body image · diets · eating disorders · fashion · fitness · Martha's Musings

We are more than a collection of parts

 

kyle-pham-648683-unsplash
Women being active and not worrying about thigh gap, or hip cleavage, or any other nonsense Photo by Kyle Pham on Unsplash

It’s tiring to be female in this world. I can only speak from a cis-perspective, of course, but it occurs to me, that howsoever you come to identify as a female, there is an endless list of things you must have or prevent if you are to present acceptably as female.

 

First it was thigh gap, that space between a woman’s thighs — the wider it is, the thinner and more desirable the women. Then it was the concave navel. Now we have a new one: hip cleavage, or what I knew as high cut underwear or swimsuit bottoms to show off the hip bones.

We are all familar with the term cleavage as associated with breasts. Plunging necklines in dresses are designed to show off cleavage. There are right ways and wrong ways to show off cleavage in the upper body.

Too much in the wrong way means you end up with sideboob reveals; too much in the right way means you may risk a wardrobe malfunction and subject unsuspecting bystanders to a glimpse of the “girls.” These days, the focus, and perhaps the parts in question, has shifted to the underboob (I can hardly wait to see if there is an upper boob!).

Regardless of the terminology, the prinicpal issue is that women continue to be divided into parts. Perhaps it’s the legs (although it and the toes had cleavage back in the day). Let’s not forget the butt or the breasts, with fashion dictating whether they were perky, ample, lean or sleek.

When I used to deliver media literacy sessions to high school students, we would talk about the techniques used to separate, disconnect, and isolate girls and women from their bodies. Instead of being seen as whole, unique individuals with our own kind of beauty, women and their bodies are broken into parts and given meaning and value by others.

The obsession with thinnness as a beauty standard has fueled anxieties and nurtured the development of eating disorders; sadly, girls and women continue to starve themselves to fit a largely artificial construct of “female” beauty.

In Canada, those of us who work in health promotion talk about the vitality message — eat well, be active, live smoke free, and support mental wellness. Being active offers tremendous health benefits and it makes me sad to see fitness being used negatively to coerce women into creating and maintaining a body shape that is not natural to them.

 

clarke-sanders-249798-unsplash
Another picture of fabulous women not caring about articifial body constructs. Photo by Clarke Sanders on Unsplash

 

Focusing on hip cleavage is just another stick we use to bash away at ourselves. It’s a stick handed to us by the arbiters of fashion and trends (I keep meaning to ask, who died and made them the rulers of the universe?) and quite frankly, I’m tired of it all.

We need to rewrite the script and start talking positively, frequently, and loudly about all the good things we can with our bodies: how strong our legs are to drive our bikes and our feet on our runs; how powerful our arms are so we can lift, wheel, and strike; how big our chests can be to ensure we can take in the oxygen we need to keep going; how wide our hips can be to birth children or to cuddle them.

We are enough as we are. In fact, we always were. Let’s remember that.

— Martha is a writer and powerlifter in St. John’s.

 

 

diets · fitness

So many bad diet headlines, so little time…

There’s a lot we already know about dieting, namely:

  • No matter what cockamamie diet we dream up, it is both true that  1) someone probably can lose weight temporarily with it; and 2) almost no one can keep weight off with it.

Imagine my 1) lack of surprise; and 2) skepticism when I saw a headline saying “lose weight by eating as much rice and potatoes as you want– no, really”. This news (and I use that term lightly) story reported on a 14-week study done on participants in a UK-based  commercial weight-loss program called Slimming World vs. a control group that did self-led calorie reduction using standard nutritional materials.

The idea behind the study was to see if eating less-energy-dense foods (of which carbs are included) could result in more weight loss, lower appetite and fewer food cravings.  And indeed the experimental group did lose more weight on average than the control group (13 lbs vs. 7). However, we don’t know that it was because of what they ate, as the experimental group had lots of attention from the researchers, peer-group support, and other treatment that (according to the study) may well have influenced the outcome. In addition, the subjective reports of appetite, satisfaction with the program, and cravings were more favorable than those of the control group. But again, they knew they were the experimental group and identified as a group.

I might add that many of the important health metrics (blood glucose level, blood pressure, etc.) didn’t differ between groups.  However, one difference in the study caught my eye:

RMR significantly decreased in the SW [experimental] group but did not change in the SC [control] group.

What’s RMR?  Resting metabolic rate. The above line says that those in the Slimming World diet plan group ended up with a lower metabolic rate than those in the control diet group. That’s not good. That’s really not good. That’s one of the many bad effects on bodies that engage in dieting. It’s bad because it means that your body’s rate of energy consumption is lower, meaning that you burn calories at a lower rate.  This is part of the reason why most people who diet regain all the weight they lost and then some.

What can help raise the RMR? Several things, but the easiest is exercise, which can contribute to increased muscle mass.

So what are the salient results from my reading of this study?

  • You can indeed eat potatoes, rice, etc. in amounts you want. (We knew that already).
  • Being part of a group with shared goals (whatever they are), may help members feel committed to and satisfied by the group’s activities.
  • Dieting often results in lowered resting metabolic rate, which has significant negative effects on bodies.
  • Exercise has no such negative effects on bodies; in fact, exercise raises RMR.

If you’re looking for eating advice from me, here’s something that looks good– this whole-wheat roti with bananas and peanut butter.

What are you finding yummy these days? I’d love to hear from you.

Whole wheat roti with bananas and peanut butter. Mmmmmm...
Whole wheat roti with bananas and peanut butter. Mmmmmm…

 

 

diets · food

Every day is “eat what you want day”…because we are grown-ups and food is beyond good and evil

I don’t know if it’s a real day, but apparently May 11th was National Eat What You Want Day. I missed it.

I get my info mostly from this:

Image description: Cartoon of hippo (?) against a purple background, sitting at a table surrounded by pies, cakes, cookies, and chocolates, with a cookie in one hand and a chocolate bar with a bite out of it in the other, chocolate smudged on face.
Image description: Cartoon of hippo (?) against a purple background, sitting at a table surrounded by pies, cakes, cookies, and chocolates, with a cookie in one hand and a chocolate bar with a bite out of it in the other, chocolate smudged on face. Image credit: Sandra Boynton.

Okay, I get that this cartoon is supposed to be a joke. And though I am not familiar with Sandra Boynton’s body of work, a reader of the blog got in touch with me to say her work “is consistently affirming, food positive, body positive, women positive and [she] deserves credit for her work in this post.” So yes: credit where credit is due.

And perhaps in the larger context of Boynton’s work, this is whimsical, funny, and affirming. I can see that. But when I first encountered it, it gave me pause because of the way it represented what Eat What You Want Day would look like.  I’m told too that the day apparently originated as a response to our diet-laden cultural mindset.  It’s a way of breaking free.  And that’s a good thing. But only for a day? Seriously? I want to say: that’s not enough.

First, every day is an eat what you want day as far as I’m concerned. It’s not just because I’m an intuitive eater. It’s also because we’re adults and we get to make our own decisions about what we eat. Literally, at every moment, you get to choose what you want to eat. So do I. And so does the person in front of you in the line up at the coffee shop who wants an apple fritter for breakfast instead of the egg white frittata.

Second, why does everyone always assume that if we eat whatever we want we will choose to eat only cookies, cakes, candy, and chocolate?  This narrative is a product of the deprivation mentality that is entirely encouraged in our society. Since veggies and fruits and all that other “healthy” stuff is what we “should” be eating (RULES!), all the fun food is what we actually want to be eating (BREAK THE RULES!).

I venture that if we only have one day where we give ourselves permission to eat what we want and if the rest of the days we are eating plain salads where the only dressing we get is the one tablespoonful that we get to dip our fork into before spearing each cucumber slice (if you’ve ever dieted you’ve done this, right?), then when we take away the rules we’re going to go for the flavour burst foods that we’re not “allowed” to eat.

But if that stuff was always on offer, without the rules, it would lose its lustre after awhile. I know this from experience. When I was a grad student my housemate and I experimented with a candy bowl as part of an assignment given to my by the amazing psychotherapist who was trying to help me recover from disordered eating and chronic dieting.

We were to keep the bowl heaped full. Just buying those mini-chocolate bars to fill it gave us an adrenaline rush. And the first week or say we went to town on those candies. We had to fill up the bowl quite a bit. Less so the second week. By the third and fourth week we weren’t as interested anymore. And today I always have a few chocolate bars on hand that I keep in a bin and that last months. Because sometimes I want salad or hummus or a farro bowl with steamed rapini and stir-fried tofu drizzled with tahini and Frank’s Red Hot, not a piece of dark chocolate-dipped crystallized ginger.

Third, this brings me to the point I really want to make, and that we’ve made many times on the blog before, in various forms: food is beyond good and evil. You’re not morally good if you eat a salad and morally bad if you eat fries. Steamed broccoli isn’t virtuous and banana tempura in syrup isn’t sinful and decadent. It’s food. You can eat it if you like.

I just despise food policing, the food police, and any kind of moralizing about food (other than vegan moralizing, which I’m totally down with even if I tend to stay silent unless asked or unless it’s totally relevant and people are saying ridiculous things to defend their participation in unnecessary animal cruelty…oops). Susan shared a story yesterday with the other blog authors about how she was at a coffee shop (buying a muffin) and a woman came in and literally lectured the owner about how muffins are cake.

You know what? Cake is awesome. So simply telling me that muffins are cake makes me want to say, “And your point is…?” All over the world people eat pastries and stuff for breakfast. If you’re eating muffins because you’re counting calories or fat grams and you think they’re low in those, then you might want to think again. But if you’re eating the because you like them, which is basically the best reason to eat whatever we eat, then someone telling you muffins are cake might go a long way to explaining why they’re so damned delicious.

I’m not the only one on the blog who feels this way about food policing. Here are some of our posts about this topic, gathered in one place, for your reading pleasure. Next time the food police make an appearance, ignore them, refer them to the blog, or tell them to go ahead and arrest you for taking pleasure in your food choices!

Why Food is Beyond Good and Evil (Tracy I)

Do You Get Sucked into Food Shaming Trends (Tracy I)

Food Demonizing and the Perils of “All or Nothing” Thinking (Tracy I)

Beyond Good and Evil (Food) (Catherine W)

Follow-Up to Last Week’s Beyond Good and Evil (Food) Post (Catherine W)

Just Eat the Damn Cupcake (Sam)

Don’t Get Sucked in by the Rhetoric of Eating Clean (Tracy I)

Diets Disguised as un-Diets: The Food Police Strike Again (Tracy I)

Disclaimer: I’m not discounting that some of us may have added reasons not to eat some foods. If I was diabetic, I would need to be careful about sugar. I do have a garlic intolerance that means I cannot deal with anything other than trace amounts of cooked garlic and almost no amount of raw garlic. That doesn’t make me want garlic. Also, there are ethical reasons for avoiding some foods. I’m an ethical vegan who pretty consistently avoids animal products because of my beliefs about the industry’s impact on the environment and my desire not to contribute to animal suffering and exploitation (two hallmarks of industrial animal agriculture). That’s a reason. And it doesn’t make me want filet mignon and veal parmesan.

Question: How do you deal with the food police?

diets · eating · eating disorders · sports nutrition

Chocolate: A yummy delicious treat

I’ve had a bag of these in the house for awhile as my go to treat in lieu of dessert. They’re delicious.

Unlike Tracy, I haven’t broken up with chocolate.

But while the chocolates are often the yummiest part of my day, chocolates are not necessarily the healthiest thing I could eat. That’s fine by me. I didn’t choose them for health reasons. I was looking for the yum. They’re a treat

Chocolate isn’t evil but it’s not exactly a health food ether. Here’s the nutritional facts.

So these are an occasional treat, not a health food. I don’t eat them as meals. They’re pleasure. An indulgence.

Maybe that’s a bit fast. Isn’t it dark chocolate supposed to be good for all that ails you? I have friends who eat dark chocolate to help with the common cold. Others who swear it helps with arthritis.

Is it really good for you? The Guardian weighs in this week.

They talk about the rebranding of chocolate as a health food and how that occurred.

“Recent years have seen chocolate undergo another transformation, this time at the hands of branding experts. Sales of milk chocolate are stagnating as consumers become more health-conscious. Manufacturers have responded with a growing range of premium products promoted with such words as organic, natural, cacao-rich and single-origin. The packets don’t say so, but the message we’re supposed to swallow is clear: this new, improved chocolate, especially if it is dark, is good for your health. Many people have swallowed the idea that it’s a “superfood”. Except it isn’t. So how has this magic trick-like metamorphosis been achieved?”

So chocolate is supposed to help with blood pressure, dementia, stroke risk and the common cold but the problem is the quality of the research which is almost all funded by the chocolate industry. Go read the Guardian story for details.

James Fell in his anti dark chocolate rant gets it right, I think.

…If you’re buying into the health washing while rationing nibbles as your reward for sticking to a soul-destroying diet, just stop. Eat a mostly healthy diet, and then when you feel like eating chocolate, you eat the shit out of it. None of this “I’ll just have a square of dark chocolate now and then” bullshit. Get some fucking Turtles, or a Caramilk bar, or a Crispy Crunch, or one of those triangle shaped Toblerone things. Get a Jersey Milk and dip that sucker in the Skippy peanut butter and say, “Mmmm … G-M-Oh-my-God-that-tastes-good.” Eat your favorite chocolate and LIVE, DAMMIT!

Want to know more about chocolate? There’s a talk on the chemistry and physics of chocolate by the University of Guelph’s Prof. Alejandro Marangoni in Waterloo, Ont., by the Royal Canadian Institute for Science on April 18.

Enjoy the talk and the occasional chocolate. Just don’t fool yourself into thinking it’s a health food. Or worse, don’t eat dark chocolate in a medicinal manner not enjoying it at all.

body image · diets · eating · fat · fitness · weight loss · weight stigma

The new health target of the century: kids

The news made the rounds of the health at every size (HAES) contacts I have in my social networks. I shouldn’t have been surprised to learn that Weight Watchers was offering free six-week memberships to 13 year olds, and yet I was.

Shortly after that, I learned the makers of FitBit were launching a fitness tracker for children. According to TechCrunch, the makers of FitBit are targetting the eight- to 13-year-old market because as the Telegraph noted, we need to do something about getting “couch potato kids” off the couch and into the gym.

Because child obesity y’all. (Insert eye roll here.)

I’ll admit I’ve been on diets, and I also have used a FitBit (see this post for how I use mine). I went on my first diet with WW when I was 14 and I needed my mom to sign for me. I can’t say it was a success because despite an endless variety of diet plans, I have continued to be my own fun-sized self and not the one society said I should be.

I stopped dieting when I reached my 40s. I read the literature, I looked at the research, and I considered the methodology of the studies. These days I try to eat most of my fruits and veggies every day, be moderate about my meat consumption, and add more whole grains, beans, pulses, and fish to my plate.

I still eat chocolate, potato chips and ice cream treats on occasion, but I am more mindful about my daily choices. And when I really, really want the chocolate bar, I go for the good stuff and thoroughly enjoy it.

Diets are all about deprivation, regardless of how they are marketed. And they don’t work. The problem with marketing to teens, especially teen girls, is they already have a decade of misdirection on what a female body is supposed to look like behind them. All those messages have been accumulating and Weight Watchers is stepping up to take advantage of the anxiety-fertilized soil to grow their market.

Ultimately, the only thing the plan will do is teach girls deprivation is the norm, their bodies at 13 are unacceptable, and it is on them to change their bodies rather than society change its expectations for the form expected for women.

At first blush, there shouldn’t really be an issue with creating a tool for kids. However, there are many people who see the number of steps reached as tacit permission to indulge. Weight Watchers for awhile had an exercise component that allowed users to collect food points through exercise and then spend them on either more, or fun type foods.

Many of these exercise tools track not only steps or other types of activities but also calories and weight. If you want off the diet train and onto the gym track, it can be very hard to find a gadget or tool that doesn’t link weight and fitness. In fact, it is one of the reasons I and my trainer make a point to track personal records that are strength based instead of scale based.

Whatever your size, age and body type, we are, at least in North America, a more sedentary society. Television, junk foods and in house gaming systems are factors in the higher weights we are seeing. But the problem with marketing fitness gadgets to kids is that after awhile the appeal is going to fade. While gamification of anything works effectively in the short term for setting goals, once kids and youth get where they want to be, there isn’t a point to doing it anymore and it stops being fun.

A co-blogger on this site shared with me some thoughts she and her sister had about the Fitbit and they echo mine: “My experience with fitbits with grown ups is they don’t understand the correlation between steps and food so it almost gives them more ‘permission’ to eat that piece of cake or whatever. I only know two people who use it in the way it was designed (make sure I get in my steps to stay fit) and they are both people who would be fit anyway. For kids, it’s a good awareness raiser and a ‘game’ but if it becomes the gadget it kind of loses its function.”

My co-blogger’s sister also made an important point that links to unpacking, resisting, or creating a new culture around fitness: “Fitness especially in kids comes from values, habits, home discussions, role modelling, fun activities, and doing things that don’t seem like fitness to the kid.”

Doing things that don’t seem like fitness are often more fun when you don’t have the “must” factor. Even I think it is more useful to say to myself: “It’s a gorgeous day out — let’s go for a walk!” instead of “I need to get 2500 more steps in to meet my time for today’s fitness.”

While I think the offer from WW for 13-year-olds is more problematic than FitBit’s plan to extend its market share by focusing on kids, I do believe we need to think carefully about how we look to change the behaviour of children when it comes to eating and moving.

Because in some respects is not how we change the behaviour, but why we feel it is necessary in the first place.

— Martha enjoys getting her fit on with powerlifting, swimming, and trail walking.

diets · eating · eating disorders · food · health

If not Weight Watchers for children, then what?

Regular readers know that I’m no fan (to put it mildly) of Weight Watchers. See I hate you Weight Watchers.

I think it’s extra awful that they are offering free summer memberships to children and I’ve written about that too.

(Added: Yes, it’s not just Weight Watchers. Goodlife Fitness does it too for high school students. FWIW, I also hate them.)

Yet, I can see the attraction. We know adults find it impossible to lose weight. That diets don’t work is a regular theme here on the blog.

Still, many people who agree that there is not much we can do about adult obesity other than helping people not gain weight in the first place, view children as the front line in the “war against obesity.” The thought is that if we can stop obesity either before it develops or in its early stages, we can avoid the health problems associated with overweight and obesity.

(Added: For those who don’t know the blog that well, I’m using talk of “obesity” and the “war on obesity” even though I think these are very problematic. See Catherine’s post with which I agree, “Obese” is a bad word—it’s got to go. I’m doing it because I think that even if that’s your framework you shouldn’t endorse dieting for children.)

What’s the problem then? Couldn’t children who are looking for help, who struggle with their weight, find some sensible advice at Weight Watchers? It’s got to be better than the semi-starvation plan that got me through high school. I lived for years on coffee, cigarettes (and, this was the 70s and 80s, we didn’t know better) bran muffins. We know lots of older children and young teens try wacky diets. At least Weight Watchers is all about regular food and includes all the food groups.

The big problem is that while common sense seems obvious, it’s actually not clear what works. “Eat less, move more,” sure, and what could be wrong with that? (James Fell says it’s bullshit and he makes me laugh.) But we don’t have a very good grip on the causes of obesity. Nor do we have a very good handle on what works to reduce childhood obesity. It’s definitely not as simple as “eat less, move more.”

If a medication had the same success rate as dieting—where ‘diet’ is behavior aimed at producing a calorie deficit by eating less and moving more—and a similar track record of bad side effects (including significant weight gain), there is no way we’d prescribe it to anyone, let alone children.

What do we know? We know what doesn’t work. Shame and stigmatization don’t work. See campaign takes creative aim at Georgia’s anti-obesity ads.

You might think who would recommend shaming, anyway? But bioethicist Daniel Callahan outright advocates shaming in his opinion piece, “Obesity: Chasing an Elusive Epidemic,” Hastings Center Report 43, no. 1 (2013): 34-40.

fat activist marilyn wann

What about labelling without shame, simply describing overweight and obesity without judgement?

However, even telling children they are overweight has bad effects

“A recent study by researchers at UCLA found that if girls had been called “too fat” by someone by age 10, they were more likely to be “obese” at age 19, and that the more people who told her she was “too fat” the more her chances of being “obese” increased. The study included controlled for income, race, childhood weight and puberty age.” See here.

Girls who are told by a parent, sibling, friend, classmate or teacher that they are too fat at age 10 are more likely to be obese at age 19, a new study by UCLA psychologists shows. The study looked at 1,213 African-American girls and 1,166 white girls living in Northern California, Cincinnati and Washington, D.C., 58 percent of whom had been told they were too fat at age 10. All the girls had their height and weight measured at the beginning of the study and again after nine years.

Overall, the girls labeled fat were 1.66 times more likely than the other girls to be obese at 19, the researchers found. They also found that as the number people who told a girl she was fat increased, so did the likelihood that she would be obese nine years later. (These findings appear in the June 2014 print issue of the journal JAMA Pediatrics and are published online April 28.)

“Simply being labeled as too fat has a measurable effect almost a decade later. We nearly fell off our chairs when we discovered this,” said A. Janet Tomiyama, an assistant professor of psychology in the UCLA College of Letters and Science and the study’s senior author. “Even after we statistically removed the effects of their actual weight, their income, their race and when they reached puberty, the effect remained.”

See also “Adolescent Dieting May Predict Obesity and Eating Disorders” Journal of the American Dietetic Association 2006.

Doctors suggest weighing children without judgement. It’s just a number. That’s all.

A set of swings with no one in them. Photo by Aaron Burden, Unsplash.

One other suggestion is to decouple inactivity and obesity and focus is on the inactivity side of the equation. There are obesity related reasons to care about inactivity but that’s not the only reason. There are also good reasons to decouple them. Efforts at improving activity (and nutrition) shouldn’t be measured solely in terms of impact on obesity.

There are no studies showing harmful effects of increasing children’s activity levels. Thin people need to move more too and overweight and obese people shouldn’t quit exercising if the scale doesn’t move

I think a similar focus on nutrition and developing a healthy relationship with food would be good regardless of its impact on weight and BMI.

But until we have a good handle on the causes of childhood obesity I think that guilting parents and shaming children has to end.

We know diets don’t work. We know body shaming doesn’t work. It turns out that even naming the problem makes it worse. Children who are told they are fat by friends, family, doctors are more likely to gain weight.

So what to do?

First, don’t take them to Weight Watchers.

Second, help them learn to appreciate the bodies they have and the things that these bodies can do. Make movement fun and joyful.

Third, help children learn to cook at home and make family meals happy occasions.

The American Academy of Pediatrics new guidelines (see here) on dealing with weight and kids suggests getting rid of body shaming, weight talk, and dieting because it predisposes kids to eating disorders and to eventual weight gain as a result of disordered eating. Since the old way of trying to eliminate obesity tends to make people more prone to illness, there are also new guidelines including emphasizing exercise and nutrition, NOT body size.

That’s all I’ve got. How about you?

diets · fitness

Looking for the “best” diet? US News and World Report will tell you…

I just found out this week that US News and World Report, the now-online-only news magazine that ranks everything from universities to hospitals to cruises (I’m not kidding–check out your cruise rankings here), has also been in the diet ranking business for the past 8 years.  Where have I been all this time?

sign post saying "over there", "nowhere", "distant", etc.
sign post saying “over there”, “nowhere”, “distant”, etc.

Well, even though I’m late to this party, I decided to dive in and see what was up (I’m leaving the very mixed metaphors in for flavor).  Warning: their diet rankings page, found here, can send you down the internet rabbit hole.  I started nosing around, and before I knew it, two hours had passed.  Yes, it was like this:

A drawing of a person at a desktop computer with their face stuck in the monitor screen.
A drawing of a person at a desktop computer with their face stuck in the monitor screen.

But I did find out some interesting things, which I will now share with you.  I’ll put them in the form of an FAQ:

  1. How did US News and World Report go about ranking diets?

Here’s what they said:

To create the eighth annual rankings, U.S. News editors and reporters spent months winnowing potential additions to our diet roster and then mining medical journals, government reports and other resources to create in-depth profiles for those that made the cut.

Yeah. I’m sure they spent a bunch of time on this.  But I don’t know what an “in-depth profile” is.  It is almost certainly not something that meets scientific standards, which is a meta-analysis.

What’s that?  Here’s Wikipedia:

Conceptually, a meta-analysis uses a statistical approach to combine the results from multiple studies in an effort to increase power (over individual studies), improve estimates of the size of the effect and/or to resolve uncertainty when reports disagree.

Want more detail?  Here’s more precise info from a medical journal discussion on meta-analysis:

Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess previous research studies to derive conclusions about that body of research.

Outcomes from a meta-analysis may include a more precise estimate of the effect of treatment or risk factor for disease, or other outcomes, than any individual study contributing to the pooled analysis.

The examination of variability or heterogeneity in study results is also a critical outcome. 

The benefits of meta-analysis include a consolidated and quantitative review of a large, and often complex, sometimes apparently conflicting, body of literature.

The upshot of the above is this: if we really want to know the answer to a scientifically complicated question like “which diet is the best for X”, and we know that many scientists have explored this question from many angles, getting many different answers to parts of this question, then we need a systematic way to analyze all those studies and combine them to try to get a coherent and reliable answer to this complicated question.  It is not a foregone conclusion that doing a meta-analysis will end up yielding either a coherent or reliable answer.  The data may be too conflicting, or there may be gaps where we don’t know enough, so we can’t draw conclusions.  This is all useful for researchers, as it points to areas for further study.  However, it may or may not help clinicians who want answers for their patients, or the rest of us, who just want answers.

2.  Wait a minute– they didn’t consult actual experts in medicine, nutrition, etc.?  How can they assess loads of technical scientific information without help?

Here’s what they said:

A panel of nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes and heart disease reviewed our profiles, added their own fact-finding and rated each diet in seven categories: how easy it is to follow, its ability to produce short-term and long-term weight loss, its nutritional completeness, its safety and its potential for preventing and managing diabetes and heart disease. We also asked the panelists to let us know about aspects of each diet they particularly liked or disliked and to weigh in with tidbits of advice that someone considering a particular diet should know.

Yeah, let me unpack this for you.  US News and World Report gathered together a panel, which includes clinical practitioners in medicine and nutrition, some diet book writers, directors of clinical programs for diabetes, heart disease, etc., and researchers and clinicians in academic medicine.  Some of these folks have a particular diet they’re promoting, and others are very busy either running a medical center or doing research and running a lab.

At best, some of these panelists read the pre-prepared packets of material on various popular diet plans (like the Mediterranean Diet or the DASH Diet) and offered their best guesses, based on their areas of expertise.  More likely, the busiest experts farmed this task out to grad students or research assistants, which is legitimate and common practice.

3. So far, all this sounds okay.  What’s the problem?

Remember what I wrote (which you may have skimmed over, which is perfectly fine) about meta-analysis?  I said that to assess a program like a diet, you have to do very fancy statistical work on dozens–hundreds of studies on that program or diet.  It takes a lot of time and brain power and qualified people, and results in a journal article.  US News and World Report couldn’t do this, and the expert panels didn’t do this.  So they’re just doing the equivalent of throwing darts at a dart board, in my opinion.

Darts in the air on their way to a dart board.
Darts in the air on their way to a dart board.

This procedure is not the way I would choose to make decisions about my health.

There’s more to say (as always), but I’ll leave it at this:  don’t let the people who advise you about what cruise to take also tell you how to eat in order to deal with your diabetes.  Just sayin’.