on 27 February 2008
Have you ever wondered about the advice on healthy eating we get?
First it was, Cholesterol is deadly, no eggs! Then it was, You only have to avoid the bad cholesterol. And finally it became, Actually, dietary cholesterol isn't really the problem: dietary fat is the problem.
First it was, margarine is healthier than butter. Then it was, Ermm, actually, guys, butter is healthier than margarine.
Have you ever wondered about the healthy diets we've been told to go on? The ones you've watched your overweight colleagues, friends or lover struggle with, to no avail? We all know they don't work. Even the authorities that recommend them admit they don't work.
Why is it that when the standard low-fat, restricted-calorie diets don't work -- and they almost never do --, it's politically incorrect to question the efficacy of the diet? It's always, the dieter is to blame; they lack willpower, they cheat, they're just plain lazy and gluttonous. And this, even when you can not lose weight on a diet that your lean friends would call meagre, and you're hungry and tired much of the day?
Have you ever wondered if the scientific foundation on which all these perpetually shifting and retreating and ineffective recommendations were made wasn't all that sound to begin with?
So, OK, I admit, I was already prepared to believe that there was something not quite right about the current dogma for low-fat diets with lots of exercise being the only way to lose weight. I followed this advice myself for much of my adult life, and, being fortunately lean, guess what? it worked, for me. But not for many other people. You might say I came to this book with an open mind.
I was not prepared for the revelations in this book. About how there are no large-scale epidemiological studies underlying the standard recommendations (and never will be because it would cost billions to do it properly). About how some of the science is not only dodgy but dreadful. About how some key recommendations rest on tiny studies. About how even the well-conducted studies support more than one hypothesis. About the large and well-conducted dietary studies that were quietly filed away because they failed to confirm earlier, smaller, less rigorous ones.
I urge you to read this book. It is not always easy going, because despite the author's narrative skill there is a lot of science to be explained. It is not a rant or a polemic, and so there is little rhetoric to get carried away by. In the interests of evenhandedness, Mr Taubes relegates some of his keenest barbs to footnotes, as when he cites an American Medical Association critique of a low-carb, unrestricted-calorie diet (despite the fact that it worked) as having the "untoward side-effect" that the subjects weren't hungry. Even then, he doesn't call this critique perverse or bizarre: simply 'peculiar'.
I am married to a hobby-chef who cooks virtually everything from scratch. No tins, no frozen food, no packages of MSG-laden powder. We know with clarity what is in the food that we eat. When she started putting on weight at a rate of a kilogram (over 2 pounds) a month, she went to her GP. Fortunately, we live in The Hague, and not in New York, so she was referred to a European-trained endocrinologist, who diagnosed the weight gain as a metabolic problem, not an addiction to fatty foods. But in the accepted public-health wisdom, as Mr Taubes explains, unexplained weight gain is not a metabolic problem, but a failure of willpower. Biochemists and endocrinologists know better. In the US, they also know better than to say so in public.
It is very possible that the medical and public-health establishment will succeed in burying this book, just as they have succeeded in burying books with a similar message over the past 40 years. These books weren't perfect: they got sometimes important details of the science wrong (as we now understand it); just as there may be details of the science in Mr Taubes's book that in the future turn out to be wrong. Mr Taubes is a scientific journalist, not a scientist. He reports the science as it is known, he draws attention to where he consciously oversimplifies, and he quite clearly knows about the issues he writes about.
This book should earn him a doctorate: it is a masterful tour of a century-plus of science, and in its way as least as impressive as the PhD dissertations and journal articles he so clearly (and sometimes ruthlessly) describes.
I don't agree with another reviewer who says that this book ought to earn its author a Nobel prize. Nobel prizes are for new discoveries. Mr Taubes describes biochemistry that, however groundbreaking in its day, is no longer controversial: it's textbook stuff. Only problem is, it's texbook stuff for biochemists, and the public-health gurus haven't got around to reading it.
So, a Nobel prize, no. A Pulitzer prize, though: that's another matter entirely.
Please read this book, if you struggle with your weight. Once you've read it, you'll at least be able to make a rational decision about what body of diet dogma to believe.
Please read this book, if you don't struggle with your weight. It may help you to understand what someone you love, who is overweight, has to go through.
Especially please read this book if reviews have predisposed you to believe that it's wrong. Before you swallow the criticism, ask yourself if you believe the critics have studied the literature as deeply as Mr Taubes has.