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I’m David Torcivia.
I'm Daniel forkner.
And this Ashes Ashes, a podcast about systemic issues, cracks in civilization, collapse of the environment, and if we're unlucky, the end of the world.
[0:13] But if we learn from all this maybe we can stop that. The world might be broken but it doesn't have to be.
Despite multiple efforts on multiple fronts, no country in the world has managed to turn its obesity epidemic around in all age groups. … These trends ask us to think about what progress in the 21st century really means. Economic growth and modernization, historically associated with better health outcomes, are actually opening wide the entry point for the globalized marketing of unhealthy foods and beverages and the switch from active to sedentary lifestyles. For the first time in history, rapidly growing prosperity is making many previously poor people sick.
[1:08] That was Dr. Margaret Chan the former director general of the World Health Organization speaking to the National Academy of Medicine in 2016.
And according to the World Health Organization obesity worldwide has more than doubled since 1980. In 1974 the number of obese people worldwide is estimated at about 100 million; That number had grown to 640 million by 2014. 70% of Mexicans are now overweight; a quarter of the Chinese population are obese – 300 million.
[1:43] It’s funny you mention the Mexican obesity problem right there Daniel, because that’s something we've discussed in the past.
If you remember Episode 9 - Nothing Left to Hide, we talk about government surveillance, and there was an example of nutrition activists who were trying to help with the fact that 70% of Mexicans are overweight, working to get a healthier form of nutrition in Mexico but because of this they were actively being spied on by the Mexican Government on behalf of these unhealthy food companies including most notably the sugar industry.
[2:11] Yeah that’s right David, and attending this health epidemic besides the human suffering associated with it are the actual financial costs.
The leading cause of death worldwide is now cardiovascular disease. And although obesity contributes to the risk of heart disease and cancer, perhaps the biggest risk is diabetes; although to be clear, obesity is not an exclusive prerequisite for diabetes.
If current trends continue, a costly disease like diabetes can devour the gains of economic development.
[2:45] Margaret Chan declared diabetes one of the biggest Global Health crises of the 21st century in part because of the massive long-term costs associated with treating it. I mean in 2015 the cost of diabetes worldwide was $673 billion, and in some countries that cost can devour more than a fifth of the National Health budget.
[3:06] Not included in that figure by the way David are the developing countries that don't have the National Health budgets to address the costs associated with diabetes and in those situations people that get it simply die.
[3:18] Let's not forget of course when we list all these numbers out the human suffering that is part of this scenario, and that's a great example of it.
Now in the United States the share of health care spending relative to GDP has been rising steadily, and in 2016 18% - almost a fifth of our entire gross domestic product - went to healthcare.
According to the CDC the annual average cost of treating cardiovascular disease is double what we spend on treating cancer. Although many chronic illnesses like diabetes and cardiovascular disease are preventable, many people are not aware of the risks until this too late.
You know I've actually done some of this advertising for the Ad Council about diabetes risks. I put together a number of PSAs on pre-diabetes that list of different things to look at, and if you score over a certain threshold then you need to get checked out and be on the watch for these kinds of diseases, so efforts are being made but it really is not enough.
This isn't just in the United States. It’s estimated that half of the adult Chinese population is pre-diabetic – that’s almost 500 million people – and once realized, the complications of diabetes are enormous. You have blindness, dialysis, and even loss of limbs.
This wasn’t something that existed in these epidemic proportions until recently. A century ago, these sorts of problems were unheard of. So the question becomes, what changed?
[4:36] That's a good question David and to understand that we have to take a look at the debate that was going on in the field of nutrition in the middle of the 20th century.
[4:45] In the 1950s, there was a debate going on about the dietary contributions to coronary heart disease, and some of the research was increasingly pointing towards sucrose, or common table sugar. The sugar industry did not like this, and the vice president of The Sugar Foundation, John Hickson, had a plan.
Now, the Sugar Foundation was a trade group - it's still around, called The Sugar Association now; they have a website that will tell you all about how great sugar is - and a trade group is just an organization founded and paid for by businesses within an industry, so you can guess what their perspective and goals are.
[5:29] Can we stop there for a second? I want to quickly pull open the Sugar Association website and read you just a little bit of the things they say about sugar and how amazing it is.
This is sugar.org there's all these exclamation marks, “So many types of sugar! All about sugar! Do you know all these things?” You get that get the facts, so let’s click this let’s get the facts of sugar.
[5:50] Give me the facts David.
[5:51] Here's a great one, okay so one of the biggest surprises they say was the range of guesses people made about how many calories are in a teaspoon of sugar, lots of people thought it was 50 or 60, one person even said a thousand but oh look here and I quote “Nature's very own sweetener only has 15 calories in a teaspoon, as well as all that natural tasting goodness, wow!” only 15 calories in a teaspoon this is great.
[6:14] Keep going give me some more facts.
[6:16] Okay here's a great fact. According to Sugar.org, “the simple irrefutable fact is this: sugar is a healthy part of a diet.” Full stop. Quote.
[6:27] Irrefutable huh?
[6:28] Yeah “carbohydrates including sugar are the preferred sources of the body's fuel for brain, power muscle energy, and every natural process that goes into the cell. And sugar is more than just a fun food ingredient it’s essential. Because it's all natural you can consume it with confidence.”
[6:42] I feel a little bit better about all the...
[6:45] Oh man for those of you curious about math: “with only 15 calories per teaspoon, sugar is no more fattening than any other 15 calories.” There you go everyone, that's the research that we need.
[6:57] Irrefutable.
[6:58] “Like all carbohydrates, the body converts sugar into fuel quickly. Fats on the other hand are stored in fat cells to be used later.” Holy shit and I can't believe they wrote this shit.
[7:07] David I don't think we're going to be able to beat the “sugar is all natural and you can consume it with confidence” quote.
But so you can see I wasn't exaggerating at all when I said that you can guess the perspectives and goals of these types of groups right that are funded by industry.
So the vice president of this foundation, the Sugar Foundation, John Hixson.
He went to Harvard in 1965, approached two nutrition scientists he considered fit for the job, and gave them money to write a review article on the current research related to sugar in the diet. Hickson essentially said "we don't like the research saying sugar is bad for people, please fix this, and here's some money." And the Harvard scientists said "understood."
This review would ultimately dismiss the research that claimed sugar caused coronary heart disease, instead promoting papers pointing the finger at fat and dietary cholesterol. And as the review was being written, Hickson got to see the drafts in progress, and before the final was published, he wrote to the Harvard scientists to say "this is exactly what we wanted, good job."
The Harvard scientist never disclosed the money they were paid or anything about the Sugar Foundation, and what’s especially interesting is that before starting the review the Harvard researchers asked Hixson to provide the papers for them to use.
That really stuck out to me. These are scientist doing serious work right? But they're asking an industry representative to provide them the papers to review. I mean you expect them to have an understanding of the important papers in their field; the most relevant ones to discuss right?
[8:46] You would think so, but clearly a sugar CEO knows what's best for us.
Sugar is all natural. So I've heard.
[8:53] But when this review article was finally published in 1967 in the New England Journal of Medicine, a prestigious Journal, it essentially closed the debate.
And it established the narrative going forward, that is fats being the primary driver of obesity, and sugar not playing a large role simply being a calorie-in calorie-out variable.
[9:14] So let’s stop for a second and let’s be clear. This was a huge coup for the sugar industry. This had been a time of declining sales, as people began to get concerned about the impact sugar might be having on their health, but when these studies finally came out paid for by the sugar industry that sugar was in fact okay to eat - no different than any other calories. 15 calorie here is the same as 15 calories there as they would claim - people were encouraged and started to buy and consume sugar once more.
This was such an effective PR campaign that they won an award for this process. And to be clear it wasn't that they won a PR award for this underhanded bribery of hard scientist, which only came out recently, but the fact of restating that sugar is just a calorie, no different than any other calorie, and that it's fat and cholesterol that contribute to heart disease and obesity far more than sugar does.
[10:01] Sounds kind of like a play right out of Edward Bernay’s book Propaganda.
[10:06] Yeah exactly and that's why we started that episode to build this idea that many times, things that we accept as facts; as science, are in fact manipulated by these sources trying to sell a product or change your behavior.
[10:19] I mean it really was a play right out of Edward Bernay’s book because what he stressed is if you wanted to influence culture, you don't do it by telling people what to do directly. You do it by influencing the thought leaders. In this case literally paying off Harvard scientists, and to drive home how influential these scientists were, one of them became the head of nutrition at the United States Department of Agriculture, and in 1977 he helped create what would become the official government stance on nutrition in America.
So these are very influential people and we talked about David how Edward Bernays would use news and media to shape the narrative in the public sphere right? And when a big paper comes out in a prestigious Journal, it does really set the narrative in a lot of ways. You'll see a proliferation of different articles that will start to come out, and any major media source like the New York Times or whatever, they may have original slants but they all cite the same exact paper.
Because in a way journalists are a little bit lazy, or they just don't have enough time to investigate everything that comes across their desk, so they rely on sources that are very credible - in this case Harvard.
[11:30] You know I've got a funny story about that.
[11:32] What's that David?
[11:33] You know James Cameron the film director?
Well back went Avatar came out a friend and I decided that James Cameron was a boring name by itself, and we went on his Wikipedia page and edited his name to become James Francis Bacon Cameron, and lo and behold because all these reporters were writing stories about James Cameron at the time, they would look up Wikipedia to find his name is James Francis Bacon Cameron and include that in their reports.
[12:00] You're kidding.
[12:02] Of course somebody realized that our Wikipedia vandalism was just that - vandalism, so they removed it but by this time the damage has been done, and we were able to go and source James Francis Bacon Cameron as his actual name, based on these news articles that were using the Wikipedia article as their primary source, and we created this circle of loops where one sourced the other and it got worse, and eventually they did clean it up but it was there for like many, many months, and many articles were written with that name.
[12:30] That's honestly hilarious David and it just goes to show I guess in the case of you know, pulling something from Wikipedia a journalist doesn't have much of an excuse right, but when you're quoting from a respected technical source; if that source turns out to be wrong it's very easy for the journalist to just say “well you can't blame me I was quoting Harvard scientist” right?
But anyway this narrative was established that saturated fats and dietary cholesterol were the drivers of heart disease, and it became so entrenched that anyone who spoke out against it was either ignored, laughed at, or aggressively attacked and discredited.
[13:06] And one of these researchers was a man named John Yudking.
Now he was a scientist that came out with a book in 1972 called Pure White and Deadly, and as over the top as that title might be he was arguing that sugar was in fact toxic and bad for health, any he published many papers in the fifties hypothesizing this very same thing, which at the time were taken very seriously, where well-respected, and had many citations.
But then the scientific winds shifted and this idea that obesity was in fact caused by fats and cholesterol and sugar was just a minor if not at all component of this, his story went so much against this narrative that it effectively ruined his career. He was denied attendance to international nutrition conferences, he couldn’t get his papers published in research journals, and many in the scientific community looked at him as a failure, and in fact use him as a cautionary tale not to be repeated.
So when other researchers would start questioning sugar, they’d say “oh great we got another Yudkin here,” and it became almost a swear word; something whispered to say “don't be like him.”
[14:07] One of the men who so effectively attacked John Yudkin was Ancel Keys, a man who also helped advance the saturated fat narrative. In 1955, President Eisenhower had a heart attack. His physician got on television the next day and, citing the research of Ancel Keys, said "cut down on fat and cholesterol."
Which is what the president did, and what the public began doing as a result.
Interesting sidenote: President Eisenhower went on to have six additional heart attacks despite changing his diet to this low-fat, low-cholesterol diet, although those might have been related to a tumor that was discovered in his autopsy that secreted adrenaline.
[14:49] Adrenaline… straight to the heart
Yea I imagine that would have a pretty severe…
I think I watched a movie about that: Crank.
Anyway
Ancel Keys, this nutrition scientist, was a man who established power for himself by funding research in line with his view, securing poisitions at important medical boards, and in the 70s he published The Seven Countries Study
[15:13] We don't want to completely smear his name, Ancel Keys was a very important scientist especially in scientific methodology. He was one these first people doing these massive, many thousands of people, studies, and that was very important for science and continues to be today, especially in biological and nutritional science.
And the feat of all this was that much more impressive at the time when they didn't have computers or electronic data collection and analysis in order to make this 12,000 participant study that much easier to analyze and collect, so we don't want to downplay his contributions to the way that we approach science, but maybe we do want to question some of his motivation.
[15:48] Good point David I'm glad you brought that up.
And this seven countries study, it involved data on over 12,000 men from 7 different countries, and it showed a correlation between saturated fat and heart disease, and since then there has been a ton of controversy around this study. The selection of countries for one thing appears to be arbitrary. For example, why was France and Germany omitted when both of these countries have diets high in saturated fat, but also low incidence of heart disease?
There is also criticism about how the data was analyzed, the nature of control, the reliability of dietary data collected, and the general inability for the study to explain differences between different countries.
[16:29] And while there are reasonable explanations for many of these things: lack of resources, the expensive cost of analyzing this data, and possibly even effects of the war causing him to omit data on France and Germany, the fact remains that the study is still hotly debated 50 years later, and there's no doubt that if we were to repeat it we would have a much more refined methodology using our modern statistical analysis and data collection.
But what matters is that despite all this it was used by Ancel to discredit and shut down anyone who though to challenge his conclusions about the effects of fat on our health.
People like Yudkin.
Even more, this study now considered controversial was used to set those nutritional standards at the time that we still live with today.
[17:11] David nothing has really changed, at least in the way that the sugar and soda industries that benefit from this narrative go about trying to use science and use research to benefit their interests
For example, in 2015 Coca-Cola funded the creation of a nonprofit organization called the Global Energy Balance Network. The nonprofit was headed by scientists from three different universities, all of whom had received substantial funding from Coca-Cola for their respective research.
One of them had actually received around $3.5 million from Coca-Cola.
The funding from Coke to start this organization, about $1.5million, was not disclosed at first, and the mission of the Global Energy Balance Network was to discredit research that claimed the foods you ate contributed to obesity and health problems, and instead direct attention to physical exercise as the most effective way to battle obesity. Here's a statement that was released by the organization, quote:
The media tends to blame the obesity epidemic on our poor eating habits. But are those french fried really the culprit? Dr. Steve Blair explains that you shouldn't believe everything you see on TV.
[18:22] Well this organization ended up shutting down the same year it was opened because the funding from Coca-Cola became evident, and because of the criticism from health experts, which just goes to show we don't approve of corporate manipulation when it's obvious, but this was just one small piece of a much larger public relations campaign.
[18:41] Or propaganda.
[18:43] Exactly, good point David; it was a small piece of a much larger propaganda campaign by Coca-Cola to shift the narrative and perceptions on diet.
[18:52] And carrying over that idea of influencers and how that word has evolved over time, Coca-Cola also has a history of paying fitness experts and bloggers to write things like “you know what a good healthy snack is? A mini Coca-Cola can!”
And I mean we all know this is an ad, but I mean maybe in many cases it's not obvious the way that they phrase it or say it, you know maybe we just assume this person loves mini coca-colas they are cute little cans, but what’s more insidious, is that many of the people who get paid by companies like Coca-Cola realize they can start making a career out of this, of hawking these unhealthy snacks do people.
No longer do PR teams have to go out and reach out to these people, but when a fitness guru sees an article come out against sugar for example, now the guru calls up Coke and says “hey you know what? I can spin this in your favor, are you interested?”
[19:41] So David what does the science actually say? We don't want to get too deep into this right about what research is pointing to in terms of nutrition science, and what the best foods are to eat… There’s plenty of people talking about nutrition these days.
[19:54] We're not nutritionist, we're not pretending to be nutritionist, we're looking at this from the perspective of how these companies have affected the way that we approach the world, how we live our lives, and our health directly.
[20:05] But to understand that we do need to understand a little bit of the science behind both nutrition and sugar, and maybe the best place to look at that is where nutrition science first got it’s start. And that’s in Germany.
So in the 1860s they invented something called the calorimeter, at the time this was a massive room sized Contraption, but what it did at a very basic level is let us burn food, and measure how much energy is stored in it, the calorie.
This really kicked off the whole idea of nutrition as a science, because for the first time we could really measure what it is that we’re eating. Although our measurements at the time were simplistic and limited to this calorie system, it was the beginning of this science. And because our tools limited our understanding of this, also the way that we thought about nutrition was limited in the same way, and for the very first few decades of this research, the science was really about calories: Calories in, calories out.
That was the idea, that we analyze these things coming in, say how much energy it has in it, and we put that into our system, we burn so much energy living, moving, acting, and then the rest of it either accumulates in our body leading to obesity, or it’s passed on to some other system.
This idea in Germany and Austria infiltrated the rest of the world and was the beginning of our fledgling nutrition science and a lot of the legacy we live with today. But as time went on and tools got better and more theories were built about this stuff, the understanding of nutrition begin to evolve, especially in Germany and Austria.
[21:20] Part of that was these studies done on animals. Now to be fair, many animal studies don't carry over directly to humans from animals, but there is some value in understanding how their biology works, and then taking that to our own, and one of these studies looked at obesity.
It said “okay, we're going to test this calories-in, calories-out idea, and feed these animals controlled amounts of food and see which ones gain weight, and which ones lose weight, and which ones maintain it.
This is where the first cracks in this calorie-in calorie-out idea began, because they found that some animals continued to gain weight, or wouldn’t lose weight, even on calorie restricted diets, or even on something that seems close to starvation. That got researchers curious. They said “wait, our understanding of nutrition as an energy system must be flawed, there must be other things at work here, hormonal or something else,” and that kicked off a whole new understanding of nutrition that's thinking about nutrition especially in terms of obesity.
This reached its pinnacle in 1938 when they started positing that maybe obesity is not as simple as fats but might be linked to insulin and hormonal imbalances in the body, but anyone familiar with world history knows very shortly after this stunning realization, Germany, Austria, and all the world was thrown into war, and these German researchers dispersed throughout the world or were lost in the conflict.
And lost with them was this knowledge, all this research that was done, and the conversation of nutrition science shifted from Germany and Austria, and the German language, to the United States and the UK. And with it the language of science changed from German to English, and the research that had already been done that was only written in German was no longer read and was lost, and nutrition science moved back towards that energy first system, something that we still are grappling with today.
[23:11] We really did have to restart the whole field of nutrition science in a way, and that German and Austrian way of looking at diet and metabolism from an endocrinology perspective was restarted and began from this foundation of energy balance and unfortunately was infiltrated early on by industry interest like from the sugar industry.
And it's just recently that we are beginning to evolve the science in a more nuanced way and get away from this narrative of fats and cholesterol and obesity that has been taken hold for so many decades.
In 2008 for example researchers from Oxford University did a large study in Europe, and it concluded that in many cases there is an inverse correlation between saturated fat and heart disease.
France, the country with the highest intake of saturated fat, has a lowest rate of heart disease. Ukraine, the country with the lowest intake of saturated fat has the highest. And the UN’s Food and Agriculture Organization in 2008 did an Analysis that found no convincing evidence that high fat in the diet related to heart disease, or even cancer.
[24:18] And it's interesting actually. If we look at the science right now we're on this almost sort of periodic swing. So in the 30s we’re talking about “oh maybe obesity is something caused by insulin and glucose related, or that is sugar related,” and then we swing back, nutrition goes back to calories-in calories-out, fats are bad, and then someone like Yudkin comes along in the 50s and the 60s and says “wait sugar is bad for you,” there's lots of research going on at the time, but then it swings back again and it says no way no it's definitely low fats in large part pushed by the sugar industry.
Then now, we're finally once again back to that point where we say “Okay wait, we have better statistical analysis, we have better research, we have a better understanding of biology, and physiology, and now, we're not so sure. These things that we thought we knew, we thought that were right, and that we thought were scientific fact that we told people what to eat based on, well you know what maybe we're not so right after all.” Look at these studies; these things don't actually correlate where we thought they should, so we have to start questioning the science and we're looking back once again towards this sugar culprit.
[25:19] In 2014 the US National Institute of Health did a 12-month study and that study, along with about 50 other similar studies, together provide evidence that when it comes to controlling weight loss and preventing diabetes, a low carbohydrate - which is also low sugar diet - is more effective than low-fat diets, and part of the main theory behind that… again these studies are not totally conclusive right? We're trying to recover from a lot of….
[25:48] Well in nutrition science, there seems to be like this very big reticence in admitting that you're wrong, and I can understand why. You set these standards and you said “we're all supposed to eat and be healthy based on this,” and to go back and say “wait we got everything backwards” is a pretty big major failure and honestly could even open you up towards some sort of legal ramifications.
So changing the narrative in very small steps makes sense.
[26:11] Well not to mention that our dietary guidelines that the government releases are only changed every 5 years.
As a scientist I guess you could be kind of resistant to suggest even at the end of this five-year period that we radically change the dietary guidelines that all our diets have been based on right?
And part of the main theory behind this NIH study and other studies suggesting low-carbohydrate diets are better than low-fat diets is related to the insulin theory of metabolism. Certain factors like sugar, and high-glycemic foods, spike insulin in the body which then directs the body to store energy as fat and increases appetite. And it appears that controlling insulin is much more important than exercise alone, or simply maintaining a certain calorie threshold.
But but we're not here to delve into the nutrition science, I mean it gets nuanced. I certainly know some bodybuilders and athletes for example and they take insulin regulation very seriously, but they can also control insulin secretion through things like intermittent fasting while still enjoying high carb meals at certain times of the day. So we don't want to pretend that nutrition and the science involved is simple and that we have all the answers.
What we’re really here to focus on is the failing of the scientific system that created all this confusion in the first place.
[27:27] And failing really is the correct word to use here.
But before I go on my rant that I've been itching to give this whole episode, let’s look at another example here. So a group funded by Butterfingers, Skittles, Hershy’s, all the delicious candy makers, sponsored a study that discovered children who eat candy weigh less than those who don't.
[27:48] That seems sort of counterintuitive so let's let's let's go in and examine this.
[27:52] Let's give him the benefit of the doubt David.
[27:54] Okay yeah okay.
Let's say that they discovered this thing and this study would suggest, just looking at the headline oh of course, candy makes you lose weight I guess, but remember correlation is not causation, so look into this. The research was obviously at first glance dubious. They correlated data from previous government surveys that asked people to recall what they ate.
This is a common type of study but it's usually not especially accurate because we're bad at remembering what we eat, and bad at remembering to write down all the things.
[28:22] So they didn't do their own surveys they just looked up previous government surveys.
[28:26] Right and meta studies are a common part of the scientific process and there’s nothing wrong with it, but there's certain things you have to do to be rigorous in your analysis.
But they didn't do that in this scenario - in fact one of the authors even didn't think the study had any merit – nonetheless, it doesn't matter if the study was good or bad, what matters is the headline.
Yeah you see we're back on our PR thing because a lot of the headlines were generated and said things like “new study finds kids who eat candy are less obese,” and it doesn't matter because nobody reads the paper, nobody reads the abstract, the science doesn't matter in this scenario; it's about pretending or suggesting that you did science even if it's bad science, and letting the PR cycle take care of the rest.
[29:05] I guess that's what happens when industry infiltrates this research and the scientific method.
[29:10] Also a lot of these companies have their own researchers that are doing studies like this; they're not just going out and paying University researchers.
But you know research is an important part of any corporation that wants to invest in its future, and some of that research is definitely going to come out in ways that favor the company. No one’s going to fund studies that make you look bad.
And this is a common tactic.
Coke and Pepsi came together, these two enemies of soft drinks, and they funded a study that generated the headline: “Study: Diet beverages better for losing weight than water.”
[29:41] Than water, oh man.
I want to say we should give that one the benefit of the doubt but -
[29:46] You're very Devil's Advocate right now Daniel but I respect your shilling for the Sugar Companies.
So then the question becomes you know like who is funding these studies? And the obvious answer is the industry, and these companies providing the money, in fact sometimes they're given manuscripts to review just like happened with those Harvard scientists back in that sugar industry study that kicked off all of this, and sometimes the studies are given to the company in order to look over and make revisions.
Sabra Dipping Company wanted to study to examine the health benefits of chickpeas, and after the research was done the authors to include hummus as a healthy food.
[30:29] This is industry infiltration of the scientific process for PR to sell things that are often times bad for us.
[30:37] Hold on David I need to stop you for a second because you're pointing the finger at industry a lot, and the industry influence on this research, but if I'm a listener right now I'm probably saying “but wait these are real studies; these are scientists who believe in what they are doing; they're doing real research, and this research is backed up by rigorous experiments right? The science will surely speak for itself.”
But I think that's why this failure of science is so insidious.
I want you to imagine 100 researchers, all studying a problem from different angles. If the science community could be 100% objective and had the incentives to pursue the scientific method without bias, then we might expect consensus to emerge as results are reviewed as a community, hypotheses are disproved or validated, and as research then shifts according to new understanding. But now imagine the same 100 researchers, but before there has been time to even review and discuss different findings, a company approaches researcher number 47 and says "hi we really like the work you're doing. We think the type of questions you're asking are really important and are beneficial to the world and humanity. Also, here's $3.5million dollars, can you do some more research?"
[31:53] In the world of academics where everyone's clawing over what little bit of money they can get to fund research, that's like a gift from God.
[32:00] So with this gift from God is there a possibility that this individual researcher now views the work they're doing from a different perspective?
Now imagine that at the same time this company is throwing money at bloggers, celebrities, public figure, and other popular individuals to write and say things to discredit the other 99 researchers.
And I want to take this one step further, and now imagine that the company also influences the gatekeepers for various grants and funding, so that when researcher number 78 writes a research proposal and asks for the funding to do it, the response is "that's not a very productive study, we will fund it, find something else to research."
Under this environment, is there a possibility that the field of research could become skewed and distorted going forward? I think that possibility is very high.
And we have to consider this process of applying for grants. These companies say they encourage researchers to be unbiased and just report the results, whatever the consequence; and researchers say they are doing the same. But we have to consider the process of applying for grants. In order to get a grant from one of these companies, a researcher has to explain what the industry might get out of it, like increased profits and sales. So not only does the company get to choose only those studies it thinks will benefit them the most, but it also puts the researcher in a frame of mind, from the very start, of "how can I benefit this company."
[33:25] And this actually happens.
Like those examples we mentioned, all of this is a topic that I'm so interested in and I’m so passionate about that we’re going to discuss at much greater length in a future episode dedicated just to science and academia.
But right now, taking a quick look at this, and building off what Daniel said, we need to really question the scientific method. This way of thinking that’s supposed to be infallible. Untouched by unjust influences. Pure objective reason.
But as this shows, as the influences of funding, of gatekeeping, of journals, and ultimately of PR, of what papers are published, told, and then because of that, cited by other researchers, used as things to build more grants; used as ways to collect more funds for research, the scientific method becomes twisted and affected by all these outside influences. And a certain research gets chosen because of these impacts from industry, from governments staffed with people serving industry. Our knowledge as a species becomes twisted as well.
What we think we know is true and objective fact is in fact impacted by these PR campaigns; by these ideas that Edward Bernays sat down in Propaganda almost a century ago.
And as time goes on and we build more and more off these studies we go farther down this path. So just like the work of Ancel Keys leading us down the wrong pathway towards blaming saturated fat and cholesterol as the single greatest factor in heart disease and cardiovascular problems, we’ve told people to eat and to live their life in a certain way that we thought was healthy for them but in fact might have been the opposite. Maybe dooming people to death because we thought we were doing the right thing but were in fact being perverted by these gross incentives pushed on us by an industry trying to sell its sugar.
Nutrition is complicated. We don't know exactly all the things going into it, and to state that this thing is benign; that it's just 15 calories and the calories are the only thing we have to worry about, ranges from either ignorant, or naïve, to manipulative, if not outright evil.
[35:23] David this is a little bit unrelated to this episode but I feel like it fits in.
This is a big problem in the pharmaceutical industry as well. Out of all the studies that are done by the drug companies, 40% never get released to the public - we don't even see them - and many of the studies that they do release have been tampered with so that the results that impact their business negatively are left out.
And to bring it back to the sugar episode it turns out that Pepsi did something very similar in 2011.
They funded a study to find out if their oatmeal, and also one of their cereal products, was more filling than on of the cereal products by a rival company.
The study that they funded found a positive result for the oatmeal, but not for Pepsi’s cereal brand. So the researcher emailed or wrote to Pepsi and said “I'm sorry, this study is only half useful to you,” and Pepsi said “well that's okay; let's just keep the oatmeal part and we'll just throw out the other half of the study,” and that's what they did.
[36:22] That’s gross. I feel like I should go and some rant here but like it's just time and time again we hear these stories about this manipulation, and the scientists and researchers who are complicit in it, the people at the company who decide to publish things this way, who don't care about the health and safety of their consumers because it might impact their company's bottom line.
To break out my favorite phrase shame on them.
[36:43] But this is not just a failure of science David this is a failure of politics as well.
[36:48] Right and this is where the story gets really interesting, because again like we talked about in terms of dietary guidelines the effects of this bad science ends up having real world consequences.
[37:00] Speaking of shame on these companies David, in 2003 the World Health Organization was trying to set the standards that would direct people to consume no more than 10% of sugar as part of their diet. And the sugar industry was super pissed about this and actually threatened The World Health Organization with blackmail saying “if you go ahead with this recommendation we are going to pressure the United States to cut your funding.”
[37:29] Now you have to be wondering what could the sugar industry have in terms of global politics and the US’s funding of these organizations?
But this is one of the most powerful lobbies in the United States, with income of billions of dollars a year, and they spend a lot of money on lobbying, and they have for decades. They're one of the oldest longest-running lobbying sources, and when they make a threat that “we're going to pressure the United States to pull funding” - almost half a billion dollars of the WHO, well the WHO takes that seriously. In fact they were getting calls from ambassadors and diplomats, senators and representatives saying that they needed to do something about this because otherwise something would happen. So they did! They made changes to their recommendations; adjusting what they thought would be in people's best interest, to something that is more agreeable with the needs and wants of the US sugar industry.
Dr. Margaret Chan:
The dominance and power of this industrial complex are immense. They help explain why highly processed junk food is becoming the new global food staple. The food industry resists interference from a health agency like WHO, and it has the power to do so.
[38:43] That was Dr. Margaret Chan again, and this is an example of infiltration by the sugar industry and putting pressure on International politics.
But this happens at the local level as well.
So the Chicago city council has been advocating for a soda tax on sugary drinks for years.
[39:02] And each time, the soda industry particularly Coca-Cola and Pepsi, they show up and they donate lots of money for quote “philanthropic causes.” In 2012 for example, Coke announced that they were going to contribute $3million to Chicago for this wellness program that would involve exercise classes, and in 2013 Coca-Cola deliver $2.5 million to pay for these recycling bins all over Chicago - this came from their philanthropic department - and what they got in exchange was the ability to put the image of Coke products on the lids of these recycling bins.
Really makes you question what the definition of philanthropy is.
[39:44] Yeah that's a fine line between philanthropic donation and tax deductible advertising all across Chicago, right?
[39:51] I think you're right.
So David, what can we do?
[39:55] My favorite part of the episode, the little bit of hope that we get at the end of each of these.
Well on this episode I mean it's sort of easy. The big thing is just don't eat sugar! Or at least not to excess.
Now I mean we are a very individualized society in most of the West and also increasingly in places where Western values have been infiltrated, and the narrative often comes back to well “you know we all make choices, and the choices we make define our lives and the places we end up,” and everything is very individualistic and “you are the person solely responsible for how you turn out in life.”
And I mean that’s technically true depending on how you look at it, but we should also recognize that the margin for change and the number of choices available to any given individual is not the same across the board.
For some people the options to eat healthy simply don't exist, or are extremely difficult to take advantage of, and in fact one of the ideas of this insulin theory of obesity is that the insulin itself increases our appetite.
So we’re almost compelled by this spiking insulin, by this sugar, to eat and we have no biological choice. Our ability to choose to be good – our willpower – is taken away from us by this food. For some people in the physical space the options to eat simply don't exist or are extremely difficult to take advantage of.
[41:12] Let me jump in here David because I know you're qualified a lot more than me obviously to talk about advertising, and you bring that up, you work in that industry.
[41:20] I feel like this is something that I'm a little bit qualified to talk about because I've worked in the commercial real estate business in the past as a broker of property, and any business that either owns a building or rents space has standards about where they want to be located.
And I’ve spoken to real estate executives and site selectors at different fast food businesses and grocery store franchises, and they will tell you exactly where they want to be, and it's driven primarily by demographics.
There are fast food businesses, and grocery stores like Family Dollar or whatever, and they will tell you “we need a location that has low income, and we need X population within 1 mile,” and why does it need to be one mile? Because they'll tell you “our target customer is too poor to own a car and they must be able to walk to our location.”
So as a broker of property when I would work on let's say a land site on the corner of an intersection. If the demographics showed that this was a low-income area, I would call up that executive at ABC Fast Food Chain all excited and say “hey I've got something great for you.”
Okay this is capitalism; this is what a system does when the only aim is profit: “we have a product; it's toxic; but it's addicting, and it's cheap to produce. How can we get this product in front of poor people and get them hooked?“
And it may not be a conspiracy that the density of dialysis centers is highest in poor communities, but it is certainly not a coincidence.
[42:54] This idea of lack of access to good food is called food deserts. Now these are areas where people cannot access nutritious and affordable foods. They’re places that lack grocery stores, and nutrition options are limited to like Daniel mentioned, fast food, convenience stores, places that sell highly processed, high sugar foods.
[43:12] We have a lot of these in areas all across the United States - somewhere between 18 and 20 million people live in these food desert. And it's a serious problem that as you would expect is concentrated in primarily low-income areas. People living in these poorest areas have 2 and 1/2 times the exposure to fast food restaurants as those living in the wealthiest districts.
[43:35] And it's not just access but affordability is a major factor in this as well. Even where supermarkets are available, cost can be a prohibitive factor to a good diet.
David I was reading online, and I came across a thread of people discussing personal responsibility when it comes to diet, and many people were saying things like “poor people, they have no excuse for not walking to a grocery store and buying healthier options; you know you must not be that poor if you can afford that $2 hot dog from QuikTrip.”
[44:03] I guess that might make sense.
[44:05] Yeah well maybe we don't have to take such a ridiculous argument very seriously but it did get me thinking; it got me curious about the cost of some of these food, so I looked it up.
I went to the US Department of Agriculture and found the average prices of vegetables and fruit across America, then I went to Walmart and I compared the price of broccoli to a 5 pack of Kraft macaroni and cheese that you can buy there.
So in 2015 the average price of broccoli was about $2.50 per pound. Which is about a 150 calories okay? That's $5 for 300 calories of broccoli.
If you go to Walmart and pick up this 5 pack of Kraft macaroni and cheese - you can get it for $4.50 - it comes with 15 servings and the total calories is 5,250.
[44:52] So you're saying if I wanted just a respectable 1,500 calories a day, the very low end of what you should be eating, out of broccoli, it’s going to cost me $25. Plus I have to eat 10 lb of broccoli.
[45:04] I would not want to do that.
[45:08] Yeah me either.
[45:09] So let me just ask you real quick David. You're a single mother, you just got off the bus from your shift - you don't have a car - you stop at the store and you need to pick up something to feed your kids when you get home. You have two options:
What do you pick?
[45:32] Obviously the macaroni. Who knows if my kids even like broccoli much less what am I going to make out of 2 pounds of broccoli by itself?
[45:39] Did I mention David that the very first ingredient in the macaroni is a refined grain - this high sugar carbohydrate product, the very same stuff linked to obesity, heart disease, and diabetes… are you sure you want to make that choice?
[45:54] I don't know I saw commercial maybe sponsored by Coca Cola stating that it wasn't diet that's most important, but being active and that's what it takes to live healthy.
[46:02] Okay I'm sure they get the idea. The industries that have fought tooth-and-nail to establish this calorie-in calorie-out paradigm have created this narrative that obesity is simply the inability of an individual to control what they eat, and the level of exercise that they engage in.
This puts the blame entirely on the individual – this single mother that David so beautifully played the role for us – and the result is a culture of shaming people. People who are limited in their choices of healthy foods; they're kept ignorant because of the manipulated industry-backed dogma, and they have no ability to change, or at least that margin is very small.
It's a vicious cycle.
[46:39] So the simple summary of that is don't shame people.
[46:42] For some these things are out of control - whether biologically because of these insulin spikes - or because they're bound by the circumstances of their life; because they are controlled by the manipulations of these industries and it affects their world and their understanding of nutrition.
The widespread occurrence of obesity and diabetes throughout our population is not - is not I have to emphasize - a failure of individual will power to resist fats and sweets, or exercise more. It is a failure of political will to take on powerful economic operators like the food and soda industries.
[47:22] And so one of those ways the governmental bodies can step in and do something is with a sugar tax. That much maligned made fun of thing in large part because industries push these stories onto journalists, saying that “this is something indicative of a nanny state. People aren't responsible enough to know not to order the large size drink?”
But in fact study after study shows that sugar taxes are very effective at cutting down on sugar consumption and the diseases related to it. So urge your politicians in Chicago in other cities and elsewhere to implement these sugar taxes, and shame the nations like Mexico that take action against these nutrition activists with surveillance and other tools in order to prevent them from enacting these beneficial regulations for our health that fly in the interest of a sugar corporations.
[48:09] And we also did an episode David recently on genetic engineering and the advances in CRISPR-related technologies, and if so much of our scientific understanding of nutrition and other physiological variables may be coming from this industry propaganda and these profit incentives, do we really want to start adjusting our genetic makeup to give us better adaptation to some of these physiological variables? Varibales that we don’t really understand, and variables that our thinking has been influenced? Not by the unbiased scientific method, but by these industry-backed research initiatives.
[48:45] I think it's a really great point and something we have to remember that in the scale of evolution - maybe just since 10,000.bc - have we been cultivating agriculture and consuming these grains, these carbohydrates, these sugars.
Have our bodies, our evolution caught up with this process? A lot of the science says no not yet, we're still coping with these changes and understanding them. Even at the same time that these industry sources, these sugar companies are pushing more and more sugar on us through the tools of science. Of declaring what nutrition is and then the governmental regulations and recommendations that come out of that.
And as these Gene Technologies develop, both manipulating the food we consume and eventually our very own genetic code, we need to remember this to question what is right; what is natural; and what we should be consuming. We might not know as well as we think we do.
To leave us on a positive note, one more time here’s Margaret Chan.
If governments understand their duty, the fight against obesity and diabetes can be won. The interests of the public must be prioritized over those of corporations.
[49:51] That's a lot to think about; a lot to process, but we hope you'll keep this in mind next time you find yourself at the grocery store looking at a menu and deciding exactly what you should be eating.
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