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Investigating the science of body weight regulation

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Causation, Correlation, Dogma, Weight, and Health

Posted by Miriam Gordon on August 10, 2009

After acquiring the book almost a year ago, I (again) started reading Gary Taubes’ book entitled Good Calories, Bad Calories. Based on what I’ve read so far, and knowing Gary Taubes’ background, I believe it’s a very scholarly work, and very thoroughly researched. From the title, it’s obvious that this book considers the scientific evidence for specific types of diets and how they affect body weight regulation.

In the first part of the book, in order to draw parallels with current scientific evidence for the “epidemics of obesity and diabetes,” Taubes puts forth a detailed historical analysis of the decades-long debate on whether dietary fat intake was the definitive cause of, rather than merely correlated with, the rapid rise in the incidence of cardiovascular disease in the developed world that started in the 1920s (when consumption of red meat increased considerably). The upshot of this work is to point out what happens when a researcher, who becomes prominent for various reasons, influences health care policy even when his/her scientific data are far from conclusive. In this particular case, Taubes discusses the work of the prominent physiologist Ancel Keys, who was convinced based on his research that the observed rise in incidence of heart disease was due to increased blood cholesterol levels, which was in turn due to increased total dietary fat intake. Keys was apparently a formidable character who felt very strongly that his data conclusively proved this hypothesis, and was very quick to strongly criticize those who opposed his theories. Throughout this time period, and even into the 1960s, there were many prominent researchers who had serious reservations about Keys’ theories, based on scientific analysis of his data as well as their own. Nevertheless, because Keys was so forceful, Taubes brings various elements to show that the media picked up Keys’ theories, and physicians who were faced with an alarming medical mystery began to recommend low fat diets to their patients, despite serious controversy over Keys’ data.

In such a scenario, the question becomes one of correlation versus causation, i.e., depending on how solid the scientific evidence is for any given observed public health phenomenon, one might be able to say there is a CORRELATION of an observed public health trend with disease, rather than being able to state, through a solid base of scientific evidence, that the observed trend CAUSES the disease. There is considerable scientific evidence demonstrating that the physical attribute of fatness does not conclusively indicate bad health, and that many  “obese” individuals are metabolically healthy.

One reason for this phenomenon of correlation overpowering the media is that it provides a solid message to address what appears to be an alarming trend. Often, people don’t have the patience to wait for conclusive scientific evidence to be produced when faced with a potentially scary scenario. When scientific evidence that contradicts the popular theory is published, it tends to be ignored, because it contradicts what has become DOGMA. This is what has happened with “obesity” research. Taubes skillfully points out that when scientifically observed correlations are not thoroughly researched scientifically, and they become socially accepted as dogma,  real scientific progress breaks down.


3 Responses to “Causation, Correlation, Dogma, Weight, and Health”

  1. Thank you, Miriam–You are onto something. I haven’t read Taubes’ book, so I am grateful for your comments. I no longer subscribe to Keys’ Lipid Hypothesis, and this does impact what I do as a heart patient, having had a quadruple bypass (like Bill Clinton) 3 years ago, and wanting my replacement arteries to last as long as possible, so that I may keep reading this blog!

    For starters, I have given up statin drugs, and now must convince my primary care physician AND my cardiologist that I haven’t taken leave of my senses.

    If you want to have your socks knocked off, buy or rent the new video “Fat Head”, in part, a rebuttal of the documentary Super Size Me and also Keys’ hypothesis, and the whole preoccupation with weight and dietary fat and cholesterol reduction. And it wasn’t paid for by the Dairy Council. Be prepared for some real laughs, despite the serious nature of the subject. Which means, don’t watch the DVD on the plane. LOL

  2. I also thoroughly enjoyed Gary Taubes’ book. It was extremely thoughtful and well-referenced. My son has Prader-Willi Syndrome (PWS), which is a genetic cause of obesity. I have put my son on a modified Atkins (low carbohydrate) diet and he does not have the hunger or the obesity or the mental retardation associated with the syndrome. Taubes found and cited the original articles on PWS that I had read when deciding how to approach my son’s syndrome. Unfortunately, those articles (published in the 1970’s) are unknown to every endocrinologist and nutritionist who provides advice to me on managing my child’s hunger and obesity. I have specifically asked about the research at every physician and nutritionist meeting and at the national PWS meetings. All I have received is blank looks fallowed by the statement that a calorie is a calorie. The current treatment paradigm for PWS is one third to one half of typical calories (food pyramid) and locked food cabinets (to prevent foraging and hyperphagia). What a sad state of affairs…

    • Lara, thank you so much for sharing your experience. This must be very difficult for you and your son. I think there is great reason to hope that the idea that a calorie is not just a calorie is seeping slowly into the public consciousness. Please see “Plot Thickens on the Healthy Obese Debate” by Sharon Kirkey on canada.com (http://www.canada.com/Health/story.html?id=1398377). You can also find a link to this article on my del.icio.us bookmarks (click the link on the left column). My del.icio.us bookmarks are listed under cactusflower99. Also, please check out the links to the Association for Size Diversity and Health and Health at Every Size under my favorite links (right hand column)as well as LindaBacon.org.

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