists rather than media including himself) and that he cares more about defending his reputation than discovering truth regarding disease prevention (like I am convinced Willett is).

        • Martin Levac says:

          Epidemiologists really do look like they don’t know what they doing. I never needed Gary to point it out to me. I’m smart enough to figure it out on my own. Are you?

    • Mark Weaver says:

      Emily,

      Agentzero and Gary already replied more than adequately to your comment, but I’ll just add that if that phoney baloney, piss poor methodology “substitution association” analysis that they did wasn’t aimed at causality, then what was its purpose? If you substitute one thing for another (which is exactly the kind of manipulation that one would assess within a randomized trial), then how much longer will you live… that’s obviously all about causality even if they play with words like “association” within the manuscript. Yes, the reporting was overblown, but the “research” was complete garbage in the first place.

    • Stipetic says:

      This is a quote from the New York Times’ article about them deadly red meat:

      “When you have these numbers in front of you, it’s pretty staggering,” said the study’s lead author, Dr. Frank B. Hu, a professor of medicine at Harvard.

      I mean, what is the public, or anyone for that matter, suppose to make of this? Just sayin’.

  45. Natalie says:

    Perhaps the compliance effect is not anything in particular that the ‘Girl Scouts’ do – but rather, the fact that Girl Scouts believe they have the power to improve their health. Studies on well-being would indicate that people – children, pregnant women, pensioners, etc. – do better when they are more involved in processes and have more responsibility. Remember the nursing home studies that found giving patients a potted plant to care for seemed to be correlated with better health? Maybe compliance effect measures the same thing – not only do ‘Girl Scouts’ care about their health, but they believe it is in their power to do something about it (as opposed to feeling overwhelmed and helpless).

  46. John Miklavcic says:

    Gary suggests that compliance is an issue is observational studies. This is a misplaced critique. Compliance, by definition, cannot be an issue in retrospective observational studies since there is no intervention; there is no treatment or placebo group that requires a protocol in which to adhere.

    The intervention that Gary suggests does not adequately test whether a diet high in red meat impacts mortality. He suggests a study in which one group is randomized to high meat, and the other to low meat, high vegetables, and high whole grains. The objective of science is to test one independent variable only, but there are 3 variables which have been altered (meat, vegetables, grains). Gary’s study design has introduced confounders- and in his article, Gary also suggests that no amount of correction can adequately adjust for confounders in studies. Gary’s logic is paradoxical. As such, the conclusion of such a study would not definitely ascertain whether red meat is a culprit. If the high red meat group was found to have increased mortality upon completion of the study, interpretations could include that diet high in phytonutrients or fibre decreases mortality, since the comparison group was consuming more vegetables and whole grain. Another issue is that the composition of protein, fat and carbohydrate is radically different between both test groups. Therefore, one is not necessarily testing whether red meat consumption causes an increase in mortality, but whether higher protein and fat (characteristics of red meat) diet causes an increase in mortality.

    There are ethics review panels needed for approval of research. Literature to date suggests that red meat is associated with increased mortality, therefore, no review panel will approve a research study that proposes intervention with high red meat content.

    Gary critiques a (Harvard) study that measures mortality as the outcome. Gary addresses “successful” Atkins’ intervention studies which measure weight loss as an outcome. As weight correlates to obesity, this a measure of morbidity, not mortality. Apples and oranges. It is also important to note that in scientific literature, just about ANY diet intervention is successful in short-term, clinically-measured weight loss.

    • Agentzero says:

      What John says Gary says:
      ” Gary addresses “successful” Atkins’ intervention studies which measure weight loss as an outcome.”

      What Gary actually says:
      “And when these experiments have been done, the meat-rich, bacon-rich Atkins diet almost invariably comes out ahead, not just in weight loss but also in heart disease and diabetes risk factors.”

      Please try again.

      • John Miklavcic says:

        Agentzero effectively supports my point. The focus of the article is a critique of a study in which the outcome is mortality. Gary’s suggestion to discern the true relationship between red meat consumption and mortality (death) is to “Do the experiments,” and Gary suggests “These experiments have effectively been done.” Yet he references (as Agentzero adequately cited above) a dietary invention which measures morbidity (weight, heart disease, diabetes) outcomes.
        He is saying that these intervention studies address his perceived “flaw” or the (Harvard) study. Yet, he is looking a completely different outcome, morbidity instead of mortality.

        • Sam says:

          To me all Gary is saying is common sense if health markers improve in these trials were meat is eaten, why meat will cause increase mortality.

        • Margaretrc says:

          And does “morbidity” not affect “mortality”? Are you saying it’s not reasonable to assume that people with more morbidity will also have a higher rate of mortality? I think you’re reaching for straws and missing the overarching point of Gary’s analysis. There are many “studies” out there that equate increased morbidity with increased mortality. Sicker people do tend to die off sooner (of natural causes, I mean) than the healthy ones, no?

          • John Miklavcic says:

            The major cause of death in North America is heart disease, not natural causes.
            Morbidity does not necessarily correlate with mortality; rather, there are varying associations. Inflammatory bowel diseases are a set of disorders characterized as a co-morbidity and very low mortality. Death rates between IBD patients and healthy individuals do not differ significantly.

            Let’s look at the case of prostate cancer morbidity.
            In an 11-year period, prostate cancer mortality is 107/100,000 afflicted persons (0.11%/11 years; Schroder et al. NEJM 2012. 366(11):981-90).
            All-cause mortality rate for men in Canada is 748/100,000 (0.75%/year; StatsCanada, 2005). Over an 11-year period, that equates to 8228 deaths (748*11 = 8228). 107 of these deaths can be attributed to prostate cancer, meaning 8121 deaths are caused by something else (8228 – 107).
            In the case of prostate cancer, there is a 76x greater chance (8121/76) of dying WITH prostate cancer than dying OF prostate cancer. I hope this helps answer your question above.

        • James D. says:

          there are studies showing links between caloric intake and mortality, and i have seen other studies suggesting it is actually higher protein intake specifically, and not calories in general, which adversely affects mortality. but to be fair, atkins is a high fat diet–not high protein as people tend to believe.

          http://www.google.com/imgres?um=1&hl=en&sa=N&tbm=isch&tbnid=AM50QhN9VrkwSM:&imgrefurl=http://www.wired.com/wiredscience/2009/07/monkeylongevity/&docid=NpF57GmuOHMfoM&imgurl=http://www.wired.com/images_blogs/wiredscience/2009/07/cr_monkeys.jpg&w=773&h=655&ei=nC5qT6_iGYPVrQfX4dmWAg&zoom=1&iact=hc&vpx=343&vpy=133&dur=3335&hovh=207&hovw=244&tx=137&ty=131&sig=107776293670206923684&page=1&tbnh=115&tbnw=160&start=0&ndsp=76&ved=1t:429,r:1,s:0&biw=1920&bih=1139

          • Bob T says:

            The only 107 per 100,000 I find in the March 15 NEJM paper is the absolute difference in prostate cancer mortality between the two arms of the clinical trial (where the rate is calculated as the number of prostate cancer deaths divided by the number of men in each arm). The paper reports that 299 of 6,963 prostate cancer cases in the intervention arm and 462 of 5,396 prostate cancer cases in the control arm died of prostate cancer. The overall death rates can be calculated from supplementary Table 5A, and it can be estimated that approximately 1290 prostate cancer cases in the intervention arm died of other causes and that approximately 1000 prostate cancer cases in the control arm died of other causes. That is, a prostate cancer case was a little over four times as likely to die with prostate cancer than of prostate cancer in the intervention arm, and a little over twice as likely to die with prostate cancer than of prostate cancer in the control arm.

  47. brittany says:

    Thanks Gary. You are always a trusted source of reason. I especially like this point “The hard part of science is left out and they skip straight to the endpoint, insisting that their interpretation of the association is the correct one and we should all change our diets accordingly.” How very true and very concerning.

  48. A Country Farmer says:

    Seems like there should be a 30 year, randomized trial study comparing the atkins vs USDA.

  49. Joshua Bey says:

    The compliance-effect is a good way to explain this. I’ve always called it the “Flanders” effect, which makes sense to any fan of The Simpsons out there:
    “The family goes to the car wash to get rid of the dust, and when Homer is there, he sees that Ned Flanders gets a senior discount. At church, Flanders admits to Homer that he is sixty years old. After he is exposed by Homer in the church, Ned says that he follows the three “c”s of success: clean living, chewing thoroughly, and “a daily dose of vitamin Church!” However, he also has never lived impulsively, and never really had any fun in life. The rest of the town stops admiring Ned for living so well, and begins to pity him for having never truly lived at all.”
    http://en.wikipedia.org/wiki/Viva_Ned_Flanders

  50. jesse says:

    Hi Gary,

    Appreciate the article, rushed as it was it was still valuable. For this particular set of cohorts is socioeconomic status a valid confounder? I thought they were all doctors and nurses.

    Jesse

  51. Joe says:

    Just a few concerns:
    - How could an RCT be done to study this exact question (to get individual level inference) ?
    - These so-called girl scouts and truckers all graduated from either medical school or nursing school (and so obviously gave enough of a s**t about their health education to complete it, and also to show up for 20+ years follow-up for these studies). Although I am not naive enough to believe that this is a homogenous group (when it comes to lifestyle behaviors); I also don’t think that these 2 groups (meat eaters and non meat eaters) are incomparable.
    - As the authors of the study pointed out, bias as a result of measurement error is likely towards the null (hence the 0.2 fold increase in risk is likely an underestimate). But even if it wasn’t an underestimate, considering the number of people who eat meat around the world, the implications are still huge!!
    - Finally, Walter Willet is a scientist (perhaps the best nutritional epidemiologist in the world). He does research and puts himself out there. It is easy to shoot down his and others work, but can you design a better study?

    Ultimately, red meat is one factor (out of about a billion) that exists in our world and that may or may not be associated with health. We shouldn’t be too quick to rush and alert the media (and the entire world) that eating red meat will kill them, but should remind them that: the poison is almost always in the dose!

  52. Heike T says:

    I have not heard of any studies that compare the impact grass-fed/grass-finished meat has on our health as opposed to the factory-farmed, antibiotic-laden, hormone-injected, pesticide and herbicide-containing, GMO-tainted garbage that is being sold as meat these days. It doesn’t need much genius to figure out that that kind of meat is the problem. Wouldn’t it be great if our mainstream media would occasionally show some remote capacity for critical thinking? Pink slime? You bet you will get chronically ill when eating that stuff. A ratio of Omega 3s to Omega 6s that is way out of proportion and contributes to high levels of inflammation? No CLA that typically can only be found in grass-fed beef and has been shown to have a role in reducing the risk for cancer? We are not talking about what nature has designed for us. It is not the nature of red meat that is to blame for disease; it is the man-made alteration, manipulation, and distortion of what should be a staple in our diet. Unfortunately, what is being called “science” these days is so heavily shaped by conflict of interest that I think it is high time that we start thinking on our own again and occasionally trust our own intuition again. On a different note, the whole cholesterol question is also a complete marketing ploy. Cholesterol is a symptom of an underlying condition your body is attempting to repair. To lower cholesterol means to interrupt a healing process. Wow, do we have it all backwards….

  53. John Miklavcic says:

    Gary suggests that a 0.2-fold (20%) increase in mortality is too modest to warrant media attention. He also cites other epidemiologists who suggest that 3- to 4-fold (300-400%) differences also do no justify attention.

    See the abstract of a study published in 1986: http://www.ncbi.nlm.nih.gov/pubmed/2871418
    Vitamin A intervention study was performed and it was found to decrease all-cause mortality by upwards of 34% in Sumatran children.

    As concerned citizens of the world, we’d be unreasonable not to think that we should get vitamin A to kids in 3rd world countries. On the other hand, Gary and the epidemiologists he cites would consider this a small fold difference, not worthy to note.

    Gary is quick to address limitations in methods of epidemiology, but doesn’t give credit to its strength as highlighted above. Small percentage (fold) differences mean monumental impact in huge populations where life and death are concerned.

    • FrankG says:

      I read that abstract as stating “…mortality in control villages … was 49% greater than in those where supplements were given”, so you are really just adding to my initial suspicions that you are either having trouble with reading comprehension or are being deliberately misleading.

      The study you cite was a random controlled intervention trial (RCT) that set out to test a specific hypothesis (real science in other words) and apparently it did so.

      On the other hand the retrospective observational study that triggered the discussion in this blog post was not even designed to test if red meat increases health risks… the best it could be used for would be to propose hypotheses that could then be tested in RCTs.

      A 49% increased mortality in the control group for an RCT bears no comparison to an estimated 20% risk based on a four yearly questionnaire whicj has some very dubious data such as: the group with the lowest reported red meat consumption claiming an average of 1,200 calories per day — hard working nurses, on their feet for 12 hour shifts at 1,200 calories per day… seriously?

      But nice tug at the heart strings ;-( those poor Sumatran children won’t convince me that read meat kills.

      • John Miklavcic says:

        The start of the sentence you refer to says “at baseline.” That means before the intervention. Intervention with vitamin A decreased mortality.

        • FrankG says:

          50 villages in northern Sumatra were randomly assigned to either participate in a vitamin A supplementation scheme (n = 229) or serve for 1 year as a control (n = 221). 25 939 preschool children were examined at baseline and again 11 to 13 months later. Capsules containing 200 000 IU vitamin A were distributed to preschool children aged over 1 year by local volunteers 1 to 3 months after baseline enumeration and again 6 months later. Among children aged 12-71 months at baseline, mortality in control villages (75/10 231, 7.3 per 1000) was 49% greater than in those where supplements were given (53/10 919, 4.9 per 1000) (p less than 0.05). The impact of vitamin A supplementation seemed to be greater in boys than in girls. These results support earlier observations linking mild vitamin A deficiency to increased mortality and suggest that supplements given to vitamin A deficient populations may decrease mortality by as much as 34%.

          I read that as “the children were aged 12-71 at baseline” and that among this group of children “mortality was 49% greater where supplements were not given”

          I do see where you get the 34% although that figure seems to take into consideration other studies and only specifies “vitamin A deficient populations” which may include adults for all we know; based on just this abstract.

          • John Miklavcic says:

            I get 34% from inverse proportions.
            Consider that relative to 0.67, 1.00 is a 49% increase (0.67 * 1.49 is approximately equal to 1.00).
            Consider that going down to 0.67 from 1.00 is a 33% decrease (1.00 – 0.67 = 0.33), hence, why I specified upwards of 34%, it’s also written in the last sentence of the abstract. Am abstract needs to respect brevity and therefore does not present that above calculations.
            I’m glad you found a passion regarding the injustice of basic nutrition is 3rd world countries. There are several great NGOs set up to help kids in such cases, one or another may resonate strongly with you and compel you to action.

        • FrankG says:

          …“the children were aged 12-71 months at baseline”* obviously

        • FrankG says:

          As a personal aside I am furious and saddened to live in a world where nearly half of these children could die for lack of basic nutrition… I’d suggest that any need for vitamin A supplementation is just indicative of lack of decent food.

    • Bill Barendse says:

      A 20% increase in risk is not the same as a 20% increase in incidence. So we are all worried if the incidence goes up by 20% but not if the risk goes up by that amount. If the relative risk (RR) is 1.2 (ie., 20% higher) then the increased incidence in the subset is the overall incidence times the RR. So let’s say that death from coronary heart disease (CHD) has an overall incidence of 25%, then in the subpopulation the incidence is 1.2 times 0.25 = 0.30, so the overall incidence has gone up 5%. Had the overall incidence of CHD been 5% then the incidence in the subpopulation would have been 1.2 x 0.05 = 0.06 or 6%, and increase of 1% in the incidence. Clearly, the overall incidence of the disease and the RR determine how important the observation is.

      The main point about RR of >= 3 being a standard for observation has more to do with reproducibility than importance. The smaller the sample the more likely it is that a RR will need to be large to be detected in the first place, the more likely it will be to be overestimated in the first place to be statistically significant, and the more likely for it not to be observed in the next study. But RR > 3 tend to be relatively stable unless the first study was dreadfully small in size. With the giant studies dealing with tens of thousands of observations this is less of a problem, although the GIGO law will always hold.

  54. England says:

    Thanks Gary. I enjoyed your article as I continued my n=1 experiment by eating a good amount of meat. Specially, while reading your blog at lunch time today, I had about 2 oz. of roast beef, 2 oz. of liverwurst and 2 oz. of Andouille sausage with several olives and pile of pumpkin sweetened with cinnamon and Stevia – a la Bernstein.
    You are a confident man. Calling out a top tenured professor of nutritional science at one of the top university in the world! And saying that he does not do proper science implying that he does not know how and/or is lazy and/or has other egotistical and/or financial reasons not to do proper science. I’m glad you did. And I agree that it is a sad state of affairs.

  55. Scott says:

    I too am skeptical of the recent research on red meat — above all because, even if we take it at face value, the effect is minuscule. Moving from the lowest quintile to the highest quintile increases your chance of dying of heart disease from 0.8% to 0.9%. Meh…

    However, I’m not sure that this critique really nails it.

    It’s never possible to control for every possible confound. But the researchers do seem to have controlled for most of the obvious ones. And, more to the point, adding lots of other factors wouldn’t necessarily make much difference. A generally “health conscious” person might do lots of things that improve their health, but all these things are likely to be correlated with each other (ie health conscious people walk more, and smoke less, and buy more organic food, and watch less TV and so on). And because they correlate, adding them to the statistical model doesn’t add any extra information. (For the geeks out there, this is the problem of multicollinearity.)

    Also, it’s not really fair to say that the study was the equivalent to comparing “Berkeley vegetarians” and “redneck truck drivers”. After all, the participants in the study were all doctors and nurses. I’m sure they varied in their degree of compliance, but not as much as is implied.

    This is not to say that I agree with the study’s findings, just to say that by dismissing it on weak grounds unnecessarily weakens the case for real food.

    II’m not sure what an ideal critique would look like… they would certainly include the unreliability (and social desirability effects) of the food questionnaires that were used). But my main objection is that these studies are not putting low-carb / primal / paleo claims to the test. After all, what distinguishes the paleo diet is not its reliance on meat. Rather, it is about replacing bad quality meat with good quality meat, and replacing grains with vegetables and fat. These studies don’t tell us anything about whether this diet is better (or not). So, who cares what they say?! (Who wants to defend the consumption of factory-farmed meat!) But, as Taubes points out, there are plenty of other studies that have tested versions of these claims, with good results. That’s what you should be citing next time some SADsack upbraids you for ordering the steak.

    • Mark says:

      Scott,

      Two points here. First, there is indeed a way to control for every possible confounder, it’s called randomization. You’ll probably say something like “confounding is even possible with randomization”, but that’s just not true. Random covariate imbalance is indeed possible (and ubiquitous) with randomization, but it doesn’t induce a stochastic bias like true confounding does. As the most excellent statistician Stephen Senn has said, there are “two incontrovertible facts about a randomized trial: 1) over all randomizations the groups are [always] balanced; 2) for a particular randomization they are unbalanced.” This is no big deal, it all comes out in the randomized wash.

      Second, epidemiologists really need to understand that controlling for all known or “obvious” confounders does not necessarily reduce the overall confounding bias, it can actually increase bias. Confounding, like any bias, can be either positive or negative. This is the fundamental reason why any causal inference based on observational data should be taken with a HUGE grain of salt, regardless of how fancy the mathematical models were.

      Sorry, one more thing… multicollinearity is completely irrelevant here, much as it usually is.

  56. Margaretrc says:

    Thanks, Gary, for injecting a bit of sanity into this nonsense. Please keep doing what you are doing. Dr. Marion Nestle’s new book, “Why Calories Count” is out and has just been reviewed (positively, I presume) by Nature. I confess I haven’t read the book–yet–but I read her blog and honestly, she doesn’t have a clue. Thinks it doesn’t matter where our calories come from, it’s all about CICO, etc. etc. How someone with an advanced degree in Biochemistry can still carry on with that stuff is totally beyond me. She does indict sugar, however, and that’s a good thing. Unfortunately, she has apparently not made the connection that healthywholegrains are a source of sugar as well. One can only hope that people who have read your books and articles will take what she says with a grain of salt. I know you are very busy, but I hope some day to see a review of her book by you in the NYTimes or elsewhere. Dr. Nestle is quite popular and has a pretty large following (not that you don’t) and some of us worry that this will be a big setback to the LCHF movement.

  57. Ida Fiorella says:

    Living a low-carb lifestyle for over 10 years, I can attest to the health benefits of eating proteins (including red meat and bacon!), healthy fats, and lots of green vegetables. My doctors have stated that my cholesterol is perfect, and I am in excellent health according to check-ups. This was not the case before I started low-carb. Several friends are now following the same low-carb plan, and they are experiencing the same health benefits. I am very thankful, Gary, that you are able to so articulately and patiently explain what the true studies show, and that you don’t let the researchers in their ivory towers get away with serving us “conclusions” that don’t even respect the basic “scientific method” they learned in grammar school. I truly enjoy your blog.
    Ida (co-author of Thin and Thinner)

  58. Elsa says:

    I love your analytic mind and scientific approach to the whole issue. You inspire confidence. Whatever the studies say; the proof is in the pudding, not so? People, like me, who have become obese by eating high carbohydrate/low fat all their life and have consequently suffered the effects of this way of eating healthwise can and will testify that their health in general has improved hundred-fold – amazingly, for me, in only 3 months! What more proof does one require?

  59. Tom Bunnell says:

    Better said: Revised and Edited:

    ‎”I have found the “devil”. Genuinely. — I know that you don’t believe that. Nobody does. — Stimulants. — It’s the “adrenaline like effects” of sugars and hybrid carbohydrates”. This is the devil, for sure and for true. “It’s God, too”. — Not just the profound effects on our bodies and body chemistry, like diabetes and heart disease and cancer and mental disease and obesity and anorexia and whatnot, our entire earths population. But the adrenaline like effects and high energy that fuels and effects our minds and intelligence and emotions and feelings and senses and sexuality and thought processes, profoundly. Our being. — Our thoughts and our decisions and our perceptions. What we see and what we think and what we feel. Our spirits, our souls, our psyche, our ego, our self esteem, our aggressiveness, our passivity. — Alcohol is the highest form of sugar. All are stimulant drugs that make us crazy. But we don’t know that and when we hear it, we think of it as absurd and we don’t believe it. We think it’s laughable. Man’s taking over of the whole world, and effecting what we see and think and feel, by stimulants. Wheat and flour and fruit and vegetables and milk, being stimulants. “This is whacko rants and raves of a lunatic madman. Foolishness, personified. Idiocy. Idiosyncrasy. Extremism, Ignorance, Myth, Imagination, Fantasy, Dreams, Hallucinations, Paranoia. — My discovery, I share with you. Yes, it is all of the above, and more. Sugar and hybrid carbohydrates. Man made stimulant drugs. Thank you.
    -Tom Bunnell

  60. As the daughter of a butcher, I ate my share of steaks and chops. But in his last years, my father lamented that he could not find a decent pork chop (the other white meat had been leaned to the state of shoe leather). The point is, my father bought his lambs (in his case) from a local farmer, had them slaughtered locally and cut the meat himself. So did the beef dealers in his coop market. The point is, maybe this study had some credence, but it may not be the red meat itself but all the junk that is fed these poor beefers at their feedlots, all the chemicals in their bodies, all the stress hormones of their last days. I don’t want to sound like a PETA person, but really so much of what we eat is no longer natural. Now most chicken is grown without hormones or antibiotics. Wish the beefers were, too, and sadly I can’t afford free range.

    • Robert Dennis says:

      “my father lamented that he could not find a decent pork chop (the other white meat had been leaned to the state of shoe leather)”

      Oh, how true that is. I like pork chops but I have to melt crumbled gorgonzola cheese on them to make them palatable.

  61. Thire says:

    Thank you for these insights. As a nutritionist myself, I have often struggled with what constitutes science when doing nutrition research and the demonizing of foods based on statistics that can be easily manipulated to tell the story the scientist wants to tell. I will use this article to help clients, family and friends to help better understand nutrition ” facts” reported in the media.

  62. Nigel Tanner says:

    As you admitted at the beginning of the article on the red meat controversy, spelling errors are not always detected by the author. An example is in the title of an article quoted by you:

    ‘When I first wrote about the pseudoscience of epidemiology in Science back in 1995, “Epidemiology Faces It’s Limits”, … ‘

    The error as you’re probably aware is that “it’s” is a contraction of “it is” and so is incorrect in this context.

  63. Crowhurst says:

    Sorry if this question’s been asked before, but didn’t a subset of the Harvard folks who published the meat study also *just* publish a study using the same data-set that purports to show some large (20%-70%) association between soda consumption and death (or cardiac death)? If that’s true, then shouldn’t the meat study have been corrected for soda consumption since it’s apparently such a large risk factor and could easily swamp out whatever signal they’re seeing from meat consumption? If not, why not?

  64. Tobey M. Wiebe says:

    “Epidemiology faces it’s limits” has a typo in the title. It should read “…its limits.”
    Thank you for insisting on what makes good science.

  65. Burpees are the Devil says:

    I would like to know why these supposedly smart guys at Harvard are putting out BS like this. What is the point? What are they trying to do here? Don’t think for a minute that they don’t know exactly what GT is saying, and they know he is right. I am tired of these guys jerking us around. What is the bigger story?

    • Mark says:

      Simple, it’s called “publish or perish”.

      • Burpees are the Devil says:

        That’s it? Just put junk out there and get paid? Why always picking on meat red meat? I think it’s bigger than that.

        • Mark says:

          Nope, sadly, that’s about all there is to it (well, that and a serious lack of understanding of basic statistics)… if you look hard enough, you can find papers to say that essentially anything is harmful/beneficial/irrelevant. It’s all BS.

        • Martin says:

          It’s like Climate Change (formerly known as Global Warming). There are a ton of bogus studies every year blaming anthropogenic climate change for T, U, V, W, X, Y, Z. The latest one links CO2 with obesity:

          http://www.nature.com/nutd/journal/v2/n3/full/nutd20122a.html

          The university is a subsidized research industry. It keeps begging for funds to do studies on whatever and the whatever gets circulated by the media & newspapers who have to fill their airtime & pages with stuff other than advertising. Some topics (i.e. food, climate) offer endless opportunities for studies and speculation and news reports & articles. They’re not going to stop soon and there’s not much you can do about it except not paying attention to them. I don’t watch TV and I don’t read newspapers.

    • Ellen says:

      Actually, there is a set of people who believe that meat is bad and only vegetarianism is good and healthy- and they are constantly trying (and failing) to scientifically prove this. It is like a religion- not based on facts, just on what they know in their hearts to be true. Colin Campbell is one example of them. Instead of seeking the truth they seek confirmation of what they already know to be true.

      • Burpees are the Devil says:

        Right. So at the most prestigious of our academic institutions, someone is deciding to direct the herds (you and me) behavior based what? Vegetarianism? This is not an altruistic campaign in the part of the researchers or university. We are being manipulated. It needs to stop.

      • Cotswold Addict says:

        You forget the political angle here. Meat eating is associated with a whole host of imperialist, classist, environmentally degrading and racist behaviors and policies that the political left opposes. In some cases, they have a point — some farming practices have some yucky side effects (manure ponds, runoff, antibiotic use, etc). “Proving” the health benefits of a vegan lifestyle wouldn’t just advance veganism, it would provide another tool in the revolutionary toolkit for overthrowing the patriarchal system.

        Of course from what we know, they would actually be better off figuring out a way to make sure everyone got enough meat, but that wouldn’t work politically.

  66. Diego Martínez says:

    THANKS VERY MUCH FOR THIS ARTICLE GARY. ITS ALWAYS VERY SATISFACTORY TO READ YOU.
    I FIND IT VERY MUCH AMAZING THAT SUCH A PRESTIGIOUS PLACE AS HARVARD AND ITS PUBLIC HEALTH SCHOOL CAN STILL THROW DIRT TO MEAT EATERS.
    IF ONLY ANYONE COULD COME WITH A REAL EXPERIMENT WITH HEALTHY INDIVIDUALS (TAKING RISK FACTORS LIKE HIGH BP, HIGH CHOLESTEROL, TABAQUIC HABIT AND ALCOHOL CONSUMPTION, ETC)/ QUALITY MEAT OMNIVOROUS EATING HABIT Vs VEGETARIANISM, THE RESULTS WILL BE ASTONISHINGLY CONVINCING IN FAVOR OF THE OMNIVOROUS DIET. I KNOW THERE ALREADY ARE, BUT JUST NEWER FRESHIER RESULTS MIGHT BE WHAT “MEAT ATTACKERS” NEED TO OPEN THE EYES OF THOSE NONBELIEVERS.
    OBVIOUSLY IF YOU CALL MEAT EATERS THE FAT, BARELY MOVING POTATO COUCH, METABOLIC SINDROME HOMO SAPIENS, YOU’RE GOING TO FIND THAT VERGETARIANISM IS MUCH BETTER. BUT EATING HIGH QUALITY MEAT (MOSTLY ORGANIC, HORMONE FREE, FREE RANGE, NATURE FED CATTLE & CHIKEN AND WILD CATCH FISH) FOR SURE COMBINED WITH A BUNCH OF VEGETABLES AND LOTS OF SEEDS & NUTS AND FRUIT (A.K.A HEALTHY VEGETARIAN DIET) WILL TAKE YOU TO A TOTALLY DIFFERENT LEVEL OF HEALTHYNESS AND OR FITNESS.
    ANYWAY JUST A HUMBLE OPINION.

  67. Jacob Brown says:

    I am surely buying your book. I’ve only just heard of you through facebook, but consider your fanbase increased!

  68. Joshua Kennedy says:

    As a physical scientist (condensed matter physicist, in fact) I have often had extremely energetic discussions with less-educated family members over the validity of studies such as this. I appreciate the way in which you present the problem, and with you I lament that a well-respected institution has supported such non-scientific work disguised as science. Thanks!

  69. ruth says:

    I appreciate that Gary, trained in physics and engineering, feels compelled to comment on health and nutrition- a topic relevant to us all, regardless of our scientific training. However, his claims that nutrition research is subject to errors from which other scientific disciplines are free is erroneous. We now understand that any phenomenon observed changes just by virtue of our observation of it. He even alludes to this in his description of the power of the placebo effect but somehow fails to apply this logic to all science, subscribing to the archaic notion of scientific silos.
    Regarding the actual study he is criticizing, it would be one thing if this were a finding unsubstantiated by other studies. However, this is one of many studies confirming that consuming animal protein in excess of 5-15% of the diet causes chronic disease. It’s that simple. This was found by one of the largest and longest epidemiological studies ever conducted– the China Study by T. Colin Campbell. I recommend this book to any who doubts the power of a plant-based diet as the basis for optimal health and the prevention of chronic disease of all kinds.

    • mark says:
    • FrankG says:

      @ruth says: “…consuming animal protein in excess of 5-15% of the diet causes chronic disease”

      It’s a wonder that I am here, considering that my ancestors lived through an ice-age (or two) in Europe.

      Our very close cousins the Neanderthals were around for a couple of hundred thousand years in Europe (even more ice-ages) and the fossil remains show them as primarily meat eaters with bigger brains (and muscles) than even us humans (homo sapiens)!

      I’m not sure if you’ve ever been up North but there’s not much in the way of fruit and veg to be had ;-)

      As above, you could do worse than read Denise Minger’s excellent review of T. Colin Campbell’s work.

    • Kathy says:

      ruth, I second Mark’s suggestion that you read the article in the link he posted. If the analysis in that article is too heavy going, I suggest you read the following analysis of Campbell’s book: http://www.proteinpower.com/drmike/cancer/the-china-study-vs-the-china-study/#more-4213
      It’s bad enough that you’ve give credence to the “conclusions” of the Harvard study Gary is writing about, but that you think that it’s somehow validated by Campbell’s book, which is an even bigger pile of pseudo-science, is truly alarming.

  70. Mikael says:

    Why did you even fall into the trap of using the term “weight loss”? As if that was the objective for changing your diet. If you want weight loss, get rid of muscle! Or why not get rid if water bound in muscle, like what no carbohydrates diets do. Then you can fool yourself you’re making progress also when you’re not.

    Personally, and I think a majority of people wanting change their bodies for aesthetic and health reasons, “fat loss” is what’s it all really about. I don’t think I have to demonstrate that fat and weight loss are not the same thing?
    To me, any ideas within this area of diets or training that is put forward that at the same time holds up “weight loss” as the objective is simply not credible. It’s a false objective and not worthy of consideration.

  71. Sam says:

    http://www.sciencedaily.com/releases/2012/03/120320152003.htm
    Low-Calorie Diet May Be Harmful for Bowel Disease Patients

    ScienceDaily (Mar. 20, 2012) — In a surprising result, Michigan State University researchers looking at the effects of diet on bowel disease found that mice on a calorie-restricted diet were more likely to die after being infected with an inflammation-causing bacterial pathogen in the colon.

    (snip)

    While research suggests inflammation associated with obesity may contribute to inflammatory bowel diseases such as colitis, the study results revealed a low-calorie diet may actually impair the immune system’s ability to respond to infection, said Jenifer Fenton, assistant professor in the Department of Food Science and Human Nutrition.
    (snip)
    Fenton said. “Understanding how a low-calorie diet increases mortality in this model may lead to new treatments for the disease in humans.”

  72. Peter Defty says:

    Hi Gary!

    Great work, keep it up….I guess after Denise Minger thoroughly debunked The China Study the “meat is bad for you” camp had to keep churning out the propaganda……. its too bad most people won’t take the time to read thoughtful tomes like yours on the matter but are scared into their vegetarian rat-holes by the headlines this study provoked.

    best

    Peter

  73. Jennifer D says:

    Hey Gary, the randomized controlled trials that you refer to – if they were only two years long, they probably could not address the question of whether or not red meat causes cancer. And how would you be able to do an RCT long enough and large enough to get a meaningful result with regard to cancer risk and red meat? It just doesn’t seem feasible that any institution would have the money to run an RCT for long enough to actually get a reliable result in that regard. Now, it would not surprise if if you were to say that if an Atkins-style diet reduces heart disease and diabetes, it probably also reduces the risk of cancer, since these diseases tend to cluster together. But that is supposition, and not evidence. Besides cancer is not one disease but a great many diseases. It’s hard to believe they all have one cause.

    • Sam says:

      Conjugated linoleic acid (CLA) differs from the normal form of linoleic acid only in the position of two of the bonds that join its atoms. But this small difference has been shown to give it powerful anti-cancer properties. Scientists at the Department of Surgical Oncology, Roswell Park Cancer Institute, New York and the Department of Biochemistry and Molecular Biology, New Jersey Medical School, showed that even at concentrations of less than one percent, CLA in the diet is protective against several cancers including breast cancer, colorectal cancer and malignant melanoma.

      Conjugated linoleic acid has one other difference from the usual form – it is not found in vegetables but in the fat of ruminant animals. The best sources are dairy products and the fat on red meat, principally beef. It is another good reason not to give up eating red meat or to cut the fat off.

      Scientists at the University of Wisconsin also believe that CLA has a slimming action. http://www.second-opinions.co.uk/cholesterol_myth_2.html

    • Mark says:

      If the question were important enough, an RCT could be done… Yes, it would need to be long and very expensive. However, saying that the right study that should be done to assess causality would be too difficult is no justification for doing a crappy study and claiming causality. Some questions just cannot be answered easily. I would take supposition based on randomized data any day over garbage “evidence” based on observational data.

  74. Kip Hansen says:

    Mr. Taubes,

    You state ‘People quit smoking and lung cancer rates came down, or at least I assume they did. (If not, we’re in trouble here.)’

    The stats (up through 2007) are available here: http://www.cancer.gov/aboutnci/servingpeople/snapshots/lung.pdf

    Men have had gains in incidence (30% reductions) but rates for women are long-term (20 years) flat as a pancake. In other words, either women are not quitting smoking thus keeping the cancer rates level, or the beneficial effect of smoking cessation is not evident in women as a cohort or something else is going on.

    Sourced from the CDC, this chart [ http://www.infoplease.com/ipa/A0762370.html ] shows smoking has halved for both men and women since 1965, so our conjecture that women haven’t quit smoking is apparently wrong, leaving us with ‘something else is going on’ or our hypothesis that ‘smoking causes lung cancer and smoking cessation/not smoking prevents lung cancer’ appears to fail or be incomplete where women are concerned.

    Add in the data that ‘Lung cancer incidence rates among female never smokers aged 40 to 79 ranged from 14.4 to 20.8 per 100,000 person-years, while incidence rates among male never smokers aged 40 to 79 ranged from 4.8 to 13.7 per 100,000 person-years.’ Note: women who never smoked get twice as much lung cancer and men who never smoked.

    So, thanks for asking/posing the question–it led to an interesting data search and a puzzling outcome.

    It is obvious from all this that, for men, ‘smoking greatly increases one’s risk of getting lung cancer’ and ‘it is much better not to smoke’ — for women ‘smoking greatly increases one’s risk of lung cancer’ but ‘not smoking doesn’t improve your chances of escaping lung cancer nearly as much as it does for men.’

    Cheers,

    Kip Hansen

    • Warren Dew says:

      It’s to be noted that the baseline rate of smoking in 1965 was much lower for women than for men, so that might explain why the effect on overall lung cancer rates isn’t statistically significant. Also, women are generally more likely to die of cancer for the simple reason that men are more likely to die of heart disease first.

      Still, you make a good point.

  75. David Stovall says:

    http://www.pbs.org/wgbh/pages/frontline/shows/diet/interviews/willett.html

    Wow.. after I read this interview many moons ago, I had high hopes he would make the flip over to the logical side of things.. Another great intellect, crushed by the weight of consensus…

  76. Michael says:

    This might get lost in the 244 comments already posted, but I’d like to direct a question at Mr. Taubes.

    Why do you dismiss the Harvard team’s ability to control for confounding variables and then later ignore the same challenges that the Stanford team faced?

    This post seems to abandon the position that variables are a major flaw in dietary studies when a study provides results favorable to Mr. Taubes’s position. As someone who does not regularly read this blog, that stood out as an unexplained sign of bias.

    • Jeff says:

      Randomized trial (Stanford) vs. observational study (Harvard)? The challenges are not the same, which is not to say that the Stanford trial is the last word, but an observational study simply can’t answer the relevant questions — it can only suggest what those questions might be.

    • FrankG says:

      Tom Naughton has an educational and entertaining presentation that helps to explain the difference between the different types of studies, trials etc…
      Science For Smart People
      http://www.youtube.com/watch?v=y1RXvBveht0

      • Michael says:

        The type of study is not relevant to my question. Both studies have variables such as physical activity, smoking, and many more. Controlling for these same variations among individuals is a major challenge for both studies. Mr. Taubes has rejected one study while accepting the other, yet both could easily be rejected under the same pretenses.

        • Mark says:

          Sorry Michael, you’re wrong. There is no need to control for such variations among individuals in a randomized trial, the randomization does that for you as long as you’re able to do an intention-to-treat analysis. The one place where the Stanford study might have some trouble with bias is the fairly high loss to follow-up, on the order of 20% in 3 groups although the Atkins group is noticeably lower at about 12%. 20% over one year of follow-up isn’t really all that high when compared to other trials, but it is definitely high enough to potential induce selection bias. Still, to all appearances, this seems like a pretty solid study.

        • Warren Dew says:

          The Stanford trial is a controlled experiment. You start with a bunch of people randomized into groups, you tell one group to eat one diet, you tell another to eat another diet. Since there is no bias about which people go into which group, the only difference is what diet they’re told to eat.

          The Harvard study in question is observational – you don’t tell people what to do, you just ask them what they do naturally. As a result, there are a lot of differences that you can’t control for.

          To take one example, most people who eat hamburgers eat them in buns. In the Stanford experiment, the Atkins people are told to eat their hamburgers without buns, so you can separate the effects of the hamburger from the effects of the bun. In the Harvard study, you can ask how many hamburgers they eat, but since you’re not telling what to do differently from each other, they’re still eating the buns, too: there’s no way to separate the effects of the hamburger from the effects of the bun.

      • gman3164 says:

        Thanks, FrankG. I just watched the “Science for Smart People” lecture by Tom Naughton, and it was excellent and very entertaining. Your posts are very informative – keep it up!

    • Martin Levac says:

      As Mark said, randomization and a control group in an experimental study takes care of the problem of confounding variables.

      For my part, I usually bypass that problem by ignoring what is not really science. An observational “study” is merely the first part of science. If it’s just the first part of science, then it’s not really science. Science is not only observation, but also experiment. The experiment is done to test the hypothesis that was generated by the observation. Without the experiment, there is no confirmation nor falsification of the hypothesis, therefore no proof. And without proof, it’s just an opinion. And as I like to say, my opinion is always better than yours. Until proof comes along to change my mind, of course.

      Gary said “Peter Medawar, the Nobel Laureate immunologist, described this proving-it’s-wrong step as the ”the critical or rectifying episode in scientific reasoning.””

      This ‘proving-it’s-wrong step’ is only possible by experiment.

  77. Eating in Orlando says:

    The NYT has been leading the anti-meat crusade…now they have thrown down the gauntlet with an essay contest.

    http://www.nytimes.com/2012/03/25/magazine/tell-us-why-its-ethical-to-eat-meat-a-contest.html

    I am going to write a response. I’d love to read GT’s response.

    • Warren Dew says:

      The problem is, some of us think eating meat isn’t particularly ethical – it’s just that eating plants is just as bad.

      • Eating in Orlando says:

        Well, that might be a good point. If we want to minimize our negative impact on the environment, cattle grazing on inedible grass and transforming it into high value protein might actually have a much lower impact than acres and acres of soybean farms.

        I’m just so infuriated by the constant drone of the vegetarian hymn I have been reading in the NYT lately. I want to write a real scorcher for their stupid essay contest.

        • Paul says:

          Meat farming, done right, may be better for the environment than most other agricultural uses as they are typically done, but it is almost certainly worse than when they are done with organic practices. And meat farming as it is typically done is very bad, too. Cattle produce enormous amounts of greenhouse gas (methane) and while this could possibly be captured and used, this is only really possible with the manure, not the cattle themselves.
          There are probably too many people on the planet for us all to eat low-carb, I think we have to admit. It takes much more land to produce meat sufficient to support one person than it does to produce a similar amount of grain. That is why the population explosion began with agriculture, after all.

          • TopaComa says:

            this is nonsense…please do a little homework and you’ll find just the opposite.

          • Paul says:

            Just because you don’t like the idea doesn’t make it nonsense. History backs me up big time!

  78. Nick Newton says:

    Awesome post: I wrote a piece on my blog based upon the reporting of the ‘science’ behind the headlines as it appeared in the British press. It is incredible that health journalists simply repeat this stuff verbatim without a moment of critical analysis. Some might call it highly irresponsible……

    Anyway, again, fantastic article, especially for one produced in haste!

  79. Nikhil says:

    Thank you, Gary, for all the good work that you have done. I really enjoyed GCBC and WWGF, and will spread the word as best I can!

  80. paul helman says:

    I have worked out a recioe for low carb muffins which are quick to make and consistently good. Keep well too.
    For a typical muffin tray
    4 eggs
    4 oz cream cheese softened
    4 tbs butter softened
    1/2 cup vital wheat gluten(10 carbs in all)
    1 cup sucralose(chlorinated sucrose)
    1/2 tsp salt
    1 /2 tsp baking powder
    1 tsp vanilla extract.
    1/2 cup whipping cream
    bake at just under 400 degrees for about 15 minutes.
    If you try it let me know what you think.
    regards,
    Paul Helman,M.D. Evanston, Il

    • Paul says:

      I assume by “1 cup of sucralose” you meant “Sucralose equivalent to 1 cup of sugar” since the carrier medium for sucralose varies widely between brands and formats. I use liquid sucralose, for example as it is very pure with no added carrier-carbs, and a cup of that probably would make my mouth explode.
      Sounds good otherwise, I will certainly try it.

  81. Ahmed Hakki MD says:

    I have read and much admire both Good Calories Bad Calories and Why we get fat and what to do about it.
    However I have also read The China Study and Dr.Esselstyn’s How to prevent and reverse heart disease
    Apparently former President Clinton is following Dr.Esselstyn no fat not even olive oil diet. Dr.Esselstyn claims to have kept 20 very sick cardiac patients alive and well for twenty years on his diet.
    Please help me reconcile your very exhaustive and cogent analysis of the fallacises relating to low fat diets with the findings of these two other books

  82. Emma says:

    This is a wee bit off topic, but I have a question I was hoping one of the more scientifically-inclined readers could answer for me (if not Gary himself, of course)…Do we know really how/why people on conventional low fat/calorie-controlled diets lose weight. Ignoring the fact that they will gain it all back (and then some) soon enough, they are actually losing weight at the time. I’m watching a horrifying hour of tv known as the Biggest Loser and I’m confused. Knowing what we know about exercise often being a hinderance to weight loss (unless you are forcefully starving yourself of the calories you want later) – and the fact that these people are doing low fat everything with not much regard to carbs and sugars – they are also losing gobs of weight.
    Is it possible there more than one mechanism to weight loss? Or is it simply a matter of “oh they were probably eating more carbs before the diet” and lower carb is just by product of restricted-calorie diets (I believe Gary touched on this in “Why We Get Fat,” but I guess I need a bit more elaboration. I’ve lost weight on weight watchers before – snack packing all the way. And I’ve mostly kept it off for a couple of years now, though I have recently gone low-carb paleo. The thing is, baring the initial ketosis induction, I lost weight faster on WW. Of course I now know that lifestyle could likely result in a future of snack-pack related diseases, I was thin, so, err, how does it all add up?

    • FrankG says:

      >> I’m watching a horrifying hour of tv known as the Biggest Loser and I’m confused. Knowing what we know about exercise often being a hinderance to weight loss (unless you are forcefully starving yourself of the calories you want later) – and the fact that these people are doing low fat everything with not much regard to carbs and sugars – they are also losing gobs of weight. <<

      I think you answered your own question there Emma: these people ARE being forcibly calorie-restricted, which will invariably leads to "weight" loss ( and not necessarily just loss of excess fat mass… lean tissue as well) but as you also rightly point out, and we should not ignore, “they will gain it all back (and then some) soon enough”.

      We can consciously control primal drives like breathing, thirst and hunger for a limited time only… after which we either have to listen to our bodies or suffer dire consequences.

      LCHF does not rely on conscious control of dietary intake but rather a spontaneous regulation of just as much nourishment (not just energy) as the body needs — in just the same way that every other animal on this planet maintains equilibrium without kitchen scales or nutritional labels on their food. That is why low carb is sustainable in the long term while conscious calorie restriction is not ;-)

    • Martin Levac says:

      The easy answer is that low fat diets, when calorie-restricted, are just low carb diets in disguise. Gary explained it well many times before. Here’s the gist of it. As low fat diets already contain very little fat, if we cut total calories, the bulk of those calories inevitably come from carbs.

  83. olly oxinfree says:

    Actually, based on my experience of eating at the Cheese Penis in Berkeley, I think I’d take my chances with the truckstop food. For starters, the prix fixe meal of whatever St. Alice chooses to serve runs upwards of a hundred bucks–which rules out 99.9% of eaters right there. Next, what she serves, you have to eat. Allergic to bottom-feeding fish or eggs? Tough tooties! Then there are the smug, hostile staff and the cramped accommodations.

    Food has become too much like a religion, and it’s the worst at the “sustainable” end of the scale, where the most absurd and untested claims are made. Upscale eco yuppie food is more like purchasing pure food indulgences for eco-sins with the promise of salvation in the form of longevity and superior life experiences. However the latter can almost certainly be attributed to factors prior to that demographic’s eating habits, such as being born upscale and snooty in the first place, and having the best of everything always. Ain’t that always the case with religion, however? I.e., the saved dictate to the rest of us, who can never hope to join them because they’ve set it up that way.

  84. josh says:

    DR Taubes I love you and i love your message but jeez you gotta learn to write shorter. and the speeches are insanely long. the message gets lost in the cloud.

  85. Susan says:

    What about nuts? Does anyone know if nuts can be eaten on the “Taubes” diet

    • Paul says:

      Well when GT posted his cholesterol numbers, he described his typical diet and stated that his snacks ran to nuts and cheese, so go ahead! Most nuts are naturally very low in carbs. You just have to get them without any sugary stuff added, not always easy. Pecans, Walnuts, Macadamia and Hazelnuts are all very low. Peanuts aren’t actually nuts, but they are low in carbs. Avoid the Cashews, which are fairly carb-y and also very prone to having sugary crap added to them anyway. And don’t worry about the salt they usually add, as GT already showed the case against salt was a hugly overblown load of rubbish.

  86. Chris C says:

    So what one thing in particular does red meat have that nothing else does in quantity?

    Carnitine

    Excessive carnitine has been separately linked to cancer, etc.

    What does excessive carntine cause?

    Manganese deficiecy

    Why does manganese matter?

    It’s needed for MnSOD (SOD-2), without which all around mortatility significantly increases.

    • Mark says:

      Sources? Carnitine supplements are used as a *treatment* for cancer patients, show me where it’s been linked as a “causal agent” to cancer.

      • Chris C says:

        Carnitine helps with ‘cancer’ due to the fact chemotherapy vastly depletes carnitine levels. With too little carnitine you eventually get liver dysfunction and eventually liver cancer. The only sources I have found claiming carnitine helps with cancer itself and not from the resulting chemo is for liver cancer.

        Way too much carnitine on the other hand, which would be what you would get from eating large amounts of red meat cause the issues listed in the previous post. Among other things its found to be linked to (and thought to be the cause of) endometriosis which in turn is linked to various other types of cancer. This research is ongoing with the latest study linking it to being the cause of endometriosis only coming out in June of last year.

        Another interesting point is that normal daily human synthesis of carnitine is only between 1/8-1/3 of what is in 3oz of beef.

        • Mark says:

          If you won’t provide your sources, I guess I’ll try. A PubMed search of “carnitine and endometriosis” turned up 3 articles, one of which came out in June of 2011 so I’ll assume that’s the one you mean: http://www.ncbi.nlm.nih.gov/pubmed/21620396. It’s not actually an aritcle, it’s a 2-page letter. And it doesn’t provide any evidence linking carnitine to endometriosis. But it is full of speculation and insane generalizations.

          Here’s the abstract of that paper, which is not at all convincing: “L-carnitine, when administered to young female mice, has been shown to induce a pathologic condition resembling human endometriosis accompanied by a marked degree of infertility. Thus, the use of this nutrient by young women may be a potential risk factor responsible for the onset of endometriosis at a later stage of their lives.”

          • Sam says:

            There are many more;
            http://www.carnitine-cancerpromise.com/detail_summary.html
            Carnitine’s Mechnism of Action
            In a number of laboratory studies carnitine has been shown to induce apoptosis in cancer cells while having no effect on normal ones. There are two primary theories of carnitine’s anti-cancer activity which application depends on the type of cancer cell. One is based on data reporting that cancer cells limit the utilization of mitochondrial fatty acids as a fuel. Carnitine, which transports fatty acid across mitochondrial membranes, increases the fatty acid fuel supply to the cancer cells having a detrimental effect on the malignant cell leading to increased apoptosis. For example, in human colon cancer cells, carnitine increased fatty acid uptake resulting in a significant increase in apoptosis. No effect of carnitine on normal colon cells was found.

    • Martin Levac says:

      That’s probably all true. But you didn’t say “carnitine _causes_ cancer”, you said it’s “linked to”. Naturally, we see the association and draw a conclusion in our mind. It’s doubtful we’d conclude that cancer causes an increase in meat consumption, therefore an increase in carnitine consumption, right? So we conclude that carnitine causes cancer. Makes sense. But is it true and how can we find out? With an experiment. We feed people lots of meat, and see if they get cancer. Obviously, that’s unethical. But we already have a famous experimental study where we did feed people lots of meat. It’s the Bellevue all-meat trial. Granted, they weren’t trying to make people get cancer, but they did find out a whole lot of things about what an all-meat diet would do to humans. And what did they find out? An all-meat diet is no worse than any other diet.

      As carnitine is linked to cancer, so is cancer linked to metabolic markers such as blood glucose, cholesterol level, and inflammation markers. In that experimental study, they looked at a whole bunch of those things and none of them gave any indication that the subjects were sick or were about to be sick. If their all-meat diet had the ability to cause cancer, it would have shown up in those metabolic markers. Since it didn’t, then it’s reasonable to conclude that meat doesn’t cause cancer.

      See what I did? I did the same thing you did. I looked at an association, and drew a conclusion in my mind. However, I did it by using much more reliable data from an experimental study. You did it with unreliable data from an observational study. Which conclusion is more likely to be true, yours or mine?

  87. Tom Bunnell says:

    You are doing all of the right things Gary. — When you think in terms of our upside down Government Food Pyramid, and Michel’s Plate(upside down), the same. Then it’s easy to see how mainstream science and doctors and public alike, blindly follow along with these authorities, and substantiate every word they say and do. Monkey see, monkey do. — Even Oprah has never “heard” our true, full message, so that she can evaluate and hire expert evaluation as to it’s substance and truthfulness. We’ll get this thing on the table before we are through. — Our president and first lady know nothing of this. — You, and you alone, lead this charge. Laborious and time consuming as it is, we know this factually, to be the right path. Simply because it’s the truth. The undiscovered, indisputable truth. — Articulating the unfathomable, and convincing a world of stimulated monkeys, they are stimulated, when they believe none of it, is no small chore. Much less the simple, obesity and diabetes and heart disease epidemic, as sugar and hybrid carbohydrate induced, rather than the fat and meat. All indisputable truths, but you could easily say, complete unknowns. — We are a bunch of screwballs, you know that. — Wacko’s off on a tangent. — How could we possibly deserve or expect to receive recognition for our work in higher circles. — Maybe we should seek psychiatric help for ourselves. We are plainly delusional. You know that.

    • Glenn Stanza says:

      Great job, Gary. I heard about the Harvard study and got to thinking that in GCBC there was a reference to the fallacy of the danger of meat eating, but then I thought I would check the blog for grins and lo and behold my question was answered on the spot. This is the reason this whole subject is so complex and confusing and why it’s such a battle to get the real story into the discussion. I thank you for your efforts in bringing some clarity to these muddy waters.

  88. I’ve been a big Gary Taubes fan for years. I’m surprised you didn’t site a few other prospective diet studies that refute the “low fat heart healthy” hypothesis. ie New England Journal of Medicine article July 17,2008 Shai low carb vs low fat, or the largest prospective study of possible dietary benefits of a low fat diet ie Women’s Health initiative, 50,000 women for 8 years…no benefit from low fat diet for either heart disease or cancer. I’m sure Mr. Taubes and his readers are are aware of the tremendous article by Marantz, Bird, and Alderman published in American Journal of Preventive Medicine in 2008, “A Call for Higher Standards of Evidence for Dietary Guidelines.” Please keep up the good work.

  89. Sarah Balfour says:

    Y’know what REALLY bugs me…?! (and I’m talking about bugs me to the point of near-apoplexy) is how the UK media (and I’m not just talking about women’s mags – which publish a new diet practically every issue (all heavy on the carbs, calorie-counted and non-fat, of course!) – I’m talking about the mainstream news-press) is how they see articles and reports like this, and run with them. Now, forgive me if I have this wrong, but I always assumed it was standard, good journalistic practice, to check FACTS (see how naïve I am…?!) particularly when it comes to stories regarding diet and health, but they quote ‘studies’, such as this, as though they were gospel. I even tweeted the editor of one paper (the Independent) after its sub-editor ran with the Harvard ‘research’ as the basis for his daily column, pointing out that it was hooey, and about as far removed from proper SCIENTIFIC study as it’s possible to be. His response…? “But it was conducted by the best US uni – why would they lie…?” My response…? “Yes, and…?” followed by a link to Denise Minger’s article on Mark Sisson’s blog. Never heard from him again – funny that…

    Of course, this has every single veggie/vegan journo screaming “We told you so!” Said paper even ran an article on Aryevedic cooking (yes, I know that’s spelt wrong – it’s only 7:30am here in the UK) – and that’s practically vegan. The lass who wrote the article (it was about a retreat in Bangalore) said she felt so wonderful afterwards that she was converted (yeah, let’s just see how wonderful she feels in a year or so – if that – when she’s depleted her body’s iron reserves!)

    There is one journo at that paper – a young Sri Lankan (he’s 25, but he’s Sikh, and beards are always ageing – at least *I* think so) who wrote in his column something along the lines of in traditional Japanese cooking, rice is only used to preserve the fish, it wasn’t meant to be eaten, as it isn’t  seen as healthy (he said something derogatory about wheat too, but I forget what). I was going to keep that paper, clip the article and keep it, as it’s the nearest an Indie journo has come to declaring “Grains are bad” (to be read in your best Mr. Mackey impersonation) but I binned it in one of my frenzied, caffeine-fuelled, cleaning episodes!

    The reason I single out the Indie (and its ‘offspring’ the ‘i’ – basically a concise form of the Indie, hence the title) is it carries the tag line ‘To Educate, Entertain and Inform’; well, as far as I’m concerned, it fails on 2 of those counts – and the jury’s still out on the 3rd…

    Well my research shows that people who take articles beginning ‘research shows’, ‘studies suggest’, or variations thereupon, at face-value  are naïve, gullible fools – and I don’t need to conduct a placebo-controlled, double-blind, trial to prove that!

  90. Brus says:

    I was reading Grace Metalious’s famous 1956 book “Peyton Place” and saw the following description of a character:

    “Nellie Cross was short and flabby with the unhealthy fat that comes from too many potatoes and too much bread.”

    See? We all used to know this stuff!

    • KevinF says:

      Nice point Brus. If I had lots of time I’d love to do a study of popular culture opinions of the causes of obesity through history. We could contrast Peyton Place with the Sienfeld episode where they all gain weight by eating faked low-fat yogurt (that actually contained fat). Of course there was the other Seinfeld where the Rabbi is lecturing that people make the mistake of thinking that “low-fat” cookies are also low-calorie.

  91. Liz W says:

    Thank you for posting this analysis. A comment and a question:
    It seems to me that these huge data sets can be massaged and worked to generate a variety of associations and effect sizes and that the preconceived notions of the investigators drive where the focus is and what gets published. There might be other ways of looking at this type of data that could support a new set of conclusions. Is anyone aware of any good randomized trials (or other type of study) showing that increasing dietary vegetable content improves clinical outcomes?

  92. J M says:

    So, what are some of the confounding factors that you suggest were not accounted for in the multivariate analysis?

  93. Martin Levac says:

    Hey, Gary, just read on MercuryNews that you formed a non-profit for nutritional research and it got its legal status this week. Congratulations! It looks like you’re taking a big step here. Wish you the best. Hope much good comes out of that. If you intend to actually design studies yourself, may I make a suggestion? Keep it simple. In your post above, you cite the A-TO-Z study. It’s my favorite low carb study because it’s so simple. Push that red button, see what happens kinda study. They’re the best ones.

    A couple of things I like to point out about that study. It’s got a major flaw: Food questionnaires. The standard idea is to ask people what they eat, and assume the answers are a cause. The problem here is that the answers are not what people eat, but what people _say_ they eat. And so it’s really hard to conclude that they lost weight and improved their health because they _said_ something. I get around this problem by either ignoring the food questionnaires, or declaring it an effect rather than a cause. It makes sense. It’s unreliable as evidence of what people actually eat, but it’s interesting to see what people say they eat when we instruct them to eat a certain way. Whatever I choose, I then consider only the reliable data: The instructions, the measurements. The instructions are the diet books, the measurements are weight and health markers. So basically, the A-TO-Z study really only tried to find out which set of instructions were most effective to produce the desired outcomes.

    It raises the question – are the instructions simply better written? You’ve been there before. Buy a DIY thingy and try your best to figure out these retarded instructions. Diet books are just that, instructions. I read Atkins, it’s far from simple or easy. The instructions just plain suck. In spite of that, it works best. This means two things. Cutting carbs and increasing fat really really works even with half-assed instructions, and we can use these studies to design much better instructions to produce even better results. Isn’t that what science is for anyway?

  94. My take on the study is that meat eaters ate less vegetables. Afterall, their large meat portions crowded out their vegetables on their plate. And it is the eating of less vegetables that gave them a higher risk of cancer. Because vegetables in general have anti-cancer properties. It is not that natural organic meat from grass-feed animals caused cancer. It is the lack of vegetables that caused decreased cancer protection.

    I do agree that processed meats are much more unhealthy than organic natural meats from grass-feed animals. Also the people filling out the questionnaire may be making errors as to the distinction between processed meats and non-processed meats. It could be possible that within that deviation of error that the increase risk found in the study is due entirely to processed meats rather than non-processed meats.

    • Martin Levac says:

      You say vegetables in general have anti-cancer properties. But then you say processed meats could also be the reason. It could be both, but I don’t think that’s it. Is meat still bad but only just less bad than processed meat? Then what is in the processed meat that makes it worse? Could it be that the processing adds more of that bad quality that makes the meat already bad? I don’t think that’s it either. Processed meat don’t have more meat. They have added sugars and other stuff not normally found in meat. Added sugars come from plants. Vegetables are plants. Are sugars bad? If yes, then shouldn’t we also view vegetables with suspicion instead of accepting their health halo without question?

      I’m not trying to convince you here. I’m just pointing out that things don’t look so clear cut when we start asking questions. Especially questions regarding things we take for granted. What is it about vegetables that makes you think they have anti-cancer properties, and can you find hard evidence that supports your belief for your own benefit? And if the hard evidence that you do find is the kind that looks at associations like epidemiological studies, is it the facts you believe, or do you instead believe the conclusions you draw from those facts?

      • cavenewt says:

        Before reading any nutritional study or reports about nutritional studies, it’s vital for us mere mortals to watch this invaluable video: Tom Naughton’s Science For Smart People. Look for it on YouTube.

        After that, you know better than to draw *any* conclusions from a prospecive study, rather than a controlled experiment.

  95. Fiona says:

    Real or Pseudoscience?
    Conclusions: Aggressive efforts are needed to reverse the positive energy imbalance underlying the
    childhood obesity epidemic. The energy-gap metric provides a useful tool for goal setting, intervention
    planning, and charting progress.
    http://www.ajpmonline.org/webfiles/images/journals/amepre/AMEPRE_3352-stamped.pdf

  96. Dianne says:

    The important points made here lead to several policy suggestions:

    Goal:
    Provide better health advice to the public.
    Actions:
    1. Require that all publicly funded scientific studies undergo a methodological accreditation by a new profession of periodically tested epidemiologists — akin to accountants in business ( to stop wasting taxpayer money, reduce duplication of effort, and eliminate garbage science.)
    2. Require that these scientific studies’ reports include conclusions certified by such epidemiologists.
    3. Establish a methodologically oriented science court — akin to judicial courts — to evaluate alternative studies, and in a nutshell gives us their conclusions as to what is known, what is not, and the liklihood that proferred advice will lead to specified levels of health benefits — so that we can all do our cost/benefit of changing our behavior. ( Such a court could also be instrumental in hightlighting good science based on merit and not just prestige of journals or institutions.)
    4. Develop bounties for scientific health information to be paid by the Government or foundations. (This could be a much cheaper alternative to drug discovery than the current version of the patent system — which needs to be reviewed as a factor in preventing the dissemination of scientific info, and a driver of unwarrented health cost inflation, the opposite of its intended purpose.)
    5. Find ways to reduce the cost and accelerate the pace of good science. ( Does anyone ever think about this?)
    4. Build a national health science database based on new professional and laymen notational systems — so that it is accessible to all who need it. (The database would also be useful in hightlighting the limitaions of our knowledge, as well as facilitating acess to health knowledge.)

    • Dianne says:

      A few more thoughts:
      5. Scientific medical info and health advice’s reliability should be given a letter grade by the accredited epidemiologist or the science court.
      6. Methodological standards need to be instituted for health research, and its dissemination. Too much is done behind closed doors by who knows what criteria.
      7. All professional newspapers should have their the science facts they print vetted by certified epidemiolosits. The information should be published in such a way to best inform the individuals so they can use their own values to determine the costs and benefits of changing their behavior. (The current level of scientific journalism usually does not contain adequate study info or vetting to allow educated citizens to act on it.)

  97. Eva Padilla says:

    I am a low carb paleolithic diet type of eater and when I read about the study cited in the NYT about meat eaters having a higher probability of earlier death, I just assumed that the bad science probably involved the unobserved correlation that the meat eaters studied ate meat from animals that were grain and not grass fed, hormone injected and antibiotic dosed, and included God knows what other toxic and unnatural pathogens incorporated into that beef diet and environment, and that is what led to the perhaps true observation that their meat eaters died earlier. This is an even clearer explanation of the faulted study yet also follows your reasoning about disregarding other correlations to explain the causality.

  98. Apologies – not directly relevant to Gary’s article but, my god, look at this:
    http://youtu.be/sIzngoAUoNM

    (facepalm)

  99. Robyn dean says:

    This is not a comment, but a question I have had since listening to your book. I have listened to it a number of times but I can’t seem to find a direct answer to this question.

    Broadly speaking, I understand that in order to lose weight insulin levels must be kept as low as possible. I understand that the best way to do that is to refrain from eating carbohydrates. What I am not clear on is what effect the quantity of insulin being secreted has on weight loss, or if that even matters. For instance, if I ate 6 small meals a day, would my body release more insulin than if I ate three large meals in a day? Is insulin released in relation to the amount of food we eat, or would the same amount of insulin be released by a small or large carbohydrate free meal?

  100. Dan Hegerich says:

    They don’t test raw meat consumption therefore, they falsely represent flesh foods-specifically red meat as the causes for health problems. They at least should state that cooked red meat and processed meats indicate possible conection to health problems. They don’t dare do a real study on raw meat consumption because the results just might be the iceberg in their gigantic Titanic agenda far from science and more in alignment with dis-empowerment or the people and profit. All second to creating fear of anything natural in the minds of such weak minded individuals. When afraid of nature then corporations and government bodies will then allow greater manipulations on nature for profit. GMO’s is just touching the surface.

    Dan

  101. Another great read, thank you Gary. Difficult to estimate how much I’ve learned from your work and the impact with my life, my family and my clients is invaluable.

  102. Robert Wright says:

    NC Paleo-blogger being sued by NC Dietetics Board for unlicensed dispersal of dietary advice:

    http://amyalkon.mensnewsdaily.com/2012/04/23/nc-dieteticsnutrition-board-wants-to-shut-down-low-carbers-blog/

    Maybe Mr. Taubes could organize a legal defense team for this man and bring the carbohydrate hypothesis debate to a head (a la’ Dr. Annika Dahlqvist in Sweden)?

  103. Razwell says:

    Hi, Gary :)

    Excellent article and very well written.

    The late Richard Feynman was very critical of the pseudoscience of dietary gurus’ claims etc. There is a video on YouTube featuring him speaking about this. He said there are all kinds of myths running around. How easy it is to not check the science , to make mistakes, and the farcical way they get their information etc. It seems a lot of the medical profession is more dogma than science unfortunately.

    I wish Harvard’s nutritional researchers could lose their long held biases and be more like Carl Sagan, Richard Feynman etc. where they maintain a scientific approach. Scientists who spend many years trying to disprove their own hypotheses are golden in my book.

    I respect Dr. Peter Libby (a cardiovascualr researcher from Harvard ) to some degree because he is cautious about being dogmatic and has been pioneering the inflammation connection. He looks outside the box. He knows we are missing a lot about coronary artery disease. There are some people (about 20 %) who have heart attacks and had absolutely no traditional risk factors whatsoever. That alone tells us we are missing something huge- a vast unknown. Dr. Libby’s work had us rethink the outdated plumbing model of arteries, and led to the acceptance of complex inflammatory processes being behind endothelial damage.

    It is worthwhile to note that internationally respected surgeorn Dr. Michael DeBakey did not accept cholesterol as the cause of coronary artery disease. He also looked outside the box.

    Wishing you the very best.

    Take care,
    Raz

  104. JA says:

    Richard Feynman has the best description of the “scientific method” I have ever read; though the ones you cite are pretty darn good too.

    “In general, we look for a new law by the following process. First, we guess it. Then we compute the consequences of the guess to see what would be implied if this law that we guessed is right. Then we compare the result of the computation to nature, with experiment or experience; compare it directly with observation to see if it works. If it disagrees with experiment it is wrong. It‘s that simple statement that is the key to science. It does not make any difference how beautiful your guess is. It does not make any difference how smart you are, who made the guess, or what his name is—if it disagrees with experiment (observation) it is wrong.”

    In the world of nutritional epi, as you assert, they use statistical inference (in which certain variables are ASSUMED to be independent) in lieu of controlled experiments in which the variables of interest are KNOWN AND CONTROLLED.
    By the way, the pseudo-science of nutritional epi is also mimicked by economists ; another “science” in which controlled experiements can not be performed or are never performed.

  105. Mark says:

    So glad to have found this and thanks for the link to Zoe Harcombe’s analysis. I have a friend who refuses to eat red meat for the most part on the basis that it’s unhealthy, giving a clear thumbs down to my liking of a good bit of steak. I’ve sent him both links and look forward to a good debate with him in the pub soon! Just about to order one of your books too :) Best wishes, Mark.

  106. Tony S. says:

    Gary, I’ve been wondering what effect, if any, my gallbladder removal has on my diet. I’ve been told that without a gallbladder, I cannot digest fat as easily. If this is true, should I eat even more fat?

    As an aside, I used to be a vegetarian and, for a while, a vegan; but I was simply unable to build muscle mass and felt physically weak at times. Last spring, I began eating farm fresh eggs after I discovered the cholesterol myth. Then, in the fall, I began eating fish almost daily. Recently, I also began drinking raw milk (which is tremendous), although I know many Paleo people oppose it. Altogether, these dietary changes are helping immensely. Also, watching your videos at YouTube brought me back to “food reality.” Being raised Italian, WE ALL KNEW in the 60′s, beyond any shadow of doubt, that bread, pasta, and “sweets” put on the weight (although we loved them, of course). Thanks so much for bringing the buried truth back to my mind and deprogramming me from the joint Madison Avenue and Big Brother food diseducation scams of the killer carb pimps! Btw, just got “Why We Get Fat” in the mail from Amazon a couple of days ago… I’m loading up my guns with all the great the ammo in it!

    • Kathy says:

      For what it’s worth, I had my gallbladder removed years ago (I now realize my gallstones were the consequence of eating low fat on Weight Watcher, which resulted in TEMPORARY weight loss) and I don’t have any problem whatsoever digesting fats. I don’t know how much one can generalize from my experience, but eating fats of all kinds has never been a problem.

  107. Hel says:

    Can anyone make sense of this?

    http://www.sugar.ca/english/healthprofessionals/weightmanagement.cfm

    Shows data indicating that BMI lower with increase in sugar intake?

    (And yes, I know, it’s from the Canadian Sugar Association (or whatever))

  108. dlr says:

    Excellent, just excellent. Another one for the archives. You should title it “Conventional Wisdom-Confirmation Machines”. That’s it in a nutshell. I’m printing it off so I can go back and read it the next time some observational study comes up with a result I WANT to believe.

  109. dlr says:

    One factor that undoubtedly explains a good deal of the “the Girl Scout” factor is the placebo effect. Persons who are consciously following ‘the current consensus’ of medical advice on diet and exercise KNOW they are doing so, and BELIEVE, sincerely, that it is good for their health. Likewise, people who DON’T following ‘the current consensus’ of medical advice on diet and exercise also KNOW very well they aren’t ‘eating healthy’, etc.

    It’s well known, confirmed by innumerable double blind studies, that DOING SOMETHING YOU BELIEVE IS GOOD FOR YOUR HEALTH, has a positive impact on your health. Eating less meat, and more whole grains is this generations official medical advice for good health and longevity. Anyone who believes that advice is true, and follows it is going to experience the benefits of the placebo effect. And eating junk food and being a couch potato, undoubtedly has the inverse ‘nocebo’ effect, since the people who eat junk food and don’t exercise, etc, no doubt believe the current consensus on medical advice as much as anyone else. They know that what they are doing “isn’t good for their health”, and reap negative health benefits regardless of whether such effects exist in reality or not.

  110. Fred Forster says:

    I ran across your blog after reading your May 14 Newseek article and feeling I needed to know whether you consult for the food industry. To sum it up, the first law of thermodyanmics is still alive and well—it governs the energy issues of each cell in our bodies and our bodies as a whole. Your scenario of why fructose is converted to fat, if true, would only happen if by ingesting it contributed to the “more energy IN than energy OUT” as you like to say in your article. But what seems to be completely off your radar screen is that over the last century, the food industry has worked very hard and very well using technology and lobbying efforts to make sure they can sell “food” with a perfect combination of surgar, fat and salt to trick our bodies into craving more. Have you ever noticed on food labels that almost invariably if a product is hyped as having less of one of these magical ingredients, it has more of at least one of the other two? So what your article is missing is identifying all the villians—first up is not the government, it is the food industry that as a whole is far more interested in the value of their stock than the health of our nation.

  111. Fellowshipman says:

    How awesome would it have been if Gary dedicated his career to disproving the myth that saturated fat is bad for us instead of, not only doing that, but proclaiming that he knows what we should be eating.

  112. Lynette says:

    At the beginning of last year I stopped eating all grains and sugar. My good cholesterol went way up and my good went way down by the end of the year. Further, my triglycerides also went way down. I eat more grass fed beef than I have in my whole life and … better cholesterol levels, lost 70 lbs. and feel great! I now only eat quality meat, veggies, fruit, and some dairy (in moderation … watching the sugar). My labs speak to it …

  113. Bill says:

    Just finished reading your Newsweek article. I have trouble accepting your presentation of the situation. Man has never invented a perpetual motion machine – i.e., one that produces more energy than it consumes – or put another way, will produce more fat in a person with a net negative calorie input. It may be that eating less and exercising more is too simplistic a recipe, but until the laws of thermodynamics are repealed, exercising enough to burn more calories than are consumed will always result in weight loss. You describe the hardworking (but fat) Arkansas construction workers to denigrate the idea that exercise will result in weight loss. What you don’t say is that you have carefully monitored the caloric intake of these individuals and determined that they don’t consume more calories than might be desirable. Your second “fallacy” is related to the first – it is just expressed differently. I won’t comment on the red meat issue, as I don’t eat a lot of it, for reasons unrelated to my weight.

    I will offer one anecdotal counter example. I am 5’6″ and weigh 135 lbs; my wife is 5’4″ and weighs about 165. Some days, I notice that my weight has drifted up a few pounds, so for a while, I make it a point to eat less or to exercise more (for example, I try to bicycle at least 20 miles a week, but get lazy at times). My weight is within 5 pounds of my college graduation weight (53 years ago). Keeping my weight steady is more difficult than when I rode regularly 60 or 70 miles a week, but eating less and exercising more has never failed me yet. As a matter of fact, one year when I was riding perhaps 100 or more miles per week, I would often come home after work and have a generous snack to hold me over til dinner. Yet, I was losing weight – enough so that I briefly worried that I might have cancer.

    My wife doesn’t exercise, avoids sugar and starch like the plague (she is mildly diabetic), but generally eats about as much as I do. Our diet is nothing special, except that we avoid salt and most processed foods. The only significant difference in our diets is the relative lack of starch and sugar in her diet compared to mine. One case doesn’t prove anything, but it does make it hard for me to consider your “fallacies” to be just that.

  114. mary hazlett says:

    Dear Gary,

    I have just begun reading Why We Get Fat, at the suggestion of a friend. I also looked ahead to the foods-to-eat section. And i have tried to understand your article above (a struggle!).

    That said, i am a vegrtarian, since 1990. At that time i lost 155 lbs. I was an exercise addict, walking 9 miles before work. I also did more exercise during the day. In 1994 my dad had a stroke; he needed 24/7 care. I lived at home and, with my mom, provided that care (while working full-time) until he died in 2007, when i was 49. After his stroke, the stress of work and caregiving burned me out. Something had to give, and that was exercise. I also began eating a lot of carbs because i would take my parents out to eat and got tired of omelets; i ate pasta and grilled cheese and potatoes. My weight returned.

    I have been in Overeaters Anonymous for over 6 years, with minimal physical results. Because of burnout i retired at age 50, and am my mom’s caregiver; at this time she doesnt require the level of care my dad needed; however, she has spent several long periods in the hospital or rehab facility. Those times are very stressful for me, as is emotional abuse/lack of support from her and most of my 5 siblings and their spouses.

    I detail this because i need you to know my history of weight loss (except for the few skinny years ive always been fat), my level of stress (i know stress secretes hormones), the abuse (ptsd), and my vegetarian diet, now high in carbs, as i dont cook. I get prepared foods from a healthy store (Earthfare).

    I will always remain a vegetarian. Frozen vegetarian products (veggie burgers/chicken/bacon etc) contain wheat gluten. You also say little/nothing about dry beans/nuts/peanut butter.

    Can you give me some advice? There are dedicated vegetarians who might want to follow your suggestions.

    Thank you.

    Mary Hazlett

    • gman3164 says:

      Mary, you may want to pick up a copy of “The Art and Science of Low Carbohydrate Living” by Jeff Volek and Steve Phinney. The have vegetarian options at the end of every chapter, if I recall correctly.
      Regards,
      gman3164

  115. Jonathan Shapiro says:

    Very interesting and educational. Thanks for the distinction between observational research and controlled tests that can determine causality. Other work seems to support the Willet study:
    • Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure, Caldwell B. Esselstyn Jr.
    • The China Study: The Most Comprehensive Study of Nutrition Ever Conducted And the Startling Implications for Diet, Weight Loss, And Long-term Health, T. Colin Campbell, et al
    These are based on observational research and some controlled study of people and animals. But Gary, I am curious whether you think these research efforts are pseudo science.

  116. Laura Shen says:

    The “compliance effect” has another effect on research and that is that “Girl Scouts” make the best, most loyal consumers. In a contracting economy, investors desperately seek out trends that will effect their bottom line. Whatever profitable nutrition advice that sounds “palatable” to the largest number of Girl Scout personalities, gets the research grant, with the back-end (processed commodities and marketing materials) already in place before the pre-packaged “results” are published.
    By the way, Europe has already disproved the tobacco hypothesis (more smokers–fewer deaths from lung cancer). Perhaps there are cofactors in their diet that protect them (or did) or perhaps there are additive or preservation techniques allowed in U.S. tobacco (but prohibited in European cigarettes) that affect the results.
    But anything in excess without the proper counterbalance of nutrients, habits, or environment is probably toxic. There are also apparent paradoxes of extremes. Whereas, there are certain games where the improbable outcome of a complete lack of points constitutes a “win”, there is also such thing as a “fat-free” diet where the excess carbohydrates consumed effectively generate saturated fat which happens to be the preferred fuel of the heart.
    Since I resent that I have to live in a world where gamblers (i.e., investors) determine my health, I actually find it fortunate that there is no universally accepted authority in either nutrition, sex, love, or religion. Because if there were, surely it would result in monopoly, slavery, famine, and destruction.
    Although I am sure I would be discarded from any health study as an “extreme”, I am one of those rare, non-compliant confoundedly healthy individuals. But, like you, that wasn’t always the case. Thanks to writers and researchers like you, Mary Enig, Sally Fallon, William Campbell Douglas, Joseph Wright, Russel L. Smith, William Dufty, Weston A. Price, and a host of others, for the last 12 years I have eaten a breakfast of champions as follows:
    Two pastured-hen large eggs cooked with plenty of pastured cow products (butter, heavy cream, and full-fat cheese), and unrefined sea salt
    Two strips pastured-pig cured, smoked bacon
    3 tablespoons chopped organic onion fried in the bacon grease and served “as is” (not patted down) as a garnish on the eggs
    4 shots fair-trade espresso coffee heavily diluted with pastured cow heavy cream
    A handful of individually selected supplements
    and a cigar for desert.
    I’m a 50-year old woman, 5’10″ who wears size 10 jeans. I won’t tell you my weight because I don’t own a scale. Besides although I am heavier than most, that’s no doubt due to my brain, bone, and muscle density, curves that can kill, and thick head of long hair, not my flat waistline (BMI is a joke, like weighing your wallet to see if you’re rich). I haven’t had my numbers done in years (blood pressure, LDL/HDL, triglycerides) but remember that they were excellent. However, since I spend so much money on food and romance, I can’t afford health insurance, but, tend toward the philosophy that plenty of sex while avoiding doctors in general is the very best health advice today.
    The last time I went to the doctor because I had exercise-related piriformis syndrome (a painful pseudo-sciatica), I left without treatment because all the doctor seemed to care about was trying to persuade me to give up cigars and craft beer, and to submit to a mammogram. Bed rest, stretching exercises, raw milk, broth, coconut oil, eggs, and true love cured me.

  117. Ben Rice says:

    So I’m not sure if you’ve spoken on this, but what about using dextrose for sweetening? I understand it is essentially powdered glucose, i.e. it doesn’t need to be metabolized by the liver like fructose does. It will increase levels of insulin, and cause fat gain, but maybe without the long term fatty liver deposits and insulin resistance?

    • Ben Rice says:

      Well, to my last post, I did a google search for my “use glucose (dextrose)” idea, and found this study in Time from 2009: http://www.time.com/time/health/article/0,8599,1892841,00.html. Seems to support my half-baked thought. I buy powdered dextrose from a local body-building shop and use it only for post-workout shakes (with lots of whey protein and water), but maybe I should be using it more widely, in baking and such. I mean, if you would like to indulge, perhaps this would be a better choice? Also, thank you so much for your excellent books and articles.

  118. Alice Davis-Rains says:

    Husband is 80; I’m 71. He’s skinny and I’m 30 pounds over. My parents, and his, were normal weight their entire lives and did not diet. They ate heartily. They were active but not athletes or fitness buffs. I live in rural Arkansas where every person you meet is overweight with few exceptions. But their grandparents were not. And they ate whatever didn’t eat them first and (in this part of the world) were very glad to get it. It seems obvious to me that it’s not the quantity of the food, but its composition. Yes, we are poor and food pantry items are very heavy rice, pasta, starches, canned goods. Fresh fruits and veggies–no. I’ve got an impossibly tight food budget and I cannot keep fresh fruits and vegetables on the table. I do the best I can. At least I live where I get seasonal gifts from neighbors’ vegetable gardens, but that’s no help in the non-gardening seasons. And the country is getting both poorer and fatter. I’m also suspicious of food additives, processing, and plastic containers. I’m suspicious of everything from the supermarket!

  119. Pauline Keogh says:

    Your Newsweek article is good, I agree with your position on sugar from my own reading on nutrition, although I’m no expert.
    BUT, saying that diets that severely restrict fattening carbs and are rich in animal products and veg are arguably the best approach (to losing weight I presume you mean, or not gainingg) and “if not, the healthiest diet to eat” is just wrong regarding the latter “healthiest diet” statement. I’m sure the approach would help one to lose or not gain weight, but the healthiest?
    I don’t think the literature supports any notion that eating meats, eggs and dairy is the healthiest diet. Epi. studies predominantly if not completely demonstrate that restricting these foods is related to better health outcomes in populations, and also in individuals.
    I’m not a veggie, but you would have to disdain Colin Campbell’s and Caldwell Esselstyn’s work to come to that conclusion.

    • Kathy says:

      Well, why WOULDN’T one disdain Colin Campbell’s and Caldwell Esselstyn’s work? In both cases, it’s utter pseudo-science.

  120. jack says:

    Gary,
    Would you comment on Carson C. Chow’s work at the National Institute of of Diabetic and Digestive and Kidney Diseases.

  121. Jim Matthews says:

    Hi Gary,
    I am loving your book “Why We Get Fat”. I have seen articles before which have proposed similar ideas, but your book puts it all into perspective, and is very readable, so is hard to put down.

    However, I read something in the news a couple of days ago, that has me confused. I have been on the internet and checked up on the details, and the article was fairly accurate.
    The headline was “British scientists discover that high fat foods hit the waistline three hours after being eaten”, and was a summary of the findings of Fredrik Karpe, professor of metabolic medicine at Oxford University. It looks to be based on something much more than an Observational Study.
    The article says, for example:
    “Volunteers were asked to eat foods that contained fatty acids. The pair (Professor Karpe and colleague Keith Frayn) then traced the fat as it was first broken down in the gut and then absorbed into the gut wall before being turned into globules called chylomicrons.
    This process took about an hour. The chylomicrons then went into the lymph system and the blood, which carries them around the body quickly.
    The process is very fast,’ Professor Karpe said. ‘The cells in the adipose tissue around the waist catch the fat droplets as the blood carries them by, and then incorporate them into the cells for storage.’
    So what to do? The scientists found the fatty tissue was only stored around the waist short-term, so could be used for energy when a person is exercising.
    However if the person continued to eat excessively, the fat moved to the hips, bottoms and thighs long-term, scientists found.
    In fact, Professors Karpe and Frayn found that exercise prompts fat cells to release fat that muscles can use. They also discovered fit people find it easier to burn fat.”

    It flies in the face of everything that you are saying in your book, and it disturbs me that his conclusions can be so different from yours.

    I still have confidence in your point of view, and I have started to eat as you have prescribed. Too soon to draw any conclusions on weight loss, but I do feel very energised.

    Best Regards
    Jim Matthews

    • Martin says:

      >> Volunteers were asked to eat foods that contained fatty acids.

      Jim, the real question is: what else did those foods contain? I doubt that it was only fatty acids. Very likely the foods contained carbs and protein. Both drive a surge in insulin. Only if insulin goes up will fatty acids be trapped in the fat cells.

      The experiment is likely invalid.

  122. Arthur Clarke says:

    Gary, in a month of shifting to a high fat/low carb diet I have already lost an easy 10lbs. (265 to 255 @ 6’5″). I have noticed that I lose more weight over night than on a normal diet. Also, my wife, who has also shifted to a low carb diet, has noticed a decline in urge to snack in the middle of the night.

    I wonder if anyone has tried the following rather simple research project. Measure the overnight weight loss of different diets. Thus, one might assemble two groups of subjects, equally male/female. One group starts on a normal high carb diet; the other on a low carb diet. After an appropriate number of weeks the two groups are reversed. Each evening before going to bed each subject is weighed and again after rising in the morning and going to the bathroom. Snacking is allowed. It might be useful to periodically measure lipids to see if and how these are effected.

  123. Bob wheeler says:

    I can’t help but wonder what your reaction is to Carson Chow’s 5/14/12 nytimes article on his mathematical model of obesity! I have read most of your articles and your book on how we get fat. I have had personal success with the Atkin’s Diet. I lost 75 pounds in 1999 and have kept it off through limiting carbs. The clarity of your writing has been inspiring for me as it has helped deepen my understanding of why carb reduction works so well. To get back to the first sentence of this paragraph – reading Chow’s article was disturbing. Also disturbing was the attention he received by being in the nytimes. Thank you for your excellent journalism!

    • Arthur Clarke says:

      Bob, I think the problem with the NYT’s Chow article is that the mathematician’s analysis aggregates all food together. If he had separated, and I think he could separate, the various food groups, he might come up with a conclusion other than the one he did, which works off of the paradym of calories in, calories out that Taubes questions and you and I stand as, admittedly, anecdotal counterevidence. I suspect the major growth in food production per capita has been in high-carbohydrate comodities like corn and corn syrup. If so, this would corroberate Taubes analysis. But is the cause the greater supply or the greater demand?

  124. Paul Meyer says:

    Gary,
    Really appreciate the work you’ve done. I have a question, have you written (or know of) a good analysis of claims by Chris Masterjohn of populations eating high carbohydrate diets that are free of the typical coronary diseases. One of the strengths of the “carb-skeptical” viewpoint is the evolutionary argument, i.e., that before the rise of agricultural there just was not that many carbs available in the human diet (may not be quite as true in the tropics). None of this is meant to question Masterjohn’s evidence, but a discussion of complicating factors (physical activity, fructose/mix of fats in diet, life expectancy, genetics) would be interesting.
    Also, though I’ve never made a systematic study of this, it seems by way of anecdote that when pre-agricultural societies did have access to a supply of carbs, their response (to some degree) was to make
    alcohol (which actually could be seen as a brilliant technique of food – and water – storage). Keep up the good work, I am planning to send a copy of WWGF to my RD mother. -PJM

  125. Jim says:

    Sadly the IOM and the USDA seem to line up on calories in & out (caution: the devil is in the details). See also the HBO Weight of the Nation.

    The reason is it is one of those things that is sort of true but not exactly true. Given 2 garbage diets, the person eating more garbage will likely get fatter.

    The extreme example is if you ate 2,000 cal of sugar vice 2,000 cal of say broccoli. Compare the fiber, nutrient, and volume of the 2 diets. Which diet would malnourish you?

    I find the 17-19th century nutrition problems illuminating. Naval ships might take 80% casualties on a long voyage due to a combination of scurvy, beri beri, and pellagra. Folks were desperate to solve the issue and many folks had many theories (e.g. an infectious disease, etc.).

    Even though the British navy solved the problem (vegetable soup, shorter voyages, unboiled lime juice, etc.), the Japanese Navy still had the problem. Dr. Takaki Kanehiro conducted an experiment with two navy ships with different diets; the ship with a good diet had dramatically fewer cases. Even so, the Japanese Army refused to believe Kanehiro’s results and continued feeding their soldiers white rice resulting in 20,000++ casualties.

    Fast forward to the US where there was a large outbreak of mental illness in the SE. Again, lots of theories….”pellagra, a disease that can lead to dementia and death, is caused by a nutrient-deficient diet, for instance, as Joseph Goldberger demonstrated in the 1910s…. Goldberger tested the competing hypothesis, which posited that the disease was caused by an infectious agent, by holding what he called “filth parties,” injecting himself and seven volunteers, his wife among them, with the blood of pellagra victims. They remained healthy, thus doing a compelling, if somewhat revolting, job of refuting the alternative hypothesis.”(Taubes) Later research established it was a B vitamin deficiency which resulted in thousands being released from mental hospitals.

    Today’s DRI are the result of the WWII Army trying to figure out how to feed large numbers of soldiers a healthy diet.

    The first point here is that folks can die or become massively sick on adequate or even excess calories. Folks are surprised when obese folks are malnourished (and we haven’t started talking about D yet). A bushel basket of french fries or potato chips has lots of calories but few micronutrients. If the standard American diet is 69% processed carbs, where are the nutrients?

    The second point is that change is maddeningly slow. It almost seems like generations of experts have to die off for change to take place.

    The third point is that folks may or may not really know their stuff. In the Stanford A to Z diet study, they found folks said they had tried the x diet, but had never read the book nor, in fact, really did the diet.

    Taubes articulates a healthy, fat loss diet based on their entire lifestyle and how the body’s hormone’s respond to foods. Great stuff. :)

  126. Morwalk says:

    It is disheartening how people are so easily swayed by pseudo-science. This highlights the need for everyone to understand the fundamental processes of scientific investigation, especially when it relates to our level of health.

  127. Sharon B says:

    Mr. Taubes,
    I read your book, “Why We Get Fat” to my husband in the car as we were returning from a road trip vacation. I would read a section and then we discussed it. Questions that arose where then answered in the next chapter or so. We were impressed with the literary research of the book and how all of the pieces were put together. For so long we have believed that “just eating less” would help us lose weight or that getting more exercise was the key. Your discussions of the scientific understanding of the body filled in the blanks that we have had for many years. Now, our next step is to keep the motivation to continue to manage blood sugar. Hoping America can see the light and move back to healthier and ‘right’ eating. Thank you so much for your book. Sincerely, Sharon, Lisle, IL

    • Donna E says:

      Sharon, for motivation and tips you might take a look at Dietdoctor.com and especially his section on LCHF for beginners. Good luck!

  128. Neil Heimsoth says:

    I was given your book and have been on your suggested low-carb diet for the last year and thank you very much, my a1c test last week, was 6.5…previously it was above 7. However, my doctor says I am eating too much fat because my triglyceride count is too high. Any suggestions?

    • gallier2 says:

      Your Doc doesn’t know what he’s talking about. TG are the lipo-proteins that transport fat (triglyceride) around in the blood. Now you have to look when was you blood sampled? In the morning in a fasting state, which means that there is no dietary fat around, your gut is empy. So where does the transported fat come from then? The liver, which produce new fat from carbs for hours and hours after your last meal. The TG lab value is therefore a marker for carb consumption, not fat consumption, for that you would have to measure that value post-prandially, which is never done.
      If you search a littlebit on low-carb and paleo forum and blog entries, you will notice that TG goes consistantly down when going on a lower carb diet.

  129. Emmanuel says:

    I have been surfing on-line more than 3 hours as of late, but I never discovered any interesting article like yours. It’s beautiful value enough for me. Personally, if all website owners and bloggers made excellent content as you probably did, the internet will be much more helpful than ever before.

  130. Hong Kyu Lee says:

    You think science too strictly. Science of way of knowing things. Cancer and obesity are very complicated issue with many “causes”. You cannot apply Koch’s postulates. In fact it was Arthur Hill, who used epidemiological data to establish cause effect relation between exposure and effect (disease, in his case, smoking and lung cancer) Hills Criteria of Causation is widely known. I thin observational studies by Walter Willett added very important information and they are true. There are some missing parts…

  131. What’s up, its good paragraph about media print, we all be aware of media is a impressive source of information.

  132. Hey! I know this is kinda off topic nevertheless I’d figured I’d ask. Would you be interested in exchanging links or maybe guest writing a blog article or vice-versa? My blog addresses a lot of the same subjects as yours and I think we could greatly benefit from each other. If you might be interested feel free to send me an email. I look forward to hearing from you! Terrific blog by the way!

  133. I am currently very much enjoying Good Calories, Bad Calories and thought I’d drop by here to see what you’ve been doing more recently. I want to take a moment to suggest that you go farther, boldly go where no man has gone before, to quote a phrase from when I actually owned a television. You’ve asked the question, in your New York Times article, and of course many times in the book – ‘Do We Really Know What Makes Us Healthy”.
    My challenge:
    “Do we really know how healthy we are?” My point is that we only measure illness, and we think being ‘not sick’ is ‘healthy’, as if healthy was a binary state. Health is much more complex than illness. Medicine and illness are subsets of healthicine, the study of healthiness – small subsets that get all of the attention. I am exploring the concept of healthiness on my blog, and find it gives me a very different viewpoint and understanding of many ‘medical issues’ – and of your book as well. Frankly, we don’t know if you, or I, or our children or our grandparents or cousins are healthier or less healthy than we – and we have no way to measure. That’s a shame. When we can measure healthiness – many of the points you make in your book will be so clear as to be trivial – and we can move on to the more difficult challenges.
    to your health, tracy
    Everyone has a right to life, liberty, and the pursuit of healthiness.
    http://personalhealthfreedom.blogspot.ca/p/subject-index.html

  134. my website says:

    I’ve a weblog and I would like to know web pages where I can locate loads of nice templates for it (Blogger)? Except from BlogSkins, please.

  135. Milt Martyny says:

    Gary,
    I love your books. A question: what is your opinion of the health effects of nitrates, such as those found in most bacon?
    Secondly, Why We Get Fat doesn’t distinguish between grain fed and grass fed meat, despite the large differences in fatty acids and mineral and vitamins. Why wasn’t that issue mentioned?

    Thank you!

    Milt

  136. Sean Burke says:

    Very interesting blog. Any reason for the apparent correlation between “Girl Scouts” (compliers) and less meat-eating? And what does that signify? Is is anything more than just an expression of the conventional wisdom that meat-eating is bad?

  137. Eric says:

    Thank you Gary for sharing your great insights into nutrition/obesity. Though I am not obese but have been overweight I found your writing absolutely fascinating and have now cut off sugars and most carbs from my diet. However, as I shop for groceries and prepare the meals and can’t stop thinking why the “establishment” has literally “fed” us the wrong diet all these many years. Big food, and big pharmaceuticals is obvious but the governments – when they have to foot the bill in health cost? Then I wondered what kind of world we would live in if we all had our proper nutrition and ate adequate proportions of meat. 7 billion people eating a meat based diet? Isn’t that why humans adopted agriculture in the first place because it was more efficient in feeding large populations. The social political environmental implications are unimaginable – perhaps as unimaginable as health cost brick wall western societies will hit in the coming decades with the obesity epedemic. God help us all. Maybe Malthus was right after all.

  138. Ricardo del says:

    Gary, recent events in Texas (not Texas A&M) indicate despite your accusatory article in Science, June 1990, and subsequent book on the topic of cold fusion – there is in fact a real, repeatable Pons & Fleischmann effect. The effect has been demonstrated as excess heat produced by Ni + H2 in front of 5,000 scientists and engineers at the National Instruments Week congress in Austin by Dr. Francesco Celani and a team of NI engineers. There are more demonstrations and data on the way. US News and World Jeff Nesbit is reporting the story and you may be aware that three divisions of NASA are studying the effect.

    Do you have any intention of correcting your errors and accusations in light of evidence you have been wrong all along? Are you open to a frank discussion of your intentions and actions 22 years ago? One is always prone to error – you have profited by your error and harm to the careers of others. What do you intend to do to make amends??

  139. Chris says:

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  140. Dirk Woods MD says:

    Fantastic article! Unfortunately, we have much of the same problem in medicine and with drug company sponsored studies. We try our best in the dimly lit room of medical science when a clinical dilemma presents itself. It sounds like you are doing the same in your area. Congrats on peeling away the non-sense.

  141. ken derow says:

    Gary, fascinatng and informative blog aqnd gives one loads to think about. I wholeheartedly agree that psuedoscientists confound and confuse correlatonand and association with casuality all the and I have seen it done in research of smoking cesssation many times.

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  142. WW says:

    Read: The China Study. Forks Over Knives is a great documentary based on the book. The authors did extensive studies specifically tracking the effect animal protein has on cancer rates. We are exposed to far more carcinogens now than every before between our artificial environments and our artificial foods, unlike when our ancestors chose their diets. There is strong reason to believe based on both a grand epidemiological study and corroborating scientific research presented in The China Study that optimal health to combat carcinogens comes from eliminating animal products from our diets.

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      I am glad to see that I am not the only person in the comments section recognizing the existence of a plethora of experimental and mechanistic research, to compliment the epidemiological results.

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    I suppose the lack of a controlled, randomized, experiment demonstrating that smoking cigarettes causes cancer in humans means that this claim is also pseudo-science? The types of evidence for smoking and cancer are analogous to the types of evidence for the meat-cancer link.

    You criticize one epidemiological study from Harvard, but what about all the experimental studies and mechanistic research that that the World Cancer Research Fund’s 200 scientists from 30 different countries summarized, and found the link between red meat and colon cancer to be ‘convincing’? They reviewed over 7000 studies, most probably including the small handful that I have seen you mention.

    I doubt that Zoe Harcombes article would get past peer-review, it is full of flaws. But this isn’t unexpected from an individual who is not a biomedical scientist.

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      The World Cancer Research Fund ‘report’ is NOT a peer-reviewed study.

      It makes no list of what ‘literature’ it reviewed. How do you know they used SCIENCE, hm? Or did they use more of these epi surveys and studies? Garbage in makes garbage out. 7000 peer-reviewed articles? Like the ones GT and actual scientists debunk with ease?

      No, the connection between smoking and lung cancer wasn’t just from epi studies, but from followup SCIENCE, cupcake.

      Try to keep up.

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    I wonder why nobody has mentioned that red meat eaters might also be people who don’t go to the doctor as often as they should, again a health factor that goes hand in hand with the Girl Scout compliance hypothesis.

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  150. Greg says:

    Mr. Taubes,

    I don’t know if you will ever read this, but if you do happen to fall on this comment…

    If you are, indeed, on a crusade to shed light on obesity, nutrition, epidemiology, etc., why is it that you have not made any attempt to go back to school for an MPH and/or a Ph.D in epidemiology with a concentration in nutrition?

    You do not know how to interpret study results because you have zero experience designing experiments as a scientist. Just because all these peer-reviewed articles are accessible to you, does not mean you know how to actually interpret their conclusions…only those with both the training and the experience to go with it know how to separate solid results from weak ones.

    If you actually read the HSPH website, they are not anti-fat, and they are also not anti-meat and dairy. I understand you must make a fair bit of money with your books, but I would have a lot more respect for you, and so would everyone else, if you admitted to being an ignoramus and publicly announced your decision to get more education before criticizing the work of researchers with decades of experience and training…

    I apologize for being so gruff, but I am being 100% sincere that if you actually did become a professional epidemiologist, I would buy your books…

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    I just spent 11 days in South Florida caring for my father who is being treated for a cancerous tumor. Besides the outrageous idea of medical treatment, I was taken with how terribly unhealthy and out of shape (especially overweight) the medical staff was. I was also impressed (negatively) by the poor quality of food that the dietitians make for hospital patients, including sugar, sugary foods, MSG ingredients, sugar drinks (including soda), etc. If these people are the subject of any study, then it’s a good guess that a good percentage of them will end up with a chronic disease, not because of specific things they eat, but because of their diets in general. I would have to agree with Gary that these studies are not studies at all, but rather observations. And without proper controls or any other scientific constructs, they are relatively worthless in terms of being able to predict health, healing or prevention.

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    I believe Gary Taubes is critiquing the following study: Pan, Bernstein et al. Red Meat Consumption and Mortality: Results From 2 Prospective Cohort Studies. ARCH INTERN MED/VOL 172 (NO. 7), APR 9, 2012. (Free copy at http://archinte.jamanetwork.com/issue.aspx?journalid=71&issueid=23009&direction=P)

    Having read the original study, I must say that I respectfully disagree with Taubes’ views.

    As I understand it, Taubes questions the associations between meat consumption and overall mortality, mortality from cancer, and mortality from heart disease. He suggests that these associations are likely a product of the ‘compliance effect.’ That is, the medical establishment has long advised cutting back on meat. Therefore, Taubes claims, “the people who [complied with this advice and] avoided red meat and processed meats were the ones who fundamentally cared about their health and had the energy (and maybe the health) to act on it. And the people who ate a lot of red meat and processed meat… were the ones who didn’t.” Taubes goes on to suggest the study has failed to sufficiently correct for this ‘compliance’ effect. Therefore, it is not red meat itself that is associated with higher disease mortality; it is the health behaviors of those people who eat red meat.

    I tend to disagree. According to the multivariate models on Tables 2, 3 and 4, the associations between meat and disease mortality appear robust, even when correcting for the degree of ‘compliance’ with many health behaviors: consumption of whole grains, fruits and vegetables; total energy consumed; smoking and alcohol; physical activity; and BMI. These variables seem to me to cover many, if not most, of the relevant health behaviors. I am not sure what else Taubes has in mind when mentioning the ‘compliance effect.’

    Furthermore, I am puzzled by Taubes’ suggestion that observational studies are not scientific. According to him, “real science” consists of generating a hypothesis, and then doing your best to disprove it in an experiment. However, experimental design is often not possible in epidemiological studies. As far as I’m aware, it is not ethical to randomize people into two exposure groups — people who are fed high concentrations of substance A vs. people who are not — and then watch for the development of cancer. It would not be ethical even if we had the tiniest suspicion that substance A was linked to cancer. Only in clinical settings, where the exposure drug is expected to yield BENEFITS (rather than cause harm), are such studies allowable — and then, only after countless animal trials.

    Therefore, much of epidemiology must, by necessity, be observational. Rather than creating a hypothesis and disproving it in an experiment, the epidemiologist formulates a hypothesis and gathers (observational) evidence to support it. If the observational evidence is statistically compelling, the hypothesis is “supported.” Otherwise, it is “rejected.” Is that so ludicrous, so scientifically unfounded, as Taubes makes it sound? Personally, I don’t think so.

    Last but not least, I take issue with Taubes’ accusation that the authors are claiming causality. According to him, the authors merely found an association between red meat and disease mortality. This does not mean that red meat causes disease. That is true; but why accuse the authors of claiming that red meat causes disease? As far as I can see, they make no such claim. Nor does the NYTimes press release, which Taubes freely criticizes, mention “causality” (http://www.nytimes.com/2012/03/13/health/research/red-meat-linked-to-cancer-and-heart-disease.html). Yes, “risk” is mentioned — but in epidemiology, risk is a statistical term, a measure of association. In epidemiological speak, “meat is linked to a higher risk of disease mortality” does not mean “meat causes death” — it just means that the association is strong.

    In short, I found the Taubes post unfair to the original study.

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Trackbacks

  1. [...] and early death.  I was about to do a Random Research Dissection on it, but then I went over to Gary Taubes site and it turns out he’s already done it.  And he links to Zoe Harcombe, who has done a [...]

  2. [...] Interesting to see that Denise included a link to the Food Frequency Questionnaire (FFQ) used for the Nurses Health Study… I was expecting a fairly free-form "what have you been eating for the last 4 years?" but instead found the questions to be quite leading… rather than "do you eat breakfast cereal or margarine?" they ask "What brand and type of cold breakfast cereal do you usually eat?" and "What form of margarine do you usually use?" — then going on to ask for specific brand details. Is it just a given that everyone eats cereal for breakfast and uses margarine? — Gary Taubes has also posted a blog entry about this study announcement, Science, Pseudoscience, Nutritional Epidemiology, and Meat… [...]

  3. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat. Share this:FacebookTwitterRedditMoreLinkedInDiggStumbleUponTumblrPinterestPrintEmailLike this:LikeBe the first to like this post. [...]

  4. [...] Taubes comments on the pseudoscience behind [...]

  5. [...] and editing, as I usually do, I’m going to do my best to get this up and out in a few hours.   Read More » Be Sociable, [...]

  6. [...] mycket läsvärt nytt blogginlägg av Gary Taubes om hur osäkra observationsstudier verkligen är:Taubes blogg: Science, Pseudoscience, Nutritional Epidemiology, and Meat (Inlägget är kort, för att vara Taubes)Läs merCissi Wallin, LCHF och gallstenen [...]

  7. [...] nice blog post by Gary Taubes about how uncertain the observational science behind them really is:Taubes blogg: Science, Pseudoscience, Nutritional Epidemiology, and Meat (a short post, for Taubes) Print This entry was posted Thursday, March 15, 2012 at 19:13 and is [...]

  8. [...] it was wrong, I didn’t see the need to beat it up here. But I would like to share with you Gary Taubes’ take on the red meat study done by the Harvard School for Public Health.. He goes deeper into the [...]

  9. [...] a big fan of meat so I really enjoyed Gary Taubes’s response on the recent “Meat Kills” article.  Share this:Like this:LikeBe the first to [...]

  10. [...] is Robb Wolf, who referred to the red meat scaremongering as “nutritional McCarthyism.” Gary Taubes also commented on the horrendous science behind the study: The problem with observational studies like those run by [...]

  11. [...] is Robb Wolf, who referred to the red meat scaremongering as "nutritional McCarthyism." Gary Taubes also commented on the horrendous science behind the study: The problem with observational studies like those run by [...]

  12. [...] Link Love Read, I’m serious, read this – Science, Pseudoscience, Nutritional Epidemiology, and Meat [...]

  13. [...] there is Robb Wolf, who referred to the red meat scaremongering as “nutritional McCarthyism.” Gary Taubes also commented on the horrendous science behind the study: The problem with observational studies like those run by [...]

  14. [...] Here‘s a great article on the faults of the recent Harvard media release Red Meat Consumption Linked to Increased Risk of Total, Cardiovascular, and Cancer Mortality.  The article author, Gary Taubes, also wrote Why We Get Fat; a book we highly recommend.  An exerpt from the article: This is an issue about science itself and the quality of research done in nutrition. Those of you who have read Good Calories, Bad Calories know that in the epilogue I make a point to say that I never used the word scientist to describe the people doing nutrition and obesity research, except in very rare and specific cases. Simply put, I don’t believe these people do science as it needs to be done; it would not be recognized as science by scientists in any functioning discipline. Like this:LikeBe the first to like this post. This entry was posted in Uncategorized and tagged clayton, crossfit, disease, fitness, Gary Taubes, gateway crossfit, gym, meat, missouri, nutrition, personal training, st louis. Bookmark the permalink. ← Biggest Loser Winner Goes CrossFit! [...]

  15. [...] the article in the New York Times about red meat? Well read it and then get a reality check from Gary Taubes here and a great response from Roxy Richardson of Function 5 Fitness [...]

  16. [...] Taubes tackles the latest red meat scare study, and discusses the problems with epidemiology in [...]

  17. [...] Gary’s article teaches us why the study is flawed.  It is a great article, but a little dense.  It will give you a good foundation in understanding good and bad science.  Read More [...]

  18. [...] Taubes tackles the latest red meat scare study, and discusses the problems with epidemiology in [...]

  19. [...] links for your reading pleasure: original journal article, here is what Zoe Harcombe has to say, Gary Taubes says this, Anthony Colpo weighs in here,  Dean Ornish does his thing here, Mark Sisson hires a Minger to [...]

  20. [...] writers acknowledge imperfection, inaccuracy or haste  in prefacing their work? Gary Taubes’ latest blog post is the most recent example I can recall. Is it better to come off strong or modest? Regardless, [...]

  21. [...] Gary Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“. [...]

  22. [...] Red Meat Linked to Cancer Flaws in the Study Science, Pseudoscience, Nutritional Epidemiology and Meat [...]

  23. [...] Gary Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“. [...]

  24. [...] Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“. designed by elegant themes [...]

  25. [...] gave it a worthy whack and pointed readers to Denise Minger’s slice-and-dice.  Gary Taubes also took the study apart and made the remaining points I would have made (and then some), so I won’t bother weighing in on [...]

  26. [...] Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“. Like this:LikeBe the first to like this post. This entry was posted on Monday, March [...]

  27. [...] y en VidaPaleo de forma mucho más escueta también se habló del estudio. Muy en la línea de Gary Taubes que ya ha tenido sus más y menos con la metodología que usan en el estudio de [...]

  28. [...] Taubes wrote a lengthy but worthwhile response, Science, Pseudoscience, Nutritional Epidemiology, and Meat. Throughout his career, Taubes has shown himself to care deeply for the practice and integrity of [...]

  29. [...] Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“. Tagged with: HSPU • Run  Share it! Click on a tab to [...]

  30. [...] Gary Taubes, author of “What If It’s All Been A Big Fat Lie”, Good Calories, Bad Calories and Why We Get Fat and What To Do About It tackles the same red-meat-will-kill-you topic here. [...]

  31. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat – Gary Taubes [...]

  32. [...] Gary Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“ [...]

  33. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat [...]

  34. [...] it a worthy whack and pointed readers to Denise Minger’s slice-and-dice.  Gary Taubes also took the study apartand made the remaining points I would have made (and then some), so I won’t bother weighing in on [...]

  35. [...] it a worthy whack and pointed readers to Denise Minger’s slice-and-dice.  Gary Taubes also took the study apartand made the remaining points I would have made (and then some), so I won’t bother weighing in on [...]

  36. [...] article I read was titled, Science, Pseudoscience, Nutritional Epidemiology, and Meat by Gary [...]

  37. [...] can find a link to his article here: Science, Pseudoscience, Nutritional Epidemiology, and MeatAnd a link to a dissection of the study here: Red Meat & Mortality & the Usual Bad [...]

  38. [...] Writers three times and was awarded an MIT Knight Science Journalism Fellowship for 1996-97". Science, Pseudoscience, Nutritional Epidemiology, and Meat If she takes no notice … well, if that, she doesn't want to know, and "science" is [...]

  39. [...] V primeru HSPH že od leta 2007 vse svoje hipoteze niso uspeli potrditi. Hm… Mogoče so se, tako kot pravi Gary Taubes (Edit, hvala Uroš T.), s to študijo odločili, da preskočijo tisti resen raziskovalni element in [...]

  40. [...] Gary’s article teaches us why the study is flawed.  It is a great article, but a little dense.  It will give you a good foundation in understanding good and bad science.  Read More [...]

  41. [...] times by others this week alone.  Three critical posts on this specific paper can be found here, here, and [...]

  42. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat One Last Rep The Second Pull Somatotype in Sport (and CrossFit) Overcome [...]

  43. [...] is why, as Gary Taubes notes in a blog post worth reading in its entirety, even “the best epidemiologists … think this nutritional [...]

  44. [...] [Complete article here with the science and the data. See also Science, Pseudoscience, Nutritional Epidemiology, and Meat] [...]

  45. [...] Gary Taubes - Science, pseudoscience, nutritional epidemiology and meat. I know, thrilling title but it’s important! Share and Enjoy: [...]

  46. [...] is in doubt and should itself be studied. Read these excellent critiques of the Harvard study by Gary Taubes (warning: it’s long but worth it) or Denise Minger at Mark Sisson’s [...]

  47. [...] Here it is…go READ! <3 Coach Miss J Did you like this? Share it: Tweet March 21, 2012|No Comments ← Get Serious [...]

  48. [...] HOWEVER… there is apparently more to this story as Gary Taubes (author of Why We Get Fat and Good Calories, Bad Calories) explains in this post: http://garytaubes.com/2012/03/science-pseudoscience-nutritional-epidemiology-and-meat/ [...]

  49. [...] Gary Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“. [...]

  50. [...] article: science, pseudoscience, nutritional epidemiology, and meat recipe: balsamic-mustard chicken + oven-roasted bacon veggies [...]

  51. [...] intake” were not excluded. There’s more to the article and I recommend reading it all. Gary Taubes also discusses the red meat report, but from a broader standpoint of nutrition science. Taubes [...]

  52. [...] (To understand why this study is only fit for “lining a budgie’s cage” please see here, here, [...]

  53. [...] thing is, that chocolate study uses essentially the same method as the red meat study. And, as Gary Taubes pointed out recently, there are definitely limits to what such studies can tell us. While chocolate has been shown to [...]

  54. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat. [...]

  55. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat. [...]

  56. [...] Taubes’ recent definition of science is worth repeating: Science is ultimately about establishing cause and effect. It’s not about [...]

  57. [...] Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“. Share this:TwitterFacebookLike this:LikeBe the first to like this post. Posted in [...]

  58. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat The Reaction from Gary Taubes on the meat study… Social sharing [...]

  59. [...] Taubes gives a scientist’s view of those headlines about what we eat. Share this:EmailLike this:LikeBe the first to like this post. This entry was posted in [...]

  60. [...] Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“. Share this:FacebookTwitterEmailPrintLike this:LikeBe the first to like this [...]

  61. [...] to further improve their chances of success.  As pointed out by Gary Taubes in his article on Pseudoscience and Clinical Studies, this factor can lead to misleading clinical results.  He calls these dieters that execute well, [...]

  62. [...] Meat will kill you Study: I’d jump straight in with a comment from Gary Taubes and  Silverhydra’s interpretation   before rounding it out with a post from Mark Sisson. [...]

  63. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat The Reaction from Gary Taubes on the meat study… CommentsPowered by Facebook Comments Social sharing [...]

  64. [...] a response from Gary Taubes, author of “Why We Get Fat” and “Good Calories, Bad Calories” to [...]

  65. [...] The Nurses Study looked at other behaviors as well.  Things such as smoking, alcohol intake, exercise patterns, etc.  Finally, the study looked at health problems.  It kept track of cancer, heart disease, mortality, etc.  All very important things when you are trying to tell people how to eat.    When you are looking at an observational study like this, particularly when it takes place over the course of 20-30 years, you have to account for “compliance bias.”   There are people (believe it or not) that listen to what health professionals tell them.  They exercise, abstain from smoking/alcohol, get the right amount of sleep, etc.  You can imagine that in the early 1980′s, when the USDA adopted its disastrous food pyramid, that health conscious people immediately cut back on meat and increased their carbohydrate consumption.  Gary Taubes does a wonderful job explaining compliance bias in this blog post. [...]

  66. [...] Here’s Gary’s rebuttal to the “Red Meat Will Kill You” study. with a few excerpts: [...]

  67. [...] Here’s Gary’s rebuttal to the “Red Meat Will Kill You” study. with a few excerpts: [...]

  68. [...] Mr. Taubes recently wrote a blog post responding to a recent study titled Red Meat Consumption and Mortality published in Archives of Internal Medicine concluding that “red meat consumption is associated with an increased risk of total, CVD, and cancer mortality.”1 If I had to summarize the entire post it would be something like: Epidemiology is a pseudoscience. Well, not all epidemiological research, just any research suggesting that eating red meat for every meal might not be healthy. Any scientist or nutrition researcher claiming that is practicing a junk science. Those that come to other conclusions are the real scientists, the good scientists. Also, I will never accept any scientific claim unless there are randomized, placebo-controlled clinical trials to back it up. Except for the claim that smoking causes lung cancer. I will accept that one without RCTs. [...]

  69. [...] Here’s Gary’s rebuttal to the “Red Meat Will Kill You” study. with a few excerpts: [...]

  70. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat [...]

  71. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat. [...]

  72. [...] Taubes had a great rant in March on misinterpreting correlation in health research. He describes the compliance effect, [...]

  73. [...] Taubes reacts to the bad science rampant in public nutrition: “Science, Pseudoscience, Nutritional Epidemiology, and Meat“ Post load and number of reps+rounds This entry was posted on Thursday, August 9th, 2012 [...]

  74. [...] drink to excess, and eat a large fries with it. Gary Taubes explains it better than I ever could: Science, Pseudoscience, Nutritional Epidemiology, and Meat Reply With Quote « Previous Thread | Next Thread [...]

  75. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat. Share this:TwitterFacebookEmailPrintLike this:LikeBe the first to like this. Posted in Health, Nutrition and tagged Gary Taubes [...]

  76. [...] by Galileo or Darwin. Is it any wonder that nutritionists have no trouble getting a worthless observational study funded so long as it supports the idea that eating plants is good and eating meat is bad? [...]

  77. [...] Science, Pseudoscience, Nutritional Epidemiology, and Meat. This entry was posted in Health Care, Science. Bookmark the permalink. ← “Liberals [...]

  78. [...] studies which rarely show  causation  and are very misleading to the general public (see “Science, Pseudoscience, Nutritional Epidemiology, and Meat?”).   It now appears that Harvard is finally coming around.    In addition to the Harvard Food [...]

  79. [...] kind of discussion. But, moreso, to avoid studies that merely show correlation and not causation. Science, Pseudoscience, Nutritional Epidemiology, and Meat eudaimonia, Mark __________________ To view links or images in signatures your post count must [...]