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Five Subjects Too Hot to Handle in Nutrition and Obesity

Sadly enough, we live in an age of angry tweets and venting spleens. So it is in nutrition and obesity (as well as politics) these days. We’ve found that five subjects – whatever you say – will attract responses that are too hot to handle.

In our view, this is a reason to try to write, think, and talk objectively about what we know and what we don’t on each of these subjects. But feelings are tender around these subjects, so please be careful.

1. Sugar

Perhaps this started with the hyperbolic claim that sugar is toxic. But the heat around this topic has grown only more intense. True believers are certain that sugar is an important driver of obesity and diabetes. Sugar sweetened beverages must be fought at every turn. If you write that declining consumption hasn’t led to any reversal in obesity trends, the bile will really flow.

Likewise, the concept of taxing sugar-sweetened beverages will stir strong emotions. When we question assertions that it’s highly effective, we can count on getting a stern lecture about having a bad attitude.

2. Carbs and Keto

Why must we have a “low-carb community“? It’s hard to miss. The fans of ketogenic diets are especially vocal right now.  So studies that show less than miraculous results for a low-carb diet will attract legions from the community to dismiss the study as “ridiculous.”

A recent commentary in JAMA Internal Medicine suggested that physicians and patients should pay attention to “the evidence, not the hype” for ketogenic diets. Heresy. Obviously, keto fans responded, those doctors have no experience with a ketogenic diet. If they did, “they would be amazed at how well people do.”

3. HAES®

Health at Every Size is a trademarked social justice movement that aims to fight weight stigma. This is certainly a good idea. But it requires strict adherence a belief system which tells us “that ‘obesity’ is not the health risk it has been reported to be.” Straying from the prescribed beliefs or losing weight for medical reasons might land you in hot water.

4. Intermittent Fasting

Just as believers in the low-carb community are convinced it can bring medical miracles, we hear some pretty strong claims for intermittent fasting as a cure for diabetes. But some of it is very anecdotal. And if you question the claims, you will attract a swarm of tweets to attack the heresy of your questions.

5. Plants and Meat

Plant-based diets are the way to go. Right? The Dietary Guidelines for Americans say so. But don’t get carried away,  because the guidelines also include some good words for lean meat. Meat has its defenders. Then again, meat is killing the planet. That’s why advocates for less meat and more plants are especially passionate.

On this subject, the only way you can avoid criticism is to mince your words and say nothing. Can we have mincemeat without the meat?

Can We Talk?

These are all important subjects, so we need to talk about them. Hard, objective questions, about what we really know and what we don’t, should be welcome. We need curiosity and a thirst for the answers to fill the gaps in our knowledge.

Push the Button, photograph © M D / flickr

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July 30, 2019

4 Responses to “Five Subjects Too Hot to Handle in Nutrition and Obesity”

  1. July 30, 2019 at 8:44 am, Sonali Malhotra said:

    This post resonates completely what a physician ( already challenged with the stigma , external and internal biases) has to face in a daily clinical practice. Not only people attack you with tweets, but they think you are a Pharma company gang trying to sell medications against the “real solutions” of low sugar, ketogenic , intermittent fasting diets.
    We need science more than the hype.
    Well Said Ted.
    Thank you for writing this!


  2. July 30, 2019 at 11:09 am, Stephen Phillips said:

    Five Subjects Too Hot to Handle in Nutrition and Obesity

    Regardless of the intervention; “A Waist Is A Terrible Thing To Mind ”

    Whatever works for an individual is the ideal

  3. July 30, 2019 at 11:26 am, Kirsten said:

    Thank you very much for your reasonable, well-researched blog. As a lay-person, I find the information reassuring when faced with my own weight challenges.

  4. July 30, 2019 at 2:17 pm, Lori said:

    I find it hard to know what the evidence based science related to nutrition is. Nutrition studies always seem designed to prove the investigators beliefs. Does eating breakfast help maintain a higher metabolic rate or do people with a higher metabolism eat breakfast because they wake up hungry? IF vegetarians are healthier is it because the don’t eat meat or just because they eat more vegetables? Trying sort it out is very frustrating!