When I was attending Gary Taubes’s lecture at Tufts University, there was a fair amount of “audience participation.” I mean this somewhat facetiously because I was practically the only individual taking part.
Taubes, an investigative science journalist, would present a slide and a quote by someone in the field of nutrition and he would ask the audience of predominately nutritional science students and professors to raise their hands if anyone had heard of the quoted person.
“Who here has heard of Louis Newburgh?” Crickets. I would sheepishly raise my hand.
A few slides would go by. “Anyone familiar with Carl von Noorden?” Hay bale drifts through the room. My hand goes up. "You don't count; you read my book," quipped Taubes. Fair enough.
But I think there’s an important lesson in this.
I have been taking a distance (read: online) clinical nutrition course in which there is a great deal of discussion on the message boards. Each week, a group of two or three students post a question related to the week’s course topic. Gestational diabetes, carbohydrates and diabetes, metabolic syndrome, childhood obesity, bariatric surgery, saturated fats, and so on. And virtually every week, my opinion runs counter to at least 90% of the students.
Seemingly, it should be relatively easy to dismiss the lunatic with the tinfoil hat (it's comfortable, okay?) as a charlatan, but something odd happens en route. I’m the one presenting the science, the history of nutrition, and the observations that refute the claims of the vast majority. This goes off like a fart in church. Everything popular is wrong? Maybe.
Some people in the class are somewhat supportive, but most, at best, are condescendingly back-patting and thanking me, in their best Dr. Oz impression, for “kicking the tires.” This is what Oz said to Taubes during his appearance. In hindsight, Taubes said that he should have responded: ‘well, Dr. Oz, I'm not sure kicking the tires makes a damn bit of difference after you've totaled the car,’ (his other shelved rebuttal allegedly was ‘the jerk store called, and they’re running out of you’) though he also conceded that this would have been edited out, along with his explanation of the complications of cholesterol, and why he declined having a cholesterol test if they weren’t going to do a comprehensive panel, like the one he ended up getting.
Others in the class claim that I’m introducing “a totally new science” to health and nutrition and that I should start my own special field. Go home and get your shinebox, Bob.
But here’s the rub: I am introducing science - not a ‘totally new science’ - science, into a field that seems to be actively avoiding it. I'm also just bringing up historical information regarding nutrition and it feels like many people think I'm coming out of left field.
I'm seen as a crackpot by the class when I bring up names like Louis Newburgh, Carl Von Noorden, Hugo Rony, Jean Mayer, Julius Bauer, Ancel Keys, John Yudkin, George Mann, George Bray, George Cahill, Eugene Du Bois, Francis Benedict, et al.
If this were a graduate level physics course (and this is something Taubes illuminated in his lecture), if I brought up names like Plank, Einstein, Tesla, Faraday, Heisenberg, Bohr, Curie, Feynman, Volta, Hubble, Fermi, et al., everyone would know who I was talking about, what they accomplished, and their contributions to the field.
In physics, if you didn't recognize these names, you would be laughed out of the field. In public health, you're mocked if you do.
If I polled the class on the recognition of the twelve names in nutrition and weight regulation I mentioned, how many of these people would they recognize? These people are pioneers in the field, yet we’re not taught very much, if at all, about them. I think it would be helpful.
I happen to know the names of guys like Rony and Bauer and their contributions to the field. For the most part, I know them because Taubes knows the names, too, and included them in articles like The Soft Science of Dietary Fat, What if It’s All Been a Big Fat Lie, The (Political) Science of Salt, Do We Really Know What Makes Us Healthy?, and wrote books such as Good Calories, Bad Calories and Why We Get Fat.
It doesn’t make me smarter than anyone that I’m the only one in the lecture hall of 200 people to pass the Taubes test, but I would argue it makes me more informed. And one of the limitations to nutrition as I see it, is that if you really want to have a full understanding of obesity, for example, you need to be familiar with endocrinology, metabolism, weight regulation in animals, anatomy, clinical treatment and trials of obesity in humans, anthropology, exercise physiology, reproduction, cell biology, and have a familiarity with the relevant research, epidemiology, and clinical trials, and the list goes on. It might take a few lifetimes to achieve this.
But it doesn’t absolve the field from trying to learn the basic sciences and have at the very least a cursory understanding of the aforementioned topics. Instead, when I invoke biochemistry and endocrinology in the regulation of adipose tissue in my class, or when I tell them that the brain can run predominantly on ketone bodies, they respond that I have “interesting opinions.” It’s the science! I’m not making it up!
This brings me to a podcast (episode 76) by Robb Wolf and Greg Everett at The Paleo Solution.
Robb was wonderfully agitated by the following question:
6. Brain Function without Dietary Carbohydrate
Craig Says: My girlfriend is a very recent graduate of nursing school and has been very helpful in my transition from a fellow vegetarian to a “things-with-a-face eater.” But she is very hesitant about my adoption of the Paleo diet mostly based on her contention that the brain cannot function properly without complex carbohydrates such as pastas and rice. I’ve been 98% paleo for the last two months with a few slips into ice cream hell. Can you give me a medical explanation that will help me in this battle? She will not join the meat-eating bandwagon but has definitely reaped the benefits of switching our diet to entirely whole foods. She is complete agreement with this aspect of Paleo nutrition but can’t understand the low-carb effect on the brain and other important bodily function. Thanks for being such an accessible and reliable scientific resource.
So Robb dusts off his 4th edition of Stryer’s Biochemistry (I happen to have a copy myself so I think that makes us beaker-brothers or something nerdy - or perhaps we’re just both interested in science - which seems to be such a rarity in the field of nutrition, that it appears peculiar that we would have science textbooks?) and goes to town: the human brain can run predominantly on ketone bodies during relative caloric, or carbohydrate, unavailability.
But it, too, brought up a larger point, which is very much related to the previous one about nutritionists having no understanding of the history of the field; they have virtually no understanding of the science behind nutrition as well.
It is valid to point out that physicians receive little to no nutrition training. Chris Kresser was just pointing this out in a podcast with Jimmy Moore. Why listen to your doctor when they have so little training in nutrition? Good question.
But what of the registered dietitians? What are they learning? I happen to have completed my didactic program requirement in dietetics. There are science courses, to be sure, but it doesn’t seem to explain my experience with dietitians and dietetic students. It is safe to say that most of them don’t understand the biochemistry, endocrinology, biology, physiology, and organic chemistry, for example, at a level where they can explain relatively pedestrian mechanisms of action. To be fair, I was recently trying to work out a problem related to organic chemistry, and turned to an expert in the field, who subsequently asked if I had indeed passed organic chemistry in college. Passed? Yes. Grasped? No. But I’m trying and will continue to do so until I can at least speak the language.
I try to make it a point to surround myself with people who are smarter than me; people who often will tell me that I’m wrong more often than I’m right. Criticism is far more useful than praise. This is how you grow. To remain stagnant is to ignore the voices questioning your methods and results and never seeking alternative explanations or questioning your own ideas. The public health authorities are phenomenal at this.
I don’t think most dietetics students make this kind of effort. What Richard Feynman called “a specific, extra type of integrity that is not lying, but bending over backwards to show how you are maybe wrong, that you ought to have when acting as a scientist.” And “this is the responsibility of scientists,” (perhaps dietitians and public health authorities are immune), “certainly to other scientists, and I think to laymen.”
In fact, most people I know don’t seem to be making the effort, or claim that they just don’t have the time. That’s why I think people like Lalonde, Kresser, Taubes, Lustig, Wolf, et al. are so invaluable, and unfortunately, so rare.
Wolf, later in his diatribe, posited a couple of questions: Why aren’t the nursing and medical students reading the textbooks and scientific literature and questioning the conventional wisdom? And why is the convention wisdom what it is when it seems to run counter to science?
I think it’s because the foundation and core principles of public health operate as a political institution. It may be fair to say that the opposite of science is politics, i.e., politics is anti-science. And this is coming from a blogger who studied political science (an oxymoron, perhaps?) as an undergrad.
Robb also mentioned that he was “mean” to his conference attendees - at a hospital, addressing the medical staff - during a recent presentation and asked them basic biochemistry and metabolism questions; and they could not answer them correctly. And maybe half the people were present to tell Robb what he was saying is wrong.
Sounds a lot like Taubes, his lectures, and his point about the dearth of understanding of one’s own field. Yet these same people in the audience of a Taubes or Wolf lecture are the ones discrediting the lecturer and dispensing the dietary advice; while Gary and Robb are relegated to “kicking the tires.”
Another point that Robb illuminated was The Russian Literature Paradox.
If you run into a PhD in Russian Literature and tell them you read Crime and Punishment, and get into a discussion about Russian lit, and the PhD rattles off names like Alexander Blok, Sergei Yesenin, Anna Achmatova, Marina Tsvetaeva, Osip Mandelstam, Boris Pasternak, Joseph Brodsky, Vladimir Mayakovsky, Ivan Bunin, Vladimir Nabokov, Mikhail Sholokhov, Mikhail Bulgakov, Andrey Platonov, Vassily Grossman and Aleksandr Solzhenitsyn, (I had to look up just a few of these names!) perhaps you should defer to this man’s opinion. It doesn’t mean that his convictions are necessarily true, but it most likely means that he is more informed and has a better grasp on the subject. And perhaps you should educate yourself on the subject before you join the discussion.
With nutrition, everyone eats, therefore everyone is apparently an expert in nutrition. Everyone has an opinion, and anyone who has lost more than three pounds in their life (about 99% of the population), feels that they can instill their wisdom upon the masses to great fanfare.
Problem is, even the supposed experts in nutrition can't tell you who the nutritional European and American equivalents to Nabokov, Dostoyevsky, Gogol, and Chekhov are, but boy are they are willing to commentate and pontificate with great resolve.
With Russian Literature, most people are wise enough to heed the advice of Mark Twain: “It is better to keep your mouth closed and let people think you are a fool than to open it and remove all doubt.”
With nutrition, every Tom, Dick, and Harry - and seemingly every public health authority - has no problem opening their mouths and removing all doubt.
In other words, the "experts" in the field of nutrition do not understand nutrition. Therefore, anyone who can rub two brain cells together can contribute to the field.
Meanwhile guys like Gary Taubes, Robb Wolf, Chris Kresser, Chris Masterjohn, Kurt Harris, Stephan Guyenet, Petro Dobromylskyj, Michael Eades, Robert Lustig, Eugene Fine, Eric Westman, Steve Phinney, Jeff Volek, et al., are having collective aneurysms on a daily basis and at some point, I believe, we are all going to realize that engaging the "experts" in a dialogue is like playing handball against the drapes.
I try - and I think this is a common thread among the aforementioned bloggers, writers, researchers, and physicians above - to treat the field of nutrition like a science, because that’s what it presumably is. And I think a significant part of the reason for the massive health problem we have is that it’s not treated as such.
Bob Kaplan holds advance degrees in exercise physiology and business, an undergraduate degree in nutrition, is a nationally certified personal trainer, and owns six Get In Shape For Women locations in Bedford, Wayland, Wellesley, Westford, Weston, and Winchester.
For more information about Kaplan's services at Get in Shape For Women in Wellesley, please call 781-237-7752 or visit at 259 Washington Street, Wellesley, MA, 02481, or online at www.getinshapeforwomen.com for a free week trial.