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EventsThe controversial Manhattan Project of Nutrition
September 17 2012 by Dr. Andreas Eenfeldt, MD![Dr. Andreas Eenfeldt, MD]()
in NuSI
in NuSI Could the recently launched Nutrition Science Initiative – aka the “Manhattan Project of Nutrition” – be the solution to the obesity epidemic?
It has certainly gotten a lot of attention online. Most popular bloggers seem to be in favor of it while others are (predictably) more or less sceptical. Here are a few voices:
Personally I’m very much in favor of NuSI and I think it may accomplish great things. But instead of making the case for it myself I’ll do something better. I’ll let Peter Attia, the President of NuSI, explain this “Manhattan Project”. Nobody does it better.
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Rigorous study of human diet clearly presents mind-boggling logistical challenges. Unless you house human subjects in a dedicated facility over long periods of time, while monitoring every scrap they eat as well as each subject's activities, it seems to me that the uncertainty which plagues diet studies cannot be eliminated. Answering the big real-world human nutrition questions unambiguously requires that you face these challenges head on, irrespective of the cost.
Even if NuSI never secured the funding to perform whatever experiments are required to get the answers we need once and for all, if they can get the major players to agree what those experiment should be, that would be great progress. Just imagine if everybody agreed the following:
1. What (if anything) does everybody already agree on? (i.e. an inventory of current consensus)
2. What are the big questions / hypotheses? (e.g. sugar, insulin, saturated fat, carbs, etc?)
3. What experiments would settle those questions once and for all? (assuming that money is no object - i.e. no compromise on the basis of cost)
4. What exactly would the design of each experiment be?
5. What would the different possible outcomes of each experiment mean?
If NuSI can get reasonable consensus on any of those five things, then even without carrying out a single experiment, they will have achieved a lot!
I think we do know what is good for us already. Natural foods prepared from basic ingredients and variety.
Comparisons of low carb vs high carb diets under strict controlled conditions if this is in NuSI plans might also be useful since we all know that there are many people who remain slim even when experiencing a high carb dietary regime and viceversa some of us struggle with weight even when ticking all the lowcarb high fat boxes...
I remain sceptical but hopeful....waiting in the wings
Robb I did check. Interestingly, he posts the announcement without comment. He's interested but reluctant to commit himself, I guess. Fair enough. He did have a glaring typo, however: "Initiave". What would Greg Say? LOL.
For example, the distribution of the SH2B1 defects, which appear responsible for some early-onset obesity, insulin signaling problems & perhaps also leptin resistance. These defects appear overwhelmingly in Caucasian/European people. It was only discovered in 2009.
We also have to look at the FTO gene, which was discovered in 2007. This is also predominantly carried by Europeans. One copy of FTO increases your risk of obesity by 30%. It's carried by perhaps as many as 40% of Europeans. Two copies of the FTO can be found in about 18-20% of Europeans, and could increase your risk of obesity by 70%, as well as correlating to T2D.
It seems likely that the repeated famines documented in European history and pre-history have encouraged the persistence of this gene, since it's only in the last 100 years we have abolished regular, wide-spread famine in Europe.
So why aren't [insert remote tribe of 1,500 people here] fat while eating 85% carbs? Well, 1 because they don't eat sugar/high fructose corn syrup and 2 - they don't have the genetics for obesity and insulin resistance to the same degree or type as Europeans any way. Maybe they have only a 5% carriage of these genes in their population. Maybe they haven't been subjected to the same famine pressures Europeans have. And so forth.
We have to talk about population genetics, because gene patterns do have an impact at the mass level. There very well may not be a 1-sized-fit-all diet. There may be a diet for Europeans based on their population genetics and another of other peoples, based on theirs.
But of course Taubes' is reductionist - he wants to reduce the obesity problem to insulin levels & fat deposition. That's his theory, and like any other serious guy, he's gonna have people test that theory for him. What's wrong with that?
But I'm serious about the FTO gene here. Everyone who's been on this blog complaining that low-carb doesn't work for them needs to drop US$100 on the gene test. You need to know how many copies you have, and which SNPs.
"FTO is mainly expressed in the hypothalamus, and it may play important roles in the management of energy homeostasis [5], nucleic acid demethylation, and in the regulation of body fat masses by lipolysis [6].Other than BMI, FTO gene SNPs have been shown to associate with a number of metabolic-related traits, such as higher fasting insulin, glucose, triglycerides and lower HDL cholesterol [7], waist circumference [8, 9], and body weight [10]."
http://www.hindawi.com/journals/edr/2012/872176/
Basically if you've got 2 copies, you've lost the genetic lottery and no diet's going to work well for you. That is, about 20% of the Western population will never be very successful at weight loss. You need to know that, as well as your APOE2/3/4 status.
With these 2 key pieces of info about yourself you can finally be in a position to take sensible action on your long-term health. Until we account for these and a few other major health-impacting genes, all the low-carb diet tests in the world are useless.
There are always going to be some folks who can't do well on any diet at all, and Taubes needs to sort those people out of his studies. Plus, once you know you're a double FTO, you can finally cut yourself some slack about your weight and work on managing your health as best you can to avoid CVD, insulin-related cancers, dementia, and T2D.
As for your own pet theory: maybe you need to write your own blog so folks can decide for themselves to read it or not..
I personally think better of Taubes. More than I do of some of the "paleo" bloggers (and certainly more than I do of their anonymous followers.)
And I don't think Attia, or NiSi's directors, or advisors, or their funder, would get involved in a multimillion-dollar quest to vindicate "Good Calories, Bad Calories."
Jesus! Isn't it at least POSSIBLE that at least ONE PERSON cares about what diet makes people healthy?
In other words, isn't it at least POSSIBLE that at least ONE PERSON isn't an opportunistic, self-aggrandizing asshole?
Isn't it at least POSSIBLE that at least ONE PERSON wants to do something GREAT with their life? Something that MATTERS?
Dare to dream, people!
Most important is the notion from Pete Attia that it would only take some 600-700 millon dollars to do this over 12 years. I´m sure this is peanuts even when compared to what is spent today on observational studies in the nutrition field. A few months ago a recieved a big envelope in my snailmail. I was inveted to participate in a nutritional study together with 300 000 other Swedes. Just by calculating the weight of the questionarie the postage alone for sending this out to 300 000 people together with a prepaid postage envelope would be something like 6 millon Swedish crowns. Thats almost 1 million dollar.
If you add to that the cost of envelopes, the cost of printing the questionarie you are well over 1 millon dollar before the study has even started. Than all subjects enrolled in the study should have a full medical checkup and I have no idea what that cost but surely a lot more than the postage, printing and envelope costs. And the only thing we know fore sure is that a study like this will tell us nothing what so ever about cause and effect regarding diets and health. Naturally I threw the questionary in the paper recycling bin.
But sadly enoght theese huge observational studies are done all over the world, over and over agian. It doesn't make any scientifical sence but it surely make economical sence. A good performed RCT can only be used for one publication. An observational study can be recycled over and over again and generate hundreds of scientific publications. Just look at Walter Willets nurses study! And the media covering "science" love them. The researcher gets good media (equals more funding) for every publication saying coffe causes/prevents breastcancer/ovarian cancer/heart disease, acid reflux et c and when you have gone through all the correlations of hundreds of different foods and hundreds of differnt diseases after the five year follow up it is time for the ten year follow up and it starts all over again.
NuSi is badly needed and should have been started decades ago.
Paleo nutrition does not need to test foods or look at any association between disease and diet because all this has laready been done before (although some of it is still on going) by our ancestors for 100s of 1000s of years.Thanks to the modern forensic like techniques of anthropology and archaelogy we have a fair good idea of what our ancestors ate and it was natural food. There is not much money to be made on paleonutriotion (except for organic farmers and health food stores) because it is about becoming food wise, buying natural foods and get cooking. As for exercise paleo does not promote a specific regime or gym membership so again big corporations are not interested. Whenever there is money to be made everybody wants you to believe they have the key to unlock the secret. Well there is no key or secret. It is all out there in peer reviewed journals. There is little money in paleo even Boyd only managed one book and Cordain squeezed three just...but the pharma industry that looms quite prominently in and around NuSI (have a look at their board of directors and advisors) loves reductionism because it generates food fads and fobias that they can then appease offering food supplements and panaceas of all kinds. Take statins. They represent the pharma answer to our utterly insane fear of cholesterol a substance that is completely essential , to our survival it is made in our livers and yet we have been indocrinated to fear it like the plague and take meds to control it!!
We fall very easily in all sort of food traps. One truth remains and it is that what we eat affects our health. This by now should be clear.
I think many of us know that NuSI or anything like NuSI is hardly necessary. The answer to what is good for us humans to eat is in our past. Whatever we ate got us here without hospitals or chemo or meds etc so it worked. Only recently we realise our rather tasty but artifical foods and its abundace are making us sick and we need to rely so heavily on our own medical discoveries...Why o WHY do we need 12 years and 600 million to re-deiscover what we should eat.....
I am curious like everybody else to see what NuSI will do and how they will do it but I fear their findings will change very little what I eat. I certainly could not stop them even if I cared to. So good luck to them and those who will follow every NuSI release with great abandon.
"forever divided"..? That is a pretty negative attitude an din my experience people will live up (or down) to the expectation you put on them. I say "vive la difference!" but at the same item I an optimistic that we can approach a time of co-operation, compromise and co-existence as co-inhabitants of this fragile ecosystem :-)
Humans will be humans and forever divided...but really do we need NuSI or any other initiative to rediscover/reinvent the wheel?
We need NuSI because humans, being humans, will spout empty platitudes like you just did until the cows come home. But those platitudes won't tell us how to reduce morbidity. Well-designed studies will.
Paleo nutrition does not need to test foods or look at any association between disease and diet because all this has laready been done before (although some of it is still on going) by our ancestors for 100s of 1000s of years.
What a pleasant fairy tale that we know everything about how they lived, that there is no disagreement on this, that they all lived the same way in every location and at every time in humanity's past, that they were all ideally healthy, that the foods they ate still exist and their lifestyles can be re-enacted, that 8 billion+ modern humans would be willing to re-enact their lives, and, if so, that the planet will support 8 billion+ modern humans living in a pre-agricultural manner.
OMFG, such nonsense.
Thanks to the modern forensic like techniques of anthropology and archaelogy we have a fair good idea of what our ancestors ate and it was natural food.
OMFG, such nonsense. There is no agreement, and there was no single mode of existence, nor any ideally healty population. And concepts like "natural food" are useless. Joel Fuhrman thinks a wheatgrass and soy smoothie is natural food.
There is not much money to be made on paleonutriotion (except for organic farmers and health food stores)
Ah -- there's not much money to be made, except where it's one of the most lucrative scams mankind has yet conceived. Thank you, Dr. Holmes!
it is about becoming food wise, buying natural foods and get cooking.
GIBBERISH! This doesn't MEAN ANYTHING. There is NOTHING ACTIONABLE in it.
big corporations are not interested.
OMFG, good luck finding a big food corporation that ISN'T interested in "organic." We are about five minutes from the advent of Paleo Froot Loops.
Well there is no key or secret. It is all out there in peer reviewed journals.
Wait -- if there's no key or secret, what's in the journals? Is it there or not?
There is little money in paleo even Boyd only managed one book and Cordain squeezed three just...but the pharma industry that looms quite prominently in and around NuSI (have a look at their board of directors and advisors) loves reductionism because it generates food fads and fobias that they can then appease offering food supplements and panaceas of all kinds.
There is little money in it? Or there is big-time drug money in it? Which one? Are you smearing NuSI as being too stupid to know that there's no money in it, or smearing them as tools of big business? And how come you're such an expert on this thing that doesn't exist yet?
You exhaust me. But your fuzzy thinking, personal attacks, appeals to authority and evocations of a cartoon Lion King past are emblematic of discussions on diet that I hope NuSI will end.
We need data on how and what modern humans need to eat of what's available in the modern era to maximize health and limit morbidity.
We've tried all the stupid platitudes. We've listened to the PhDs building careers extrapolating from inbred rodents being force-fed rat chow. They have made us fat, diabetic, and cancerous.
It's time for some data.
No, for me this is the symbolic demonstration that NuSI will not be considered to focus on GT's publications and that they will operate open minded with as much brilliant scientists as possible regardless if they are "with Taubes or against him". Results will count.
I am very curious about the findings and wish NuSI good luck!
Modern humans as you call us live in a stone age body whether you like it or not. I am geneticist and I know that our genome has dieverged by a tiny amount from that of our paleolithic predecessors certainly not in any way enough to make us adapted to eat what we eat now and in the quantities we eat it. We are our ancestors but eat in a way that would be unrecogniseable to them.
And no we do not know EXACTLY what our ancestors ate and probably never will also because it varied with geographical location and seasons etc....But we have a damn good idea and we don't need a blank slate because a blank slate that ignored our past as an animal species is what has caused the huge dietary mess we are in in the first place.
and YES in my opinion humans are sadly divided..there is hardly consensus even within the paleo community about what constitutes paleo. We cannot even read the same papers and information and come with a consensus.
The dietary world is strewn with fad foods plucked out of thin air. Think vegetable margarines completely artificial man made stuff that we were sold as healthier than health and we all fell for it.
I am not smearing NuSI the info is there on their web site for anybody to make their minds up for themselves. I am cynical though of people motives especially business minded people. It is now ever so easy after we have shouted that there is an obesity epidemic to label everybody else as bad and onselvef as the new beacon of truth. THis is what the Ancel keys of the past have done.
I doubt strongly NuSI and its foudners and directors are any different. I actually quite like Taubes dunno about Attia
We do not need to start from scratch and build another arbitrary list of foods that make you fat and foods that don't.
Blogs are about expressing one's opinion and not necessarily to be judged according to that. I think NuSI is potential a huge hot air baloon that is there to spin money for some enterprising people who have equated the obesity epidemic to a new money making facility.
In the end whether we are obese or not we will be left to ourselves. There are no miracle cures or foods. We decide as individuals what we eat and how much, whether we prefer our rewards in short term (full stomach) or in the long term (helthier and less medication).
I remain curious but guarded. We shall wait and see....
I greately admire Taubes and anybody who goes out and tries to make things better but please allow me some ground for doubt and a wee bit of cynicism.
As I said I here waiting in the wings curious and a lttle hopeful too.
For example surprisingly (or not) a great deal of previous nutrition research was sponsored by the likes of Cocacola, Pepsy etc especially when it came to looking into the effects of sugar on health. You can imagine such research can never be completely unbiased even now that researchers must declair their affiliations and conflicts of interests. Taubes has spoken out about this.
So I am curious to see who will NuSI accept funding from for this myth debunking research.
I am curious about everything it is all in the making I know...I jsut come with a huge baggage of scepticism sorry that is all and this can be good in science. Have you seen NuSI's motto taken from Einstein I believe...I quite like that!
We jsut have to wait and see...
I don't assume anything is doomed to failure before it has even gotten off the ground yet... especially when it is driven by people who I respect as having high ideals, while being well aware and well motivated to avoid just the very pitfalls that you are so concerned about.
Let's give NuSI a cautiously optimistic chance to succeed... for all our sakes!
I never wished or thought NuSI failure you are using this word for the first time.
In fact I think NuSI will succeed whatever its goals are. These and the means it will use I am curious about.
I remain with my doubts and sceptcism....
Hopefully we can all agree that scientific understanding of human nutrition is incomplete. Although we currently lack the experimental science to give us black-and-white answers about every important aspect of human nutrition, we still need to make dietary choices in real life and I think it's desirable to base those choices on some kind of rational principles. I regard the central principle of the paleo diet as a rational one: that a person is likely to do well on a diet that provides a balance of nutrients, but which consists primarily of foods eaten by his or her ancestors over a very long period of time (long enough for evolutionary adaptation to have taken place). Ok, in practice that requires some guesswork since we're not sure what everyone ate throughout history, and the result of that guesswork won't be optimal, but in the presence of considerable uncertainty it seems like a very practical starting point.
Well, to be fair, there is at least some agreement about what was eaten by some of our ancestors at certain times. Archaeologists and anthropologists really have used some incredibly ingenious methods (which I think one could call "forensic-like") to obtain reasonably convincing evidence about what some of our ancestors ate. Obviously, we only catch a glimpse here and a glimpse there of our ancestors' large variety of diets, but I believe these glimpses can provide some insight into our degree of evolutionary adaptation to certain modern day foods. To take a hypothetical example, given evidence that some particularly tasty food was widely eaten by humans in many parts of the planet for millions of years - and given no compelling modern day evidence that it's harmful - I would be content to eat it, provided of course that it didn't actually make me feel sick or anything. If I was better informed, perhaps I could provide a concrete example.
I'm sure there are lots of people out there trying to make a fast buck from paleo. However, I eat a paleo-ish diet, and I really don't think anybody is making much money from me eating it. I suppose there are farmers, butchers, greengrocers, etc that benefit from my choice, but they're really just providing good quality food at a fair price - I don't feel that I'm paying a "paleo premium".
If "Froot Loops" are what I think they are (some kind of breakfast cereal?), then I really don't think it matters whether someone puts the word "paleo" in front of them or not - they won't ever be paleo!
Agreed, but since it will be a long time before all of the important questions are definitively answered, I want a rational basis upon which I can make dietary choices in the meantime. The principle of paleo seems like a good starting point to me, although hopefully I remain open to persuasion.
Your main problem for the "insulin hypothesis" is the classic question of why Asians aren't fat from living on rice. Here he gives you the answer - a quick trip to Google does indeed suggest that the Chinese don't have the FTO SNPs for insulin resistance or diabetes that Westerners do:
"Our data do not support that the FTO common variants are major contributors of obesity or type 2 diabetes in the Chinese Han population."
http://www.ncbi.nlm.nih.gov/pubmed/17959933
Based on their genetics, rice doesn't hurt them - whereas it can be highly problematic for a very large number of Westerners. So the next time someone throws the Kitavans at you, you have a scientific answer - check out the FTO SNPs. But you all refuse to see any problems in your Taubes worship, so you reject any science, even if it makes your case stronger!
Amazing. Why have low-carbers never discussed this FTO issue before? I'd never heard of it, but it definitely is a good argument for your side.
On a related point, I'm sure I'm not the only one whose interest in diet and nutrition goes far beyond obesity and weight loss. Of course, understanding obesity (and what caused the recent dramatic increase in it) seems likely to be a very important part of the puzzle, but the anecdotal evidence of many low-carb enthusiasts suggests more wide-ranging benefits than just weight management. Assuming one considers the wider health implications, even finding cast-iron genetic markers for obesity doesn't leave people without those markers in the clear. For (a bit of a shaky) example, let's imagine for a moment that those genetic markers are associated with obesity not because they make metabolic dysfunction more likely, but rather because they make metabolic dysfunction more likely to manifest itself as obesity. You know what I mean?
And instead of looking for rigorous evidence, people think it sufficient to mouth empty tautologies and platitudes like "just eat real food" and "eat naturally". Of course, when one points out that they're begging the question (what makes a food 'real', and how can you prove that its 'reality' is actually better for you?), they just claim one's sold out to The Man. At this stage, "Paleo" seems to have devolved into little more than soothing mood-music and empty slogans.
I think I've had just about enough of the self-serving fantasy fairy-tales that paleo folk tell themselves to justify their desires to eat ever more "natural" starch and "natural" fructose and "lean" protein. Their arugments are based on the naturalistic fallacy, and can be as profoundly anti-science as the most medieval of religions.
I much prefer products of the Enlightenment like NuSI than "fauvist" paleo fantasists. I wish Gary and Peter the best of luck!
Here is a relatively new paper on estimating the diets from hunter-gatherer populations.
"Diets of modern hunter-gatherers vary substantially in their carbohydrate content depending on ecoenvironments: results from an ethnographic analysis."
http://www.ncbi.nlm.nih.gov/pubmed/21745624
It is appealing Strohle and Hahn give statistical estimates--range, median, mode, and mean-- of carbohydrate intake in 229 H/Ger diets, and it highlights patterns of carb intake with latitude. I also like it because the authors mention (Table 6) the discordance between international governmental recommendations for higher carbohydrate intake compared with much lower hunter-gatherer carbohydrate intake, on average.