Nutrition

A man sees what he wants to see…

Published 7.16.2017
As I sometimes do, what follows is a collection of links I've found in recent (and in this case, not so recent) readings online.

Aseem Malhotra wrote a book after visiting one of the Blue Zones (Pioppi). Malhotra, a cardiologist, is a frequent target here for his dangerous babbling against regular exercise for weight loss, though he himself goes to the gym regularly. Malhotra is team LCHF (low carb high fat), and clearly wants to the be the “bad boy” heart doc who tells you shove fat down your gob and don’t worry about exercise. This review correctly points out that AM shoves everything through a LCHF funnel, no matter the evidence.

Pioppi is at the very centre of the nutritional orthodoxy. Not only did Ancel Keys live there for many years, but it is recognised [sic] by UNESCO as the home of the Mediterranean Diet. In a sense, The Pioppi Diet is an attempt to erase the legacy of Keys and reclaim the village for the one true faith of LCHF. Keys attributed the Pioppi residents’ low rates of heart disease to the relative scarcity of saturated fat in the Mediterranean diet, but as far as Malhotra and O’Neill are concerned, saturated fat has been exonerated and their job is to discover what is really going on there.

In that age old LCHF tradition, Malhotra and his coauthor cite a lot of research, but misstate what the cited research shows. Gary Taubes and Nina Teichholz are both rightly infamous for doing this. It seems to be the LCHF way.

It soon becomes clear that The Pioppi Diet is not a serious review of the evidence. It provides a distorted and superficial account of a tiny fraction of the evidence. It does not really attempt to overturn the scientific consensus, it simply ignores it. Meanwhile, it devotes page after page to a handful of low carb activists who are portrayed as world-leading authorities, such as Zoe Harcombe, Tim Noakes, Nina Teicholz, Jason Fung and Robert Lustig. While all these people have books to sell, Malhotra and O’Neill accuse ‘many scientists and doctors’, as well as the media, of being ‘under the financial influence of the food and pharmaceutical industry’. This, we are told, is why they ‘disseminate selected, biased and outdated information’. When your best evidence is a single study from 1956 which has never been replicated, this is a bit rich.

Residents of Pioppi (as all the Blue Zones) do not exercise. They are simply not sedentary and tend to have jobs that require manual labor. Do they eat a LCHF diet? No. No, they do not. At least the doctor is forced to admit that becoming physically active can lead to weight loss. This is huge admission for Malhotra, who, along with diet doctor Yoni Freedhoff, likes to downplay the importance of exercise as part of losing weight.

Do you know what the people of Pioppi actually eat? Processed carbohydrates. Farm workers in rural Italy do not – could not – survive on a diet of fish and seasonal vegetables. Pasta is as central to the Italian diet as potatoes are to Britain’s. So too is bread. This is the elephant in the room for anyone trying to pretend that Italians eat a low carb diet. As a 94 year old Pioppi resident said last year: ‘Pasta is my favourite [sic] food. I don’t understand why so many people try to cut that and bread out of their diets – it is like medicine for the heart and it is silly not to eat it.’

The reality is that people can eat anything, and that carbs are a fine source of calories. Ingesting excess calories habitually is a recent human development. In general, ancestral communities had no excess food, so people couldn’t get fat even if that would be their natural inclination. Now of course, all someone needs to do is reach across the table and open the bag of chips.

Dairy farmers really don’t like plant milks. But for once I agree with Marion Nestle without provisos. This issue is about marketing. No one gets confused between cow’s milk and plant milks. Let them fight it out. The US department of agriculture (USDA) is mostly interested in soymilk because it wants to help the "Big Ag" soy farmers.

A fascinating look at the liver, an organ I know relatively little about. If the heart, lungs or kidneys fail there are mechanical means to provide the functions. But if the liver fails, all you have is a transplant. The liver will repair itself though, which means that donors can give a portion of their liver— theirs recovers, I don’t know how that works in the receiving body.

Protect your liver!

And while scientists admit it hardly seems possible, the closer they look, the longer the liver’s inventory of talents and tasks becomes.

In one recent study, researchers were astonished to discover that the liver grows and shrinks by up to 40 percent every 24 hours, while the organs around it barely budge.Others have found that signals from the liver may help dictate our dietary choices, particularly our cravings for sweets, like a ripe peach or a tall glass of Newman’s Own Virgin Limeade — which our local supermarket chain has, to our personal devastation, suddenly stopped selling, so please, liver, get a grip.

Scientists have also discovered that hepatocytes, the metabolically active cells that constitute 80 percent of the liver, possess traits not seen in any other normal cells of the body. For example, whereas most cells have two sets of chromosomes — two sets of genetic instructions on how a cell should behave — hepatocytes can enfold and deftly manipulate up to eight sets of chromosomes, and all without falling apart or turning cancerous.

Everything that comes in through your mouth goes through the liver before the body can use it. The blood vessels of the liver leak, and the hepatocytes (liver cells) are covered in villi that swim in the blood and interact with what’s floating there.

The liver also keeps track of time. In a recent issue of the journal Cell, Ulrich Schibler of the University of Geneva and his colleagues described their studies of the oscillating liver, and how it swells and shrinks each day, depending on an animal’s normal circadian rhythms and feeding schedule.

Are chopsticks the reason obesity is much less of a problem in Japan? While it’s true that people (especially westerners unfamiliar with them) eat slower using chopsticks than when using forks, I think social pressure has more to do with it. There is still a stigma to being fat in Japan, though there are those making the health at every size (HAES), fat body positive (FaBoPo) arguments.

Physical activity helps kids get leaner while improving classroom performance. Calorie intake did not change, nor should it. Growing kids should not be restricting calories. I don’t think the leaner part has anything to do with the performance, I think the movement does.

Kids who moved more lost visceral fat, which is the type that deposits around the organs. However, I think it’s a stretch to say that’s the cause of the better performance. I think getting a break from focusing on schoolwork for 70 minutes a day allowed them to focus better when they went back to it. One of the best things about homeschooling was that I could allow my son the time he needed between subjects to move around and decompress.

When dad are involved kids tend to be leaner.

Children of dads who more frequently performed caregiving tasks, such as helping them to brush their teeth, get dressed, or go to bed, were 33% less likely to be obese at ages 2-4 (OR 0.67, 95% CI 0.52 to 0.88, P<0.05), reported Michelle Wong, a doctoral student at the Johns Hopkins School of Public Health in Baltimore, and colleagues.

Every one-category increase in the frequency fathers took their kids out for walks or play reduced their obesity risk by 30% (OR 0.70, 95% CI 0.5 to 0.97, P<0.05), Wong's group reported online in Obesity.

There are a lot of speculative reasons as to why this might be. The study asked about dad’s preparing food, and all the information is self-reported. Possibilities that occur to me (Note: speculation ahead) include increased household income and stability, meaning that better food is eaten because better food can be afforded. Kids are more active because there are two parents involved. It’s hard to go out and play with your kids when you’re busy doing 100% of the cooking, cleaning, wage earning etc. Parenting alone is much harder than parenting with a partner, that much can be said with certainty. Having a second pair of hands means that responsibilities can be shared. The word partner in that sentence implies that the relationship is a positive one.