The weird belief that people follow dietary guidelines

A study was published in Nutrition last week in support of the strange fantasy that Americans became obese because they slavishly followed government dietary guidelines. This is the premise of Nina Teicholz's recent book The Big Fat Surprise (see here for my review). Teicholz is thanked for her "support" at the end of the new study.

The revisionist history is that, from the 1970s, the US government told its citizens to abstain from fats and stuff their faces with carbohydrates. Americans dutifully complied and became obese as a result, because fats are wonderful and carbs are dreadful.

The evidence for this hypothesis comes from dietary data from the US National Health and Nutrition Examination Study (NHANES) which the Nutrition study cites:

Consumption of fats has dropped from 45% to 34% with a corresponding increase in carbohydrate consumption from 39% to 51% of total caloric intake. In addition, from 1971 to 2011, average weight and body mass index have increased dramatically, with the percentage of overweight or obese Americans increasing from 42% in 1971 to 66% in 2011.

For Teicholz and her supporters, this is proof that fat consumption has fallen by 25 per cent since 1971. But this is like saying that the British population has declined because the UK has a smaller share of the world's population today than it did fifty year ago. It is, to be blunt, a lie. What actually happened is Americans kept eating the same amount of fat but started eating more of other foods, mainly carbohydrates, thereby increasing their overall calorie intake which, combined with more sedentary lifestyles, led to world-beating levels of obesity.

The inconvenient fact that the amount of fat consumed has not fallen for over forty years is acknowledged in the study itself:

Since 1971, the shift in macronutrient share from fat to carbohydrate is primarily due to an increase in absolute consumption of carbohydrate as opposed to a change in total fat consumption.

... Daily fat consumption fell to 83 g in 1971, and remained at approximately the same level through 2011. In contrast, carbohydrate consumption, although basically at from 1965 to 1971 in terms of total calories, has risen to 278 g/d since 1965, an increase of 30.6%.

It is true that the US government recommended that dietary fat should make up less than 35 per cent of energy consumed, but it should go without saying that they wanted this to happen by people reducing the amount of fat they ate, not by increasing the amount of everything else they ate.

Americans abided by neither the letter nor the spirit of the guidelines, and yet the authors make the silly claim that...

These patterns and changes in consumption are consistent with the hypothesis that Americans on average adhered to the government dietary recommendations regarding fat, saturated fat, cholesterol, and carbohydrate.

You can read the USDA dietary guidelines for 1980 here. They are perfectly sensible, but it is a stretch to claim that Americans have been faithfully following them.

For a start, it says "use less of all sugars" and "eat less of foods containing these sugars", something that Americans conspicuously failed to do over the next twenty years. The rise in sugar consumption—which USDA plainly did not endorse—is one of the major causes of the rise in carbohydrate consumption.

USDA explicitly told people not to eat more simple carbohydrates like sugar because "they provide calories but little else in the way of nutrients." Insofar as it told people to eat more complex carbohydrates, it said "If you limit your fat intake, you should increase your calories from carbohydrates to supply your body's energy needs." USDA recommended that Americans "substitute starches for fats and sugars". That's substitute, not complement.

On the subject of "maintaining an ideal weight", USDA recommended that Americans "increase physical activity", "eat less fat and fatty foods" and "eat less sugar and sweets". Americans did none of this. They reduced physical activity, ate the same amount of fatty foods and ate more sugar. Unsurprisingly, they did not maintain an ideal weight.

Insofar as Americans were aware of the guidelines at all, they clearly did not "dutifully" follow them. The only aspect of the guidelines which they came close to meeting, albeit by accident, was a reduction in fat consumption as a percentage of total calorie consumption, but since this was entirely an artifact of increased calorie consumption, it is not what the USDA desired or recommended.

In sum, American nutritional guidelines were neither extreme nor dangerous (as the revisionists would have you believe), but even if they had been, it wouldn't have made any difference since Americans ignored them.

(See Carbsane for more of the problems with this study.)

Share

Tweet

Coffin dodgers

From The Telegraph...

Alarm over sudden drop in female life expectancy

Life expectancy for women has suffered a drop on a scale not seen for decades, as their lifestyles become more like those of men, official figures show. 

Surely that's good news for all those people who are worried about 'health inequalities'?

They are not talking about life expectancy at birth (which continues to rise), but life expectancy at a very advanced age.

It means the average woman aged 75 can expect to live 13.1 years; five weeks less than in 2011.

For a woman aged 85, average life expectancy is now 6.8 years - a fall of two and a half months, in two years.

So a 75 year woman can "only" expect to live until she's 88 and an 85 year old woman can "only" expect to live until she's 91. Am I alone in thinking that this is, if anything, too long?

Various people are claiming to be very concerned about this blip. The state-funded super-charity Age UK are blaming the "decline of state-funded social care" (ie. "give us more money") while the renowned Twitter troll John Ashton, still at the Faculty of Public Health after avoiding the sack, is blaming—you guessed it—"lifestyle factors".

Prof John Ashton, president of the UK Faculty of Public Health, said the fall in women’s life expectancy might reflect changes in the lifestyles of the baby boomer generation, which were taking their toll decades later.

“One of the issues we have seen is women living lifestyle’s [sic] becoming [sic] more like those of men over recent decades, with more smoking and drinking,” he said.

Because every single health issue is about smoking and drinking, isn't it? Even a FIVE WEEK decline in estimated life expectancy for people aged 85.

Where to begin? Firstly, someone who is 75 or 85 was born either before or during the Second World War and is therefore not a baby boomer.

Secondly, look at the graph that forms the basis of this mini-panic...

Ooh, look at the scary drop! Can you even see it? The graph is interactive on the Telegraph website and, as a result, you can see what the figures are. Taken together, they show that life expectancy for 65 year olds was 21 (2011), then 20.9 (2012), then 21 again (2013). For 75 year olds, it was 13.2, 13, 13.1 respectively. And for 85 year olds, it was 7, 6.8, 6.8.

In other words, there was no decline in the most recent year's data for any of the age groups, nor was the tiny decline seen between 2011 and 2013 for the 75 and 85 year age group "on a scale not seen for decades". The post-1980 trend shows many small ups and downs. Amongst the 85 year group, for example, life expectancy fell in 1982, 1985, 1988, 1991, 1993, 1995, 1999, 2003 and 2008.

It is, however, noticeable, that the trends in life expectancy get flatter as the cohort gets older. Life expectancy for 95 year olds, for example, has barely risen at all since 1980. This is because—whisper it!—they have reached the biological limits of human life. One day, we may see the trend for the other cohorts flatten out too, but it is far too early to say that this is already happening, even with the 85 year olds.

I have said before that the 'public health' movement is actually a longevity movement. It has cheerfully abandoned the concept of premature mortality in favour of a mindless body count. Longevity isn't a bad measure of utility if you're measuring it from birth, but it becomes preposterous when you start fretting about people who are already in their 80s and 90s.

The 'public health' lobby pile absurdity upon absurdity when they start blaming "lifestyle factors" on people living to be 91.6 when, if only they hadn't smoked or drank so much, they could have lived to be 91.8.

John Ashton wants us to believe that someone dying in their tenth decade of life is a preventable and premature death. Not only that, he wants us to believe that these great-great-grandmothers would have lived longer if they hadn't been heavy-smoking baby boomers [sic]. Even if this were true, what kind of warning is it supposed to be? Aren't these people supposed to have died decades earlier?

Perhaps I am giving Ashton too much credit for thinking his position through. More likely, he was phoned up over a bank holiday weekend about an issue of supposed public health and he gave the Pavlovian response of "smoking, drinking, blah, blah, blah" because that is all he, and his fellow nanny statists, knows how to do.

Share

Tweet

The Dark Market revisited

The tobacco display ban came into full effect in the UK today, making it a crime for shopkeepers to show customers tobacco packaging. With an election looming, it is worth remembering that both the Conservatives and Lib Dems opposed this absurd policy in opposition before nodding it through once in power. This is because no matter who you vote for, public health always get in.

It is also remembering that the case for the display ban was based on a tissue of lies from ASH and the Department of Health, who worked together to drastically understate the cost of retailers. Their collaboration was laid bare in a series of e-mails released under the Freedom of Information Act. This scam received some media attention (eg. in The Guardian) and I later told the full story in a mini-report titled The Dark Market. 

It is a fine example of how the government and its sock puppets stitch up public consultations, manufacture evidence and mislead the electorate. If you haven't done so before, today is a good day to read The Dark Market.

Share

Tweet

Sunday sermon: A creeping persecution

Here's a video of the indefatigable Patrick Basham talking about the nanny state in Australia recently. Enjoy.

Share

Tweet

Debating the Alcohol Health Alliance

I was on Five Live earlier in the week debating with Ian Gilmore—sorry, Professor Sir Ian Gilmore—of the Alcohol Health Alliance. Gilmore wants to stop Guinness from sponsoring the Premier League. It's "morally wrong" apparently.

Gilmore doesn't seem to know anything about sport or advertising, but you can listen from 28 minutes here if you're interested.

Share

Tweet

Swedish exceptionalism

Sweden's state-owned alcohol retail monopoly—Systembolaget—has put out an amusingly smug advertisement for itself.



If you can't be bothered to watch it, the message is "free markets—bad, state-owned monopolies—terrific". Presumably, the aim is to convince Swedes that they are better than everybody else because they can't buy a drink after 6pm and it costs a king's random when they do.

To be fair, off licences in Sweden have a good range of choice (as the advert proudly declares), but that is offset by the fact that there is no choice in off licences. If the state doesn't stock it, it is effectively illegal.

Systembolaget gives the government a way to exploit and patronise the public at the same time. It's a hangover from the Sweden's brush with prohibition and the subsequent Bratt System. As Swedes are aware that most countries don't treat their citizens like children in this way, there is always a danger that they might turn against the state-owned model. And so, as with any socialist system, the state has to resort to nationalistic propaganda.

h/t C.W.Norton

Share

Tweet

What will the manifestos bring?

FTI Consulting have published a briefing paper about what to expect from the General Election. On page 32 there is a section on 'lifestyle' that is worth reading.

Following the end of the duty “escalator” on beer, the cut in beer duty in the March Budget demonstrated once again that politicians believe lifestyle industries and products capture the electorate’s attention. Albeit nuanced by broader arguments around choice, health and public responsibility, these complex consumer issues will continue to be a feature of debates in the commons long into the next parliament.

The tobacco industry has been rocked by the last-gasp success of the campaign to standardise “plain” packaging, the consequences of which are yet to arise after its implementation. The debate is far from over, especially if the Conservatives form another government: questions about illicit trade and intellectual property remain unanswered and noises about costly and time-consuming lawsuits are rumbling. Tobacco companies have set their sights on other industry challenges too: the evolution of alternative tobacco and nicotine products such as Electronic Vaping product (EVps, commonly known as e-cigarettes) means that “big tobacco” faces continued uncertainty as to what their products will look like and how they can be sold in the near future.

Going into the election, support for the alcohol industry appears sweetened with a 1p reduction in beer duty and duty on cider and spirits such as scotch whisky cut by 2 per cent, “to back one of the UK’s biggest exports”, as Osborne outlined in the last Budget. Whilst currently unsuccessful, the argument for minimum unit pricing has not been permanently defeated, with a report emerging from the house of Lords recommending a trio of paternalistic measures: minimum pricing, a variable tax rate in line with alcoholic strength and new rules on alcohol labelling. These are particularly likely to be pursued in the event of a Labour victory at the polls.

Alcohol faces a local / national pincer movement; the Local Government association has called for the government to divert a fifth of the current total annual duty on alcohol to councils and has requested power for councils to take public health issues into consideration when deliberating licenses, and supporting licensing and trading standards departments to tackle the black market in alcohol.

Authorities like Newcastle and Ipswich are mooting the prospect of local control over late night levies or the strength of alcohol which can be sold in their areas. as with proposals for local control over gambling (the number of bookies in an area, and what’s available within them), such measures can grow, spreading out so that in the end the effect is the same, or similar to, a national ban, without the national debate that would have gone with it.

The government faces pressure to take action against fixed odds betting terminals (FoBTs) in efforts to tackle problem gambling. This is not as simple an argument as it may seem; whilst some argue that too many outlets offering FoBTs on a high street can lead to a degradation of the street appearance and impact on the local economy, the impact of shop-based terminals (with the employment they offer and rates they generate) versus internet gambling as a source of addiction and poverty is more complex. There’s a safety point at play too, since the ability to police the age of gamblers, verify that they’re not drunk, observe and identify problem gamblers and so forth is much easier when the provider of the opportunity to gamble can actually see the punter – which of course doesn’t happen when the gambling’s being done at home. The government has set out that the future of FoBTs is “unresolved”. With the industry being placed under continued scrutiny, it can be expected that the gambling industry’s future faces uncertainty, though the Treasury will be wary of legislation that reduces the income it receives from the already heavily taxed and regulated gambling industry.

Sugar and fat in food and drink are next in the firing line, with a coordinated campaign by health bodies having grown momentum over the course of this parliament. A tax on soft drinks and energy drinks has been debated by public health officials and opposed by industry, but the government has not yet committed to a review or any progress on the issue. The debate should not be dismissed given the focus public health research is placing on diet and sugar intake, and the repeated cycle shown throughout this parliament in all of the tobacco, gambling, alcohol and food and drink debates – that progress for the “nannying” side of the argument is never permanently beaten. seemingly, it’s just delayed.

This briefing covers many of the big issues, but there are others—mandatory food reformulation, outdoor smoking bans, and a multitude of advertising bans, for example. These (state-funded) campaigns will continue regardless of which party is in charge. The shrieking will get louder and the pseudo-academic 'evidence' will get more and more absurd.

Whether they succeed doesn't much depend on the make up of the next parliament either. The last five years have shown that you cannot expect a party with the word 'conservative' or 'liberal' to be either of those things, while Labour's crusade against e-cigarettes at the EU level shows that the socialists are as hostile to free markets and free choice as ever. So long as the public health parasites keep saying 'think of the children!' there will be a gormless or ambitious politician ready to grab a quick headline.

Whatever happens, don't expect to see it in the manifestos before the election. Being unpopular, 'public health' garbage tends not be the kind of thing politicians want to put to a vote. The Tories and Liberals brought in the tobacco display ban despite being opposed to it when Labour were in charge. Plain packaging wasn't in any of the parties' manifestos and Labour's 2005 manifesto explicitly promised that its smoking ban wouldn't include wet pubs and private members' clubs. In fact, the only major 'public health' policy in the 2010 manifestos was minimum pricing in the Liberal Democrats'—and that never happened.

It's almost as if you can't trust them, isn't it?

Share

Tweet