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Everything we eat causes cancer…sort of

Read meat causes cancer. No, processed meat causes cancer. OK, it’s both read meat and processed meat. Wait, genetically modified grain causes cancer (well, not really). No, aspartame causes cancer. No, this food coloring or that one causes cancer.

Clearly, everything you eat causes cancer!

That means you can avoid cancer by avoiding processed meats, red meat, GMO-associated food (no, probably not), aspartame, food colorings, or anything “unnatural.” Or so it would seem from reading the popular literature and sometimes even the scientific literature. As I like to say to my medical students, life is a sexually transmitted fatal disease that gets us all eventually, but most of us would like to delay the inevitable as long as possible and remain as healthy as possible for as long as possible. One of the most obvious ways to do accomplish these twin aims is through diet. While the parameters of what constitutes a reasonably healthy diet have been known for decades, diet still ranks high on the risk of concerns regarding actions we take on a daily basis that can increase our risk of various diseases. Since cancer is disease (or, I should say, cancers are diseases) that many, if not most, people consider to be the scariest, naturally we worry about whether certain foods or food ingredients increase our risk of cancer.

Thus was born the field of nutritional epidemiology, a prolific field with thousands of publications annually. Seemingly, each and every one of these thousands of publications gets a news story associated with it, because the media love a good “food X causes cancer” or “food Y causes heart disease” story, particularly before the holidays. As a consequence, consumers are bombarded with what I like to call the latest health risk of the week, in which, in turn, various foods, food ingredients, or environmental “toxins” are blamed and exonerated for a panoply of health problems, ranging from the minor to the big three, cardiovascular disease, diabetes, and cancer. It’s no wonder that consumers are confused, reacting either with serial alarm at each new “revelatory” study or with a shrug of the shoulders as each new alarm joins other alarms to produce a tinnitus-like background drone. Unfortunately, this cacophony of alarm also provides lots of ammunition to quacks, cranks, and crackpots to tout their many and varied diets that, they promise, will cut your risk of diseases like cancer and heart disease to near zero—but only if adhered to with monk-like determination and self-denial. (Yes, I’m talking about you, Dean Ornish, among others.)

All of this is why I really wanted to write about an article I saw popping up in the queue of articles published online ahead of print about a month ago. Somehow, other topics intervened, as did my vacation and then the holidays, and somehow I missed it last week, even though a link to the study sits in my folder named “Blog fodder.” Fortunately, it just saw print this week in its final version, giving me an excuse to make up for my oversight. It’s a study by one of our heroes (despite his occasional misstep) here on the SBM blog, John Ioannidis. It comes in the form of a study by Jonathan D. Schoenfeld and John Ioannidis in the American Journal of Clinical Nutrition entitled, brilliantly, Is everything we eat associated with cancer? A systematic cookbook review.

Now, when John Ioannidis says a “systematic cookbook review,” he really means “a systematic cookbook review.” Basically, he and Schoenfeld went through The Boston Cooking School Cookbook and tested whether various ingredients described and used in the recipes in the cookbook had been tested for an association with cancer and what was found. What I love about John Ioannidis is embodied in the methodology of this study:

We selected ingredients from random recipes included in The Boston Cooking-School Cook Book (28), available online at http://archive.org/details/bostoncookingsch00farmrich. A copy of the book was obtained in portable document format and viewed by using Skim version 1.3.17 (http://skim-app.sourceforge. net). The recipes (see Supplementary Table 1 under “Supplemental data” in the online issue) were selected at random by generating random numbers corresponding to cookbook page numbers using Microsoft Excel (Microsoft Corporation). The first recipe on each page selected was used; the page was passed over if there was no recipe. All unique ingredients within selected recipes were chosen for analysis. This process was repeated until 50 unique ingredients were selected.

We performed literature searches using PubMed (http://www. ncbi.nlm.nih.gov/pubmed/) for studies investigating the relation of the selected ingredients to cancer risk using the following search terms: “risk factors”[MeSH Terms] AND “cancer”[sb] AND the singular and/or plural forms of the selected ingredient restricted to the title or abstract. Titles and abstracts of retrieved articles were then reviewed to select the 10 most recently published cohort or case-control studies investigating the relation between the ingredients and cancer risk. Ingredient derivatives and components (eg, orange juice) and ingredients analyzed as part of a broader diet specifically mentioned as a component of that diet were considered. Whenever ,10 studies were retrieved for a given article, an attempt was made to obtain additional studies by searching for ingredient synonyms (eg, mutton for lamb, thymol for thyme), using articles explicitly referred to by the previously retrieved material, and broadening the original searches (searching simply by ingredient name AND “cancer”).

How can you not love this guy?

His results were also not that surprising. First, he noted that for 80% of the ingredients his methodology identified there was at least one study examining its cancer risk. That’s forty ingredients, which he helpfully lists: veal, salt, pepper spice, flour, egg, bread, pork, butter, tomato, lemon, duck, onion, celery, carrot, parsley, mace, sherry, olive, mushroom, tripe, milk, cheese, coffee, bacon, sugar, lobster, potato, beef, lamb, mustard, nuts, wine, peas, corn, cinnamon, cayenne, orange, tea, rum, and raisin. He also notes that these ingredients represent many of the most common sources of vitamins and nutrients in a typical US diet. In contrast, the ten ingredients for which no study was identified tended to be less common: bay leaf, cloves, thyme, vanilla, hickory, molasses, almonds, baking soda, ginger, and terrapin. One wonders how almonds aren’t considered under nuts, but that’s just me being pedantic.

One also wonders whether “Dr.” Robert O. Young, alkalinization quack extraordinaire, who claims that cancer is due to too much acid and that alkalinization is the answer, has heard about no studies for baking soda, which to him, along with a vegan-based diet that is allegedly “alkalinizing,” is part of the “alkaline cure” for everything from cancer to sepsis to heart disease. Now, if you type “baking soda cancer” into the PubMed search box, you’ll actually pull of over 350 articles. However, none of them appear to be epidemiological studies. This reminds me. I need to look into that literature and do a post about it again. But I digress.

Let’s get back to the meat of the study itself. (Sorry, I couldn’t resist.)

Having identified the studies and meta-analyses, Schoenfeld and Ioannidis next extracted the data from the studies, looked at the quality of the studies, the size and significance of the effects reported, how specific they were, and whether there were indications of bias in any of them. The results they found were all over the map, with about the same number of studies finding increased compared to decreased risks of malignancy, and, as before, Schoenfeld and Ioannidis provide a helpful list:

Author conclusions reported in the abstract and manuscript text and relevant effect estimates are summarized in Table 1. Thirty-nine percent of studies concluded that the studied ingredient conferred an increased risk of malignancy; 33% concluded that there was a decreased risk, 5% concluded that there was a borderline statistically significant effect, and 23% concluded that there was no evidence of a clearly increased or decreased risk. Thirty-six of the 40 ingredients for which at least one study was identified had at least one study concluding increased or decreased risk of malignancy: veal, salt, pepper spice, egg, bread, pork, butter, tomato, lemon, duck, onion, celery, carrot, parsley, mace, olive, mushroom, tripe, milk, cheese, coffee, bacon, sugar, lobster, potato, beef, lamb, mustard, nuts, wine, peas, corn, cayenne, orange, tea, and rum.

The statistical support of the effects was weak (0.001 # P , 0.05) or even nonnominally significant (P . 0.05) in 80% of the studies. It was also weak or nonnominally significant, even in 75% of the studies that claimed an increased risk and in 76% of the studies that claimed a decreased risk (Table 1).

To boil it all down, what we have here are a bunch of studies that report an association between a food or food ingredient and either increased or decreased risk of various cancers, but the vast majority of them have very weak effect sizes and/or nominal statistical significance. Next, Schoenfeld and Ioannidis looked at ingredients for which meta-analyses existed and found 36 relevant effect size estimates based on meta-analyses. Many of these meta-analyses combined studies using different exposure contrasts, such as highest quartile/lowest quartile versus another measure, such as the highest versus lowest consumption. Only 13 meta-analyses were done by combining data on the same exact contrast across all studies. As one would expect when one pools diverse studies, meta-analyses tended to find smaller effects than individual studies, as shown in the following table from the paper (click to embiggen):

As I said, these findings are all over the map. Now, if you really want to see how chaotic the literature examined by Schoenfeld and Ioannidis is, take a look at the effect sizes found for ingredients for which there have been more than ten studies:

As you can see, it’s quite complex and all over the map, although there are a few ingredients for which the studies do appear to be fairly consistent, such as bacon being associated consistently with a higher risk of cancer. Bummer. Or is it? Let’s continue with Schoenfeld and Ioannidis’ analysis. What they found is rather disturbing. First, they report that although 80% of the studies they examined reported positive findings (i.e., a positive association between the food or ingredient studied and some form of cancer):

…the vast majority of these claims were based on weak statistical evidence. Many statistically insignificant “negative” and weak results were relegated to the full text rather than to the study abstract. Individual studies reported larger effect sizes than did the meta-analyses. There was no standardized, consistent selection of exposure contrasts for the reported risks. A minority of associations had more than weak support in meta-analyses, and summary effects in meta-analyses were consistent with a null average and relatively limited variance.

In other words, there are lots of studies out there that claim to find a link, either for increased risk or a protective effect, between this food or that ingredient and cancer, but very few of them actually provide convincing support for their hypothesis. Worse, there appear to be a lot of manuscript-writing shenanigans going on, with the abstract (which usually means, I note, the press release) touting a strong association while the true weakness of the association is buried in the fine print in the results or discussion sections of the paper. Given that most scientists tend not to read each and every word of a paper unless they’re very interested in it or it’s highly relevant to their research, this deceptive practice can leave a false impression that the reported association is stronger than it really is. Yes, I realize that we as scientists should probably be more careful, but a combination of time pressures and the enormous volume of literature out there make it difficult to do so. Moreover, as Schoenfeld and Ioannidis note in their discussion, although they didn’t cover the entire nutritional epidemiology literature for all these ingredients (which would be virtually impossible), their search strategy was “representative of the studies that might be encountered by a researcher, physician, patient, or consumer embarking on a review of this literature.” In other words, they tried to search the literature in a way that would bring up the most commonly cited recent studies.

The effect is likely to be even worse for the lay public, who get information filtered through press releases that tend to amplify the same problem (lack of proper caveats and discussion of how nominal or marginal the association actually is when examined critically). After all, university press offices are not generally known for their nuance, and reporters tend to want to cover stories they deem interesting. Marginal studies are less interesting than a study with a strong, robust result. So studies all too often tend to be presented as though they have a strong, robust result, even when they don’t. This is facilitated by another problem observed by Ioannidis, namely the wide variety and inconsistency in definitions and exposure contrasts. This, argue Schoenfeld and Ioannidis, make it easier for reporting biases to creep into the literature.

There’s also the issue of reporting bias, which could easily be more acute in nutritional epidemiology. The reason is that there is, understandably, a huge public interest in what sorts of foods might either be protective against or cause cancer. In an accompanying editorial, Michelle M. Bohan Brown, Andrew W Brown, and David B Allison, while noting that Schoenfeld and Ioannidis’ work does indeed suggest that everything we eat is associated with cancer in some way, also note that their study reports evidence of publication bias:

They [Schoenfeld and Ioannidis] found that almost three-fourths of the articles they reviewed concluded that there was an increased or decreased risk of cancer attributed to various foods, with most evidence being at least nominally significant. It appears, then, that according to the published literature almost everything we eat is, in fact, associated with cancer. However, Schoenfeld and Ioannidis proceeded to show that biases exist in the nutrient-cancer literature. The fidelity of research findings between nutrients and cancer may have been compromised in several ways. They identified an overstating of weak results (most associations were only weakly supported), a lack of consistent comparisons (inconsistent definitions of exposure and outcomes), and possible suppression of null findings (a bimodal distribution of outcomes, with a noticeable lack of null findings).

Brown et al note that the sources of these sorts of biases have been well known for a long time and can lead to self-deception. The types of bias most responsible for positive findings appear to include what is known as “white hat bias” (“bias leading to distortion of research-based information in the service of what may be perceived as ‘righteous ends’”), confirmation bias (in which overstated results match preconceived views, so that the authors overstating the results don’t adequately consider the weaknesses of their work), and, of course, publication bias. These biased results are then disseminated to the public through the lay media. As Brown et al note:

The implications of Schoenfeld and Ioannidis’ analysis may be important for nutritional epidemiology even more broadly. Numerous food ingredients are thought to have medicinal properties that are not sufficiently supported by current knowledge—for example, coffee “curing” diabetes (11). These distortions can also be used to demonize foods, as shown by the longstanding presumption that dietary cholesterol in eggs contributes to heart disease (12). Causative relations between various foods and diseases likely do exist, but the evidence for many relations is weak, although conclusions about these relations are stated with the certainty one would expect only from the most strongly supported evidence.

Indeed. Another implication, not noted by either Schoenfeld and Ioannidis or Brown et al, is that weak research findings suggesting a link between this food or that food and cancer, not only lead to the inappropriate demonization of some foods but to quackery. Anyone who has been a regular reader of this blog or one of the other blogs of the contributors to SBM, or who has followed the “alternative medicine” online underground will immediately note that quacks frequently tout various “superfoods” or supplements chock full of various food ingredients believed to have protective effects against various diseases as the cure for what ails you, be it cancer, heart disease, diabetes, or whatever. Publishing studies with weak associations tarted up to look stronger than they really are only provides fuel for these quacks. Indeed, there is one site run by a Sayer Ji that devotes much of its news section to publishing stories and abstracts describing such studies. I’m referring to GreenMedInfo, which routinely publishes posts with titles like Avocado: The Fat So Good It Makes Hamburger Less Bad; Black Seed – ‘The Remedy For Everything But Death’; and 5 Food-Medicines That Could Quite Possibly Save Your Life. And that’s just one example. Mike Adams, for instance, does the same sort of thing, just yesterday posting articles claiming that various foods can “lower blood pressure fast” and that the “Paleo diet” combined with vitamin D and avoiding food additives can reverse multiple sclerosis. Not surprisingly, the same sorts of hyperbole can regularly be found on The Huffington Post, and touted by supplement sellers. Even mainstream media outlets like MSNBC get into the act.

Of course, in all fairness, in science, most studies should just be published and let the chips fall where they may. It’s unfair to blame the authors of nutritional epidemiology studies for how their studies are used and abused. It is not unfair to blame them if they use poor methodology or the strength and significance of their findings in the abstract and hide their weakness by burying it deep in the verbiage of the results or discussion sections. If Schoenfeld and Ioannidis are correct, this happens all too often. Obviously, their sample is a fairly small slice of the nutritional epidemiological literature and as such might not be representative, but given the methods used to choose the studies examined I doubt that if Schoenfeld and Ioannidis had gone up to 100 foods they would have found anything much different.

Unfortunately, in almost the mirror image to the nutrition alarmists, one also sees a disturbing temptation on the part of those who represent themselves as scientific to go too far in the other direction and point to Schoenfeld and Ioannidis’ study as a convenient excuse to summarily dismiss nutritional epidemiological findings linking various foods or types of foods with cancer or other disease. For example, the American Council on Science and Health (ACSH) did just that in response to this study, gloating that it proves that its dismissal of food health scares are insignificant. Well, actually, many scares are insignificant, but surely not all of them are. The ACSH also almost goes into conspiracy theories when it further claims that the mainstream media except for a couple of UK newspapers, such as The Guardian, ignored the study. Although arguably this particular study didn’t get huge coverage, it’s going a bit far to claim that the mainstream media ignored it. It didn’t; the study was featured on Boing-Boing, The Washington Post, Reason, Cancer Research UK, and others. Of course, one can’t help but note that the ACSH is the same organization that has referred to advocating organic foods as “elitist”, likes to disparagingly refer to questions about links between environment and cancer as “chemophobia,” and been very quick to dismiss the possibilities that various chemicals might be linked to cancer, as so famously parodied on The Daily Show. a few years ago. We must resist the temptation to go too far in the opposite direction and reflexively dismiss even the possibility of such risks as the ACSH is wont to do, most famously with pesticides and other chemicals.

Indeed, as was pointed out at Cancer Research UK, the real issue is that individual studies taken in isolation can be profoundly misleading. There’s so much noise and so many confounders to account for that any single study can easily miss the mark, either overestimating or underestimating associations. Given publication bias and the tendency to believe that some foods or environmental factors must cause cancer, it’s not too surprising that studies tend to overestimate effect sizes more often then they underestimate them. Looking through all the noise and trying to find the true signals, there are at least a few foods that are reliably linked to cancer. For instance, alcohol consumption is positively linked with several cancers, including pancreatic, esophageal, and head and neck cancers, among others. There’s evidence that eating lots of fruit and vegetables compared to meat can have protective effects against colorectal cancer and others, although the links are not strong, and processed meats like bacon have been linked to various cancers, although, again, the elevated risk is not huge. When you boil it all down, it’s probably far less important what individual foods one eats than that one eats a varied diet that is relatively low in red meat and high in vegetables and fruits and that one is not obese.

So what can be done? It would be a good thing indeed if the sorts of observations that Ioannidis has made lead to reform. Between Schoenfeld and Ioannidis’ study and the accompanying editorial several remedies have been proposed that are not unlike steps that have been imposed on clinical trials of therapies and drugs: increased use and improvement of clinical trial and observational study registries; making raw data publicly available; making supporting documentation such as protocols, consent forms, and analytic plans publicly available; and mandating the publication of results from human (or animal) research supported by taxpayer funds. I must admit that the last of these is already a requirement, as is registration of all taxpayer-supported clinical trials at ClinicalTrials.gov, but the other proposals could also help.

Finally, I’ll finish with a quote from the editorial by Brown et al:

As Schoenfeld and Ioannidis (6) highlighted, comprehensive approaches to improve reporting of nutrient-disease outcomes could go a long way toward decreasing repeated sensational reports of the effects of foods on health. However, none of these debiasing solutions address the fundamental human need to perceive control over feared events. Although scientists may have ulterior motives for looking for nutrient-disease associations, the public is always the final audience. It is therefore imperative that we spend less time repeating weak correlations and invest the resources to vigorously investigate nutrient-cancer and other disease associations with stronger methodology, so that we give the public lightning rods instead of sending them up the bell tower.

That last remark refers to Ben Franklin’s lightning rod and how churches used to think that ringing bells would protect against lightning strikes when in fact ringing bells only put the bell ringers in danger from lightning, which often struck bell towers because bell towers were usually the highest buildings in most towns. It’s a metaphor that fits, because the superstition about lightning before the lightning rod could divert devastating lightning strikes from bell towers is not unlike the irrational beliefs about food-cancer links that all too often predominate even today. The answer is more rigorous science and less publicizing of weak science.

Posted in: Cancer, Nutrition

Leave a Comment (36) ↓

36 thoughts on “Everything we eat causes cancer…sort of

  1. cervantes says:

    Sayeth Joe Jackson:

    Everything
    Everything gives you cancer
    Everything
    Everything gives you cancer
    There’s no cure, there’s no answer
    Everything gives you cancer

    Don’t touch that dial
    Don’t try to smile
    Just take this pill
    It’s in your file

    Don’t work hard
    Don’t play hard
    Don’t plan for the graveyard
    Remember -

    Everything
    Everything gives you cancer
    Everything
    Everything gives you cancer
    There’s no cure, there’s no answer
    Everything gives you cancer

    Don’t work by night
    Don’t sleep by day
    You’ll feel all right
    But you will pay

    No caffeine
    No protein
    No booze or
    Nicotine
    Remember -

  2. David Gorski says:

    Heh. I forgot about that song. If I had remembered it, then I would have started my post out with a snippet from it.

  3. Janet says:

    I recommend foodpolitics.com for good reporting on nutritional research. Marion Nestle has a bona fide science background and writes in a very user-friendly way. Her books are excellent as well. She has no particular ax to grind except the difficulty of doing proper nutritional studies. Her work centers on public health, which is where the politics come into the picture.

  4. Janet says:

    Why doesn’t the link turn blue?

  5. Harriet Hall says:

    I have an old cartoon showing a long row of dead lab rats with signs showing what killed them. The signs cover pretty much everything: tobacco, foods, pharmaceuticals, air pollution, etc. Only one has a smile on its face. Its sign says “Sex.”

  6. Angora Rabbit says:

    “When you boil it all down, it’s probably far less important what individual foods one eats than that one eats a varied diet that is relatively low in red meat and high in vegetables and fruits and that one is not obese.”

    This is the bottom line. Over the 20yrs I’ve substantially revised and cut my Nutrition & Cancer lecture to just one 50min talk. After we cover rates and basic cancer biology, I’ve dropped nearly all the nutrient side of it ’cause the data just don’t hold up. Their take home is what you state above. Plus we talk about sunlight, alcohol, smoking and genetics.

    Would love to post more but I am literally starting the 2200 mi drive home from my Oregon sabbatical. :) Looking forward to reading the AJCN paper when I return.

  7. bhami says:

    Buried in the middle of this interesting analysis is what I consider your “money quote”, namely: “When you boil it all down, it’s probably far less important what individual foods one eats than that one eats a varied diet that is relatively low in red meat and high in vegetables and fruits and that one is not obese.”

    Unfortunately, the pervasive tone of the article as a whole, and that of many of the following comments, is the sort of fatalism that leads right back to the destructive Standard American Diet, something like, “since no strong science shows that this particular steak, or Coke, or Twinkie, will kill me, I’ll just go right on eating my steak AND Coke AND Twinkie.”

    Joel Fuhrman MD is a clinician and has been writing good science-based books on nutritional topics for over a decade. His new book is “The End of Diabetes”. Here are a couple of quotations from that book:

    p. 31: “Moderation doesn’t work.”

    p. 39: “Following a correct diet and exercise plan as a remedy should not be labeled alternative or complementary medicine. It is simply the way all properly educated doctors should be practicing. Everything else should be called malpractice medicine. Offering patients drugs and surgical interventions without informing them that, for most diseases, nutritional excellence and exercise are safer and more effective in the long run is not adequate informed consent to the use of medications. The risks of medicines are downplayed and their supposed benefits greatly exaggerated by a medical profession and drug industry who offer drugs as the panacea to all that ails us.”

  8. Alia says:

    And as a result of all those sensational press releases like “Tomato sauce protects from cancer” or “Bacon causes cancer” over here we even have a saying “American scientists found that…” – which basically means that what follows is rubbish. Sad but true.

  9. Narad says:

    Joel Fuhrman MD is a clinician and has been writing good science-based books on nutritional topics for over a decade.

    Joel Fuhrman claims with a straight face that “headache is the body’s detoxification response to the stress placed on it.”

  10. Lytrigian says:

    Clearly, everything you eat causes cancer!

    Well, yeah. That’s why coffeehouses in California must now display Prop 65 warnings. Roasted coffee — along with a great many other cooked foods — contains acrylamide, which is (of course) carcinogenic in sufficient quantities. Not the quantities found in coffee (or pretty much any other cooked food) as far as anyone can tell, but Prop 65 brooks no rational threshold.

    Now that a Prop 65 warning is posted on almost literally every single place of public accommodation in the state, you’d think SOMEONE would see the uselessness of it.

  11. kb says:

    Is it just me who thinks the first sentence of the post has a typo?

  12. rmgw says:

    Your friendly neighbourhood (well, my neighbourhood) vegan reminding us all that there are ethical reasons not to eat meat (or indeed any animal products) which kind of obviate all these long-winded debates.

  13. The Dave says:

    Lytrigian:
    Having recently moved away from the Land of Fruits and Nuts, I was contemplating making a similar comment about the ridiculousness of Prop 65 warnings. A couple years ago my wife wanted to make a quilt for a friend who was having a baby so she dragged me to the local, chain-fabric store to find fabric. She then proceeded to hem and haw and spend WAY more time then needed trying to find the right fabric because there was a Prop 65 warning posted over most of the quilting fabric (apparently because they use formaldehyde in the processing of it). It was either new or we had never noticed it in the many times we had gone there previously. The exterior of every building of the apartment complex that we lived in (and all other complexes I could see) had the same prop 65 warning…

  14. Narad says:

    Your friendly neighbourhood (well, my neighbourhood) vegan reminding us all that there are ethical reasons not to eat meat (or indeed any animal products) which kind of obviate all these long-winded debates.

    Unfortunately, ethical debates are not immune to long-windedness.

  15. Quill says:

    There is an old Bill Cosby routine that features Bill, now that he is getting older, going to his doctor for a physical and advice on how to live longer. Part of the conversation goes something like:

    “So, Bill, do you eat food?”
    “Uh, well, yes….”
    “STOP IT! It will kill you.”

  16. Lytrigian says:

    Is it just me who thinks the first sentence of the post has a typo?

    Clearly, Dr. Gorski wishes to discuss some meat he has encountered in the literature.

  17. Brian Herbert says:

    But bell ringers don’t go into the bell towers to ring bells. Can you image how deafening that would be?

  18. bs king says:

    The Dave:

    Being from Massachusetts, I had not encountered the joy that is Prop 65 until a few weeks ago. As a New Year’s Resolution I had decided to start working out more, and so I ordered a set of kickboxing DVDs that came with gloves/resistance bands.

    When I got it, there was a huge Prop 65 warning label on it that the gloves might give me cancer.

    At the point where you’re warning people against exercise in favor of a chemical that might have been used on the product at one point, I think you’ve gone too far.

  19. Lytrigian says:

    But bell ringers don’t go into the bell towers to ring bells. Can you image how deafening that would be?

    http://www.youtube.com/watch?v=daGR7ZEbwqM

  20. TonyMach says:

    Something to chew on about nutrition, even if it is not (directly) related to cancer:
    Triglycerides and Carbohydrates
    http://rdfeinman.wordpress.com/2012/07/11/reading-the-scientific-literature-a-guide-to-flawed-studies/

  21. Janet says:

    @TonyMach

    I can’t tell if you are recommending this or what. It looks like a load of science-y rubbish to me. One comment goes on at length about Bastyr “College” in Seattle and all the wonderful Naturopaths he knows.

    I lost 45 lbs. Have kept it off for seven years now. I eat carbs as part of a balanced diet. I eat real serving sizes. I minimize carbs and get them from whole grains and veggies, veggies, veggies. I don’t eat meat, but that’s personal, not diet advice.

    No one sticks to severely restricted “diets”. Only about 5% of people who lose weight, keep it off more than a year or two–because they can’t stay with the unrealistic regimens they subject themselves to. These endless discussions of carbs vs. protein, good fats/bad fats (as if you can eat all the olive oil you want!), and all the rest are just useless. Eat what you like, within reason, and don’t exceed your DAILY CALORIC NEEDS. If you “eat good food, not too much, mostly plants” as Michael Pollan so succinctly summarizes, and weigh yourself regularly, you’ll do better than worrying about nutritional studies that are nearly impossible to properly conduct to begin with.

    Maintaining weight is simple, but never easy for most of us. I think that one is from Marion Nestle.

  22. oraknabo says:

    “When you boil it all down, it’s probably far less important what individual foods one eats than that one eats a varied diet that is relatively low in red meat and high in vegetables and fruits and that one is not obese.”

    Sure, this is great advice, but I really don’t understand the attitude about Ornish from you or the article you linked to. I guess it’s easy to throw your hands up in frustration because it’s hard to get Americans to eat better, but I would say that’s a pretty emotional, non-scientific response. If all Americans were smokers and drug addicts, it would probably be hard to get them to participate in studies to see if it’s beneficial to not smoke or do drugs too.

    The fact is that most highly refined foods and many animal foods are made deliberately to get the highest dopamine response possible from the brain, ensuring that they crowd out the healthier options we have available. It’s exactly the same as addiction. You get addicted to cocaine and pretty soon everything else in life pales in comparison. It takes a while to get off the drugs and get back to a normal life. The same goes for getting off the super calorie-dense food and learn to enjoy fruits and vegetables again.

    It may feel like “monk-like determination and self-denial” for the 3-6 weeks it takes to neuroadapt to a lower calorie diet, but I’d bet most of the people you know that aren’t smokers or drug addicts don’t see their every-day abstinence of those vices as “monk-like determination and self-denial” either.

    There’s nothing wrong or even difficult with abstaining from junk food and animal products completely. The social stigma is a hard one to get by and the constant presence of marketing from companies who make millions from getting us hooked on those foods certainly makes it worse, but it’s going to take educating people about it, like doctors like Ornish are trying to do–just like doctors had to educate America about the dangers of smoking–not throwing our hands up and shaming them because the average person is too difficult to work with.

  23. PernilleN says:

    On Science Friday jan. 11. there was a very interesting interview with Robert Lustig, author of “Fat chance”, about diet, sugars (especially fructose), exercise. He also talks about addiction to sugar.

  24. Narad says:

    The fact is that most highly refined foods and many animal foods are made deliberately to get the highest dopamine response possible from the brain,

    This is frankly nonsensical. You think frozen-pizza manufacturers are running PET scans in product testing? Feedlots were established with dopamine release in mind?

    ensuring that they crowd out the healthier options we have available. It’s exactly the same as addiction.

    You have a rather crude understanding of the neurochemistry of addiction, as well. If it were all about dopamine, only a single target drug would be needed in the treatment context. The big boy in ethanol, benzodiazepine, and barbiturate dependence, for example, looks very much to be downregulation of GABA(A) receptors, with upregulation of NMDA receptors coming in second. It should not be surprising that sedatives are rather different from stimulants such as cocaine.

  25. Narad says:

    (Oh, and the vast majority of the recipes in Eat More, Weigh Less are freaking ghastly.)

  26. Scott says:

    On Science Friday jan. 11. there was a very interesting interview with Robert Lustig, author of “Fat chance”, about diet, sugars (especially fructose), exercise. He also talks about addiction to sugar.

    Pretty run-of-the-mill for SF these days. An extremist with an axe to grind given a totally unquestioning platform to say whatever he wants, regardless of evidence.

    When somebody wants to claim that 99% of the established knowledge base about diet is completely wrong and utterly backwards (e.g. calories, body fat, and obesity are all completely irrelevant), writing a book about it is not convincing. And then the mind-boggling clueless oversimplification that all we need to do to fix medical costs is regulate fructose… hello, that’s NOT what’s different about the US.

    Even if there’s ultimately a certain amount of truth to his claims, he’s going about it the wrong way.

  27. oraknabo says:

    @Narad

    I’m no scientist and I don’t claim to be an expert in any field, but I’ve worked in marketing and advertising for a long time and I know how food products are focus tested and I can tell you it’s a fact that frozen pizza manufacturers don’t give a crap how nourishing their product is, only that you prefer the taste of it to all of the other options available to you.

    I apologize for making the mistake of using the word “dopamine” when i meant it in a more general sense than trying to describe the specific mechanisms of addiction.

    @PernilleN
    I’d watch out for Lustig, he aligns him self pretty heavily with the paleo crowd.

  28. PernilleN says:

    @oraknabo: I didn’t say I subscribe to everything he says, but it was interesting. And I don’t care what crowd he’s with.
    :)

  29. Chris says:

    PernilleN:

    On Science Friday jan. 11. there was a very interesting interview with Robert Lustig, author of “Fat chance”, about diet, sugars (especially fructose), exercise. He also talks about addiction to sugar

    When I listened to that, I kept thinking about this article: High Fructose Corn Syrup: Tasty Toxin or Slandered Sweetener?

    It probably stuck in my head a bit more since I have seen Dr. Laidler give that talk in person.

  30. oraknabo says:

    @Narad – you might think its a ridiculous notion that PET scans could be used in product testing, and I realize this is a fairly recent development, but some corporations really do spend significant marketing money on brain scans these days:
    http://www.fastcompany.com/1769238/neurofocus-uses-neuromarketing-hack-your-brain

    I’m going to try to avoid assumptions here as much as possible, but I think I can safely start out by assuming that the basic drive of this blog is ethical and that most people posting here and most of its readers probably agree exposing quacks is valuable because it’s unethical to sell people things under the claim that they are beneficial when they have little provable effect or detrimental effects.

    I would also assume because of that that most readers of this blog won’t fall back the argument that marketing success outweighs any ethical concerns involved in selling people food. If you can make that argument, then what’s wrong with misleading people to sell homeopathics or being as popular as Dr Oz?

    I may not be an expert in addiction, but there have been studies to show that there have been addiction-like responses in animals to high-calorie foods and that eating high calorie foods decreases interest in healthier food choices:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2947358/

    “We found that development of obesity was coupled with the emergence of a progressively worsening brain reward deficit. Similar changes in reward homeostasis induced by cocaine or heroin is considered a critical trigger in the transition from casual to compulsive drug-taking. Accordingly, we detected compulsive-like feeding behavior in obese but not lean rats, measured as palatable food consumption that was resistant to disruption by an aversive conditioned stimulus. Striatal dopamine D2 receptors (D2R) were downregulated in obese rats, similar to previous reports in human drug addicts. Moreover, lentivirus-mediated knockdown of striatal D2R rapidly accelerated the development of addiction-like reward deficits and the onset of compulsive-like food seeking in rats with extended access to palatable high-fat food. These data demonstrate that overconsumption of palatable food triggers addiction-like neuroadaptive responses in brain reward circuitries and drives the development of compulsive eating. Common hedonic mechanisms may therefore underlie obesity and drug addiction.”

    I don’t have much data to link to on this, but I think it’s pretty obvious that most animals, free from involvement in humans will not develop significant amounts of obesity, cancer and heart disease and the species that do are usually either humans themselves, pets of humans or lab animals deliberately exposed to the causes of these diseases. The common thread here is that all of these species are fed by food produced by humans, specifically by the contemporary food industry.
    http://www.petobesityprevention.com/big-pets-get-bigger-latest-survey-shows-dog-and-cat-obesity-epidemic-expanding/

    That’s as much logic as I can put into one blog comment about this. Maybe you can deduce my meaning from the above facts and assumptions better than in my original comment, but all I’m trying to say is that food is made by most food-producing companies to be more appealing than nourishing and that it takes a lot of education and basically withdrawal from harmful foods to learn how to eat well. Doctors like Dean Ornish are trying to have a positive role in reversing epidemics like heart disease and obesity and I don’t think it does anyone any good to call out their efforts as being useless because the average american doesn’t want to give up their Big Mac.

  31. PernilleN says:

    @Scott:
    “When somebody wants to claim that 99% of the established knowledge base about diet is completely wrong and utterly backwards (e.g. calories, body fat, and obesity are all completely irrelevant), writing a book about it is not convincing.”

    Are you sure we heard the same program? I didn’t hear him say half of that.

    Regards
    Pernille Nylehn

  32. Scott says:

    He definitely said, not quite in so many words, that calories, fat, and obesity don’t matter – only fructose consumption. I specifically recall a spiel where he said that somebody could be obese, but if they got that way without consuming fructose, it wouldn’t cause metabolic syndrome. The first part of the sentence you quoted is my interpretation of said statements.

  33. Scott says:

    He definitely said, not quite in so many words, that calories, fat, and obesity don’t matter – only fructose consumption. I specifically recall a spiel where he said that somebody could be obese, but if they got that way without consuming fructose, it wouldn’t cause metabolic syndrome. The first part of the sentence you quoted is my interpretation of said statements.

  34. Scott says:

    Apologies for the double – no idea what happened.

  35. PernilleN says:

    He did (as I remember) say you can be thin but metabolically unsound, and vice versa, which is absolutely true. (Not if you are really obese of course, but a few extra kilos don’t matter if you’re fit and have a healthy diet.)

    And he definitely said that exercise is the best thing you can do for your health, even though it often doesn’t help you losing weight. Perhaps that’s why I liked him.

    But I may have to hear it again.

    Pernille Nylehn

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