I started reading Death by Food Pyramid : How Shoddy Science, Sketchy Politics and Shady Special Interests Have Ruined Our Health by Denise Minger several months ago (Minger writes the Raw Food SOS blog). I was cruising along, really enjoying the book, when I made the mistake of watching the first season of Game of Thrones on Amazon Instant Video. That led me to reading the 5 books currently included in George R. R. Martin’s Song of Ice and Fire series, and Death By Food Pyramid was put to the side for a few months.
I finished my journey through Westeros a few days ago (must have been well over 5000 pages!), and immediately picked Minger’s book back up. Finished it in two days. Song of Ice and Fire has apparently made me a very fast reader.
Anyway, to the point, Death By Food Pyramid is an excellent book. I rarely write book reviews here on Runblogger because books take a long time to read, and book reviews are hard to write. But I feel compelled to write about DBFP because I like to think that if I were to write a book about nutrition this is what it would look like. (There’s no way that will happen since although I generally try to eat well, I have far too “healthy” an appetite for IPA, pizza, and coffee to give anyone nutritional advice.) One of my goals when I wrote Tread Lightly was to objectively look at the science underpinning potential links between running shoes, running form, and running injuries. In her book, Minger takes a similar approach to investigate the links between nutrition and health. This is a much bigger topic, and the consequences of getting nutrition wrong are far more dire than the consequences of running poorly in a bad pair of shoes. Minger tackles the topic masterfully.
In about 250 pages Minger goes through such topics as how science works (great explanation!), why most nutritional advice coming from the US government is suspect and often tainted by special interests and lobbying groups, and (my favorite) why no single diet is going to necessarily be best for promoting good health for all human beings (which is basically what I concluded about running shoes and form – due to human variation, no single best answer for all people). She covers all of this ground in a lighthearted yet rigorous way, and cites tons of scientific and historical documents to support her position.
To give you a few examples of her approach, I’ve pulled a few quotes that I highlighted from the book:
On Nutrition Advice in General
“No matter how far science advances, nutrition is still a field booby-trapped with hucksters, charlatans, and diet gurus hoping you’ll blow half your paycheck on their life-extending line of goji berries and deer antler velvet.”
On Nutrition “Experts”
“Folks with low genuine skill in their field suffer from double trouble: not only do they grossly overestimate their own abilities, but they also don’t even have the knowledge necessary to realize what they’re saying is inaccurate.”
“Anyone who’s certain they’re right about everything in nutrition is almost definitely wrong.”
“Ignorance more frequently begets confidence than does knowledge.”
“Currently, no nutrition-oriented classes are required to get a Harvard medical degree—and ditto for 70 percent of the other medical schools in the nation.”
On Peer-Reviewed Journal Publications
“Science-ese ultimately prevents most of us from venturing beyond the reader-friendly blurbs we see in newspapers and popular diet books. It holds us hostage to ignorance, ensuring any health news we receive must first pass through layers of middlemen.”
“…peer-reviewed studies can seem infallible to the media and general public alike, and often dodge the scrutiny and skepticism other publications receive. Unfortunately, the reality is hardly rosy.”
“We know that the system of peer review is biased, unjust, unaccountable, incomplete, easily fixed, often insulting, usually ignorant, occasionally foolish, and frequently wrong.”
“We shouldn’t assume that just because a study endured peer review, all the thinking has been done for us.”
Minger wades through a lot of the science on topics like whether or not saturated fat to heart disease, whether red meat is bad for you, the pros and cons of a plant-based diet, and much more. She hammers home repeatedly that correlation does not equal causation, and I particularly like this quote on that topic:
“Sleeping with shoes on might be correlated with waking up with a hangover, but pulling off your sneakers before bed won’t stop that headache if the real culprit is tequila.”
She finishes the book by analyzing three diets that seem to perform well for some people – Paleolithic, Mediterranean, and Plant-Based. She then looks at the diets of indigenous groups that are (or were) known for their good health. Among these she tries to identify commonalities in what they do and don’t eat. Some of this won’t be surprising (e.g., sugar and processed foods are minimized), but some of the commonalities are interesting (e.g., lots of shellfish, eating animals head-to-tail rather than just choosing muscle meat).
I’ll finish by saying again that one of my favorite parts of the book is Minger’s emphasis on human variation when it comes to diet. She points out several examples of how humans can differ when it comes to the ability of the body to process food. For one:
“It turns out the number of AMY1 copies contained in our genes is not the same for everyone. And the amount of salivary amylase we produce is tightly correlated to the number of AMY1 copies we inherited. In humans, AMY1 copy number can range from one to fifteen, and amylase levels in saliva can range from barely detectable to 50 percent of the saliva’s total protein.44 That’s a lot of variation!”
Minger then goes on to describe how people with varying amounts of amylase respond to starch intake in very different ways (e.g., those with low amylase tend to see a larger insulin spike after eating starches), and how these differences could predispose some individuals on a high starch diet to increased risk of things like Type 2 diabetes. The point here being that, as Minger writes:
“…chasing a single ideal diet is the wrong way to approach health…It’s simply a genetic reality. And it goes a long way to help reconcile how one of your friends could shed eighty pounds following Atkins while another claims they’ve never been slimmer or more energetic since going lowfat vegan.”
This human variation makes me think that maybe I should think more about eating like my nordic ancestors than hunter-gatherers on the African savannah. Sure we all share a single human lineage, but some things have changed since humans move out of Africa. My ancestry prior to 1900 was almost entirely in Scandinavia (Sweden to be exact), and I wonder if a diet similar to what was commonly eaten there would be more optimal for my health. Tough to know, but interesting to think about. And I’m not sure I’ll be adopting my great grandfather’s taste for pig’s feet any time soon (though he did live well into his 90’s).
I don’t want to give too much away, I’ll simply recommend that if you are interested in science and nutrition, read Death By Food Pyramid. It’s a great book.
About Peter Larson
Sounds like a book well worth reading from those quotes!
I immediately recognized her comments about “Nutrition experts” as describing the Dunning-Kruger effect which seems to be rampant nowadays:
http://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect
Good review. I’ve had this book on my list for a while; might have to pick it up soon.
Also, made my way through first two books of SoIaF, but time to read has not been large enough to continue the journey :).
I added this book to my wish list. Good review.
Over my desk is a quote from “Boys in the Boat” the story of the University of Washington rowing team in the 1930s. Their coach, Al Ulbrickson, addresses the new team members by saying “You will eat no fried meats, you will eat no pastries but you will eat plenty of vegetables. You will eat good, substantianl, wholesome food – the kind of food your mother makes.”
It’s dated, since most moms I know these days take their kids to the nearest drive-thru on the way to soccer practice, but it cuts to the heart of the dieting craze. Less process, more natural and whole foods.
Very interesting, thanks for the review! I definitely will pick up a (digital) copy soon.
Great review, thanks. Will have to grab a copy.
In this review of Denise Minger’s work you’ll see how she play loose and fast with what we know about human nutrition and history.
http://healthylongevity.blogspot.com.au/2014/02/death-by-food-pyramid.html
Thanks for sharing that. My general take as a non-expert on nutrition looking from the outside is that nutrition is fraught with disagreement and for anyone who takes one position there are others who will attack it and defend a different position. Some of the debates seem to get rather vicious. It’s one of the reasons why I rarely ever write about nutrition here – I have not read all of the literature and have no authority for giving out advice.
The reason why I liked Minger’s book is because I don’t feel that she advocated strongly for any one type of diet. She basically said that we are all a bit different and that prescribing a single diet as best for all people is not a wise approach. I felt that she took three somewhat different diets that seem to benefit people and essentially looked for what they have in common. She tied this in with historical data to give some general guidelines that people can experiment with. Never did I feel she was telling me I must eat meat (or abstain from it), go vegan/vegetarian (or not do that), or eat a Mediterranean diet. The only point I feel she made strongly was to minimize sugar, processed foods, and PUFAs. And to eat nutritionally dense foods.
That last part (avoid sugar & processed foods, eat nutrient-dense foods) is somewhat of a common ground between paleo/primal folks and vegans. Haven’t read the book yet, but it’s on my list.
Just read the critic of Denise Minger’s book linked to on healthylongevity blog, it itself is contains errors and misleading analysis. I believe the healthylogenvity blog is the one with the unhealth bias.
A lot of people blame the food pyramid for a lot of things, but I haven’t met a lot of people who ever followed what it prescribes.
So, in my view, the food pyramid is the straw man of the tale.
In fact, all controlled studies that made participants follow what the food pyramid prescribes showed a positive outcome.
In general, you can establish any recommendation, which most people won’t follow, because most people go for what is cheap to buy and fast to prepare, and then assign any ill-health to the recommendation.
We’ve had a concerted campaign of doctors and public health officials telling people to eat more grains, grain products, and seed oils. People today (on average) consume more of these foods than they did in the 1970s, both as a total amount and as a % of calories. So…the recommendations “worked” in one sense that people are consuming more of the recommended foods. What Minger points out is that these recommendations were based on faulty science to begin with, and have given us a raft of unintended consequences since then.
The usual caveats about correlation and causation.
The recommendations may have increased the consumption of whole grains, seeds and seed oils, but the consumption of refined sugars, industrial, processed foods and artificial food stuff increased dramatically as well. The recommendations were not to eat more of that and keep eating as much of everything else. :)
I do not believe there is any “evil” food, be it fat or sugar, but ascribing an effect to a set of recommendations very few people actually follow consistently…is disingenuous.
In fact, I would say this: Even if you ask the Paleo or LCHF people to write the next food pyramid, the population at large will continue to eat as they always have.
30 years from now, will you be able to blame the Paleo/LCHF pyramid for a set of recommendations no one strictly followed?
All fad diets work using a combinations of these 3 approaches:
1) They remove something. (e.g., fat, sugar, carbs, meat, whatever…)
2) They add something. (e.g., some low caloric density food…containing lots of roughage)
3) They replace something. (e.g., fat with fruits, carbs with lean meats, candy with milk, whatever)
Without banning any particular food category, you can get positive results by studying where your daily calories come from. Logging your nutrition for 2 weeks will be an eye opener for most people.
Finally, yes, there are plenty of special cases, some IR people who should avoid carbs or fast carbs, some people who will do better being vegetarians for various medical reasons, some people who may not have the capacity to digest this or that nutrient for other medical reasons, etc. This being said, you cannot address entire populations using remedies that make sense for special cases.
Science is always waiting to be found faulty. If any of it stands the test of time, it becomes confirmed Science.
What you see happening these days is this: “Damn, cholesterol or fats were never linked to CVD! (which seems to be quite true) Ergo, cholesterol and fats must be good for you and should be preferred!”
Between these 2 statements, there is a leap from one “faith” to another. Yet, Science is not about believing, it’s about challenging beliefs.
EF: Good points all the way around, although I would not be so quick to find the standard “high carb/low fat” nutritional guidelines to be blameless. How people follow/interpret recommendations in the real world is another good question. Being the paleo/primal type that I am, I would say any increase in population-wide grain consumption is almost by definition an increase in industrially processed foodstuffs, regardless of how the original recommendations were phrased.
I agree that people (on average) merely added more of the recommended foods and increased their total calorie consumption, rather than replacing meat/dairy with grains. So the question becomes: when people (on average) started eating more of the recommended foods and kept eating just as much of everything else, why didn’t all those extra calories make us feel full?
Are cholesterol/fats per se good or bad for us? Naturally-fatty _whole foods_ containing fats and cholesterol amongst many other nutrients appear to be quite good for (most of?) us for several reasons–these foods are nutrient-dense, are consumed whole or relatively unprocessed, and are quite satiating to the appetite.
In your opinion, what changed starting in the late 1970s, when the modern obesity epidemic really takes off? I ask this not just to be argumentative, but because I think this is a genuinely important question.
Obviously, I can only offer my opinion, which I formed reading research from all sides.
It doesn’t mean much in the grand scheme of things, but it’s all I have to offer.
“In your opinion, what changed starting in the late 1970s, when the modern obesity epidemic really takes off?”
In my view, fundamentally, overeating happened. Plain and simple. Of everything. Healthy and unhealthy.
In more details, I think a great many households stopped being responsible for preparing their own food and started to rely on external food sources to feed their owns. Prepared/processed foods, instant this/frozen that, dehydrated this/packaged that, restaurants, fast foods restaurants, take-out restaurants, etc.
People stopped buying their own ingredients, stopped preparing their own meals and started relying more and more on the food industry to supply their nutrition.
This probably happened as more and more women joined the workforce and found themselves in need of quick solutions to household nutrition. (http://www.npr.org/templates/story/story.php?storyId=120146408)
[Not blaming women here ; men should be equally held responsible for the nutrition of their families.]
Once this situation was established, market economics brought the concept of “food quantity to price ratio”. Food chains and food providers in general started to compete based on that quantity/price ratio. Consumers started to seek the highest quantity/price ratio, mostly following the prompts of advertising and “common sense” (Why wouldn’t you patron a restaurant that serves you twice as much food for the same price?).
This competition escalated to the point where people lost track of what normal servings truly are. Who really consumes 3/4 cup of cereal in the morning? Who does really consider a 4-ounce steak a “normal” serving of meat? (I once heard a patron yell at a waiter when he was served a steak that was less than 8 ounces.) You could go on with such examples until kingdom come.
All this overeating obviously led to ill health in its most common forms, obesity, diabetes, CVD, food allergies, food-borne diseases. The food industry did what it does best, it started to produce foodstuffs that hit all the bullet points highlighted by experts. Alas, you don’t go very far when you address the symptoms rather than the root cause. Granted, the food industry has nothing to gain by telling consumers to eat less or to take ownership of their food supply instead of relying on any industry for something as vital as nutrition.
So, there you have it, that’s my theory. I could show you a lot of graphs that correlate all of it, but correlation is a trivial way to “prove” anything.
In the end, you have to ask yourself, is that something that rings possible? What you do after that, is yours and yours alone to decide.
Pete you would be happy to know that in WV we have a grant teaching Med Students not just about nutrition , but also how to cook. We are aligned with Minger, Taubs, Lustig, Noakes, Westman, and others who understand that good fats are not bad and that the carbs for folks who have IR (insulin resistance) will kill them.
http://wvpublic.org/post/wvu-medical-school-cooking-lessons-nutrition
Just returned from South Africa teaching course with Tim Noakes. he is changing the world there. Read this book as well as “Big Fat Surprise”. As a runner I used to be a carb junkie. no more and feel much better and not hungry all the time. my patients loose weight if they cut the carbage. Dr Mark Cucuzzella
This is a good book on the expose of the collusion of the government and big business. It is also helpful in explaining how studies are done and the value of different types of studies.
It’s sad that after doing such a good job explaining the importance of proper studies and science in the selection of how one should eat, Minger concluded the book with recommendations based on her personal experience, and logical analysis along with anecdotal evidence, which she accurately states indicates no cause and effect relationship.