The truth about nutritionists

[ciphergoth]

San Francisco appears to be rather fun! Back tomorrow.

For those who enjoyed the NYT "Eat food. Not too much. Mostly plants" article, here's the wonderful Ben Goldacre of Bad Science writing about why 'nutritionism' isn't just nonsense, it's right-wing nonsense.

Comments

[indigo-violet.livejournal.com]

Have you been to any bars in the Castro district? CJ made a new friend (the waiter) and got his drink for free while I, er, had to pay for mine.

[barking-watcher.livejournal.com]

It wasn't Moby Dick by any chance? When I was there in 2005 the bar man was very friendly and bought me drinks for free.

I don't buy your assertion

[webcowgirl.livejournal.com]

Huh. I don't really think he made much of an argument for nutritionism being right wing nonsense. Clearly, studying nutrition is very useful; else how would we have learned how to fight off beri beri, how to reduce retardation by adding iodine to salt, and a host of other, useful (I sincerely believe) things about diet? Actually, I even read an article about how some international non-profits were working with salt producers to add iodine in parts of the former Soviet Union. So nutritionists are really doing a lot of good, I think. And as for designing spaces that encourage more exercise (and better health), I think you'll find it's "the people" who need to push for and get those things, not the media. As you well know, the media covers stories "the public" finds interesting, so getting our fellow folk interested in these stories is probably more useful than figuring out who to blame for the lack of interest in articles on why do poor people eat more poorly than the rich (this may or may not even be true depending what society you're looking at). I just didn't see evidence for "right wing nonsense" as the cause of "nutritionism" in his article. (Me, I'd be just as much willing to blame TV and laziness for it as anything else: if people wanted to cook instead of eat as quickly as they can, and go for walks instead of sit in front of the tube, we'd all be a lot healthier. Except for me, of course, as I am free of the demon tube and can walk to work.)

That said, I did have a lovely home-made beef barley soup (mostly vegetables and barley) for lunch along with an apple/mango salad. Yum!

Re: I don't buy your assertion

[friend-of-tofu.livejournal.com]

I think there's an appreciable difference between nutritionists who have a rigorously scientific approach to their area and those who generalise, overhype and become obsessed with a few very specific food types. Since I believe Ben Goldacre to be talking about the latter sorts of 'nutritionists' (as opposed to nutritionists without the inverted commas, for whom I have great respect) and thus I thought his article was spot-on, if not indispensable.

Just because 'nutritionists' might broadly be saying the right thing doesn't excuse their talking twaddle. In fact, it makes it worse, because a lack of scientific rigour allows those with a genuine commercial interest in promoting poor food choices to attack them on quite valid grounds, and therefore makes anyone else trying to promote sensible food choices in the same arena look bad as well. The public is befuddled, no-one improves their diet and everyone who isn't a large commercial interest loses. Take Robert Cohen, the infamous founder of www.notmilk.com, who is particularly on my mind today because of this latest insanity (http://community.livejournal.com/veganpeople/2082432.html). I believe that he does more harm than good to the cause of veganism with his wildly spurious claims - which, of course, is why the Vegan Society refuse to be involved with him. I also believe that this kind of thing has a wider negative impact on the improvement of health through a more plant-based diet generally.

I'm glad Ben Goldacre hasn't simply stuck to the infuriating lack of evidence for these types of claims but has firmly dragged the debate about health back into the important territory of deprivation and social exclusion, factors which are frequently forgotten in a culture which tends ever more towards blaming the victims of ill-health for all their suffering and never stops to ask why or how they had the opportunity to end up in their current state in the first place.

Yay responsibility, say I.

Re: I don't buy your assertion

[webcowgirl.livejournal.com]

I think the assertion that nutritionism is right-wing nonsense doesn't hold water. Promoting eating milk and meat, that's a capitalist thing, as is the way these business interests affect the production of nutritional guidelines, but I'm not seeing right-wingers here, just selfish people concerned with propping up their market share.

I remember when I was dirt poor and someone was lecturing me on why I needed to eat organic. Dollar per dollar I couldn't get enough calories to do organic, and that's when beans and rice was about all I could afford. I was arguing with this person on a talk radio show and they were so arrogant about how my poverty didn't excuse me from my obligation to buy this really expensive food! I really felt malnutrition cancelled out the benefits of eating food produced better. This certainly is a poverty issue, that you can't eat organic when you're poor, but I'm really not seeing a poverty-nutrition-health connection (other than inability to afford good medical care) in Ben Goldacre's essay. There's only about one paragraph where he talks about what the stories ought to be but saying it's all about the entertainment industry is pretty silly. (Media whores are what they are and while he criticizes them rightly it's really a problem in any field.)

So I stand by saying I'm not seeing him making an argument that bad nutrition is right-wing nonsense, and I'm also not getting how it's about deprivation and social exclusion in a first-world society. Maybe this is just because I'm American (not that I'll usually fall back on this but we don't have the kind of class thing going on there is in the UK), but I also know that rich people can afford to eat really bad food that kills them, and poor people who aren't in third world countries can eat very simple foods that are cheap and take care of their health needs quite nicely. I feel pretty confident about this being true since I grew up dirt poor. (I also note in Seattle they have a program in a very poor neighborhood to teach people how to plan good meals, doubtlessly looking at nutrition issues to do this; so perhaps I see thing in an overy rosy view.)

On the other hand, I find this article (here for anyone without an NYT account) - about (of all people) the South Beach Diet's doctor's program for keeping people from having heart attacks - makes it clear that prevention is just too expensive for most insurers (how most health care is paid for in the US) to bother to pay for it, and as near as I can tell the NHS seems mostly interested in giving you some pills and getting you out the door, but this doesn't seem to be about not-poor or poor. No one I know has enough money to pay a fancy doctor like this guy to have a special program created to get their health on track - to me it seems like the kind of thing only available to the super rich. So this indeed is a failing of the health systems of both of these countries, that they are more interested in cheap care than in the making the investment it takes to care for people over decades.

PS: Hope I'm not rambling too much. Pardon me while I run off to find some pineapple.

Re: I don't buy your assertion

[ergotia.livejournal.com]

We must talk about the "class thing" in the States some time :)
It seems obvious to me that the study of nutrition per se is not a bad thing, but the constant bullying by quacks like "Dr" Gillian is part of an ever growing right wing trend towards blaming the unhealthy for being unhealthy eg"if they just ate right they would not get cancer" bollocks type arguments. The next step is tom justify not providingn health care because all illness is self inflicted.

I think that is indicated in the article.

Of course "poor people" can eat well in this country, but there are many reasons why people from all income brackets sabotage themselves healthwise. Personally I would argue that many of these reasons are related to living under terminally fucked up global capitalism.

This is a bit of a ramble, but just one more thing. A voluntary sector advice organisation (I think it was NACAB ?)in the UK had always advised "poor people" to buy fresh veg, whole grains, cook from scratch etc as part of their debt advice strategy. They stopped doing this in the 90's as various studies showed that it is actually ch4eaper to buy and eat processed filling rubbish - filling the kids up on white bread and marg with sugar sprinkles is much cheaper than giving them fresh fruit for example. Not better for you, of course, but cheaper.

Re: I don't buy your assertion

[ergotia.livejournal.com]

On a different note, I still think you should think about changing your doctor. The NHS is chronically and acutely under resourced and the whole approach seems to go something like "First guilt trip them about smoking, drinking, eating crap and not getting enough exrecise. If that does not get them out thye door or just is not true, prescribe Prozac and tell them to lose weight anyway. If they dare come back after that, prescribe a higher dose of Prozac. And install a trapdoor to make sure you get them out after six minutes" However, I have found that if I am proactive ie reading up on whatever my problem is and suggesting treatments I am always listened to and usually appropriately referred. My GPs areb all professional, hard working and committed but they are just not given what they need to donanything other than help you help yourself.

Re: I don't buy your assertion

[webcowgirl.livejournal.com]

When I went back before my trip I had a MUCH better doctor who correctly diagnosed a problem, gave me informational literature about how to treat it AND suggested another doc at the clinic who could help me, AND said she had enough time to diagnose the problem the other doctor had been so lame about treating (resulting in referral for physio), plus retook my blood pressure since it had been so high last time the other GP said I might not be able to continue a prescription I'd been on for years! So yay Dr. Laurie, she'll be my regular from now on.