Perspective is a funny thing. We try to wrap ourselves in science and so armored conquer the mysteries of the galaxy. We validate our conclusions in terms of mathematics; because it is the universal language. It is beyond human influence, devoid of human emotion and unresponsive to the human condition; as much as you want may want it, one plus one will never give you five.
Yet the purity of math in conveying the physics of the universe is exactly why it is doomed to eternal failure in conveying the human condition. Without the human, there is no human condition. And there are few conditions as fundamental to the individual and society at large than what we choose to consume. What we eat and drink is both literally and figuratively who we are.
However, a recent study that tells us that it is not what we eat and drink, but only how much that matters. This has generated a lot of press. The research states that candy, soda, and fast food are not likely to be a leading cause of obesity in the United States. The media in turn has extrapolated that conclusion into the message that candy, soda, and fast food will not cause ill health.
Let’s break this down at several levels.
Of paramount importance, is the fact that the study has yet to be published. The information and conclusions put forth in the press and thus to the public are based on a press release from the institution which performed the research. It is impossible to objectively comment on the research, methods and conclusions drawn from a press release (the official citation as listed; David Just and Brian Wansink (2015). Fast Food, Soft Drink, and Candy Intake is Unrelated to Body Mass Index for 95% of American Adults. Obesity Science & Practice, forthcoming). It is a spin zone that makes an F5 look like a tumbleweed.
For the sake of argument, let us make the reasonable assumption that for all intents and purposes the peer-reviewed journal version will be similar, if not completely identical, to a paper of the same name and by the same authors released just one month earlier.
The study aims to look at the relationship between the intake of fast food, soft drinks and candy and the risk of obesity as defined by the body mass index (BMI). Their hypothesis is that any such correlation is driven by the extremes of the population and if you eliminate the extremes at either end you will find that no such correlation exists. In other words, if you get rid of the super models (BMI<18.5 kg/m2 ) and Fat Albert (BMI>44.9 kg/m2 ), there is no relationship between the consumption of fast food, soft drinks and candy and your weight; at least for 95% of the population. Nirvana in a Snickers bar.
There are a host of issues regarding the use of BMI as a measure of obesity and extrapolating that to health or illness. I devote a chapter to that discussion In the Fallacy of the Calorie: Why the Modern Western Diet Is Killing Us and How to Stop It. Suffice to say, it is inaccurate and misleading at best and as the originators of the measurement noted, while it may have some use in population analysis; it should never be applied to the individual. Additionally, many studies suggest that the lowest mortality and best health occurs not in those with a normal or ideal BMI (BMI 18.5 to 24.9kg/m2 ), but those within the overweight category (BMI 25 to 29.9 kg/m2 ). This “obesity paradox” is a real phenomenon that has spawned papers, books and ongoing research and discussion.
While another title for this paper may be “garbage in, gold out” the research maxim “garbage in, garbage out” still holds true. The data for this paper was based on 2007 to 2008 Center for disease control’s (CDC) National Household and Nutrition Examination Survey (NAHNES). There were 5000 people who underwent a broad health survey. The food data was collected via two non-continuous 24 hour dietary recalls conducted in face-to-face interviews.
Quick, right now tell me what you had for dinner four days ago?
Now you understand the difficulty in ascertaining accuracy with such a method. Add to that a doctor in a white jacket asking you face-to-face if you ate your vegetables or whether you descended into that red light district of dietary Hell and gobbled a few dozen piping hot Krispy Kremes. Other studies have shown that in this situation Dr. Gregory House got it right: people lie.
Allowing that caveat, the amount of food consumed was not measured. It was categorized by “eating episode rather than amount eaten because it is less subject to recall bias.”[i] If you are claiming it is not the type of food consumed, but rather the amounts that are relevant, you should probably measure said amounts.
Food was classified by location as being away from home, or fast food. There is a universe of difference between a chef crafting wholesome, local, fresh cuisine and industrially assembled gruel. What foods were analyzed was chosen on an ad hoc basis.
Although the authors allude to it, they do not directly come out and link an increased BMI to worsening health. Which by them saying that fast food, soft drinks and candy don’t have an impact on your weight implies that there are no untoward health consequences associated with eating such foods. They didn’t have to. The media took that toss and ran it into the end zone for a McTouchdown and a supersized happy dance.
The researchers conclude that “Soda, candy, and fast food are…not likely to be a leading cause of obesity in the United States.” The lead author, Dr. Just takes that one step further saying, “that diets and health campaigns aimed at reducing and preventing obesity may be off track if they hinge on demonizing specific foods.”[ii]
The authors disclose no funding conflict for this particular research project. But it is important to note that the senior author, Dr. Brian Wansink is a PhD and professor of marketing and the area of expertise for both researchers is economics. Funding for the Cornell University Food & Brand Lab, which is run by Dr. Wansink, comes not only from government funding, but industry trade groups. I cringe when such a “renowned authority on healthy eating” is a “fast-food-loving, organics-hating” marketing and economics professor.[iii]
That is not to lay fault with the messenger and invalidate my previous points by making this an ad hominem argument. It is however, critical to understand where and how the premise of their hypothesis arose; what perspective and experiences shaped it into being.
The study authors argue that candy, soda, and fast food have no impact on your BMI. That is the proposition that their data aims to support. I would argue, and have argued, that the BMI is for the most part irrelevant when it comes to discussions regarding health, wellness, illness, and disease; which would make the outcomes in this paper irrelevant for such a discussion regardless of conclusion.
The problem lies in the media’s arguing from the consequences on this paper’s purported findings. If I consume candy, soda, and fast food I will not get fat. If I am not fat or obese I will be healthy.
The erroneous conclusion is that it doesn’t matter what you eat, just how much you eat when it comes to health or illness. It is a misconception that it is not the quality of the comestibles, but the quantity of calories that matter. That my friends, is just ancient history and another fallacy of the calorie.
Bias is a funny thing. We wrap ourselves in science and with a few flips of statistical gymnastics proclaim a universal truth. But like the luggage we never quite get rid of, it stays with us and subtly influences our thoughts as they wander and travel. The road to bypass surgery is paved with Tastycakes.
[i] (Just & Wansink, 2015)
[ii] (Cornell University Food and Brand Lab, 2015)
[iii] (Butler, 2015)
Butler, K. (2015, April). This Fast-Food-Loving, Organics-Hating Ivy League Prof Will Trick You Into Eating Better. Retrieved from Motherjones.com: http://www.motherjones.com/environment/2015/03/brian-wansink-cornell-jun...
Cornell University Food and Brand Lab. (2015, November). Candy, Soda, and Fast Food are Not Driving the Rising Obesity Trend in the US. Retrieved from Cornell University Food and Brand Lab: http://foodpsychology.cornell.edu/OP/fast_food_science#
JunkScience. (2015, November 5). ‘Junk food’ not related to obesity for 95% of the population. Retrieved from Junkscince.com: http://junkscience.com/2015/11/junk-food-not-related-to-obesity-for-95-o...
Just, D., & Wansink, B. (2015, October 1). Fast Food, Soft Drink, and Candy Intake is Unrelated to Body Mass Index for 95% of American Adults. Retrieved from SSRN: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2668214
Obesity Science & Practice. (2015, October). Obesity Science & Practice. Retrieved from Wiley.com: http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2055-2238
Reinberg, S. (2015, November 5). Junk Food Not to Blame for Obesity Epidemic? Retrieved from WebMD.com: http://www.webmd.com/diet/obesity/20151105/junk-food-not-to-blame-for-am...
Sciience Daily. (2015, November 5). Obesity: Is junk food really to blame? Retrieved from Science News: http://www.sciencedaily.com/releases/2015/11/151105102935.htm