A Mathematical Challenge to Obesity
nytimes.com
nytimes.com
This doesn't actually follow logically. I know Mr Chow is implying that there's a lot of data that this interview obviously doesn't present, but there are serious problems with this thesis on the face of it. For one thing, if obesity correlates directly with the availability of food, then the most obese people ought to be those to whom food is most available. But the rich in our society are proportionally not as obese as those who face periodic food shortages; and low-income children are proportionally shown to be at much higher risk of suffering from obesity. [1]
Not only that, but the statement that food production has simply gone up and therefore food prices have simply gone down is incredibly... simplistic. There have been arguments for years [2] about what food prices have gone down or up and how that may or may not have affected obesity.
I want to believe that there's data behind this fellow's claims, but I can't help but feel as though, no matter what the data is, summarizing it in the way he does is deceptive.
[1] http://jama.jamanetwork.com/article.aspx?volume=303&issu...
[2] For example, http://www.good.is/post/the-inconvenient-truth-about-cheap-f...
Your point about the rich is an interesting one. A conceivable explanation for this could be that higher-end restaurants tend to have a different value-proposition than lower-end ones: instead of focusing on quantity, they focus on quality.
Finally, I think the point you bring up about the summary being misleading is a good one. Reporters are generally not known for accuracy when reporting on scientific matters.
It is not too far-fetched to think the same could apply for Food. It's probably best to ask the question to people working for food products companies such as Nestle or Danone, where I expect a number of researches must have been conducted.
If you are just fine dining you will get larger portions but will still go starter, entree, main course, dessert.
The portions are small because you cannot eat that much. The prices are high because at a good restaurant they are serving food that is hard to make and they do it well.
A lot of fine food can be very rich. So I am not sure about not ingesting too many calories. Perhaps relative to eating an entire pizza on my own. But not to eating a regular balanced meal.
It's a trickier problem on a broad sociological level, though. The sugar peddlers have an incentive to create and maintain the addiction, and yet they're also just giving people what they want, and at the end of the day, it's still a free country. We can't ever expect all people to abandon sugar any more than all people have abandoned smoking.
As much as I hate to agree with libertarian dogma, I think the USDA is a big part of the problem. They've been been promoting high-carb diets and "moderate" sugar consumption for decades, and it certainly smells like yet another government-industrial complex protecting existing profits.
Grains, specifically cereal grains, may serve as a limited dietary source of fiber, essential amino acids, vitamins, and minerals. As with everything, it is best to exercise moderation but I wouldn't recommend fully removing grains from the diet.
Refined (table) sugar is a common offender but small dosages of fructose and sucrose from a daily serving of fresh fruits and vegetables are justifiable.
Such things as russet potatoes are probably more questionable than oats, for example, as I believe they are almost entirely starch.
Hulled rice and quinoa are wonderful too.
Russet potatoes are typically unnecessary.
If we go back to what we would think of as the dark ages of nutritional knowledge, there were lean, healthy, athletic people back then. And it wasn't just people who ignored all the nutritional dogma of the day, either. The people who swallowed it most conscientiously were lean as well. It seems like so much has changed since then, but has it? Go to the gym today and you'll see a bunch of people who work out, eat paleo, and have low body fat. Thirty years ago they'd still be lean and in great shape, but they'd believe an entirely different dogma about nutrition.
If what we ate was anywhere near as important as how much, then the people who were most disciplined about following the old low-fat, relatively-high-carb diets would have been at a disadvantage compared to people who paid no attention and half-assed it. Or, if the low-fat guys were right, they should have been leaner than the guys who thought milk and eggs were the secret. But consistently, decade after decade, people who are disciplined about diet and exercise are lean and fit no matter what they believe. When people let their discipline slip, most of them end up overweight to some degree. The entire sum of our nutritional knowledge has yet to change that.
Proof?
"And it’s something very simple, very obvious,
something that few want to hear: The epidemic was
caused by the overproduction of food in the United
States. ...This, of course, is a tremendously
controversial idea. However, the model shows that
increase in food more than explains the increase
in weight."
"And it’s something very simple, very obvious,
something that few want to hear: The car accident
epidemic was caused by the overproduction of cars
in the United States. ...This, of course, is a
tremendously controversial idea. However, the model
shows that increase in cars more than explains the
increase in car accidents."
It makes it sound like we could just cut food production across the board and prevent obesity.
.
I would argue the problem isn't the quantity, rather the quality. Quality in regards to:
- Nutrients vs Fat and sugars
- Number of meals a day and the time we eat those meals
- Sugary drinks vs Water
- Appropriate meal size
- Fast food vs home made meals
The solution for the 21st century is going to take more than cutting food production. Just as curbing injuries from car accidents will take a different approach than limiting US car production.
But you didn't, argue. You simply asserted. You threw out the article's theory by constructing a straw-man you didn't even bother tearing down, then proceeded to inform us of your views.
I know of people who tested urine or saliva to monitor ph levels but I did not. I monitored it symptomatically. I could feel when my gut was more acid and it eventually became clear that lung inflammation was directly correlated.
As for blood ph, the body works really hard to keep that within a narrow range. Otherwise, you die. And pretty quickly. The body will strip your bones of calcium to try to keep blood ph stable. If you have an acidity issue, it is best to assume it is systemic rather than localized.
Cut food production, food prices rise, people can't eat as much. It's an extreme solution, perhaps, and one with more political obstacles than I care to think about right now, but it seems "addressable" to me. What if we stopped some of the farm subsidies that don't make sense? What if we significantly increased taxes on unhealthy foods, which is probably justified since unhealthy foods probably directly lead to a rise in healthcare costs down the line? (Now I get to sit back and wait for someone to post facts from one or more of the localities that have tried raising taxes on e.g. sugary foods. I love the Internet!)
that would actually work.
anyway, let's continue with your automobile parable. I think you're actually spot on with the quality argument. it was necessary to increase safety in passenger vehicles by state intervention (Euro NCAP), and alike the state, in my opinion, needs to chip in if consumers can't control their eating behaviour (just like there always will be irresponsible drivers out there). I'm actually a die hard libertarian, but it is hard to argue that imposing some sort of "fat tax" wouldn't actually reduce obesity (especially since obesity is higher in low income households)
heck - we got the smokers to feel terrible about themselves, I bet we can do the same to fat people... /rant
It needs to be explained how he determined that this isn't related to _why_ they are obese in the first place, i.e. whether these are purely correlational facts. It would be nice if the New York Times wasn't susceptible to elementary statistical fallacies like this but... well this is nutrition after all.
The person you are replying to did not say or imply that.
See "Weight of the nation."
For instance, I just tried http://caloriecount.about.com/cc/calories-goal.php (after googling it out of the blue) with starting weights of 300 and 200, ten pounds to lose both ways, everything else the same. The calculator suggested the 200 pound guy needed to eat 500 calories a day fewer than the 300 pound guy did.
If experimental data says otherwise, the calculator is simply wrong.
It's even consistent with a simple causal model. Obese people have larger bodies, which require more maintenance -- a larger supply of blood vessels and a heart working harder to fill them, more energy expended in getting up and going to the bathroom, et cetera. So it's kind of "no mystery."
Now, it might still be the case that this documentary was correct -- for example, while basal rates might be higher for obese people, perhaps normal-weight people simply have an exercise routine which increases their metabolism in general. Something like that would be useful and would help colomon understand why the result is backwards. Unfortunately, I didn't see the documentary and therefore I don't know this particular reason, but the question is legitimate and is not well-dismissed simply by saying, "oh you know that crazy internet."
The Katch-McArdle and Cunningham try to be more specific and relate to the Lean Body Mass (LBM).
However -- since LBM is reasonably correlated with overall weight -- then we can assume that (all else being equal) the fatter person has a higher BMR.
In other words, suppose the obese guy needs 3500 calories a day to maintain his weight, and the skinny guy needs 2000. Then I guess it might be true that if the obese guy eats 3510 calories a day, he will gain weight faster than the skinny guy eating 2010. That seems counter-intuitive but at least plausible.
In other words, it's not a linear relationship.
That seems to make a lot of sense, actually.
Both sorts of calculators are based on broad averages and simplifying assumptions. It's not like the people at about.com went out and carefully measured intake, metabolism, and weight loss for 10,000 people, making sure to have enough data to get statistical resolution between a 300-pound builder and a 300-pound couch potato.
For example, suppose it assumes you'll have 15% body fat at your goal weight. If you told it your goal weight was 290 as opposed to 190, it would factor in 85 addition pounds of lean body mass and recommend extra calories to sustain that lean body mass. The article says something different: that the same person lean at 190 will gain less weight from an extra 10 calories per day than the same person obese at 290.
> It needs to be explained how he determined that this isn't related to _why_ they are obese in the first place, i.e. whether these are purely correlational facts.
I would settle for a simple statement that "An extra 10 calories a day puts more weight onto an obese person than on a thinner one," all else equal or controlling for other factors.
So much of science is based off accepting statistical evidence, that it would be invaluable for science reporting to state, at least in laymans terms, the statistical veracity of results. In this case such a statement should be even easier since we're dealing with a theoretical model of obesity. Is there a coefficient for "current weight" that is independent of other factors?
I agree that more explanation is needed...the thinner person may be thin because she is more active, and the obese person may be obese because she is more sedentary. An extra 10 calories would seem more likely to put more weight on a sedentary person than an active one.
As a culture we're eating ourselves to death while worrying that low probability events like terrorist attacks are going to kill us. We're killing us and we're doing it slowly.
At least a large part of this is due to lack of education. For all the time we spend on math and science in public schools, we spend none of it on some basic principles like nutrition.
I was rather obese in high school, and the (Canadian) government foot the bill for nutrition courses and consultations with a dietitian (this is a big can 'o worms too: preventative programs like this are way easier in a single-payer system).
I now have the ability to judge what's good for me, and what isn't, as well as effective alternatives to existing choices. That knowledge has been instrumental in my weight loss.
The problem with that "fantastic advice" is that it's rarely coupled with real constructive suggestions. "Eat less and eat healthier, fatass" is unproductive when the person lacks the knowledge to make effective choices, and alternatives to break entrenched habits aren't presented. Sure, a Big Mac is universally unhealthy, but what do you replace it with? A grilled cheese sandwich isn't much better, nor are a lot of "healthier looking" alternatives (anything with mayo slathered in it is dietary suicide, regardless of how much greens you stick in it also). How do you curb hunger when in the process of downsizing your portions? Curling up in a corner isn't super effective. Blood sugar management throughout the day to get you through the rough patches? None of this is trivial knowledge.
Of course, the factor making all of this substantially worse is that the signal to noise ratio in dietary literature is horrific. For every real, researched book on effective diets, you have 3 more fad diets backed up by voodoo and pseudoscience.
If you wanted to translate this advice for institutions to an advice for individuals, I think it would instead be something like, "pay attention." The hardest costs to see are often the steady everyday costs -- that morning coffee, the groceries, subscriptions, and so forth. The conclusions that "abundance is the problem" and "we're throwing away too much food" seems to suggest that it has sneaked in during the moments when people aren't paying attention; people now don't pay attention to the quantity of food they buy, so more of it gets bought, more gets eaten, more gets thrown away. Look at the things that come automatic, be less worried about single failures and more worried about the general patterns.
If you want to lose weight, stop eating packaged food, cut out fast-food and cut back on restaurants/take-out.
Make your own food (like everyone did 40 years ago for most meals) and you'll find yourself controlling your portion intake by default.
Portion control was much, much easier. I still ate until I felt full; I just felt full a lot sooner, and experienced a big drop in between-meal cravings.
Eat 500 calories below your MBR + burn rate and you lose one pound per week.
You can do it while eating garbage food (fast food, heavily processed food products) or you could do it while eating a totally vegan diet. It doesn't matter for weight loss.
If anyone can find the author's slides or related article, I'd appreciate a link to them.
He links to the slides from that conference: http://sciencehouse.files.wordpress.com/2012/02/aaas122.pdf
...I didn’t even know what a calorie was.
I call bullshit.
One important thing in higher education for math and physics is to be able to perform detail technical computations or modeling for phenomenons. In common high school and undergraduate physics class, it only requires students to be able to come up models with intuitions. But in graduate schools, you are trained to examine each step to make sure nothing is left out or based on assumptions that are wrong in your mind.
Therefore a lot of time you are not sure what something is until you re-examine all postulates that you learn when you are young.
An MIT-trained physicist should know the common name for a unit of energy. Sure, he might not remember the conversion from joules to calories, but to have never heard of it?
That's taking a literal reading ("I didn't know what a calorie was"), but perhaps he was referring to a more nuanced understanding ("I didn't understand how energy was used by the body"). That interpretation wasn't clear from the text though -- it seemed an overwrought attempt to portray an "Aw shucks, I didn't know what I was doing!" attitude.
So, with that in mind, children learn that one calorie is the amount of energy needed to raise 1 g of water by 1 degree c.
But what does that actually mean for a human body? How is a calorie in fat worked out? How is a calorie in sugar worked out? How do we know they're equivalent?
I find this to be wonderfully ironic, because the nutritional calorie is 1000x larger than the physics calorie. In nutrition, one calorie is the amount of energy needed to raise 1kg of water by 1 degree C. So yes, it's entirely possible that this fellow didn't know what a "calorie" was in the realm of nutrition.
If it were regular physics calories, the energy content of food would be nowhere near enough to sustain us. A typical human body at rest will consume around 8 megajoules per day, or about 2 million calories. But that's only about 2 thousand big-C food Calories.
Forgetting or ignoring this difference results in amusing things like the beer and ice cream diet: http://training.fitness.com/weight-loss/beer-ice-cream-diet-...
Calories in calories out.
Every time someone says that, the people with a hobby-horse to ride come out and beat on the person for a bit. Especially if they imply that honey (no, sorry, the correct term now is HFCS) isn't the Devil's own temptation sent to corrupt and impurify our precious bodily fluids.
then run the following command:
java -cp WeightAppletv10.4.6.signed.jar weightapplet.MainPanel "And it’s something very simple, very obvious,
something that few want to hear: The epidemic was
caused by the overproduction of food in the United
States."
If we take the "overproduction" assertion as fact, this begs the question: Why is this happening?
One answer is that consumers have more money to spend and they are choosing to spend some of it buying (and consuming) more food. Fair enough.
Another answer could be that, in certain segments, government geniuses decided they know better than to let free market work. They go in and throw money around to make producers do what they would not under normal circumstances. That triggers over-production of certain goods. Which triggers lower prices. Which triggers higher consumption. And so on.
Another possible answer is a combination of the above. I am, admittedly, against government meddling in our lives. I want them out of nearly everything. Go throw parties for foreign dignitaries and balance our books. Maybe do a few more things. Oh, yes, those borders. Deal with them will ya? Any time these guys dip their ignorant toes into the water of our lives they invariably create a mess that our children and our children's children will have to pay for.
Of course, this philosophy extends to self-responsibility. In my family we might have a soft drink or two at parties here and there. Just like having ice-cream, in moderation it is an occasional treat. Aside from that, water only. What the hell is wrong with people that go into a gas station and order a 64 ounce soft drink? That's like consuming a cup full of sugar while you drive to work.
This is where another angle in this equation comes into play: A third-payer system of health does not penalize bad behavior. Someone who is a complete moron when it comes to how they take care of their bodies and what they put into it should suffer the financial consequence of having to pay a lot more for healthcare. Today, those of us who try to be sensible are paying for the idiots who are not. That is fundamentally wrong.
If you want a healthy and slim population, again, get government the hell out of the way. Yes, it can be that simple. Don't manipulate markets and don't get involved in healthcare. People should buy and pay for their own health insurance, just like they do car insurance. If you drive like a mad-man and get tickets and accidents your insurance goes up or it could be cancelled. The end result is that people modify their behavior to what is a financially sensible state.
The same would happen with healthcare if people were directly responsible for their own insurance and suffered the consequences of their dumb decisions. Smoke and destroyed your lungs? Your insurance should cost you $50K per year. Enjoy. Drink alcohol like an animal and turned your liver into mush? $75K a year. Have fun. The rest of us would have sensible policies which would reward us for being responsible while covering us in the case of catastrophic events or serious illness outside of our control.
To be clear, I don't have a problem contributing to the pot to help out those afflicted with cancer or similar horrible diseases. A portion of everyone's premiums would cover these out-of-the-norm cases. Then there's the case of obesity caused by diseases like Cushings Syndrome (pituitary gland tumor) that's potentially deadly and has nothing to do with over-eating. We need to collectively help those people. Nothing wrong with that.
I do have a problem supporting the moron who has a Double Big-Gulp every day chased by a large pizza and no exercise other than playing XBox for hours every day.
That said, the app for the model looks interesting. I had my basal metabolic rate measured last year before I started a Master's Swimming program. I like numbers and wanted to have some data. It was 1850 kcal/day. According to the Human Weight Simulator I have to consume 2576 kcal/day to maintain my weight. That, for some reason, feels way too high. I haven't counted calories in a long time, but might do it for a few weeks just to get a sense of what this model is doing. I doubt that I am consuming much more than 1700 kcal/day on average. But, I could be wrong.
I'd be nice if they released a paper with this equation the article mentions. Is that published anywhere?
I actually studied Logic in Spanish while my family was living abroad. Sometimes that does a number with my brain because I actually think about the fallacies in Spanish!
Thanks for pointing that out.
However, if someone would like to start a diet-centered startup with me, I believe I have an insight that invalidates every diet book on the planet.
Every diet book on the planet makes one very false assumption. Before we get to the assumption, let's review something uncontroversial:
- You put on fat by eating more calories than you use; and you lose fat by using more calories than you eat.
In other words, losing fat (beating obesity) would seem to be a combination of "diet and fitness". If you like, you can view every diet book on the planet as a combination of strategies that fall into those two categories (eat less or use more of the calories).
So how can ALL those strategies be wrong?
Let's turn the equation "net fat gain = calories in - calories out" into something more familiar. "net bank account gain = money in - money out."
is it really so simple? Yes. Everyone who weighs more than they want has more money in their bank account (more Calories on their body, ready to burn off) than they want.
Now to get to the big diet books' fallacy, let's turn this around. You're a multimillionaire and want to lose half of your money. What's the easiest way to do it? The easiest way to do it, if you're a millionaire, is to call up your accountant and say, "I would like to donate half of my money to Bill and Melinda Gates foundation, please arrange this."
That's a strategy. You can write it down on a piece of paper and fax it to your accountant with your signature on the bottom, after a few more signatures it's done.
So, what is the difference between THIS strategy and a DIET strategy? Simple: When you wrote that down to fax your your accountant (or booked a hotel room by email, or booked an appointment with a repairperson, contractor, whatever, basically anything like that) then the strategy you wrote down and faxed, in that fax, had the effect that the person it addresses WILL OBEY YOUR COMMAND. They will follow your strategy.
Whereas, if you decide "every morning 5 pushups" and write it down, even if you fax it to yourself that does NOT mean that its recipient (you) will do 5 pushups the next morning.
In other words, every diet book on the planet thinks that you are the boss of the person doing the dieting and exercising, and simply have to micromanage what they do.
But you are NOT the boss of you. Let's recap.
Writing:
"Dear ---, After careful deliberation I have decided that I will immediately be donating 1/2 of all of my wealth to the Bill and Melinda Gates foundation. Please liquidate an appropriate portion of my investments in stocks, bonds, and mutual funds (in equal measure) for me to to be able to donate half of my net worth, and then prepare the donation for my signature. Yours truly,"
now it will start to happen, and another signature or two and it's done. (Even if this was considerable work for the accountant!!!)
Now write down: "Starting tomorrow morning, as soon as you wake up please ensure your first action is to do 5 pushups and 5 situps. For seven days do so, then for the next week do 10 of each, the next week 15 of each, then 20, and os on, until you reach 50 of each (after 10 weeks), which you should keep doing indefinitely. Yours truly, yours truly."
Simple strategy, right? Only problem is, if you fax it to yourself, I can almost guarantee you that the recipient of the fax will not do what you want. Even if you sign it. Even if you really, really want you recipient to follow through. They won't.
Every single diet book makes the SINGULAR mistake of thinking that its reader is free to choose a strategy of consumption and of exercise. Not so: the reader can agree with every word. Unlike agreeing with every word of investment advice that a rich person can order an accountant to follow through on, the reader of any diet book has no such power to order that a strategy (of either diet or of exercise) be executed.
- read about Tahiti, decide you want to see it, call your travel agent and have them book a room in Tahiti, and a room will be booked in Tahiti.
- read a fad diet, decide you want to see the results, and... no guarantee you will have a chance to see them.
In sum, if you see what is wrong with the present offering, please email me for collobaring on an interesting alternative.
Can you summarize your idea in a way that doesn't sound like a late night infomercial? The analogy of spending money and weight loss is flawed. The key to spending the money is not deciding that you want to do it. It's the action of writing the letter, signing the paper or calling your agent. Even when spending a great deal of money, this is an action that requires little willpower over time. You order someone to take care of it and it's no longer on your mind. In contrast, weight loss requires a constant input of will power over a long period of time. That's where people fail.
They're all based on the premise I've outlined. Kind of like there are a whole lot of different alarms (and strategies, like - for me - placing the alarm across the room) that all 'do something' beyond waking you up long enough that you turn the alarm off before falling back asleep for good. There's not one strategy here.
To me, diet and exercise-based books are like strategies for waking up: they think that having a strategy like "When the alarm wakes you up enough that you turn it off, do turn it off, but don't go back to sleep!" Well, yeah, that's the "super-strategy!" All strategies are equivalent to this, just like all strategies are equivalent to "use more calories than you consume". It doesn't help someone who wakes up just long enough to turn a 'naive' alarm off.
If there is some way to reach you I'm happy to share a complete list.