The WHEAT of the Nation

Weight of the Nation

I just saw the first episode of the much talked about HBO program Weight of the Nation, about the American obesity crisis. As you’ve probably heard they take an utterly conventional approach. When it comes to causes of this disaster all we’re hearing is the same old failed talk about too much food, fat and calories in – and not enough exercise.

Is that tired advice going to fail less badly today than it has failed us during the entire obesity epidemic? Doing the same thing over and over and expecting a different result is, as Einstein’s famous quote goes, insanity.

But what really blows me away is the title graphics, pictured above. When wheat (starch!) is considered an icon of health, is it any wonder that the massive weight of the nation is increasing every year?

The producers should be sent a copy of Wheat Belly.

18 comments

  1. Dr. Eenfeldt I had reservations about this documentary as well. There was a lot of glaring things that seemed odd especially an experiment they showed of a lady eating more calories from fatty fast food. She was quick to point out all the fat and calories in fast food...but not the carbohydrates! I wrote a little bit of my own critiques on it here for anyone who is interested:

    http://thefatnurse.wordpress.com/2012/05/16/hbo-documentary-the-weigh...

    However, it did have some good points such as talking about sugar and showing how corn subsidies created this vast amount of processed carboy food that we have now. they even touched on insulin resistance a little bit.

  2. I actually liked the discussion about the farm bill and incentives for the larger farms to mass produce unhealthy foods like corn and sugars. This leaves out some of the small mom and pop farmers from competing. However, wheat production is glaringly missing here and throughout the movie. I guess they cant attack their holy "healthy whole grains"! - Jeff Gerber MD
  3. moreporkplease
    I was appalled to read an article today about fatty liver disease: apparently now 30% of all Americans are suffering from some stage of NAFLD, as well as 10% of teens (http://abcnews.go.com/Health/Diet/fatty-liver-teens/story?id=16374773#.T7iMSXlYv3o). Doctors now report seeing it in 9 year olds!

    I had never heard of NAFLD, I thought fatty liver was only for alcoholics. But now it's another epidemic; it may be worse than Dr. Lustig's warning in Bitter Truth - the liver problems he alludes to there are apparently already here in many more people than previously estimated.

    How to treat NAFLD? You guessed it:

    Alterations in hepatic glucose and energy metabolism as a result of calorie and carbohydrate restriction
    Jeffrey D. Browning, Brian Weis, Jeannie Davis, Santhosh Satapati, Matthew Merritt, Craig R. Malloy, Shawn C. Burgess
    Article first published online: 9 OCT 2008
    DOI: 10.1002/hep.22504
    http://onlinelibrary.wiley.com/doi/10.1002/hep.22504/full#bib7

    An amusing thing about this small study is that the low-carb group lost 2x as much weight as the low-fat people, which messed up the researchers variables a bit; they complain about it a bit in the paper:

    "Every attempt was made to equalize caloric intake between the two dietary restriction groups. However, a trend was noted toward decreased caloric intake in the group undergoing carbohydrate restriction (Table 2). It is possible that the differences observed between these two groups are solely the result of differences in caloric intake and weight loss."

    Oh sniffle. :)

  4. I actually think this film is a very ambitious attempt to explain to the public the main causes, consequences and seriousness of obesity. In my opinion we should respect this huge effort made by the CDC and NIH, we should support it and help them spread the message.

    Although over consumption of sugar and refined carbohydrates may have contributed to the obesity epidemic and although LCHF may be very effective for many to lose weight, the problem of obesity is much more complicated. Although we may continue to debate whether a calorie is a calorie or not, we should combine our efforts and join forces in the fight against obesity.

    Some say that carbohydrates are the problem, other say that fat is the problem. Well it is obvious that if we eat to much of both those macronutrients we will have a problem. If we cut down seriously on carbs we will lose weight. The same thing will happen if we cut down seriously on fat consumption. If we cut down on both we will lose weight. Moderation will always be successful. To teach people to chose healthy foods and recognize it is of central importance, no matter whether it is fat or carbohydrate.

    I know there is an ongoing tug of war between the LCHF followers and those who support the more traditional nutritional views http://healthandnutritionmd.com/health-and-nutrition-blog/the-war-of-...

    So, although most of the people who visit this site support LCHF and believe it is the right way to go, I find it a bit arrogant to negatively judge the huge effort by the NIH and CDC or see it as a failure because it is not always in line with the concepts of the LCHF theoretics.

  5. Alexandra M
    Axel F - What a load of crap.

    "...help them spread the message."

    Help them spread the message? What message? The message they've been spreading for the last 30 years? "The message to avoid fat and to eat more carbohydrates? Do you think the problem is that the "message" has not got out?

    "Some say that carbohydrates are the problem, other say that fat is the problem. Well it is obvious that if we eat to much of both those macronutrients we will have a problem. "

    No, it is NOT obvious at all. It's only obvious in the same way that it's "obvious" that the sun goes around the earth.

    "I find it a bit arrogant to negatively judge the huge effort by the NIH and CDC or see it as a failure because it is not always in line with the concepts of the LCHF theoretics."

    The efforts of the NIH and CDC are judged negatively because they are NOT supported by science. It's the NIH/CDC/USDA recommendations that are"theoretics," in other words, ideas that are NOT supported by evidence.

    Don't you ever read anything?

  6. What I found really interesting about the HBO series was that they kept talking about the huge cost of the obesity epidemic to the nation (some $160 billion plus) as if that money is just flowing down some black hole. It's not. It's flowing to Wall Street. And as long as that's the case, there will be an enormous effort to keep the money flowing. In reality, the total money flow associated with the obesity of our nation probably tops a trillion dollars by the time one adds in the profits from the food industries. LCHF is a threat to that cash flow. Low fat/ high carb keeps the money flowing.
  7. Justin B
    @Alexandra M,
    Ha! I was just about to write nearly the exact same thing after reading Axel's post. People like to disregard that science has been conducted about this issue. The only people I could ever see "teaming up with" are paleo and maybe raw vegans, because they tend to eliminate processed grains and sugar as well. I don't think either group really wants to team up with us though.
  8. Cathy N
    Cate: Your comment hit the nail on the head. Spot on!
  9. PJ
    @ Axel F . . . Wow, if everyone followed your conventional midline advice we should all be healthy and trim. I think you have COMPLETELY missed the fact that we didn't have this obesity/health problem 50 years ago. What changed? Did we suddenly forget how to eat in moderation? We suddenly became lazy overeaters? Obesity is not that complicated on a large scale basis; it is only the individual that may have more complicated issues. If we kept government out of our kitchens, we wouldn't have this problem to begin with.

    Who do you work for? HBO? USDA?

    Drives me absolutely crazy when people promote "everything in moderation"!!!

  10. I watched episode two last night and it was not as good as episode one, in my opinion. There was too much about counting calories and a calorie is a calorie etc. I was upset to see the grossly obess people interviewed - just so sad to see the lives of these people so ruined.

    I will watch the next two episode mainly because of the educational aspect but I don't see much coming out about grains and carbs!

  11. @Alexandra M... LCHF is not the only dietary approach supported by science. For example the scientific evidence supporting the beneficial effects of the DASH diet and the Mediterranean diet is very strong. Those are not LCHF diets. Don´t misunderstand me. I find LCHF to be very useful for many individuals who have to lose wight and I do not doubt the positive effects of LCHF on the metabolic syndrome. You might not believe me, however, but I have seen people lose weight by eating less and exercise more. Sounds conventional and simple, but true anyway. There are many different ways, you see, and LCHF is not the only right way to for for everybody. If it is a religion in your case, so be it. I know I am not about to change that.

    @PJ...it is a pity that you don´t like moderation. Many people don´t. Maybe that´s one of the causes behind the obesity epidemic.

    Well. I guess I´m pushing the wrong buttons again..

  12. PJ
    @ Axel F Yup! You still completely missed the point . . . AGAIN. But, I did understand your completely condescending attitude. I never said I didn't LIKE moderation; I said it drives me crazy that some people believe that is the holy solution to the epidemic we are experiencing. BTW, no one has ever said that LCHF is the only solution to weight issues. We are saying that it is certainly a way of life that works for a lot of people and if one is having health/weight issues, it would certainly be something one could try. After all, millions of people can't be wrong.

    I, too, have seen people eat less and excercise more and lose a lot of weight. Duh! What many of us are saying is that it is not the solution to the obesity problem we have in this world because it DOES NOT WORK FOR EVERYONE. Ah, wouldn't it be wonderful if there were a one size fits all solution?

    I noticed you told Alexandra you find "LCHF to be very useful for many individuals who have to lose wight and I do not doubt the positive effects of LCHF on the metabolic syndrome." Well, I would hazard a guess that an obese person probably has metabolic syndrome. So what's your argument?

  13. Maggan A
    Axel F

    "but I have seen people lose weight by eating less and exercise more"

    Fantastic! what planet did you say you came from?

  14. Alexandra M
    LCHF is not the only dietary approach supported by science.

    Umm. Yeah, it is.

    "...beneficial effects of the DASH diet and the Mediterranean diet is very strong..."

    Okay, can we have some links to papers in peer-reviewed journals? And NOT papers based on observational studies?

    "I, too, have seen people eat less and excercise more and lose a lot of weight."

    It IS possible - but highly unlikely. The failure rate for conventional diets is something like 95%. If you have evidence of a large number of people practicing restriction of calories and exercising and losing "a lot of weight" you should post the links here because that would be useful information to have.

  15. NS
    How arrogant and limited you are. LCHF is the O-N-L-Y diet 'supported by science,' eh? No other diet can work because they lack what you have arbitrarily concluded to be reasonable evidence. Tell that to those morbidly obese rice-eating Asians; tell that to all the people who have lost weight, kept it off, and are happy on paleo, raw, Furman, Ornish, Weight Watchers, Mediterranean, etc...Hey guys, even though you've been successful, your efforts are not scientific! Even though you've reversed your heart-disease and cancer, it's not real! Show me the peer-reviewed papers! And last I checked, calorie-restriction, regardless of macro-nutrient content, still results in weight loss, and so does starvation, but perhaps we need a peer-reviewed paper to remind us of that.

    Incidentally, "science" is nothing more than observations - your favorite target of derision - whose conclusions are validated through repetition; that's it. The conclusions, notwithstanding your zealotry, change over time as new and different observations occur. LCHF's contributions are important and meaningful. But the debate will continue and so will the science. In asking for studies from Axel, you demonstrate the same tunnel vision Atkins critics used when they cried for the same thing from him. History indeed repeats itself.

    LCHF is one option that works. And this blog is great to get that word out. But it is not the only way.

    I wonder how far Dr. E will allow the fanaticism to go here.

  16. Alexandra M
    "You know, the exact same advice that has failed us through the entire obesity epidemic. The same advice that repeatedly (at least 17 times so far) turns out to be the least effective when actually subjected to scientific tests. In a word, crap advice. You guessed it: it’s all about desperately trying to ignore your hunger, counting your calories and eating “balanced diets”. And a balanced diet is as usual defined seemingly without a shred of science involved. A balanced diet is basically what the “experts” believe that you should eat." - Dr. Eenfeldt*

    "...tell that to all the people who have lost weight, kept it off, and are happy on paleo, raw, Furman [it's Fuhrman, not Furman], Ornish, Weight Watchers, Mediterranean, etc."

    Lost weight? Maybe. Kept it off? Highly unlikely. Even Weight Watchers has a 90%+ failure rate, and of the 10% who manage to lose substantial weight, only a tiny fraction manage to keep it off for more than five years. And lastly, happy? Far from it. As Dr. Eenfeldt said, these diets are about "desperately trying to ignore your hunger." Not a formula for happiness AFAIC. For a diet to "work," it must be sustainable. Incessant hunger is not.

    I know it's heresy, but I don't draw a bright line between LCHF and paleo - they are (as I understand them) more similar to each other than they are similar to the standard "western" diet.

    "The conclusions, notwithstanding your zealotry, change over time as new and different observations occur."

    It all depends on whether the conclusions were right or not, doesn't it? Or are we off into postmodern-land where there is no truth and everything is contextualized social construct?

    *See the doctors latest post today.

  17. @Alexandra M... This was your request yesterday:

    "Okay, can we have some links to papers in peer-reviewed journals? And NOT papers based on observational studies?"

    I will start with the Mediterranean diet. Here are four references per request. The links are provided so you can start reading right away. These are from two of the most respected peer - reviewed journals in the medical community, NEJM and JAMA. They are not observational studies.

    I´m happy to provide you with more data if you wish.

    Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates
    Frank M. Sacks, M.D., George A. Bray, M.D., Vincent J. Carey, Ph.D., Steven R. Smith, M.D., Donna H. Ryan, M.D., Stephen D. Anton, Ph.D., Katherine McManus, M.S., R.D., Catherine M. Champagne, Ph.D., Louise M. Bishop, M.S., R.D., Nancy Laranjo, B.A., Meryl S. Leboff, M.D., Jennifer C. Rood, Ph.D., Lilian de Jonge, Ph.D., Frank L. Greenway, M.D., Catherine M. Loria, Ph.D., Eva Obarzanek, Ph.D., and Donald A. Williamson, Ph.D.
    N Engl J Med 2009; 360:859-873February 26, 2009
    http://www.nejm.org/doi/full/10.1056/NEJMoa0804748

    Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet
    Iris Shai, R.D., Ph.D., Dan Schwarzfuchs, M.D., Yaakov Henkin, M.D., Danit R. Shahar, R.D., Ph.D., Shula Witkow, R.D., M.P.H., Ilana Greenberg, R.D., M.P.H., Rachel Golan, R.D., M.P.H., Drora Fraser, Ph.D., Arkady Bolotin, Ph.D., Hilel Vardi, M.Sc., Osnat Tangi-Rozental, B.A., Rachel Zuk-Ramot, R.N., Benjamin Sarusi, M.Sc., Dov Brickner, M.D., Ziva Schwartz, M.D., Einat Sheiner, M.D., Rachel Marko, M.Sc., Esther Katorza, M.Sc., Joachim Thiery, M.D., Georg Martin Fiedler, M.D., Matthias Blüher, M.D., Michael Stumvoll, M.D., and Meir J. Stampfer, M.D., Dr.P.H. for the Dietary Intervention Randomized Controlled Trial (DIRECT) Group
    N Engl J Med 2008; 359:229-241July 17, 2008
    http://www.nejm.org/doi/full/10.1056/NEJMoa0708681

    Mediterranean Diet, Lifestyle Factors, and 10-Year Mortality in Elderly European Men and Women
    The HALE Project FREE
    Kim T. B. Knoops, MSc; Lisette C. P. G. M. de Groot, PhD; Daan Kromhout, PhD; Anne-Elisabeth Perrin, MD, MSc; Olga Moreiras-Varela, PhD; Alessandro Menotti, MD, PhD; Wija A. van Staveren, PhD
    JAMA. 2004;292(12):1433-1439.
    http://jama.jamanetwork.com/article.aspx?articleid=199485

    Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome
    A Randomized Trial FREE
    Katherine Esposito, MD; Raffaele Marfella, MD, PhD; Miryam Ciotola, MD; Carmen Di Palo, MD; Francesco Giugliano, MD; Giovanni Giugliano, MD; Massimo D'Armiento, MD; Francesco D'Andrea, MD; Dario Giugliano, MD, PhD
    JAMA. 2004;292(12):1440-1446.
    http://jama.jamanetwork.com/article.aspx?articleid=199488

  18. Alexandra M
    I'll respond to this, but I've got a big project going on at the moment. As soon as that's done, I'll look at the papers and respond - though I think I already described how my husband and I each gained 50 pounds on the "Mediterranean diet."

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