Butter Nonsense

Posted by Martin Cohen


Last week saw President Trump throwing out a CNN reporter from the White House Press Pool for disagreeing with him about ‘the facts’.

CNN called it an attack on press freedom, but the collective response from other journalists has been muted. And no wonder, because these days the press are themselves heavily into ‘denying’ certain views. We've all heard about ‘Climate deniers’ and how evil they are, but this last month saw a vehement attack on Cholesterol deniers!

Sarah Boseley, longtime health editor of the supposedly liberal UK newspaper, The Guardian, launched the attack with a piece called:

Butter nonsense: the rise of the cholesterol deniers

The stand-first sums up the piece accurately:

‘A group of scientists has been challenging everything we know about cholesterol, saying we should eat fat and stop taking statins. This is not just bad science – it will cost lives, say experts’.

The back story is that The Guardian, has long been very chummy to the pharmaceutical industry and regularly promotes the case for expensive drugs and mocks campaigners. Its longtime medical writer, Ben Goldacre, under the heading we just saw reused by Ms Bosely of ‘bad science’, regularly wrote in favour of Big Pharma and against alternative medicine let alone common-sense approaches without ever declaring his own links. There were family links as well as a career one via the Institute of Psychiatry to many of the industries favoured by the arguments in his articles.

‘Big Phama’, firms like Unilever; SmithKline Beecham and Pfizer Limited (two producers of antidepressant drugs); Novartis Pharmaceuticals (previously Ceiba Geigy); Lilly Industries Ltd (the manufacturers of Prozac); Hoescht Marion Roussell; GlaxoSmithKline (vaccine manufacturers) … and so on smiled on his work. Goldacre even received an award for ‘science journalism’ in 2003 - the award that year being sponsored by GlaxoSmithKline.

It’s enough to make you cynical, as is the fact that in the early years of 2000, the Institute of Psychiatry held over 200 research grants with an annual value of around £14.5 million. Its second highest source of funding was the pharmaceutical industry. The Institute is part of King’s College London, and part of the UK’s public education system. Yet for all the money the public devotes to universities, and for all the special status of university academics, private money like this drives research findings.

But back to butter, and the new money-spinner today is prescribing drugs called statins in order to reduce cholesterol. Justin Smith estimated in a piece for Statin Nation that the market for these drugs was more than $19 billion and rising. In The Guardian piece, Boseley says ‘statins are out of patent and therefore no longer make money for the companies that originally put them on the market’.

Note those ‘weasel words’, ‘for the companies that originally put them on the market’.

I looked at the cholesterol debate - I could hardly NOT do - in my food book published this month *. It is (chemically speaking) a very 'complex' area (all diet things seem to be when you get into them), but there are some studies that can be talked about in a broader sense, including several iconic long-term studies of low-cholesterol diets which do seem to demonstrate:

(a) that it is effectively impossible to isolate one factor in a dietary study, (alteration of one factor disguises changes in other factors too) and

(b) in as much as it is possible, not only that there is no evidence to support the 'low cholesterol diet' approach, there are indications that it might actually increase the risk of heart disease!

The Guardian piece makes little attempt to present a 'debate' but instead pushes the view that there is an argument for refusing to give cholesterol-deniers a platform, just as some will no longer debate with climate change sceptics. The position is summed up by one of Prof Rory Collins of Oxford University, a professor of epidemiology who says quite unashamedly that by cholesterol deniers he means people who dispute the claim that diets high in cholesterol are dangerous for heart health. As Sarah Boseley puts it here, these are people saying butter is safe and statins are dangerous. BAD PEOPLE!

No real evidence is actually offered in the piece, and when I asked Ms Boseley for any background studies she might have used, she did not respond to the request.

In fact, the available evidence is very different. One small study of Australian men found swapping from butter to margarine, for example, found the death rate from heart disease went up amongst the margarine eaters. Another study, in Denmark, that put people on a low-salt diet precisely to protect heart health, found that perversely it led to cholesterol levels shooting up!

Surveying the research, some 20 years ago now, Dr Laura Corr a cardiologist at Guys Hospital in London concluded that :

‘The commonly-held belief that the best diet for prevention of coronary heart disease is a low saturated fat, low cholesterol diet is not supported by the available evidence from clinical trials"

However, seven years ago, an influential meta-analysis by the Cholesterol Treatment Trialists found that:

‘Observational studies show that there is a continuous positive relation between coronary disease risk and blood cholesterol concentrations [and] larger reductions in LDL cholesterol [the so-called 'bad cholesterol'] might well produce larger reductions in risk.’

In 2015, another systemic review by researchers from various international institutions in Japan, Sweden, UK, Ireland, US and Italy, published in the BMJ, insisted that - on the contrary! - as LDL cholesterol went down, all-cause mortality went up while higher levels of ‘bad ’ were apparently linked to living longer.

Don’t ask for new studies, as there have been so many, and yet analysis of what they prove remains completely partisan. It has been noted that the actual trial data held by the Cholesterol Treatment Trialists’ Collaboration on behalf of the industry sponsor has not been made available to other researchers, despite multiple requests over many years.

Since then, rather than demonstrate their case through persuasive research, advocates of the low-fat, low-cholesterol diets have sought to shut-down debate even trailing that new term cholesterol deniers...

After reading all the evidence, my feeling is that cholesterol levels are not simple, one dimensional values to be turned up or down like a thermostat and attempts to shoehorn it into a Manichean (good / evil) view of dietary factors risks actually harming human health. Attempts by governments and media to rule definitively on it are unwise and a distraction from practical steps that can be taken.



* ‘I Think Therefore I Eat’ is published by Turner in the U.S. on November 20

Butter Nonsense

Posted by Martin Cohen


Last week saw President Trump throwing out a CNN reporter from the White House Press Pool for disagreeing with him about ‘the facts’.

CNN called it an attack on press freedom, but the collective response from other journalists has been muted. And no wonder, because these days the press are themselves heavily into ‘denying’ certain views. We've all heard about ‘Climate deniers’ and how evil they are, but this last month saw a vehement attack on Cholesterol deniers!

Sarah Boseley, longtime health editor of the supposedly liberal UK newspaper, The Guardian, launched the attack with a piece called:

Butter nonsense: the rise of the cholesterol deniers

The stand-first sums up the piece accurately:

‘A group of scientists has been challenging everything we know about cholesterol, saying we should eat fat and stop taking statins. This is not just bad science – it will cost lives, say experts’.

The back story is that The Guardian, has often seemed to look fondly on the pharmaceutical industry and regularly promotes the case for expensive drugs and mocks campaigners. Its longtime medical writer, Ben Goldacre, under the heading we just saw reused by Ms Bosely of ‘bad science’, regularly wrote in favour of Big Pharma and against alternative medicine let alone common-sense approaches without ever declaring his own links. There were family links as well as a career one via the Institute of Psychiatry to many of the industries favoured by the arguments in his articles.

‘Big Phama’, firms like Unilever; SmithKline Beecham and Pfizer Limited (two producers of antidepressant drugs); Novartis Pharmaceuticals (previously Ceiba Geigy); Lilly Industries Ltd (the manufacturers of Prozac); Hoescht Marion Roussell; GlaxoSmithKline (vaccine manufacturers) … and so on smiled on his work. Goldacre even received an award for ‘science journalism’ in 2003 - the award that year being sponsored by GlaxoSmithKline.

It’s enough to make you cynical, as is the fact that in the early years of 2000, the Institute of Psychiatry held over 200 research grants with an annual value of around £14.5 million. Its second highest source of funding was the pharmaceutical industry. The Institute is part of King’s College London, and part of the UK’s public education system. Yet for all the money the public devotes to universities, and for all the special status of university academics, private money like this drives research findings.

But back to butter, and the new money-spinner today is prescribing drugs called statins in order to reduce cholesterol. Justin Smith estimated in a piece for Statin Nation that the market for these drugs was more than $19 billion and rising. In The Guardian piece, Ms. Boseley says ‘statins are out of patent and therefore no longer make money for the companies that originally put them on the market’.

Note those ‘weasel words’, ‘for the companies that originally put them on the market’.

I looked at the cholesterol debate - I could hardly NOT do - in my food book published this month *. It is (chemically speaking) a very 'complex' area (all diet things seem to be when you get into them), but there are some studies that can be talked about in a broader sense, including several iconic long-term studies of low-cholesterol diets which do seem to demonstrate:

(a) that it is effectively impossible to isolate one factor in a dietary study, (alteration of one factor disguises changes in other factors too) and

(b) in as much as it is possible, not only that there is no evidence to support the 'low cholesterol diet' approach, there are indications that it might actually increase the risk of heart disease!

The Guardian piece makes little attempt to present a 'debate' but instead offers the view that there is an argument for refusing to give cholesterol-deniers a platform, just as some will no longer debate with climate change sceptics. The position is summed up by one of Prof Rory Collins of Oxford University, a professor of epidemiology who says quite unashamedly that by cholesterol deniers he means people who dispute the claim that diets high in cholesterol are dangerous for heart health. As Sarah Boseley puts it here, these are people saying butter is safe and statins are dangerous. BAD PEOPLE!

No real evidence is actually offered in the piece, and when I asked Ms. Boseley for any background studies she might have used, she did not respond to the request.

In fact, the available evidence is very different. One small study of Australian men found swapping from butter to margarine, for example, found the death rate from heart disease went up amongst the margarine eaters. Another study, in Denmark, that put people on a low-salt diet precisely to protect heart health, found that perversely it led to cholesterol levels shooting up!

Surveying the research, some 20 years ago now, Dr Laura Corr a cardiologist at Guys Hospital in London concluded that :

‘The commonly-held belief that the best diet for prevention of coronary heart disease is a low saturated fat, low cholesterol diet is not supported by the available evidence from clinical trials"

However, seven years ago, an influential meta-analysis by the Cholesterol Treatment Trialists found that:

‘Observational studies show that there is a continuous positive relation between coronary disease risk and blood cholesterol concentrations [and] larger reductions in LDL cholesterol [the so-called 'bad cholesterol'] might well produce larger reductions in risk.’

In 2015, another systemic review by researchers from various international institutions in Japan, Sweden, UK, Ireland, US and Italy, published in the BMJ, insisted that - on the contrary! - as LDL cholesterol went down, all-cause mortality went up while higher levels of ‘bad ’ were apparently linked to living longer.

Don’t ask for new studies, as there have been so many, and yet analysis of what they prove remains completely partisan. It has been noted that the actual trial data held by the Cholesterol Treatment Trialists’ Collaboration on behalf of the industry sponsor has not been made available to other researchers, despite multiple requests over many years.

Since then, rather than demonstrate their case through persuasive research, advocates of the low-fat, low-cholesterol diets have sought to shut-down debate even trailing that new term cholesterol deniers...

After reading all the evidence, my feeling is that cholesterol levels are not simple, one dimensional values to be turned up or down like a thermostat and attempts to shoehorn it into a Manichean (good / evil) view of dietary factors risks actually harming human health. Attempts by governments and media to rule definitively on it are unwise and a distraction from practical steps that can be taken.

* ‘I Think Therefore I Eat’ is published by Turner in the U.S. on November 20

BOOK REVIEW: I Think, Therefore I Eat

Reviewed by Colin Kirk

‘Felling rain forests to free up land for growing animals and vegetables, pulverized into so called foods,..is nightmarish..’ PICTURE: Lowland rainforest in Sulawesi's Tangkoko Reserve, Indonesia. Photo by Rhett A. Butler for Mongabay.

Martin Cohen is well known to generations of budding philosophers for his ‘101’ books. Amongst many other productions Political Philosophy from Plato to Mao stands out for critical analysis presented with lucidity and humor. I Think Therefore I Eat is a worthy successor to these seminal texts.

In an age when most journalism is no more than regurgitation of the PR blurb of commercial and political interests, philosophy regains its rightful place as investigator. This account, not simply of food its production and marketing but of the constituents of the human body that result, is unique and unlikely to be surpassed.

These days experts contribute to the human horror story. It requires philosophy to correct their ever changing sound bites with straightforward examination of the facts. Witty and readable, I Think Therefore I Eat will shock food experts of all kinds but the rest of us will think carefully before we eat. We’ll improve our life styles and extend our life expectancy as a result.

This book is almost impossible to classify. The philosophy is certainly in evidence but unobtrusively, amongst careful description of the grotesque constituents of junk food and their effects on the human body and mind, interspersed with unusual recipes that rush one into the kitchen.

There is structure to this bizarre conglomeration that meanders through the food fashions of the past hundred years with reference back to the eating habits of philosophers over the previous two and a half millennia.

Not all the foodies referred to are generally regarded as philosophers nor are their eating habits necessarily sound, quite the reverse. Hitler exemplifies these peculiarities of some of the thinkers selected. Mein Kampf is a work of philosophy but a diet of macerated boiled vegetables was not a healthy choice, nor were the concomitant medical interventions designed to ease the Fuhrer’s resultant flatulence.

One great strength of this book is the exposure of the appalling practices of free market exploiters of the environment both around us and inside us. Felling rain forests to free up land for growing animals and vegetables, pulverized into so called foods, contaminated with all manner of chemical contrivances to extract the last fast buck, is nightmarish reading.

These are not scenes in a horror movie from some way-out, backward, banana republic but day by day activities of world brand agricultural, chemical, pharmaceutical, food and drinks manufacturing industries that fuel economic growth for the few and ill health for the many.

Even when there were active Food and Drug Administrations in Western Democracies, well healed lawyers, scientists and medics ensured they had little actual clout against conglomerate industries with turnovers measured in billions of dollars or euros. The quality of expertise applied to such matters is low and the price charged by such experts extremely high. These are business models of the worse kind applied to the basic essentials of life.

Every page of this book contains good advice but it leads to no overall conclusion of the one-size-fits-all variety, with the possible exception of the seal of approval given to real chocolate. Most of what’s sold unfortunately isn’t.

At heart this is a work of philosophy and its conclusion is the usual one. Be yourself, it’s up to you. Examine all facts directly yourself, not the conclusions of characters who claim to be experts. Interpret the facts as best as you can and decide a course of action that suits you.

We all know that we are what we eat but we apply that knowledge as our appetite dictates. However, we now know that our appetites are massively influenced by advertisements, chemicals, manufactured flavors and plasticized finishes that do us no good and a great deal of harm. The golden delicious chips at McDonald’s are a prime example.

Western Democracy, the political model we live in, is designed by and for multibillionaires and their bureaucratic and expert camp- followers, who are paid handsomely to betray us into horrid eating habits as they transfer our money into their pockets.

Fidel Castro, another philosopher not usually thought of as such, was forced, by the collapse of Russian Communism in 1989 and the total American blockade of Cuba that ensued, to cultivate every square meter of land capable of growing food. The city of Havana and every other city, town and village became fruit and vegetable gardens. The Cubans did not starve to death as intended but became more healthy and versatile.

The problem with doing the right thing by growing your own food, should that be your conclusion, is that it requires a great deal of thought and planning. Further, success follows a series of disheartening failures as one learns by experience. For good health, fitness and longevity it’s worth it.

This is not a reference book as such but you’ll refer to it time and again in your pursuit of good eating habits. You’ll more likely find it on the shelf of recipe books in the kitchen than along with Kant and Kierkegaard.

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Colin Kirk is the author of Life in Poetry.

BOOK REVIEWS: Back to the Future with the Food Gathering Diet

Posted by Martin Cohen*

BOOK REVIEW
Back to the Future with the Food Gatherers Diet

How we imagine hunting and gathering - in this case, on the South Texas Plains

Food Sanity: How to Eat in a World of Fads and Fiction
By David Friedman (Turner 2018).

Psst! Maybe someone should have told David Friedman, well-known media personality as well as the author of this new look at food issues – there are hardly any vegans. So if you pitch a book on 'how to eat' to that crowd, you take the risk of ending up preaching to a much reduced congregation. Add to which the serious vegans in town won't like some of what Friedman has to say, because vegans don’t eat eggs and certainly don’t eat fish. All of which only goes to show, that food is a pretty controversial and divisive issue these days, and if you want to be honest, as Friedman evidently does, you're going to have to risk trampling on the dearly held, indeed dearly munched, beliefs of lots of people.

But I hope Food Sanity does find that wider readership, because I’ve read a lot of books and articles recently about food and this one really does clear out a lot of the deadwood and present some pretty mind-boggling facts (and figures) to ‘put the record straight’, as Jack Canfield (of Chicken Soup for the Soul fame) puts it, by way of an endorsement of the book.

Take one opening salvo, that as I say, will surely lose Friedman lots of readers in one fell swoop: the Paleo or ‘Caveman’ Diet. This is probably the most popular diet going and that’s likely because it fits so excellently people’s dearly held prejudices. Plus, it allows them to eat lots of beef-burgers and chips, while cutting out things like muesli which only hippies eat anyway. But oh no, Friedman has done his research and found out that Stone Age folk didn’t really eat lots of red meat washed down with a beaker of blood, as we like to imagine. Instead, using both archaeological and anthropological research as a guide, he says that the earliest human tribes spent most of their time eating fruits and seeds, which they gathered, and probably only really sharpened the spears (or so, at least, I imagine) for internecine human disputes.

Friedman finishes his deconstruction of Paleo by consideration of human biology too: notably the fact that we just aren’t built to catch our fellow animals. We lack the right claws, teeth and general physique too. He points out, a thing curiously overlooked, that Stone Age people would have been rather short and squat - not the fine figures wielding clubs that we imagine. He retells Jared Diamond’s tale of a hunting trip by one of today’s last remaining ‘stone age’ tribes, in New Guinea. At the end of the hunt, the tribe had caught only some baby birds, frogs and mushrooms.

This is all fascinating to me, but compelling too are Friedman’s physiological observations, most particularly on the acidity of the human stomach. The gastric fluids of carnivores are very acidic (pH 1), which is essential if they are to break down the proteins and to kill bacteria. Our stomachs, however, are much less acidic (pH 5), and simply can’t tolerate much uncooked meat. And if, yes, Stone Age man might have done a bit of cooking, it would probably have been rather rudimentary with parts of the meat not really cooked.

Actually, by the time I had finished reading all of the reasons that ‘humans can't eat meat’, I was left puzzled by Friedman’s conclusion which was that a significant proportion of the prehistoric human diet (nonetheless) seems to have been meat. Less surprising was Friedman’s hearty endorsement of eggs, which surely everyone has heard by now are really not dangerous, and don’t cause heart attacks after all, and fish, which he carefully defends form claims that they are today dangerously contaminated with things like mercury.

However dairy gets the thumbs down, with a disdain that I personally felt was unjustified. Dairy, after all, is much more than drinks of cow’s milk - it is goat and sheep milk, cheese and cream too -  and an inseparable part of many dishes. We are advised here instead to swap to things like ‘almond milk’, and ‘hemp milk’ but I know these substitutes very well, and, well, they ain’t one. At least Friedman doesn’t try to suggest we switch to soya milk because, as he rightly observes, that is a food disaster just in itself

There is, to be honest, a bit too much bad news in this book - so much so that I started to skip some  sections, which fortunately the book’s modular structure permits. On the other hand, Friedman makes an effort to leaven the mix by including some good news and positive suggestions, including a two page table of the healthiest foods on earth. What are they? They're all fruits and veggies - the things that Plato and Pythagoras were praising and recommending nearly three thousand years ago. It seems that it’s time, if not indeed long overdue, to go back to following their advice.

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*Martin Cohen is the author of a forthcoming book on food issues too called I Think Therefore I Eat, which is also published by Turner, and due out in November 2018