Sorry food fascists, nutrition is not the key to health

Pretty Woman makes a choice between bad food

There are seemingly a million different dietary prescriptions for health and they’re all based on a fundamental misapprehension. In contrast to popular belief, nutrition is NOT the key to health.

You’d never know that to look at the food fascists among us. They insist that they can control their health through diet, though the specific diet differs dramatically from faddist to faddist, conjuring ideal values of protein, carbohydrate, fat and supplement intake essentially from thin air.

The rise of heart disease and cancer as major causes of death is the inevitable result of being healthier than ever.

Pretending that nutrition is the key to health makes about as much sense as pretending that the reason your car eventually stops working is because you didn’t use the right gas. Fuel can’t prevent the effects of wear and tear or accidents.

Similarly, food is fuel and it can’t prevent the effects of wear and tear on our bodies, either. It is only magical thinking that leads some people to believe that it can.

Why would anyone think that nutrition was the key to health?

Most people are ignorant of what life in general and diet in particular was like in prehistoric times. As I explained in the recent post Paleo-suckered, many imagine that the Paleolithic Era was a time of human flourishing, a literal Garden of Eden. That’s certainly the central premise of the Paleo-diet: in contrast to Americans, our Paleolithic ancestors were purportedly healthy and if we copy their diet we could be healthy, too.

It’s hard to imagine anything further from the truth. We are the ones who are healthy; they were scraping along and barely surviving. Had human beings not developed technology, they might have become extinct just like every other hominid species that has ever existed. There is not a single health parameter that was better in Paleolithic times than today. In every possible way that you can measure health, we are exponentially healthier than at any other time in human history.

So why do we think that we are not healthy now?

Let’s look at causes of death in the Paleolithic:

Starvation
Infection
Childbirth
Accidents/Violence
Cancer
Heart Disease

Cancer and heart disease killed relatively few people because they’re diseases of wear and tear, far more common in old age than in youth or early adulthood. Very few people lived long enough to get them.

Let’s look at common causes of disease in our country today:

Starvation
Childhood Infections
Childbirth
Accidents/Violence
Cancer
Heart Disease

Starvation, childhood infection and deaths in childbirth have dramatically decreased to the point that they represent only a small fraction of deaths. Not surprisingly, accidents/violence and the diseases of old age kill a larger proportion of the population than ever before.

This chart illustrates the 10 leading causes of death by age group in the US:

image

Cancer and heart disease are primarily diseases of old age. As the average lifespan approaches 80 years, the majority of deaths are obviously going to be diseases of old age.

A key point that many people forget is that everyone dies. It didn’t have to be this way. Bacteria are essentially immortal. Unless they’re eaten, they will continue to split into daughter cells forever. As higher organisms evolved, finite life expectancy evolved with it. Although we often say that people die of “old age,” they die of wear and tear on critical organs like the brain and heart.

You can’t prevent wear and tear in a car, but if you treat it poorly you can make it worse. However, there is no way that you can prevent wear and tear by changing the formulation of the gas that you put in the car. Similarly, you can’t prevent wear and tear in the human body (yet), but you can make it worse. Obesity increases the wear and tear on the heart. Certain behaviors (tanning, smoking) dramatically increases the wear and tear on the skin and lungs respectively, leading to skin cancer and lung cancer. But there is no reason to believe that changing what you eat will prevent natural wear and tear.

Human beings have never been healthier than we are today. That heart disease and cancer (diseases of wear and tear) are the major causes of death is the inevitable result of being HEALTHIER. Unless we find a way to live forever, cancer and heart disease will continue to represent a growing proportion of deaths.

Could we be healthier still?

It’s possible, but we will die nonetheless; the only difference is that we might be older at the time of death. There is NO WAY to completely prevent wear and tear, and it is wear and tear that kills us.

Avoiding obesity can reduce wear and tear on the heart and avoiding certain behaviors can reduce the wear and tear that leads to cancer, but there’s no reason to think that food has a greater impact on health beyond reducing obesity.

Nutrition is not the key to health and never has been; it is only wishful thinking that makes people believe otherwise.

  • LM

    I cannot believe you get away with posting this garbage. We are not the healthiest we’ve ever been. The CDC estimates 1/3rd of all Americans will have Type II diabetes by 2050… a highly preventable disease using diet and lifestyle. This is the first generation of kids that will live shorter lives than their parents. Tell me, dear Amy, why cancer incidence rates continue to rise?

    We are almost at the bottom in terms of life expectancy in the US compared to similar industrialized countries and where American diet and lifestyle so goes chronic disease (China, Japan, Mexico, etc.).

    Don’t start using the Paleo diet as the only argument for nutrition and health. The CDC readily admits diet and lifestyle are the primary contributors to chronic disease and chronic inflammation is now an accepted hypothesis for why chronic disease is so ubiquitous. Plant antioxidants show potential for protecting cellular health, mitochondria, preventing angiogenesis in terms of cancer prevention, protecting skin cells against UV damage, making the arteries more flexible to prevent against heart disease and clot formation, etc.

    What about Omega-3s, turmeric and ginger for calming inflammation and pain in arthritis? Or herbs such as calendula which show, in reputable scientific studies, to help initiate skin healing during injury? I have reminded you in multiple posts about the number of pharmaceuticals with plant origins. And NIH has funded studies on turkey tail mushrooms and breast cancer with promising results.

    Why in heavens name should an OB/GYN with NO nutrition education be giving education on the values of food and disease prevention???? You came from the era where food was for fuel only and caloric intake was the only metric used to value a food item (a very 1980s mentality). Food matters, Amy. I’m sorry you’re so blind-sided by modern medicine dogma you can’t see that.

    • Laura J

      I keep asking myself the same question. You are on the right path. We are not as healthy as we are today. That’s a whole other topic to cover. Gotta keep up on new trends and studies that indicate that foods are healing. I haven’t drank a soda in 5 years, nor eat foods with high fructose corn syrup and read every single label on the foods to catch the hidden additives in disguise. I love my OBGYN. She’s young and keeps up to date on new trends so she can implement them. She is someone I’d invite to my house because she is personable, funny, light of heart, and loves her job and patients.
      Turmeric & ginger are the one spices I use on everything. Got a cold? Just add shredded raw ginger & lemon to your tea, works everytime.
      My sister in law uses turkey tail mishrooms; she makes a tincture and this is a great new study that is just getting started. My husband makes Dit Jow (tincture for injuries)
      If you could find more rewarding stuff to do with your life, AMY than to sabotage others when you have a public blog. Then you have the nerve to ask me who I’d want as president? Whoever wins and I could care less, going to keep on doing what I do best, love my family! Enjoy the cool breezes, the colors of fall on the mountains. Keep off the beaten path and enjoy life.

      • Nick Sanders

        Got a cold? Just add shredded raw ginger & lemon to your tea, works everytime.

        You’ll be better in a week or 10 days!

  • Mariana

    OT, but I trust this group to give me a sound answer. Is there enough isoflavone in tofu (and soy based drinks) to mess up with a man’s (or boy’s) hormones? I’m a woman and I cook with tofu for my family once a week. My kids and I like the flavour, it’s easy to prepare and cheap. We eat about a block a week. I use half the block in one meal and eat the rest myself with salad at work. My kids paediatrician said it’s fine (my daughter is five, my son is 3), but my nutritionist (I’m trying to lose weight) said it’s not good for little boys, because of the Isoflavone. She also said it’s ok if the boy is slim, but not if he is chubby, it woul give him “man boobs”. I’m skeptical about this… If there was so much isoflavone in tofu, wouldn’t it be a problem for both men and women? Can anyone help me make sense of it?

  • Amy Tuteur, MD
  • mabelcruet

    My personal view on diet-I’m a pathologist, the person who looks at your diseased and cancerous bowels under the microscope.

    Its a shame that food is essential for life, because we totally screw ourselves up with it by emotionally investing in it so heavily. Its become an emotional support when upset, a celebration when happy, a diversion when bored, a friend when lonely. Instead of accepting it as a necessary fuel, and maybe as a something that enhances your life around the edges a bit (meeting friends can be that bit nicer with some good grub, a picnic in the park enjoying the fresh air and sunshine is a lovely day out), we’ve turned it into something it absolutely is not, all by magical thinking.

    A broad based diet, with enough protein, enough vitamins, enough energy to keep you going, enough fibre-that’s all we need. Whether you get your protein from animals or other sources is your own choice-the body doesn’t care where the amino acids actually come from as long as it gets the right ones in the right amounts. Enough calories so we don’t waste away, not too much so we don’t get fat-maintain a middle ground. But, when it comes down to it, its your body, do what you want it. If you want to eat butter, cheese by the pound and whipped cream pastries every day-fine, go ahead, but don’t start screaming about doctors being useless when you have your coronary artery bypass, peripheral vascular disease and diabetes at age 40. Take responsibility for your own health. That means thinking about what is important to you and do something about it yourself-modern medicine can’t make make all things possible, but alternative medicine, and that includes nutritionists, sure as hell won’t either.

    • Mattie

      I mean, I’m all about eating sensibly (I don’t eat especially ‘healthy’ but I do eat a varied diet, with fruit and veg, and not that much ‘junk’) but do you not think food should be enjoyable? It’s like that old saying, do you eat to live or live to eat. I definitely live to eat, I love cooking, and I love eating. I hope that when I have children that they love eating too. So many of these fad diets suck the fun out of food, of cooking, of licking the bowl or dribbling chocolate sauce into your mouth when there’s leftovers. There are so few easily accessed pleasures in life, make and eat good food 🙂

      • The Computer Ate My Nym

        This is totally rank speculation here, but I wonder if stressing too much about what you eat/what your weight is/etc doesn’t increase the risk of poor health outcomes. Stress increases endogenous cortocosteroids, which increase blood sugar and have other potentially unpleasant long term effects. Maybe the average person is better off being 10 pounds overweight, licking the bowl, and eating the occasional steak than obsessing about grains, carbs, fat, sugar, etc. (Unless playing the game “how can I make a tasty brownie without wheat?” is amusing.)

        • Monkey Professor for a Head

          I can make tasty gluten free brownies, but I make no claims for them being healthy!

          • guest

            Similarly, I make a great meatless chili, but I make it because it tastes great, not because I claim soy protein crumbles are somehow better for you than other ways of making chili. (And it surprises the hell out of me that this is my favorite chili recipe – I’m not a vegetarian.)

        • fiftyfifty1

          “Maybe the average person is better off being 10 pounds overweight, licking the bowl, and eating the occasional steak than obsessing about grains, carbs, fat, sugar,”

          This is without a doubt true. Especially because obsessing about nutrition is sad. We have all sorts of brainpower and we (especially women) waste it all on shaming ourselves over dessert or snack foods rather than using it on our passions and talents. The other reason is because multiple studies show people who are modestly overweight live longer.

          • Monkey Professor for a Head

            Even putting the health part of it aside, people may be better off anyway when you consider quality of life. I love cooking and baking, and I immensely enjoy eating the results. It may not alway be ideal from a nutrition point of view, but it makes me happy.
            Of course taking this to extremes isn’t a good idea either, as obesity and poor health can cause great unhappiness. As with everything in life, balance is best.

          • Toni35

            Loving and enjoying food and being a healthy weight are not mutually exclusive. I know you didn’t specifically state that they are, but there is an implication that you cannot both enjoy tastey food and avoid being overweight. You most certainly can.

          • Monkey Professor for a Head

            Not my intention at all. Using myself as an example, my diet is perhaps not ideal, and is very much based around what tastes good, but I am not myself overweight. I am a dress size up from what I was before I had my son, and there are days when Id like to fit into my old clothes again, but at the present moment I do not want it enough to alter my diet.

          • Toni35

            What confuses me about those claims is that otoh, we are told that being overweight or obese increases our risk of chronic health problems. But then we are supposed to believe that overweight people live longer… Something doesn’t jive here. Is the weight recorded at time of death? I ask because sometimes when we are dying we lose weight. Certain treatments cause (or are very likely to cause) weight loss (I’m thinking chemo, but there are likely others). Are we looking just at weight at death, or are we looking at weight at the time a person first became ill? Strikes me that could make a pretty big difference.

          • CNP76

            Mostly those studies show that a little bit overweight at the end of life gives you an edge (or a cushion) over the normal weight person. Because when illness strikes it can cause weight loss so a little bit extra gives the elderly a bit more padding to lose before they become underweight from their illness.

          • Toni35

            That makes a good deal of sense. Part of the problem with all cause mortality as a metric is that it includes things that have little or nothing to do with weight (car accidents, gunshot wounds, shark attacks) What do you make of this?

            http://theconversation.com/mondays-medical-myth-overweight-people-live-longer-12825

            From the first chart provided, it seems the lowest risk of death is seen in people in the upper half of “normal” bmi (22.5-24.9 being at the lowest risk level). It’s when all “normal” weights get lumped together, and all “overweight” weights get clumped together, that we see the supposed paradox. Thoughts?

          • Toni35

            Question – do these studies control for body fat percentage? An “overweight” person with a lot of lean body mass, and a healthy body fat percentage may very well be at lower risk of death than a “skinny fat” person (normal bmi, but too high a percentage of body fat)? We all know bmi is just a screening tool, not the be all end all. It doesn’t take into consideration body composition. Plus, having some excess “padding” may be protective in some instances (catabolic diseases, or traumatic injury). Also, these studies appear to be epidemiological. Great for making a hypothesis, not so great for making actual recommendations. Not sure how (or if it would be ethical) to create a RCT of this sort of thing?

          • The Computer Ate My Nym

            No, the studies I’ve read rely on BMI alone. OTOH, they are population level studies, looking at survival in the US and other countries overall, not selected populations. So in order to argue that the results are skewed due to high percentage muscle, you would have to argue that most people in the US who are obese are so due to high muscle content.

        • Charybdis

          Barley flour. My dad was allergic to wheat, so Mom used barley flour to bake for him. I liked the barley cookies and cakes better than the ones made with wheat flour.

      • mabelcruet

        I completely agree with you, but at the moment food is being used as a proxy for far more than food-if we need to teach children to approach food positively rather than seeing puddings as a reward for good behaviour, or getting a treat of sweeties because they’ve got a good report card, thats where we go wrong. We shouldn’t be saying having pudding is wrong, having pudding in itself is neither wrong nor right, its just pudding. If they want pudding, then fine, eat it, but then how do you get across that a couple of times a week is OK, but not every meal? You’re making a judgement, making pudding special, and that then makes it a treat, and then it becomes a reward, or a treat for when you feel miserable. Its impossible not to start extrapolating like that. Enjoying food is wonderful, and cooking and making lovely tasty meals that everyone eats is great, but its difficult to stop it at that.

        And now we’ve got food as a battlefield, with oneupmanship for who eats the most organic, or the best supplements, or the newest faddy superfood. I wish we could just eat what we fancy without people enforcing a moral value on it. Personally, I love chia seeds-I chuck them in yoghurt overnight and they swell up and give me a filling breakfast full of fibre and protein and relatively low fat and low calorie. But I also love an Ulster Fry especially with fried soda and tattie bread! I try not to think of it as cheating on the diet, or being ‘naughty’ if I have a fry, it literally is once every few months, but the way we see food is so ingrained in us, so I see it as a bad-girl thing.

        • Chant de la Mer

          It’s complicated to create awareness of how to eat without creating “good” and “bad” categories of food, I’m working out how to do it myself for my kids but I try to mention that they need lots of different kinds of food to grow big and strong and tell them that sweets taste yummy and give you energy but won’t help you grow strong (simplified for a 5 yo) like veggies/fruit/meat will.

          I tell my kids that their food gives them energy and helps them grow and how each food on their plate helps (some are exaggerated because I’m trying to get two picky little boys to eat their veggies!). Treats and sweets are yummy and they give you lots of energy (blood sugar) but too much will make your stomach hurt because it doesn’t like all that sugar. So basically I try to keep it factual and focus on the nutrition and physical side of eating, at least for developing their palates and helping them eat an appropriate amount of varied food.

          • fiftyfifty1

            “It’s complicated to create awareness of how to eat without creating “good” and “bad” categories of food”

            What about not doing any nutrition talk at all and just setting a good example by cooking and enjoying delicious meals that incorporate all types of foods?

          • Toni35

            That’s great when they’re very young. As they get older kids have the pesky habit of asking questions (why can’t I have cookies for breakfast? Why do I have to eat vegetables?). I try to avoid telling my kids that foods are goo/bad. I avoid referring to food as “junk” or “a treat”. But it can be difficult not to. When they ask I try to talk about nutrition, and what the specific food in questions provides their body (and what it doesn’t). They did ask why I stopped eating bread and past – I told them about my eczema and how eliminating most of the wheat from my diet seems to get rid of it. They did ask why I don’t eat much in the way of fruit or potatoes anymore – I told them about my blood sugar. I agree that it’s not wise to attach “good vs bad” to kids’ food choices, but they do notice things and they do ask questions. They’re like little people that way.

          • Chant de la Mer

            Oh I try to do that as well, but because we’ve been working on the pickiness I’ve been going on and on about how food helps us grow, be strong and have energy and we need all kinds of different foods for different reasons. I’ve been dealing with food issues in myself though and sometimes it’s good to remind myself that food is nutrition and its neither bad nor good by itself but how I treat food that creates the problems. I’ve been trying to convey that idea to my children by teaching them that food is fuel but should be tasty.

          • mabelcruet

            That sounds very sensible, putting it in a way they understand. I’m probably the healthiest I’ve ever been currently (I’m nearly 50), and that’s purely because my body can’t cope any more! My gallstones and subsequent lack of gallbladder meant reduced fat, my blood pressure and pre-diabetes meant weight loss and more exercise to get them back to normal, my creaky knees and achy hips meant weight loss and more exercise-hey presto! After 1 year of making huge changes I’m now ‘normal’-weight, blood presure, blood parameters, BMI. It would have been a heck of a lot easier starting out with good eating habits in the first place.

    • Irène Delse

      That’s very sensible advice. Just like we can’t have our cake and eat it, we can’t ingest calories and expect them not to be metabolised.

    • T.

      I am obese. I am perfectly award that with my family history it means I am rather likely to get a heart attack in my fifties which may or not kill me.

      However, “using good wrongly” ensured that I did not killer myself at age 29, since I also suffer from severe anxiety and depression with deep syicidal tendencies and food was the main way I used to have something at all that felt good in my life. For my age group suicide is the second cause of death, obesity-related problems are way down the line.

      Currently, my psychiatric problema are under control because of CBT and medication. However, my therapist and my psychiatrist agree that the added anxiety to try to lode Wright could shatter the equilibrium and happiness I fought tooth and nail for.

      So if it kills me in my fifties at least I enjoyed 20 more ywars of life instead of being a normale weight corpse.

      Think before saying that people “sue good wrongly”. Thank you.

      • mabelcruet

        I’m not sure what you mean by saying ‘sue good wrongly’, I never mentioned anything about suing anyone. What I said is exactly what you said-its down to each of us individually to decide what is best for us personally and take responsibility for those decisions.

        • Toni35

          I’m thinking she meant “use food wrongly”… Typo perhaps?

          • mabelcruet

            Thanks, I didn’t understand that at all. But nowhere did I say we ‘use food wrongly’. What I said was I wish that we didn’t have this tendency to label food as good food or bad food, or a particular diet as a good diet or a poor diet.

          • Who?

            I think the author was meaning to respond to Chant de la Mer, below, who talked about not using ‘good’ or ‘bad’ to categorise food.

    • Laura J

      We are what we put in our bodies. Well said!

  • Who?

    This is semi-off topic, but sad story about how far wrong people can go following pseudo-science and woo.

    https://www.theguardian.com/australia-news/2016/aug/10/baby-almost-died-after-mother-breastfed-while-on-water-diet-on-naturopaths-advice

    • mabelcruet

      There was another horrible case in Australia-Penelope Dingle died of metastatic bowel cancer after being treated by a homeopath Francine Scrayen. The coroners investigation into her death came to the conclusion that Francine Scayen was to blame, even though she herself denied that she was providing medical care or treatment, but also that the deceased woman’s husband had put considerable pressure on her to accept homeopathy/reject conventional surgery and chemo,

      http://www.homeowatch.org/news/dingle_finding.pdf

      There’s a very good blog online ‘Scammed to death’ about it. Scayen tried to silence the journalist legally.

      Direct quote from the report:

      ” Mrs Scrayen claimed that she did not purport to treat
      the deceased’s cancer and said that she had no knowledge
      that the deceased had a belief that she was advising that
      homeopathy could provide a cure for cancer”

      So, basically, if you believe that you will be cured, and you aren’t cured, its your fault. At least that seems consistent with all the other quacktitioners, frauds and quackademics out there-blame someone else.

      • Who?

        Yes that was also horrifying.

  • Puffin

    Wondering if people could give me a hand. I’m 27w with kid 3. I had placental issues, possible mild accreta, with kid 1. With kid 2, I only got to the hospital two hours before she was born (at 37w) half of which was spent waiting for a room. I was refused an epidural because I was too far progressed. I then had a retained placenta and was starting to bleed heavily so the OB removed it manually without me having had any analgesia. The memory still gives me shaking, sweating, wake-up-in-terror nightmares to this day, five years later.

    Given my history of rapid labour and placental issues, I wanted to just schedule a c/s at 37-38w since my second was spontaneous at 37. OB wasn’t in favour because I’m not taking time off school (I start clinicals 3 weeks after my EDD, so a c/s at 37w would mean 6 weeks recovery time/attending school via Internet.) I’m thinking of instead pushing for an induction at 37w. I absolutely do not want to go into labour outside of the hospital. I’m terrified of having placental issues or of not being able to get pain relief again. I cannot go through another labour like that. I *need* a scheduled delivery. How can I go about getting my OB on my side?

    • demodocus

      The induction might be a good middle ground. You laid out all your reasoning and your nightmares, yes? Then I’d probably just beg everytime I saw the ob. But I can’t talk like a professional

    • Roadstergal

      Ugh, I’m so sorry about the way things went for your first 2. 🙁

      Ask your OB for a guarantee that a VB will not result in a longer recovery time than a C/S.

      Since that doesn’t exist…

  • Allie

    Oh, boy! All I can think is ‘Toni35 is going to lose his or her shiz over this!’

    • Toni35

      Thanks for the shout out 🙂

      No loss of shiz here. People can do everything “right” and die young anyway. Bodies fail all the time (and people get hit by busses on the regular). There’s something to be said for the ‘none of us make it out alive anyway, live fast, die young, leave a beautiful corpse mentality’. Getting old isn’t for the faint of heart 😉

      A healthy diet (and there are LOTS of healthy diets) won’t make you immortal, won’t prevent your body from aging, won’t prevent disease. Why would you think I would disagree with any of that? That said, I have four children under age ten. I wear my seatbelt. I don’t text and drive. I don’t drink excessively. I maintain a healthy weight (through diet primarily). I got my blood glucose back to normal (from prediabetic) by changing my diet and losing weight. I chose to have kids. I’d like to be around for them at least until they reach adulthood (hopefully as long as possible). There are no guarantees, of course. I could be snuffed out next week in a variety of ways. But I’d like to know that I’m doing what I can to “maintain my vehicle”. My kids didn’t ask to be born, I chose to have them. So I feel a sort of obligation/sense of responsibility to do what I can (whether it ends up helping or not is beyond my control) to reduce my risk of dying prematurely. When I’m Dr. Amy’s age? My kids will be grown, hopefully fully functional members of society, who won’t need me so much anymore. At that point I can eat all the things, drink all the things, and smoke all the things. I’ll be at the end of life anyway. Who cares if I weigh 300+ lbs with blackened lungs and a pickled liver at that point? I’d be close to death either way.

      My mom is in her mid 60s. She wants only comfort measure if she develops a serious health condition. She is DNR. Makes perfect sense to me. Her kids are grown and independent. Not that she doesn’t want to be around, but ya gotta go sometime. She feels like she’s lived her life and every day from here on out is a bonus. I get that point of view. I agree with it. But she and Dr. Amy are at a much different stage of life than I am. I wouldn’t expect their priorities to be the same as mine.

      I totally agree with this post. The only point I would make (and it was made in the post) is that diet does impact weight. And weight impacts risk of chronic disease and early death. So in an indirect way, yes diet does impact chronic disease and lifespan. But if you are happy with your diet, and happy with the results, keep on doing what you’re doing. There is no one “right” way.

      Oh, wait, I’m supposed to be a “food snob”…. sorry to burst your bubble….

  • The Computer Ate My Nym

    Diet can help health on the margins. Apart from true deficiencies, overly processed food can lead to obesity, reflux, constipation, and all sorts of other issues ranging from unpleasant to life threatening. That being said, there is no single diet that will cure every problem you have and no diet that is the best for everyone. The ideal diet depends on the person, the situation, and the time in their life. For all I know, there may be situations where the Doritos and Mountain Dew diet is the best thing someone can do for themselves.

    • Roadstergal

      http://www.bicycling.com/training/fast-foods

      Adam Myerson, Pro Cyclocross and Road Racer
      “Mountain Dew and Snickers—it has fat, slow sugar, fast sugar, protein, tastes good, and isn’t ‘energy food.’ I even put frozen mini Snickers in my race bag for long road races.”

      Chris Horner, 2011 Tour of California Winner
      “Coke and Snickers.”

      • The Computer Ate My Nym

        I went dogsledding and winter camping a couple of times. We were encouraged to keep candy bars, cheese sticks, and granola bars in all our pockets and eat them frequently, including when we woke at night. Dinner started with someone throwing a pound of butter into the frying pan and more fat laden food was added from there. I came home a pound or two lighter than I left. Mountain Dew would have been less practical in that situation because it would have frozen.

        • Roadstergal

          Yep, when you’re expending a lot of calories, calorie-dense food is good.

          As soon as you mentioned Mountain Dew, I thought of all of the bicycle racers I see grabbing a Coke out of a musette bag or at the end of a stage. Sugar and caffeine!

          • The Computer Ate My Nym

            Although I’m by no means a serious athlete, my personal bias is that I am better off eating more and exercising more than eating less (or less “junk food”) and exercising less. But this belief may be informed by the fact that I’d rather play half an hour of Zombies Run and then go eat a cookie than do neither.

    • fiftyfifty1

      What exactly is an “overly processed food”. And which of these overly processed foods lead to reflux?

      My husband eats little that isn’t highly processed. His diet is black coffee and peanut butter toast with bacon for breakfast. A Blizzard (like a McFlurrie) for many lunches. And a few cans of beer and more peanut butter bacon toast for dinner. Oh, and a Twix bar. He doesn’t work out. Tall slim and healthy in middle age. Poops twice daily and no reflux.

      • The Computer Ate My Nym

        Yep. Varies from person to person and within one person depending on the point in their life where they are. There is some fluffy evidence* that increasing fiber can reduce GERD, so in this case I really meant white flour/rice/etc as “overly processed”. But some people can live on white rice and brioche without it ever being an issue. If a given diet is working for a given person, there is no need to change anything.

        *For example: http://www.ncbi.nlm.nih.gov/pubmed/24603400

        • fiftyfifty1

          Well, that link is about abdominal breathing, not processed foods.

          Even if we are talking about increasing fiber (although I am not aware of any even fluffy evidence for fiber decreasing reflux), it’s not that “overly processed foods” are causing reflux. If a person wants to increase fiber they can switch from white rice to brown rice, but a far more efficient way would be to continue eating whatever rice they have always eaten and take a (processed) fiber supplement.

          • The Computer Ate My Nym

            That’ll work too…unless it doesn’t for that particular person. As I said, there is no one true diet that works for everyone. But saying so sells no books and starts no movements.

      • The Computer Ate My Nym

        Also, “overly processed” was poor wording. Food with concentrated sugar, removal of the fiberous part of the wheat kernel before grinding, high temperature cooking, etc can result in a food product that isn’t the healthiest for the average person living an average lifestyle to eat exclusively. A given individual in a given situation may well need such food for optimal health.

        • StephanieA

          I do horrible with fiber. Bloating, stomach pain, etc. I’m probably in the minority, but I do much better on food that is more processed. Brown rice causes stomach pain, white rice doesn’t.

      • Guest

        Breastmilk must be overly processed, given how severe my son’s reflux was.

        And as for adult me, you know what gives me the worst reflux? Raw fruits and certain raw vegetables, like peppers. So processed, those raw foods.

        • fiftyfifty1

          “Breastmilk must be overly processed”

          Well, milk probably is the most processed food on earth. You put all sorts of food into the machine (mom) and out comes a uniform, textureless, fiber-free, sugar laden, white fluid.

  • attitude devant

    When I was in med school a bunch of us freshpeople lobbied for a nutrition class (we were encouraged to complain if we saw holes in the curriculum) and an elective was put together for us…..and it was enlightening. Because I walked in there being a believer about vitamin supplementation and walked out being the exact opposite. Do you know how few diseases are actually due to vitamin deficiency? Damn few. Scurvy, which is completely preventable by a very modest amount of vegetables and/or fruit, exists only in extreme circumstances such as those originally described (long sea voyages). Beriberi, caused by thiamine deficiency, only exists under the rarest of circumstances in the modern world. Rickets is a terrible problem only in people who are not exposed to sunlight AND have no access to Vitamin D enriched food. Even in pregnancy, vitamins are not needed if the diet is reasonably varied, with the exception that folic acid supplementation has a modest protective effect against neural tube defects and iron supplementation is useful in women without adequate dietary iron. That’s it.

    • The Computer Ate My Nym

      I had a patient who had scurvy or at least measured vitamin C deficiency and a possibly related bleed. Heck if I know how he managed it.

      In some situations vitamin supplementation can be actively harmful, i.e. higher risk of cancer in vitamin A supplemented smokers.

    • fiftyfifty1

      I know what you mean, although rickets does happen around here (dark skinned, breastfed babies living in a northern latitude). And plenty of iron def anemia in picky toddlers who get most of their calories from milk and in teen and perimenopausal women with heavy menses. That and occasionally something funky in an extreme alcoholic.

    • Caylynn

      I am a dietitian. We are sadly seeing rickets again, especially when parents think almond milk is better than cows milk (although almond milk doesn’t need to be fortified with vitamin D in Canada) and they never expose their babies to sunlight (as that can cause skin cancer).

      Needless to say, as a dietitian, I believe diet has a major impact on health. But there are many ways one can have a healthy diet, and anyone claiming that there is one optimal diet out there for everyone is seriously deluded.

      • Roadstergal

        I think of diet like ‘the microbiome.’ Some very specific bad ones, and a multitude of different ways to have ‘good’ ones.

        Also true of romantic partners.

    • Sue

      How many times do we hear the old trope “doctors only get (x = small number) of hours in their training about nutrition”? (Essentially always proclaimed by ppl who never went to medical school).

      These people confuse nutrition (learning how nutrients work within the body, physiologically and pathologically) with dietetics (analysing and prescribing dietary formulae).

      In terms of how nutrients are absorbed, and work, and the results of deficiency or toxicity, there is a huge body of learning, from the role of salivary amylase and the role of Vitamin K in the clotting cascade to the constituents of bile and the anatomy of the colonic wall. This is all part of understanding nutrition.

      Dietetics, on the other hand, is a body of learning and profession in itself. Doctors collaborate with dietitians as they do with physiotherapists and speech pathologists. Dietetics is the “therapy” arising from nutrition knowledge, much as physio is the therapy arising from knowledge of anatomy and musculoskeletal function and speech pathology is the therapy arising from an understanding of the anatomy, physiology and pathology of speech and swallowing.

      • Azuran

        And that ‘doctor only get X’ trope become ridiculous when compared to other things we learn in school. There is a lot of things to cover and only a finite set of hours. You can’t have 200+ hours of everything.
        Sure, the base curriculum in my program only had a 30 hour class in nutrition. Which is about the same as the amount of hours I had in my intensive care class. More than I had on blood transfusions. I had only maybe 3 hours on advanced imaging like ct-scan and MRI. Less than 2 hours on neonatalogy. The ENTIRE fish section was 5 hours, the entire exotic pets was 15 hours. The basic surgery training was neuter one dog, spay one cat.

        But that why there are clubs, conference dinners, extra-curricular activities and additional optional courses you can take on top of the basis curriculum to get more experience in the fields you know you will need.
        And learning doesn’t stop when you get out of school. It never stops. I’ve learn so much since I graduated, my bosses showed me a lot of things. I’ve read a lot in medical textbooks, journals and such. And I still have continuous education every single year.

        • MI Dawn

          And I’m sure there was more information built in when you had the exotic pets or fish section. After all, care and feeding of fish in a nutrition course can be made very short then you know that later on, you’re discussing FISH and how to feed them properly as a focused discussion.

          Nursing and medical school are like that. Sure, we have one class on nutrition. But part of EVERY other area was nutrition information based on the specific study (OB, pediatrics, medicine, surgery, etc)

          • Azuran

            Indeed, everything crosses over in every other class. There were bits of general nutrition in the ‘general medicine’ class of every species. And again more specific nutrition whenever we learned about any specific disease.

    • Anne

      And iodine.

    • Amy

      My best friend is a dietitian. Unless she’s working with a specific client in conjunction with the client’s doctor, she is pretty mum on how effective diet could be on general health. Her only pronouncements on the subject are eat more fruits and vegetables, limit sweets. In other words, what every adult has heard their entire lives, basic common sense. She also doesn’t give her kids supplements or take any herself.

  • Mac Sherbert
    • attitude devant

      I’ve been puzzling over it. I can’t tell if this was pursued as a malpractice action or as a false advertising action. All the writing focuses on the false advertising, but the details and the award are sort of like a malpractice case. And I can’t imagine you could get $16 million on a false advertising case.

      • Amy Tuteur, MD

        It appears that both claims were made. It sounds like it was malpractice, after all.

      • Mac Sherbert

        Seems to be both.
        “On Aug. 5, 2016 the jury awarded $10 million in compensatory damages for Malatesta’s injuries sustained during childbirth; $1 million to her husband for loss of consortium; and $5 million in punitive damages for reckless fraud.”

    • CSN0116

      Holy shit she got a sympathetic jury, and access to a large insurance policy to draw from. I’ve seen accidents that cause a person to become quadriplegic award less. I’ve seen cases with dead babies award less. Damnnnnnn. Dare I say any good lawyer would have put enough doubt in the jurors’ minds that the damage would have occurred regardless, or it was exacerbated by being her fourth delivery, some shit.

      And sounds like a nurse fuckup. The hospital’s policies, and doctor’s promises, were likely legit. But one (two?) dumbass caused a world of hurt…

    • moto_librarian

      It really does sound like she tried to get answers from the hospital and pursued this suit as a last resort. Could this type of injury simply be caused by vaginal birth? It sounds absolutely horrible, and I don’t understand why the nurse would hold the baby inside of her like that. Nobody was talking about fear of cord prolapse or anything.

      • Mac Sherbert

        I scanned some comments (might have been a different article) and someone said that the nurses were penalized for catching babies. No idea if there’s any truth to it, but that would kinda of explain things.

        • MI Dawn

          Not when I was practicing as an RN. But in today’s litigious society? Maybe.

      • Margo

        Maybe she was holding the baby in because the doctor had not arrived, or the woman was still half on hands and knees and the nurse didn’t know how to assist when woman on hands and knees. I did once work in an environment where several doctors used to get really ratty if the baby was born before the doc arrived.

        • Siri

          Holding the baby in is assault, battery and malpractice; there is never any justification for it. In the UK it wouldn’t matter what a doctor had said; any midwife who attempted to obstruct a spontaneous birth would lose her licence to practice.

          • guest

            Yeah, there’s a huge difference between telling someone not to push yet to try and wait for a doctor, and physically holding a baby in to prevent it coming out.

    • swbarnes2

      Wonder why there were no wireless monitors when the OB thought there would be. Do you think the nurses said “Sorry, we just don’t have any wireless ones available and we HAVE to monitor you, so you need to stay in bed?”

      • Bombshellrisa

        It’s interesting that a lot of doctors write orders for things that aren’t available. I remember every resident ordering daily weights on patients who couldn’t stand to be weighed, they all assumed that the beds weighed the patients. Nope. The only way to get a weight on those people was to use a sling contraption that lifted the patients up OR have the lift team use their equipment that also had a scale. The same thing has happened with things on L&D like having a mirror (some units only have one or two) or even extra pillows (seems like there are never enough).

        • Montserrat Blanco

          I have weighed patients that could not stand by themselves by supporting them and “hugging” them together with me on the scale. Then I just weight myself and discount that weight from the total one. It is the same Method that I use for weighting my suitcases before travelling.

          • Bombshellrisa

            It can work, but not usually for the patients I would see. Most of them were amputees, morbidly obese or hadn’t stood on their own in quite some time.

        • Heidi

          Oh the nightmare that was getting weights on bedridden patients that were almost NEVER in beds with scales! It was always the 30 year old who was super-ambulatory who didn’t need a daily weight that’d end up with the bed that weighed. At my hospital, it was up to night shift, who already suffered less staff, because obviously it wasn’t busy on a med-surg floor! Because you know, medical emergencies and altered mental states wait until morning to crop up! I tell you, everyone loves to be woken up at 4am to be rolled onto a mat and jacked up in the air.

          • Bombshellrisa

            It gets better, since medical had the majority of the dialysis patients they believed that the (one, old, rickety, gross) bed scale and sling belonged to their unit. So all other units had access strictly between the hours of 1 and 2am, and only if we asked first.

    • MI Dawn

      My reaction is OMG. While as a nurse we were taught to encourage a mom not to push if the MD wasn’t there, we were ALSO taught to NEVER hold the baby back. It was safer for the RN to deliver the baby than hold it back till the MD got there. I’m just blown away, if what the reporters say is true.

  • Fleur

    OT: Thanks to everyone who gave me advice the other day on introducing my daughter to solids! She’s taken to the whole process with a ridiculous amount of enthusiasm and actually snatched the spoon from me to try (unsuccessfully) to feed herself today. If it weren’t for you guys, I’d still be trying to make sense of the crappy NHS guidelines, so thank you.

    PS Is it safe to come out? Have the paleo people gone yet?!

    • Amazed

      Your daughter sounds great!

      P.S. I think you’re reasonably safe right now. It’s just us, lowest modern consumers of food-like substances here.

      • Fleur

        Thank you! She’s a real little character 🙂

        Phew, that’s a relief. I’m still trying to get my head round how, of all the groups of people Dr Amy calls out here, it’s not the lactivists or the anti-vaxxers, but the fricking paleo diet enthusiasts who create the biggest shitstorm!

        • Toni35

          Don’t forget the intactavists… I think they create the biggest “shit storms”, personally. And the post count was, last I checked, still under 500. Not much of a shitstorm by this sites’ standards, lol. Though it is the most traffic I’ve seen in several weeks.

    • Megan

      Glad your daughter enjoyed her first solids! My daughter is starting to get more interested though hasn’t quite gotten the mechanics of it yet. Enjoys sweet potatoes though so we keep trying!

      • Fleur

        Sweet potato is a winner here too! 🙂

  • T.

    TOTALLY OT but cool:

    Today I went to a medical museum, in Venice (I live here) and I when I saw these things, I thought somebody here could be interested (feel free to share wherever if you want). In that hospital, the first ”Ward” about Obstetric was constructed in the first half of 1800s (of course, only for rich women, who could afford a doctor)

    The first is a textbook describing managment of breech presentations, first half of 1800s.

    The second is a collection of forceps plus a pelvis used in training.

    The third is more forceps (oh, the lost art of forceps delivery, lets us rejoice it is lost)

    The fourth is a part of a rather ancient breast pump, because yes, some women pumped even in the 1800s, and I don’t envy them none.

    • attitude devant

      Oh dear. I used every single one of those forceps while I was in training……

      But not the breast pump.

      • T.

        Some things don’t change, do they?

        I wonder how that breast pump worked myself, I fear something similar to cupping…

        • attitude devant

          I suspect it was actually for hand suppression

          • Amazed

            Look ominous to this layperson. To the last.

        • cookiebaker

          I thought that long straw off the back was to suck on to create a vacuum and draw the milk out.

      • MI Dawn

        Yeah…I was taught how to give them to the MD in my nursing school days (and saw them used by a very few older MDs over the vacuum extractor).

      • mabelcruet

        I remember reading about the Chamberlens who invented the forceps but kept it a family secret for almost two hundred years, and the author did an estimate of how many babies could have been saved had they shared it with other accoucheurs. Charlotte, Princess of Wales, died in childbirth because the Royal Accoucheur, would not use forceps in an obstructed birth, and both mother and baby died. He took his own life shortly afterwards. Thats why we got Queen Victoria-she wasn’t in the direct line of ascension until then.

    • Roadstergal

      That sounds so cool. Did you take pictures?

    • sdsures

      That’s really neat! I was about to comment on a photo I’ve seen in a FB group that helps med students and nurses learn anatomy, as well as the general public (since it’s a public page). If anyone’s interested, here is the link: they have both historical photos of medical procedures, as well as modern. https://www.facebook.com/DailyAnatomy/

      I remember seeing a preserved skull with some sort of periorbital cancerous mass. It must have been painful.

      I’ve also been to the Bodies Exhibit in Las Vegas. It was fascinating! Has anyone else seen it?

      • Roadstergal

        Ooh, thanks for the facebook link. I’m adding it to my feed. (I recently went through a cull of my FB friends, including an ex-scientist friend who has gone full hog into NCB and Magic Breastmilk woo, and so I have room. :p )

    • Megan

      Reminds me of the Mutter Museum in Philadelphia. The class of first year medical students at my school always takes a field trip there during orientation. Always cool to see that kind of stuff and makes you very thankful for modern medicine.

      • sdsures

        I’d love to see it. I think it’s run by the same doctor who started the Bodies Exhibit?

        • Megan

          Not sure but it’s really cool. There is also a cool Civil War Medical museum in Frederick, MD if you’re into that kind of thing. You know, like bone saws and the like…

          • sdsures

            Oooh! YES! (My husband might not like to go there, though. He refused to visit the Bodies with me.)

      • Roadstergal

        I remember Sarah Vowell talking about the Mutter Museum in Assassination Vacation. Definitely a place I regret not visiting when I was in college at Bryn Mawr – I didn’t know about it!

    • Roadstergal

      Okay, now that I’m looking at your post today, the pictures are showing for me! Sorry for what looks like a really odd comment below…

  • CSN0116
    • Roadstergal

      Dr Todd Bodd. LOL!

      I’m getting to like this show. “Just eat a lemon, ever!” And vitamins vs cats. The Linus Pauling performance! Although I’m not going to blame the vitamin craze fully on him. I think we might have gotten there without him, or to something similar – it’s the whole Talisman thing?

      Similarly:
      https://www.youtube.com/watch?v=0Rnq1NpHdmw

  • CSN0116

    Ahhhh, the epidemiological transition. You want to your population “dying slowly” from chronic conditions versus acute ones. This illustrates success.

    OT: I held the door for an old man the other day. He struggled to walk and then looked me straight in the eye as he exited and said with a smile, “Don’t ever get old.” He then revealed he was 96-years-old. I told him that the entire purpose of getting old is living longer, which is something everyone wants, and in his case he had hit the jackpot and was much better off than my 29-year-old self. He laughed. Then he lit up a cigarette which he revealed he’d been smoking, daily, since age 13 😛

    • Amazed

      My black joke is that humans are never satisfied. When someone grows old, it’s, “It sucks to be old!” When someone dies young, it’s basically the same.

    • MI Dawn

      My grandfather lived to be 96 also. Until his very last days, he was up, active and happy. He smoked occasional cigars or a pipe, drank regular cocktails (always after 5 pm!) and ate what he wanted. He also lived with second-hand smoke for many years as my grandmother smoked for 50 of the years of their marriage (she quit as a 50th anniversary present for him and lived into her 80s also).

      Diet, exercise, healthy habits all help. But nothing beats genetics!

      • The Bofa on the Sofa

        I saw a statement recently, something like, you need to be healthy to live to 75 (or maybe 80), but from there, it’s mostly a matter of genetics. This was based on analysis of very old people (including super centenarians)

        • LaMont

          Actual Convo I’m Not Too Proud Of (brought to you by my family’s terrible genetics and a stupid quarterlife crisis):

          Me: I can’t believe it! At 37, which feels way too soon, not only will I have to have my life figured out, but it’ll be half over!
          Friend: What’ll be half over?
          Me: Life!
          Friend: Ah f*ck that’s what we’re doing now.

          • MI Dawn

            I’m a quarter of a century older…now I’m feeling ancient. :p

    • Sue

      A posterboy for the benefits of good genes.

  • Mel

    I’m 34 years old. Here’s the list of “big nutritional ideas” that have been shown to be flawed that I can remember:
    1) Low-fat will lead to weight loss! (Kind of. As long as the replacement foods are complex carbs heavy and not pure sugar.)
    2) Dietary cholesterol is totally the main cause of high cholesterol! (Oops. Not for a lot of people.)
    3) Excess sodium causes high blood pressure. (Partial credit for correctness in African-Americans and Hispanics. Doesn’t seem to work that way in Whites.)
    4) The Atkins Diet will save humanity. (If you don’t mind constipation, looking vaguely ill and possibly dying of heart disease…..)
    5) High percentage of milk fats are evil! (Well, except if you are a child-bearing aged woman or a child….)

    • Amazed

      My personal experience with those:

      1) Low-fat does lead to weight loss! Of course, that’s because low-fat tastes so vile that I’d rather have a salad without any oil than ever use anything low-fat. High-fat makes me feel ill, low-fat is gross, so chances are, when you give me low-fat, I’ll skip the meal, rather than suffer it. Meat? Great, as long as I’ve cut out all the fat. Cheese? Full-fat, please. A little bit drowned in a sea of tomatoes.
      2) Never tried to follow my cholesterol levels. When they do test me, they’re delightfully average. Guess my cholesterol is dietary just fine.
      3) Few foods have enough sodium for me, so I add more and more. Low blood pressure all the way through.
      4) The Atkins diet makes me violently ill in a few days. Limit my fruit intake in any shape, and you get an ugly, spotty, ill-tempered monster. Oh, and one who feels faint all the day.
      5) Milk is evil. Yoghurt is fine. Admittedly, that has more to do with my tastes than science. No science can make me drink evil milk.

      • MI Dawn

        Ugh. Low-fat foods. I can’t tolerate them either! They taste terrible to me, and have a horrible aftertaste. Same with most low-calorie foods. And don’t ask what sucrolose does…

      • Sue

        The problem with “low fat” is that people go for manufactured, processed reduced-fat products, which are often sweetened to make them palatable.

        The other way of eating low fat is just to eat less fatty food. We can still eat full-fat foods, but moderate the quantity.

        • Who?

          That’s what I do-full fat everything, but in small portions. If I take the time to chew, enjoy and swallow (as opposed to inhaling the food) I fill up pretty fast.

          • sdsures

            Good advice.

    • sdsures

      I’m 35. My personal experience with #3: people have been so panicked about sodium that they try to cut it completely from their diets. That causes problems with over-hydration. (This is why sports drinks like Gatorade contain salts.)

      Sometimes when I have one of my migraines – not always, but sometimes, a small bag of potato chips can abort it.

      That’s not to say that I think everyone SHOULD gorge themselves on salt. They definitely shouldn’t. Moderation in all things.

      • KeeperOfTheBooks

        When I started walking regularly, I was disgusted to find that I suddenly started getting migraines again, and far more regularly–like, daily–than I ever did before. It took a while for me to figure out the cause–to wit, that I was walking in the summer in a humid, subtropical climate, so both the temperature and humidity were hovering in the upper 80s/low 90s. As a result, I was losing a fair bit of salt via sweat, and while I was drinking a huge amount of water to rehydrate, water alone, of course, wouldn’t replace salt. A few ounces of Gatorade after my 4-mile walk makes all the difference between a migraine and no migraine during the summer. Huzzah!

        • sdsures

          Huzzah! Barometric pressure changes are the most painful triggers for my migraines.

    • TheArtistFormerlyKnownAsYoya

      May I add? 6) Counting calories and exercising will help you lose weight! Because 100 calories of a Twix bar totally has the same effect on your body as 100 calories of raw carrots, and if you eat an extra Twix you can just go to the gym and work it off. Just eat whatever and exercise more!

      • The Computer Ate My Nym

        Disclosure: This is nothing but a wild ass guess, but…I strongly suspect that 100 calories of carrots is not the same as 100 calories of Twix. Calories are measured by dropping the thing in a calorimeter and burning it. But this isn’t how it works in the body and in “natural” foods like carrots, some calories that are locked up in fiber, which is burnable but not digestible. So it is possible that, for example, whole wheat flour is lower in accessible calories than a like amount of white flour because of the higher fiber content of whole wheat flour. But this is just a guess.

        • TheArtistFormerlyKnownAsYoya

          Agreed, I was adding to the list of “flawed nutritional ideas”…100 calories of Twix is most definitely not the same as 100 calories of raw carrots! Your guess sounds legitimate to me, a layperson. 😉

          People would love to believe that they can eat garbage food every day as long as they don’t exceed X amount of calories, or if they do, they can just run an extra 20 minutes on the treadmill. Sadly, it doesn’t work like that.

          • fiftyfifty1

            “People would love to believe that they can eat garbage food every day as long as they don’t exceed X amount of calories, or if they do, they can just run an extra 20 minutes on the treadmill. Sadly, it doesn’t work like that.”

            Really? Seems to work that way for me…I eat a lot of the foods every day that people like to disparage as “junk” “garbage” and “shit”. I don’t work out, although I do go for a walk daily. I have a normal BMI and low cholesterol and blood pressure.

          • Toni35

            It absolutely works that way. Weight management comes down to calories in vs calories out (CICO). Now, it can be difficult to estimate the CO side of the equation, and so there may be some trial and error there (tho the online calculators seem to be pretty accurate for most people). And even CI is tough to determine without weighing and measuring every crumb (which is part of why I always hated calorie counting – too obsessive and tedious). As long as you keep your CI number at (or below) your TDEE you will maintain (or lose) weight, independent of what you are eating.

            That said what we eat can have an impact on how much we eat. Some foods are more satiating than others. Some foods provide little in the way of nutrition. But so long as you don’t eat too much calories overall, you will maintain your weight. I find the “junky” foods, as well as high sugar and high starch foods, to not be particularly satiating (and yet I also find them hyper-palatable and hard to moderate). I find protein, fat, and fiber to have the best staying power. But this is subjective and everyone will be satisfied by different things.

          • Chant de la Mer

            There was that one guy that did the “twinkie diet” and ate only hostess snacks for a month but kept his calories at the right amount for him and didn’t gain weight. So I’d imagine that for most people they can just manage the calories and be fine as long as they didn’t miss out on important nutrients. However that said, each person is different and satiety is a big part of things, 100 calories of twix is a small volume of food compared to 100 calories of carrots.

          • StephanieA

            Agreed. Calories in, calories out. I eat a lot of junk and maintain a healthy weight. I just don’t eat more than I need to. I would much rather eat a cookie than a giant bowl of vegetables.

          • Tiffany Aching

            This might be simply because 100 calories of carrots (a very large serving) must be more filling than 100 calories of twix bar (I’m pretty certain that the standard serving exceeds 100 calories), which means you will eat less after.

          • TheArtistFormerlyKnownAsYoya

            I agree with that as well, but I was thinking more along the lines of sneaking in a McDonalds burger or something similar every day, but still keeping your calorie count under some target…I know from trying to lose weight by counting calories that this will *not* work.

          • SporkParade

            I found calorie counting to be effective. I treated my calorie limit like a budget, so I ended up making decisions like, “I can eat 400 more calories today; that’s one serving of ice cream or a chicken breast with salad. I’ll take the chicken breast with salad.” The only downsides are that you have to be careful to have accurate count of what you’re eating and that your body might not burn the expected number of calories, especially if you have a thyroid condition or a history of extreme dieting.

          • TheArtistFormerlyKnownAsYoya

            Did you sometimes choose the ice cream? I treated it the same, like a budget – I was very diligent about counting calories for a good six weeks. I started at 1800 a day and I took it down to 1500 calories by the end of it and never budged a pound. I finally figured out that WHAT I was eating had far more of an effect on my weight than calories – I gave up dairy a few months ago and lost a ton of weight without even trying to. Seems that cheese likes to stick around on my body.

          • SporkParade

            ::shrug:: Anything other than calories in/calories out violates the law of thermodynamics. Is it possible that dairy had that effect because it’s pretty calorie dense, and therefore even a slight under-measurement adds up to a large number of calories? Or maybe you’re slightly lactose intolerant, and eating dairy caused you to become bloated?

          • Irène Delse

            With cheese and ice cream, it’s easy to underestimate quantities, that’s sure.

          • nomofear

            An average-sized woman should drop to about 1200 cal/day for weight loss. For me, right now, 1500 is maintenence. I use the myfitnesspal app and count every.single.thing, and I consciously overestimate to account for possible overages in pre-packaged foods, and optimistic eyeballing. And I don’t count my exercise against the total, unless I’ve really worked that day and am feeling really, really hungry (as in, a few glasses of water didn’t help).

          • Amazed

            I lost weight this way without even trying to. When I was studying for a series of exams, I didn’t leave the flat for two weeks straight, save for a few runs for coffee when I ran out of it. All I had in my cupboards were a few unhealthy snacks of… I don’t know how to describe it in English, a few unhealthy wheat snacks with much salt and a ridiculous amount of chocolate bars. Existing on about 800 calories a day of chocolate alone and an additional 237 (I remember the number!) of the snack – and coffee, of course – I lost about three kgs in 2 weeks. I’ll never repeat the experience. I was feeling so anxious and unwell and not having fruits is simply not my way of feeling healthy. But I lost the weight anyway. I didn’t even know I had. All I could think about was, OMG, I’ll fail the exams! OMG, I can’t memorize anything! OMG, things I learned YEARS ago and applied for years are escaping my memory! I guess for me, this wasn’t a good way to lose weight after all. Skin issues, weakness in the limbs and so on. Pretty much like each time I limit fruits and veggies. Makes sense that other people can lose weight and feel fine. After all, people do the Atkins diet and don’t get the side effects I do.

          • StephanieA

            I’ll second your experience minus the feeling bad part. I eat whatever I want, which is often not entirely healthy, especially the week before my period. I do try to cook for my family, but it doesn’t happen every night. I eat of lot of tortilla chips, PB&J, boxed Mac and cheese, baked goods, and cereal with milk. I eat a little fruit when I’m in the mood, but I don’t really care for most fruits. My diet probably isn’t great, but I’m thin and healthy. My job requires me to be on my feet and I stay active at home by cleaning, chasing kids, etc. I don’t feel bad at all, because when I have a junk food heavy day I usually crave healthier foods the next day, so it’s fairly balanced in the long run. I really think that calorie balance matters more than what the diet is made up of.

          • Toni35

            As long as you are in a calorie deficit you will lose weight, independent of what you are eating. That said, restaurant food (like that McD’s hamburger) is difficult to accurately account for because how it is made can vary (one day someone might go heavy on the ketchup, another day someone might add more mayo or onion than typical). And calorie dense food has very little margin for error (take an extra half serving of spinach or broccoli that you don’t account for? Probably not a big deal; take an extra half serving of cheese or almonds that you don’t account for? that adds up fast!). Were you weighing your food? People who are eyeballing portions are notorious for underestimating. Don’t get me wrong, I eyeball my food too, but I’m not claiming to defy the first law of thermodynamics. And I eat McDs burgers sometimes (hold the bun). It never impeded my weight loss, tho the high sodium content may increase the amount of water I am retaining, so it might appear as tho I’ve gained, but it’s not actual fat gain (unless you are eating a 3500+ calorie burger, in addition to your regular maintenance calories… I’d love to see that burger, lol).

          • Heidi

            I don’t know how much of it might be based in pseudoscience, but supposedly our gut bacteria influence what carbs spike our blood sugar. Then something, something, insulin spikes can influence how much fat we store.

          • TheArtistFormerlyKnownAsYoya

            I remember reading a story about a woman who received a transfer of gut bacteria from her daughter (or was it the other way around?) and was suddenly able to maintain a healthy weight after struggling with it for many years. I just meant to suggest that it seems like there are other factors at play than strictly calories consumed vs. calories used in exercise – this seems to have been my experience, and when I read stories like hers, I guess I’m more likely to buy into it due to my experiences. I don’t know if it’s pseudoscience or not. I can’t find the story but here’s an article on gut bacteria as it relates to weight gain/loss:

            http://www.scientificamerican.com/article/how-gut-bacteria-help-make-us-fat-and-thin/

            I can actually get away with eating well over the recommended calories for my height/weight/gender and still maintain a stable weight (getting harder as I age!) but cutting those calories by 500 or even 800 a day doesn’t seem to cause me to lose weight. Maybe I’m underestimating my calories, or have food sensitivities, as others suggested.

          • swbarnes2

            I think the fecal transplants have been used to treat otherwise intractable C-diff infections. But of course, it’s one thing to say “Extreme dysregulation of the gut flora can cause serious problems, and radically changing it can help some very sick people” and another to say “people who are asymptomatic can improve their health even more by mucking with their gut flora”

            There probably is some feedback there between diet and gut flora, but there might also be a certain stability that is hard to tamper with using diet changes alone.

          • Toni35

            Yes… 100 calories of carrots is about 2 full cups of chopped carrots. 100 calories of twix is not even one individual cookie (two cookies in a standard size package). The carrot contains a lot more water and fiber, and slightly more protein. The twix actually has less grams of total carbs (but more “net carbs”), but more fat. If I had to choose, I’d probably choose neither, lol. Both are seriously lacking in protein and only the twix has any fat to speak of. Can I have a steak with my carrot? That would change my answer 😀

          • Irène Delse

            And it takes longer to eat 100 calories of carrots, which gives the subjective impression to be more fulfilling. At least for a time.

        • QuantumMechanic

          Are you sure about that? Looking at the listed calorie content of, say, celery, I have to think food labels give a bioavailable number, not a calorimeter number.

          • The Computer Ate My Nym

            Not entirely, no. I may be out of date with respect to how calories are determined.

        • Irène Delse

          Is that really how dieticians account calories? You would think that they’d know human beings don’t digest cellulose.

      • Siri Dennis

        You’re right; if I had to choose, I’d have the Twix bar! It contains fat and protein, both of which we need, as well as vitamins A, C, and B-12, iron, magnesium and calcium. Twix will give you more varied nutrition than carrots will.

    • lilin

      I’m just waiting for the anti-anti-sugar backlash to begin.

    • Roadstergal

      I’ve actually been thinking about what the next Thing is going to be. I propose phenylketoneuria. Like anti-gluten, it’s based on a real, but rare, disorder. Like so many food fads, it can lead to fashionable rejection of many common foods. Like many food fads, it can lead to an initial weight loss due to just not eating a lot of common foods. And aspartame is utterly contraindicated.

      • Chant de la Mer

        Ooooh you might be on to something! It has the side benefits of “removing toxins” so I’m sure it’ll be a huge hit!

    • Toni35

      My experience with #1 is that it does work, IF you don’t go replacing the fat you removed from your diet with an equivalent (or, worse yet, greater) number of calories of anything else. Which was always tough for me to do, since I find fat particularly filling and satisfying, and carbs, even “complex” ones, not very filling at all. I felt out of my mind with hunger on low fat diets 🙁

  • TicToc

    Just a heads up on the car analogy… In some cars (particularly old cars), fuel choice can seriously affect wear and tear on fuel pumps and spark plugs. That wear and tear can then cause accelerated wear and tear on other engine parts. There may be a better analogy for the point you are trying to make.

    • J.B.

      Actually I think the analogy might be more appropriate if extended. As long as you have minimum octane required for your car and reasonable quality gasoline (my thermo prof recommended getting name brand rather than bottom of the barrel) you should be fine. A sports car needs high octane and an Olympic athlete should have optimum nutrition. A Toyota or regular human beings are ok with lower grade, as long as the base is decent.

    • Roadstergal

      Are you talking about leaded gas and valve seats? I’m quite dubious that was ever a thing. Leaded gas was originally brought in as an anti-knock additive, but when it started to be phased out because, well, environmental lead (and better octane boosters), a certain subset of the Real Vehicles Burn Lead contingent said running unleaded was bad for valve seats.

      • tictoc

        Engines that were built before ethanol blends became common may have parts that are not compatible with ethanol (causing premature wear and tear).
        Fueling your vehicle while the gas station tanks are being filled can result in poor quality dirty fuel being put into your vehicle which can also cause premature wear and tear on any vehicle.
        Occasionally ethanol levels are higher than advertised in certain fuel blends and can cause wear and tear on even newer vehicles not meant to run on greater than E10 fuel.
        Obviously octane matters for some vehicles.
        Just saying it matters for cars.

        • Roadstergal

          Oh, you’re talking about E15? I suppose that’s a parallel, as well. Alcohol is fine in moderation, and some people’s engines are more tolerant of it than others. 🙂

          • tictoc

            No, not specifically. I was speaking of E10 with more than 10% ethanol. It happens sometimes with poor quality control. Even with that aside there is still the issue of vehicles built prior to ethanol availability being incompatible with ethanol fuel, octane issues for high end cars, and dirty fuel for all cars.

          • Paula

            Ethanol blends caused tumors in my plastic motorcycle tank. :p

          • Roadstergal

            Not the engine! 🙂 And that’s why Ducati sold a metal tank as an ‘option’ for the 848…

            Manufacturers are more and more going plastic, now. But they seem to be getting better at it – we’ve both had a few plastic tanks now that haven’t had any swelling issues.

  • rox123

    “[…] but there’s no reason to think that food has a greater impact on health beyond reducing obesity’
    How about the difference between food that has vitamins and food that doesn’t?

    • Amy Tuteur, MD

      How about it?

      • rox123

        Well, I am no doctor and don’t pretend to know, just asking.
        For instance vitamin C – as far as I know it is not produced by the human body so we need to ingest it. If I live exclusively on popcorn and Cola – doesn’t this mean I’ll get a vitamin C deficit? I know it’s an extreme case but I’m gonna go out on a limb here and assume that there are more foods that don’t have it.

        • Heidi_storage

          Sure, if you eat a highly restricted diet of any kind you’re liable to develop some kind of deficiency.

          Of course, a lot of foods these days are fortified (iodine in our salt, folate in our grains, Vitamin D in our milk), so you’re probably better off eating exclusively Big Macs and Pop Tarts than our ancestors were foraging about for what they could find.

    • Azuran

      Compare two people who have a diet that has a reasonable amount of calories and isn’t grossly deficient in some kind of vitamin or nutrient.
      Regardless of what kind of diet they eat: strictly paleo, vegan, standard or even with fast food 2-3 times per week. It won’t make any difference in their health. That’s the point.

      You only need a basic well balanced diet without too much excess to get the maximum benefits you can get with diet. Going to extreme measures and extremely restrictive diet is useless.

      • rox123

        Yes, I agree with that. I just meant that I can think of different destructive effects other than obesity – in the case of really bad diets, but I guess I was taking the phrase I quoted a bit out of context.

    • Mel

      Remind me which vitamin deficiency causes obesity again?

      • rox123

        I didn’t say vitamin deficiency causes obesity, I meant that there might be other benefits to having a good diet than not getting fat.

        • Taysha

          Define “good diet”

          Because that’s the main problem

    • Roadstergal

      You definitely need to be careful with that. People have died from eating foods that are too rich in active Vitamin A, eg.

      • Mel

        Ooh! Ooh! Eating polar bear liver (and many other cold-seas aquatic mammals) can lead to Vitamin A overdose in short order.

      • rox123

        People died because of scurvy too.

        • Roadstergal

          Absolutely. But you almost never see scurvy in the US, even among people eating fast-food heavy diets. Vitamin deficiency is rare. Ironically enough, I think a baby whose mom has bought into the “EBF for at least one year” business would be at greater risk of vitamin deficiency than your average American adult eating your average American diet…

          • Liz Leyden

            The Washington Post recently ran a case study on a boy who turned out to have scurvy. It wasn’t a diet issue so much as a mental health issue. Between his extreme food avoidances and speech delay, the docs examining him suspected autism. Apparently, the handful of children diagnosed with scurvy every year usually have autism. Scurvy in adults is associated with poverty and psychiatric illness.

            https://www.washingtonpost.com/national/health-science/doctors-were-stumped-by-this-toddlers-painful-legs-rash-and-bleeding-gums/2016/07/25/12f84954-1861-11e6-aa55-670cabef46e0_story.html

          • Irène Delse

            I knew a guy who basically destroyed his brain through alcoholism and malnutrition. He was mentally disturbed to begin with, and instead of seeking help, he turned to alcohol, cigarettes and long sessions on the internet. That was when he was still communicating. Later, I learned that he had stopped working and become isolated. After living for who knows how long on mostly alcohol, he was found one day in a coma, brought to the hospital. He recovered physically but had lost all his memories. Of course, these are extreme cases.

          • TheArtistFormerlyKnownAsYoya

            I’m curious how this ties into prenatal vitamins. Do we really need them, or not? Currently pregnant and tried 3 varieties, and they all made me horribly nauseous – not for an hour or two after taking, but all day and all night. I eventually quit taking them because they made me unable to go to my job, which I need. I take Floradix pills now because I’ve had problems with low iron and B vitamins prior to pregnancy. Why do doctors recommend prenatals to everyone regardless of diet?

          • swbarnes2

            (I’m getting this mostly from sciencebasedmedicine.com). Folic acid taken before you test pregnant definitely helps prevent neural tube defects in the fetus. That’s certain. But the window for that closes at about 8 weeks, I’m not sure if it helps after that. And if pregnancy is making you not want to eat much, you might have a vitamin deficiency. But if you don’t have a vitamin deficiency, and you have a handle on the folic acid thing, I don’t think there’s any evidence that they help.

            But since you’ve been diagnosed with deficiencies, you are not in the same boat as most women, and yeah, you probably do need them. I suppose you could skip the multivitamin and just take what you need separately, maybe you could stomach them better. It might be the iron that’s getting to you.

          • sdsures

            I’m on iron (not pregnant). Ferrous sulfate tablets made me terribly nauseated, but ferrous gluconate is tolerable. My doc told me to come back if I get sick again from it, and we can keep trying to find a type I can tolerate. So far it’s OK, so don’t be afraid to ask your doctor to try a different version.

          • Roadstergal

            I’ve had to supplement with iron here and there due to labs, and the ferrous sulfate doesn’t make me nauseated, but it gives me really weird, almost black poops. :

          • sdsures

            Yeah, the black poop is guaranteed with all iron supplementation. AFAIK, it’s nothing to worry about, but ask your doctor if it’s concerning you. It scared the crap out of me the first time I saw it (so to speak)!

          • TheArtistFormerlyKnownAsYoya

            In first trimester deficiency may have been a concern, I could only stomach fruit, fried foods, and cereals for about 2 months. But I eat everything now, we make our food at home and eat fresh fruits and veggies daily. I looked up sciencebasedmedicine’s article and it’s very interesting to note that she concluded routine iron supplementation for all pregnant women has no supporting evidence! In my layperson’s “research” I had thought I found that folic acid and iron were the only two I really needed to be concerned about. Well, I do need to worry about iron obviously but not everyone does.

          • sdsures

            Because extra folic acid is needed to ensure that the fetus’s neural tube develops properly.

          • TheArtistFormerlyKnownAsYoya

            That is true, but prenatals contain far more than just folic acid.

          • sdsures

            *nod*

          • TheArtistFormerlyKnownAsYoya

            Just as an example, here’s Centrum’s prenatals composition:

          • sdsures

            In other words, those amounts are what the fetus takes from the mother, so she has to take the vitamins with these amounts to replace them?

            Are prenatals available in a single pill, or do they come in multiple pills?

          • TheArtistFormerlyKnownAsYoya

            As far as I know PregVit is the only brand that comes in multiple pills. It splits the iron and vitamin A apart as those are supposedly what tends to make people nauseous, so you take one in the morning and one in the evening instead of all at once. It didn’t work for me, I was just as nauseous.

          • Heidi

            I know some doctors have suggested just taking folic acid or even a B-complex if the whole prenatal makes you nauseated. Maybe you could ask your OB/GYN if that’d be okay while you are still feeling nauseated? Sometimes that’s all I could handle during the beginning. When I was further along, my stomach could handle the prenatals.

          • TheArtistFormerlyKnownAsYoya

            I haven’t had the courage to try the prenatals again, but I did take a folic supplement along with the Floradix at the start, and now just the Floradix (which contains enough folic acid for 2nd/third trimester). I didn’t even have morning sickness on its own, only from the prenatals. I’ve heard it’s the high doses of vitamin A and iron that make you nauseous with prenatals, but my Floradix’s iron never made me feel ill like that.

          • Heidi_storage

            Harriet Hall at sciencebasedmedicine basically said they’re a waste, except for the folic acid.

          • TheArtistFormerlyKnownAsYoya

            Thanks, I’ll check that out!

          • Megan

            I personally tell women with morning sickness and can’t tolerate a prenatal to just take folic acid.

          • KeeperOfTheBooks

            Check with your OB, YMMV, and all that, but I found that while prenatals with DHA made me badly queasy, taking a plain prenatal in the morning and a separate DHA supplement at night made me much less sick. My BFF suggested that to me as having been helpful to her, so sample size of, well, all of two. :p Still, I’m not sure how it could hurt.

          • sdsures

            I thought Dr Amy wrote about a case recently where a crunchy family’s toddler got scurvy, and it turned out that his diet consisted solely of chocolate milk and graham crackers. If it’s not an article she wrote personally, it’d be posted on the Skeptical OB FB page.

          • Liz Leyden
          • sdsures

            Yep, that’s the one. Thanks!

        • attitude devant

          I think one package of ketchup with your fries daily is plenty of C to ward off scurvy. (for the record, I have fries maybe twice a year, I’m just saying that you don’t need much C to not get scurvy)

          • Paula

            Potatoes are also rich in Vitamin C.

          • The Bofa on the Sofa

            I hate most fruit (esp peaches, but also citrus and pears and berries), so don’t eat any. Yet, I am not at risk for scurvy in any way. Apparently, something in my diet suffices.

          • Toni35

            Many vegetables have plenty of vitamin C. Peppers come to mind (although technically they are a fruit, but most people think of them as veggies… Same with tomatoes; they are technically fruit, and have lots of C).

    • MI Dawn

      Are there ANY foods that don’t have vitamins in them?

  • Brooke

    Trolling Paleo dieters so hard omg. Nutrition is important and does prevent and reverse disease. Read How Not To Die by Michael Greger.

    • fiftyfifty1

      “Read How Not To Die by Michael Greger.”

      More important than that, BUY How Not To Die by Michael Greger $$$$$.

      • Brooke

        He has a lot of free information on his website and cites his sources unlike someone.

        • Nick Sanders

          Well, certainly not Dr. Tuteur. This blog is full of free information and cited sources.

          • TheArtistFormerlyKnownAsYoya

            Ah, but I think Brooke here “feels” that Dr. Tuteur does not provide citations. That’s almost as good as it being true, right?

        • Taysha

          I’d like to know how not to die.

          I don’t think it’s possible to be immortal just yet. I mean, unless he writes fiction.

          • Roadstergal

            One of my favorite works of fiction is more honest than Michael Greger.

            “Tell me, Genry, what is known? What is sure, unpredictable, inevitable — the one certain thing you know concerning your future, and mine?”

            “That we shall die.”

            “Yes, There’s really only one question that can be answered, Genry, and we already know the answer. … The only thing that makes life possible is permanent, intolerable uncertainty: not knowing what comes next.”

          • Megan

            Meaning of Life? 42.
            How not to die? 48.

          • Charybdis

            Save a table at Milliways and So Long and Thanks For All The Fish.

          • Did you just quote Left Hand of Darkness? *swoon*

        • Megan

          Does the free info on the website (and yes, I’ve been to his website) include how not to die or do you have to pay for that special tidbit? Cause I’d love to know how not to die.

        • fiftyfifty1

          “cites his sources unlike someone”
          You, that is.

    • Amy Tuteur, MD

      Why? Everyone dies and Michael Greger can’t do a damn thing about it.

      • Linden

        I LOLd. That is some *condensed* Brooke, right there.

      • Brooke

        I know its difficult for you to read something that contradicts your already established view but maybe you should have looked into the author and the book before commenting.

        • Taysha

          Only viruses don’t die since they are technically not alive.

        • CSN0116

          “I know its difficult for you to read something that contradicts your already established view but…”

          I can’t LOL loud enough! Is this shit for real?!!!!!

        • Roadstergal

          Are you disagreeing with the fact that every human dies and Michael Greger can’t do a thing about it?

          • Brooke

            Fine. Die of a preventable disease because your head was stuck to far up your ass to even Google Dr.Michael Greger.

          • Roadstergal

            Are you disagreeing with the fact that every human dies and Michael Greger can’t do a thing about it?

          • momofone

            What do you consider preventable, and how did you arrive at your answer?

          • moto_librarian

            Just out of curiosity, are your kids vaccinated, Brooke? That is the most effective means of preventing death for preventable disease, after all.

          • Heidi

            Ha, I’ll take death over living forever with some Brookes!

          • Linden

            I refused to google dr whatsisname three hours ago, and already I am coming up in boils and coughing up half a lung. Heed Brooke’s words, people. To google, before ’tis too late!

          • Roadstergal

            I use Bing search – will I still live?

          • momofone

            I’m sorry; Brooke was very specific. Too late now.

          • Bombshellrisa

            There is no such thing as Bing Medical school and you can’t get a credential for being a Bing scholar. Sorry!

          • Nick Sanders

            WHY?!

          • Who?

            You may be on to something-I bet most of the people who have died in the last day or so had not googled drwhoeveritis. So there’s the proof-and you don’t even need to follow the dietary advice-just google!

          • Sue

            Only boils and coughing? I refused to google Dr Whatsisname only minutes ago and I have already died of preventable woo deficiency. (Posting from heaven. Lots of social media here 😉 ).

        • MI Dawn

          I looked at the book, Brooke. It’s your standard “eat what I tell you to eat and you won’t get diabetes, CHD, cancer” nonsense. Yes, eating right will help someone stay healthier. But it won’t trump genetics. And it won’t let you live forever. His title is ridiculous.

          • Roadstergal

            I wonder about the insidiousness of the whole idea of eating around certain diseases. Eg, T1D. The older you are when you get Type 1, the less acute it is, and someone who’s on the older side (in that disease, in your 20s is on the older side) can control their symptoms somewhat with a very strict diet. Not as well as with appropriate use of insulin, but ok enough, and then they bray on message boards about that nasty pharma industry trying to make them take shots when you can control T1D just fine with your diet. I wonder about parents of young kids with very acute T1D getting the idea that their kid doesn’t need those nasty shots…

            Similarly, I was chatting with a clinical scientist on IBD who was very nervous about people who ‘eat around their symptoms’ and don’t take treatment, as they can indeed reduce their symptoms – but it doesn’t arrest or reverse the inflammation and fibrosis.

        • Irène Delse

          It’s true, the claims of immortality are a tad too extreme to be accepted just because you’re “omg” in awe of them.

    • Elizabeth A

      Given that there is no way to not die (only, if you are fortunate, some ways of increasing your odds of surviving a finite time span), that’s a really dumb book title.

    • SL27

      How does nutrition reverse disease? My parents had a neighbor who got cancer young (I’m not sure her age, but all of her kids were still living at home). She went into remission, switched to an all organic plant based diet, and her cancer still came back. She died while waiting for a bone marrow transplant. What could she have done differently?

      • Brooke

        Notice I didn’t say all disease. Did you even Google the book?

        • Sue

          “Did you even Google the book?”

          That’s really funny. A nasty person who only drops in here to criticise and stir somehow thinks that other readers rush to chase up her recommended reading. Hilarious!

      • sdsures

        Not talking about borderline diabetes, are we? Sometimes a person can alter their diet and stop it progressing into full-blown diabetes. This was what my husband’s diabetes nurse said to him when he was first diagnosed.

        Apologies if I am inaccurate. Anybody know?

        • Caylynn

          pre-diabetes can be reversed with diet and exercise. Once you have type 2 it cannot be reversed, but some very few manage to control it with only diet and exercise. Most people with type 2 need medication to keep their blood sugars under control, however. I’m an RD with experience in a diabetes centre.

          • MI Dawn

            Yes, but you’re biased towards medications since you work in a diabetes center! (/snark).

            My ex developed type 2 several years ago. His MD didn’t rush to put him on medications (gasp!) but encouraged diet, exercise, and scheduled him for multiple visits with an RD (who was awesome, btw). He monitored his sugars and HbA1C. Unfortunately, he did end up needing to go on metformin. BUT…by continuing with the RD, diet, and exercise, he is on the very lowest dose of metformin possible with well-controlled sugars and A1C. After all, as I’ve said before, you can do all the right things but genetics are a bitch and he has a very strong family history of type 2.

    • momofone

      My (extended) family has been affected by Duchenne muscular dystrophy. I am very interested in what nutritional information you can share for reversing this. (Hint: It would need to change genetic makeup.) I’ll be waiting with bated breath.

      • Mel

        Waiting for the list of drinkable mutagens…..

        • momofone

          Brooke must be compiling the list now. It’s taking a little while.

        • Irène Delse

          Deepak Chops has it covered! I recently saw one of his books in a bookstore here, it was something about learning to modify your DNA in a beneficial way… Somehow, I don’t think he was talking about generic engineering!

          • sdsures

            What a wacko that guy is.

      • Brooke

        Notice I didn’t say ALL diseases. Omg.

        • momofone

          Oh, ok. So SOME diseases, which you have chosen not to specify, but DEFINITELY not other diseases. I see.

        • momofone

          You want to be taken seriously, and “Omg” is the best you can do when someone challenges a claim YOU made?

    • J.B.

      If by “trolling” you mean pointing out logical fallacies on her own blog then ok…

    • Taysha

      Why would I take my advice from something someone’s selling?

    • Heidi_storage

      How Not to Die: Get translated into Heaven directly, a la Enoch and Elijah. Otherwise, you’re sort of out of luck. Someday Michael Greger will die, and so will you, and so will I.