2013-03-04

Case Closed!

Over at The Huffington Post, one Dr. Jonny Bowden provides some much-needed levelheadedness regarding all the recent hype surrounding "the Mediterranean diet." He concludes:
What we can say is this: No diet, ever, in the history of the world, has been higher in sugar and processed carbohydrate junk foods than the one that most people in America consume on a daily basis.
And I believe that no diet is better designed to produce the epidemic of obesity, diabetes and heart disease we are currently witnessing.
My own personal opinion is you could design a dozen diet studies showing the superiority of a dozen different diets (from Atkins to Ornish to the Zone) as long as you compare each of them to the crap we're eating now.

With a bar that low, almost any diet is going to look like a superstar.
This is rather interesting, since it highlights what has long been a feature of pharmaceutical research and health research in general.

The way this racket goes is something like this: The researchers identify their conclusion in advance of the study, because they know what point they wish to make. The point is something relatively mundane, as in this case (diets rich in monounsaturated fats from foods such as nuts and olive oil are good for the body), and is therefore easy to "prove" (since it is practically common knowledge). The researchers then design a "control group" around a piece of behavior that the researchers wish to correct. In this case, the researchers wish to point out that an "American" diet of carbohydrate-rich processed foods and very little "fat" (meaning, saturated fat) is bad and we shouldn't eat that way. Finally, the researchers go through the motions of testing an obviously superior data point to an obviously inferior one, and voila! They prove their point, QED.

We see this in the pharmaceutical industry all the time. The way it goes is that scientists assemble a group of basically untreated sick people as the "control" group, and then they assemble a second group who receive treatment - typically, the pharma company's newest offering. The researchers have tested this product seven ways to Sunday, and usually it isn't very "new" to begin with. Sometimes the chemical they're testing is nothing more than an enantiomer. All they have to do is show that their product performs better than a group of sick, untreated people.

Fortunately for us, this game no longer flies in the pharmaceutical world. Unfortunately for us, it still works with Food God research such as the recent study "on" the Mediterranean diet.

Dr. Bowden provides some additional criticisms that are useful here:
I'm a big fan of the concept of Mediterranean eating, even though I've never seen anyone definitively define what "the Mediterranean diet" actually is. (Check the definitions: Most are squishy and vague with phrases like "higher in vegetables" or "lower in dairy.") We do know that in all styles of Mediterranean eating, there is way less sugar. And there's lots of olive oil, nuts and other good stuff.
And later:
And we still don't have a good definition of the Mediterranean diet. (As my mentor, the great Robert Crayhon once quipped, "People think the "Mediterranean diet" means adding a bunch of olive oil to your corn flakes.") And we still don't know which aspects of the so-called Mediterranean lifestyle are the ones that really produce the results. Is it the olive oil? The nuts? The vegetables? The low level of red meat? The fact that they eat slowly and in the middle of the day? Maybe it's all of those things, maybe it's just some of them...[.]
Adherents to what I call the Food God concept (the idea that society desperately needs to regain its "balance" by hanging out at the farmers' market more often) would desperately like all of us to add piles and piles of vegetables to our diet. And nuts. And quinoa. And wine. For some reason, people who worship Food God believe that becoming a wine-obsessed vegetarian will magically correct a large chunk of society's problems.

Hence, the Mediterranean diet. "Ordinary people" like it because they don't have to be vegetarians. They also like it because it provides a rationalization for heavy wine consumption, long nights at the local "bistro" (another fuzzy concept), snobby dinner parties, and the belief that whatever you're eating is healthy if it is topped with parmesano reggiano (not mere parmesan cheese!). Food Godists like it because it nudges society closer to both veganism and European medieval serfdom (plus bikes!).

And since pure veganism is an obviously tough sell to people who, you know, like to enjoy life, the Mediterranean diet serves as a conceptual apparatus by which we can be pressured into behaving more like Marin County hipsters and less like Dallas debutantes.

Considering all that, it's good to know we have friends like Dr. Jonny Bowden adding some intelligence to the discussion. Sadly, I don't think articles like his have much impact on the world at large - certainly not as great an impact as those extolling the virtues of the wine-and-wheatgrass diet.

But it's better than nothing.