Right off the bat, I have both positive thoughts and expectations, as well as some reservations about the Nutrition Science Initiative (NuSI), co-founded by Peter Attia, M.D., and Gary Taubes: billed as The Manhattan Project to End Diet Fads. I met Peter for the first time at AHS in Boston, introduced by Sisson, and had a fun chat with Gary. I'll bet they must have been just bursting at the seams about all of this, so close to its launch.
I initially got wind of it via Tim Ferriss, clearly someone instrumental in rallying some of the initial sponsorship and funding. Good moving & shaking, Tim. Rather than go into specifics about how the institution is designed, set up, etc., just see the link at Tim's place (and the two slide decks especially), as well as Dr. Stephan Guyenet's take on the whole thing.
In short, Stephan's reservations echo my own (while I remain very positive and enthusiastic overall). But I'll explain mine differently. Before I do, here's Peter Attia's 3-minute launch video.
The criticism I like the best about me is that I don't usually dig into "teh science" first hand, very often. It's true. I do sometimes, and I generally don't much care for posting on studies unless I can get my hands on the full text (abstracts are marketing and press releases). As a recent example of digging into a study first hand, exchanging email with the lead researcher, then synthesizing various takes on it: Synthesis: Guyenet, Colpo, Calories Count, Food Quality Matters, Macronutrient Ratios are Qualitative. But mostly, I'm about integrating everything out there with some basis, and then attempting to synthesize that integration into the widest possible context for an overall sum greater than the constituent parts...too often counted like beans.
I'll start at the beginning and that beginning starts with Gary Taubes, Good Calories, Bad Calories, and one of his lectures after his best-selling book hit the scene. I called that January, 2008 post 180 Degree Errors.
...But in the sense it implies that eating more causes children to grow, it's completely false. In fact, the reverse is true. As children, we don't eat more so we can cause ourselves to grow bigger than we already are. We grow bigger than we are, and the effect is that we eat more in order to sustain our larger base metabolism. Growth hormone causes growth. Food is just the raw material.
The reason this error is so easy to make is because it's self evident that if we don't eat at all, we'll starve and die, and in fact, malnutrition can cause stunted growth. But that's because the minimum necessary raw materials aren't present. Let's draw an analogy in the form of building a skyscraper. If you don't have the minimum amount of concrete and steel, then the building is not going to be built to its full height. But what if you pile up two times the amount of concrete and steel required to build to plan? Is that going to cause it to be built, or built bigger than plan, or faster? No, you need the "growth hormone" to build it: construction workers. They use the raw material, build with it, which creates the demand for additional raw material; but it is the act of building that is the cause for the increased demand for "feeding."
To stretch my analogy even further, one might describe those construction workers as being hungry for raw materials. Even further, what happens if their hunger for those raw materials goes awry, is no longer integrated with the plan? We'll, then, perhaps you end up with something akin to the Winchester Mystery House.
What I have always believed Gary Taubes to be right about is that "you eat too much" doesn't say anything important. That's an indictment of character, and I'm sorry, but we're animals, and animals—contrary to ancient fantasies—are not imbibed of Original Sin. We don't have inherent design flaws. Why we eat too much is the question to ask, and if you pay attention, calories do matter. Or:
- Calories Count...BUT
- A Calorie IS NOT a Calorie
Sounds self contradictory, eh? But in fact, this is where the modern science that looks only at calories or Taubsian Doctrine [smiley] come together, if you stop thinking in binary terms...that either Taubes is right or modern obesity researchers are right (or both wrong). Me? I think they both have pieces of the puzzle, and they both lack pieces of the puzzle. To me, when Gary says that fat accumulation is a hormonal disregulation, it's a priori—you don't even need to get up off the couch to know it's true.
But there are other pieces to the whole puzzle. Who has another piece? Brad Pilon and Martin Berkhan, pioneers both in using fasting or intermittent fasting (IF). But they don't do studies. They practice. ...Fast forwarding a year, to January 2009, I did a short post on Hunger.
The longer I go down this path of paleo-like eating, the more I am convinced that hunger is the key. I tell people, now: ultimately, this is not a battle of the bulge, fat, or weight. This is a battle over hunger and ultimately, your hunger is going to win in the long run unless you simply have the rare constitution to be miserable all the time -- like many of the calorie restriction folks do.
I didn't actually mention IF in that post but in retrospect, I have to wonder if that wasn't really it, mostly. You see, over the years I've seen both Brad & Martin field tons of success stories under a general paradigm of dietary agnosticism, i.e., the fasting outweighs all, whether you include grains, sugar...whatever—so long as there's some sensibility to it. If so, what could be going on there? Is it that calories count, or that hunger normalization counts more, or both?
What I found in fasting and working out fasted was what I called "high resolution into hunger." That is, I could get on a leg press with lots of weight in a fasted state, do reps, and make myself ravenously hungry to not hungry at all inside of a minute or two, from one extreme to the next, back & forth. In short, I found fasting to be a solid means of getting a handle on hunger and what you're going to do about it. Fasting is like practicing hunger for fun.
So where are we so far? Well, to my mind, I don't see the right questions being asked by very many. Let's look at Food Reward. Again, definitely a factor, definitely part of the big picture. But to put it in a wide perspective, how often do you say or think "I need a reward," as opposed to "I'm hungry?" Naturally, there's a fooling one's self overlap, but we're human animals. We generally get hungry every day. Do we get hungry because we're really feeling hungry, or, is it a perpetual fooling of one's self? I doubt it. It's probably both, but what's dominant in the equation?
Or, how about economics and scale and doing more with less? Food is cheap, now, relatively speaking. But how can that confounding variable be accounted for in any study? McDonald's offers a reasonably "balanced meal" at very low cost, especially if one retroacts to the earlier days of McDonald's, with something like the Mini Meal. That was the Big Meal back in the day and in current dollars, was probably three or more times as expensive while being half of the calories.
To put it another way, who doesn't think that the macarons et chocolats du Pierre Hermé, Paris, are not about the most rewarding things on the planet? But you'll pay way, way more relatively than you will for just about any other frivolous thing. Not to take anything away from those studying food reward: I realize that most likely, cost is part of the overall picture. It's an integrated "more for less" calculation. How many times have you heard someone describe the food at a (crappy) restaurant being "great" exclusively in terms of the huge portion sizes (talk to old folks)? Getting "a lot" for one's money seems to have been disconnected from any sense of hunger or need.
Now let's move onto the biggest confounder of all: micronutrient nutrition. ...It's almost too bad (not really) we don't live still in an age where things like rickets, scurvy, pellagra and other such conditions were so commonplace that everyone had a constant reminder of how important it is to get nutrients. Let me, right here, give a shout out to my friend Kurt Harris, MD, who was right: There is no such thing as a macronutrient.
- There is No Such Thing as a Macronutrient Part I - Fats
- No Such thing as a macronutrient part II - Carbohydrates
To cut to the chase, there are: NUTRIENTS. Nutrients include vitamins, minerals, lipids, amino acids, starches, sugars and whole hosts of things...in....FOOD. And of course, anyone paying attention must have to ask: how come the government always recommends the most nutrient vapid food (grains, vegetables, fruit)? It's really a huge story that ought to fill a book, but when everyone was poor as dirt and the cheapest calories were grains and sugar (still are), and people made sure to get some dairy because it had good nutrition, what happened? "Fortification," an awfully dishonest, misleading moniker. It gives the impression that that recommended industrial food (hint) was good and that adding nutrients just made it better (yea!). Nope. What it did, only, was to target staple foods like wheat and milk, to have added into, enough nutrients to barely prevent the aforementioned nutritional deficiency diseases, because that's what everyone was eating (and the government it totally efficient when it comes to public health :). Real food needs no "fortification," especially when you include plenty of food-chain animals.
To integrate something even more, Julia Ross has a couple of books out and has also gained some acclaim in clinical settings for her success rates in getting people to overcome substance addiction. How? It's not by feeding them protein (macronutrient). Rather, she targets a specific range of supplemental amino acids (nutrients). Get it?
So we don't really know what optimal levels are in terms of nutrients (Laf: we can't even stop arguing about 3 "macro" nutrients). ...It's always been focussed on minimums of specific nutrients to prevent woeful in-your-face deficiency.
...A while back, I wrote a post about how I suspect the root cause of obesity is malnutrition: Malnutrition –> Health Degeneration –> Obesity & Other Diseases of Civilization.
The idea, simply stated, is that perhaps the very root and fundamental cause of obesity and other "diseases of civilization"—obesity being a good ill-health marker—is malnutrition. But, because food is plentiful and we're not talking about malnutrition in terms of chronic caloric deficit, the malnutrition is subclinical, i.e., no obvious micronutrient deficiencies such as would usher in rickets, scurvy, and other well-documented, easy-to-spot diseases arising out of micronutrient deficiencies like vitamin D, C, or others. Or, to put it another way, sufficient or even excess macronutrient nutrition in the face of mal-micronutrient-nutrition.
A few whom I corresponded with got the wrong idea about that. I was not trying to assert that malnutrition was a direct per se cause of obesity—but going back to Taubes, Hunger, Food Reward: the thing that gives all of these "ideas" a stage, front & center.
- Taubes: Hormonal Disregulation leading to adverse fat storage (seems more likely if malnourished, even if calorically replete)
- Unbridled Hunger (seems more likely if malnourished, even if calorically replete)
- Guyenet: Food Reward leading to overconsumption (seems more likely if malnourished, and...even if calorically replete)
But here's the rub...and now I get to my own reservations about this project, and I wish to frame these reservations as constructively as I can.
It strikes me as just a competing paradigm of calories count vs. carbohydrates count, as simply as I can state it. And I think that sort of binary thinking is wrong, on both parts. Furthermore, I expect to learn more over the years, but as it stands, no more than I already suspect, I suspect.
We're creatures of volition and unique in the animal kingdom. We have invented means in human civilization by which a single individual of its making...using mind, accumulated capital and cooperation, can produce values for millions—just as single individuals have been known to oversee the torture and massacre of millions. This will never be accounted for in any study, but dollars count a lot, and they count every day and for a lot of people individually.
Individual true hunger vs. a reward mentality—and faking of hunger, and its overlap—will never be satisfactorily accounted for in a study. Too complex. Too individual.
There are tons of vitamins and minerals and other essentials and so-called phytonutrients (a word that really means: we don't know what the hell it is) in food. Food contains nutrients. "Macro" nutrients are a mere abstraction, a grouping together by type. For that matter, so are nutrients in general, because we can always deconstruct to the chemical or even atomic properties. "Phytonutrients" are the stuff we have no fucking idea of, but some may be essential. We don't know. At this point, deconstruction perhaps needs some deconstructing. In the end, we're all protons, neutrons, and electrons—or, are we quarks, Higgs Boson, and other sub-atomic and sub-sub-atomic particles? Who knows? Just eat real food?
Back from the ridiculous, I just hope this isn't a project intent on ushering in just another, new set of confounding variables in an effort to "prove" that low carb was right all along, and those who look at calories primarily were wrong. I think you're both wrong—and right—frankly. There's pitfall in looking at anything so complex as human behavior so simplistically, when you are dealing with the economics, the mass of production, the industrial interests, the nutrients at base, teenage girls, and the fact that people get hungry every day no matter what.
...Or, a sweet potato is not the same as a Big Gulp...nor is a Sandwich Jambon Beurre the same as a Hot Pocket!
Here are a few off-the-top-of-my-head suggestions.
- State your study limitations (confounders), always. See above.
- Go ahead and give the macronutrient breakdown, but also the MICRONUTRIENT breakdown of the foods consumed (has ANYONE ever done that?).
- Learn more from the successes of your opponents than you do from their failures.
- Integrate widely. Synthesize wider contexts as a matter of routine operation and base ethic.
- Have fun.
It's no secret, given the foregoing, that I'm hugely enthusiastic about any sort of study that can attempt to drill down into how replete full NUTRITION from real food (beef liver, people—the most nutritious, and don't forget oysters, clams, mussels, eggs, etc.) effects hunger and indeed, behavior in that context. When I was thinking of this post, I had in mind a bunch of ideas and suggestions as to how to design such a study but you guys are the experts in that regard.
Everyone knows I have a little book. What I'm most proud of is doing a bit of original work—I think it's chapter 3—in terms of comparing nutrients in various foods. I spent more time there than on anything else. When I went to AHS, I saw Matt Lalonde do basically the same thing in his presentation, my favorite of the whole conference.
A calorie is most certainly not a calorie, while calories do matter for fat accumulation and loss. This is what I would like NuSI to integrate, above all else.
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