Category Archives: nutrition

Who’s the Real Elitist in the the Anthony Bourdain-Paula Deen Spat?

bourdaindeen

Them’s Fightin’ Words

Anthony Bourdain set the food world aflutter about a week ago when he criticized Paula Deen for encouraging Americans to eat food that’s “killing us” and “sucks.” Here’s the full text of the quote that started the whole thing, which appeared in TV Guide Magazine August 18:

bourdain scarf The worst, most dangerous person to America is clearly Paula Deen. She revels in unholy connections with evil corporations and she’s proud of the fact that her food is f—ing bad for you. If I were on at seven at night and loved by millions of people at every age, I would think twice before telling an already obese nation that it’s OK to eat food that is killing us. Plus, her food sucks.

It was a stupid, incendiary remark. Spite masquerading as “straight talk” and a shameless attempt (on TV Guide’s part, if not Bourdain’s) to manufacture controversy and attract page views. And hypocritical to boot. The claim that Deen has “unholy connections with evil corporations” is mighty rich coming from a guy who shills for Chase Sapphire. Furthermore, Bourdain himself isn’t exactly shy about eating rich, “fattening” foods on his show or serving them at his restaurant, which offers traditional French brasserie fare, including all the requisite butter, beef, bacon, sausage, foie gras, eggs, cream, white bread and fried potatoes. Check out the clip from No Reservations titled "Bourdain makes a deep-fried discovery," in which he points out that in almost every cuisine and every region, someone has figured out that dipping things in batter and cooking them in hot fat tastes pretty darn good before enjoying some deep-fried crab cakes and walleye. I’m not convinced that butter and fried foods are “killing us” or that either he or Paula Deen has a meaningful impact on how very many Americans eat, but I’m also pretty confused why he thinks her cooking is significantly worse for people’s health than he stuff he tells people it’s OK to eat.

Bourdain eventually backed off the hyperbole of his initial remarks on twitter, clarifying that he didn’t say Deen was the worst person in America, just the cook on the Food Network who’s the worst for America and adding that she’s probably very nice “as a person.” He also groused about how no one ever asks him who the best chefs on the Food Network are, and said the next time someone asks him about the worst ones, he’ll keep his mouth shut.

bourdain twitter

Meanwhile, Deen fired back with a populist appeal. In an interview with The New York Post, she defended her cooking on the grounds that she and the other maligned Food Network hosts feed “regular families” who struggle to put food on the table. She also claimed that she uses her wealth and celebrity for good, pointing out that her “partners” (i.e. the “evil corporations” Bourdain referred to) donate meat to food banks and that the other Food Network hosts also work to help uncontroversial charity targets: the hungry, sick children, and abandoned animals:

scary paula “Anthony Bourdain needs to get a life. You don’t have to like my food, or Rachael’s, Sandra’s and Guy’s. But it’s another thing to attack our character. I wake up every morning happy for where I am in life. It’s not all about the cooking, but the fact that I can contribute by using my influence to help people all over the country. In the last two years, my partners and I have fed more than 10 million hungry people by bringing meat to food banks.”

Basting Bourdain for his apparent lack of charity and his attitude, she said, “My good friends Rachael, Guy and Sandra are the most generous charitable folks I know. They give so much of their time and money to help the food-deprived, sick children and abandoned animals. I have no idea what Anthony has done to contribute besides being irritable.

Deen continued, “You know, not everybody can afford to pay $58 for prime rib or $650 for a bottle of wine. My friends and I cook for regular families who worry about feeding their kids and paying the bills . . . It wasn’t that long ago that I was struggling to feed my family, too.”

Her attempt to align herself with “regular families” and portray her role as Smithfield’s spokesperson as some kind of charity work is just as ludicrous as Bourdain’s remarks.* She admits she has “no idea” what kind of charitable work Bourdain does or doesn’t do, but certainly implies it’s less than her. And then she mentions expensive foods, as if $650 wine has anything to do with Bourdain’s comments. As Rebecca Marx of the Village Voice pointed out, “Deen is no less a member of the culinary aristocracy than Bourdain—they just belong to country clubs with different rules.”

*Which is not to say that Deen doesn’t do any good work as Smithfield’s spokesperson. Perhaps, like Sandra Lee (another of Bourdain’s targets, although in the TV Guide article he mostly sounds scared of her), she uses her influence as spokesperson to get more food from Smithfield to hungry people. Taking their money and promoting the brand doesn’t mean she necessarily agrees with everything they do; perhaps she figures she can do more good that way than by refusing their money on principle. But I also doubt her deal with them is entirely about charity and not at all about personal gain.

Pot, meet Kettle

I’m not convinced the rules they’re following are really so different. Deen and Bourdain have both established their brands and built their celebrity by catering to essentially the same mass desires. First, they trade heavily on the fetishization of “authenticity.” Deen plays up her Savannah roots, performing what essentially amounts to a drag version of genteel Southern whiteness*—an exaggerated drawl and big hair and constant ya’lling and calling everyone “honey.” Bourdain does it by seeking out street food and the off-the-beaten-path restaurants that only the locals know about, or, even better, people who will cook “traditional” foods for him in their homes.

Both of them serve up something that looks and feels “real” in a way that answers the dissatisfactions of global capitalism and the seeming unreality and homogeneity of mass production, multinational corporate brands, slick but empty advertising, artificial flavoring. As Andrew Potter argues in The Authenticity Hoax, the search for the “authentic” is largely a disguised form of status-seeking, and it’s a particular preoccupation of the wealthy, educated classes. As he explains in an interview with WorldHum:

There are certainly authentic experiences—insofar as the authentic is defined as something that’s a refuge from the modern world. But what I try to argue in the book is that the search for the authentic comes at a price. It tends to be quite expensive to find these things. The other side is that it ends up an arms race….

People have sort of authenticity in degrees. For instance, let’s say the absolute fake is going to some Italian restaurant in some fake Venice in Vegas. That’s the absolute fake. Here in Toronto, where I live, you can go down to little Italy and go to an authentic Italian restaurant, probably run by real Italians. And then you could actually go to Venice. And once you’re there, you can either go to the tourist traps they have all set up for tourists, or if you’re really lucky you know a local who will actually make you a dinner in Venice, which you would call the epitome of authenticity. So all these things have varying degrees of authenticity to them and, not coincidentally, they have varying degrees of priciness attached to them.

Secondly, they both celebrate a particular form of illicit gustatory pleasure and culinary excess. Deen’s unabashed love of butter and bacon and Bourdain’s celebration of meat and alcohol offer an antidote to anxieties about eating “right” and the repressed, Puritanical elements of both diet culture and the Organic/vegetarian/macrobiotic/fair-trade/raw/local/sustainable movement.

You can tell it’s about backlash & rebellion, rather than just what Bourdain and Deen happen to genuinely enjoy, because they’re clearly aiming for shock value as much as for deliciousness. When Deen pretends she’s going to drink melted butter (see below) or makes burgers topped with bacon and egg with glazed donuts in place of the bun, she’s deliberately thumbing her nose at the current nutritional establishment that says calorie-dense food and fat, especially saturated fat, is Public Enemy #1.

Bourdain’s whole persona is based on the bad boy reputation he cultivated in his first memoir, which is as much about sex, drugs, and rock and roll as it is about cooking. And he says nasty things about Vegans and Alice Waters and seemingly takes any opportunity to talk about how much he and his daughter like to eat bunnies (not rabbit, mind).**

Vegetarians, and their Hezbollah-like splinter-faction, the vegans, are a persistent irritant to any chef worth a damn. To me, life without veal stock, pork fat, sausage, organ meat, demi-glace, or even stinky cheese is a life not worth living. Vegetarians are the enemy of everything good and decent in the human spirit, an affront to all I stand for, the pure enjoyment of food.

They both specifically delight in being naughty, in breaking the rules. And people who are similarly fatigued or fed up with dietary rule-making (which fatigue, again, is more prevalent in the wealthy, educated classes who make the rules in the first place) or just hate The Man in general absolutely love them for it, though rarely both of them. They are competing brands, but they work in basically the same way.

*Which is not to say it’s entirely fake or 100% an act. Both Deen’s and Bourdain’s public personas are probably like any of our social selves—socially-constructed identities that aren’t exactly real, but also aren’t exactly fake and change according to context. I doubt either Deen or Bourdain have deliberately concocted every aspect of their personas to appeal to mass audiences in these ways—what’s more likely is that they have achieved success where other aspiring celebrities have not because their personas happen to resonate with current popular desires and fears, which makes them effective entertainers. But that doesn’t mean they’re just being “true to themselves,” whatever that even means. Neither of them is probably 100% the same on and off camera. In some sense, both of them are probably relatively savvy managers of their personas, because they’re extremely valuable brands. I’m sure they think about how their performances, including things they say to TV Guide or The New York Post, will affect how their fans and critics perceive them. And it would be almost inhuman if they didn’t attempt to manipulate the outcome at least a little bit, even if usually in subtle ways like saying “ya’ll” or “fuck” just a little more frequently.

**Oddly, Deen has also talked about eating rabbit—supposedly her grandfather would hunt rabbit and squirrel before going to work in the morning and her grandmother would skin them and cook them for breakfast with grits and biscuits and honey.

Win, Lose, or Draw?

So the answer to the question of who’s the real elitist is probably “both” or “neither.” They’re both playing the same game: enabling the dominant social class to justify status-seeking by playing the role of rebels against the Culinary Establishment. They offer foodies plausible deniability about the pretensions involved in the middle-class preoccupation with food. At the same time, they both celebrate the lowbrow, the un-pretentious, and the debased bodily pleasures of eating and drinking. Neither of them is typically in the business of telling people how they “should” eat, except to the extent that they reinforce particular constructions of “authenticity” and desirability.

I can see why The Atlantic declared the results of the fight to be a “draw.” But I think Deen ultimately gained the advantage. Even people who thought Deen’s comments were stupid seem to agree with her that Bourdain was being a snob. By portraying him as the one with exclusive tastes, reminding people that he’s a professional globe-trotter, and reducing his rebellion to mere irritability, she made Bourdain into the Culinary Establishment. Even if people roll their eyes at the idea that she’s really on the side of the “regular families,” she successfully re-framed the fight. Also from The Atlantic:

What They Say They’re Fighting About: If Paula Deen is "the most dangerous person in America" or some permutation of that charge. Bourdain points to her caloric recipes and mass-appeal. Deen refers to her charity work and Bourdain’s lack thereof.

What They’re Really Fighting About: Class, privilege, and good food–and whether the first two are connected to the second.

If it’s a fight about health, she loses. If it’s a fight about class, then Bourdain is the snob because he’s the one saying her food is bad, and she’s the rube saying “to each his own.” The best evidence of her success is Frank Bruni’s piece in The New York Times, whose title is a barb aimed directly at Bourdain: “Unsavory Culinary Elitism.” Although Bruni agrees with Bourdain that Americans are too fat and laughs at Deen’s attempt at populist identification, he ultimately sides with her and scolds Bourdain for “looking down” on people with less money or less sophisticated tastes:

Put aside her one-with-the-masses pose, ludicrous in light of the millions she has made from television shows, cookbooks, cookware, mattresses and more. She’s otherwise 100 percent justified in assailing the culinary aristocracy, to which even a self-styled bad boy like Bourdain belongs, for an often selective, judgmental and unforgiving worldview….

To give him his due: we are too fat and must address that. But getting Deen to unplug the waffle iron doesn’t strike to the core of the problem any more than posting fast-food calorie counts or taxing soft drinks do. A great deal of American obesity is attributable to the dearth of healthy food that’s affordable and convenient in low- and even middle-income neighborhoods, and changing that requires a magnitude of public intervention and private munificence that are unlikely in such pinched times….

I prefer his TV show, “No Reservations,” a summons to eat adventurously around the world, to any of Deen’s. But these preferences reflect privileges and don’t entitle me, Bourdain or anyone else who trots the globe and visits ambitious restaurants — the most casual of which can cost $50 a person and entail hourlong waits — to look down on food lovers without the resources, opportunity or inclination for that.

Bourdain has probably eaten $50 meals far less often than Bruni, the former NYT restaurant critic, but it’s easy to elide Bourdain’s globe-trotting in search of what Potter calls the “epitome of authenticity” with the practice of eating at “ambitious restaurants.” Getting street food in Thailand is certainly as far out of reach for most Americans as the latter. Highlighting the exclusivity of his habits hurts Bourdain’s brand. Suddenly, instead of playing David to the Food Network’s Goliath, he’s Anton Ego and Paula Deen looks more like one of the rats who cooks delicious but humble peasant food.

I’m sure the damage to his reputation hasn’t been significant—his fans love him because he’s kind of a jerk, not in spite of it. But I think his tweet was right: if someone in the media comes calling, asking you to say nasty things about other people, you should probably just shut up.

2010 Year in Review, Part II: The Non-Recipes

2010 nonrecipes collage

A Record of Sticking Places

In September, Lauren Berlant wrote the following description of writing on her blog, Supervalent Thought

Most of the writing we do is actually a performance of stuckness.  It is a record of where we got stuck on a question for long enough to do some research and write out the whole knot until the original passion and curiosity that made us want to try to say something about something got so detailed, buried, encrypted, and diluted that the energetic and risk-taking impulse became sealed and delivered in the form of a defense against thinking any more about it. Along the way, something might have happened to the scene the question stood for:  or not.

At first, I thought of that as something that applied only to “serious” writing—to articles or book chapters that unfold over months or years. But in retrospect, I think it’s actually one of the reasons I started this blog: to have a place to delve (even if only shallowly) into the kinds of questions that were distracting me from writing my dissertation and then seal them up so they’d stop cluttering my thought process. At some point in the process of writing most of the longer, essayish posts, I get sick of the topic and just want to be done with it. So I finish it, and even if I haven’t entirely resolved the question I started with, I feel released from thinking about it at least for a while.

However, the blog hasn’t quite had the intended effect of freeing me up to write the dissertation because, unsurprisingly, getting mentally “free” takes up a lot of the time and energy I ought to be spending on that other, more important “performance of stuckness.” And the whole idea of having a mentally “clean slate” before I deal with my dissertation was probably always a hopeless ambition.

So this part of the retrospective on the year is also a sort of penitent offering to anyone who’s come to appreciate or even maybe expect this kind of content. In the next six months, I need to finish and defend and submit my dissertation. Also, I’m getting married. Between the two, I’m probably not going to have the time to do a lot of longer posts on culture/history/politics. I’m toying with the idea of taking excerpts from the dissertation and editing them into blog-friendly essays on the weekends. But in case I don’t end up having the time to post much of anything substantial for at least the first half of 2011 and that makes you sad, maybe there will be something here that you missed or might be interested in revisiting.

Special Series

Image from Look at this Fucking HipsterHipsters on Food StampsA three-part look at the bogus “trend” piece published last March in Salon about college-educated people using food stamps to buy organic, ethnic, and otherwise non-subsistence-diet foods and what it says about food & social class in America:

Part I: The New Generation of Welfare Queens—A critique of the article that places it in the longer history of concern about how the poor eat

Part II: Who Deserves Public Assistance?—An analysis of the comments and some of the myths about social class and poverty in America they reflect

Part III: Damned If You Do-ritos and Damned If You Don’t—An attempt to explain the contradictory trends of patronizing vs. romanticizing the poor and how they eat and what kinds of contemporary anxieties the bogus trend of hipsters on food stamps might be a response to

Responses to Food, Inc.—Posts related to the film (and the broader agendas it gave voice to) and how they distort the picture of the American food system and confused their audience.

I never got around to going through the list of suggestions at the end of the film. Perhaps I'll get to it in 2011.Part I: No Bones in the Supermarket—An interrogation of the film’s premise that “looking” at the food system will lead everyone to the same conclusion

Part II: Is the Food More Dangerous?—The film suggests that industrial animal agriculture is responsible for the deadly strain of e coli that killed at least one innocent child, but it turns out that’s not true. Grass-fed cattle have less generic, harmless e coli but the same prevalence of 0157:H7.

Price, Sacrifice, and the Food Movement’s “Virtue” Problem—Why a food “movement” predicated on spending more or making sacrifices is necessarily limited to the privileged few.

The Myth of the Grass-Fed Pig—Why not every farm animal can or should be “grass fed,” and the ecological argument for vegetarianism.

The Myth of the Grass-Fed Pig, Part II: Cornphobia—On the epidemic of irrational fears about corn inspired by Michael Pollan’s books and the documentaries he has appeared in.

Don’t Drink the Agave-Sweetened Kool-AidWhy agave nectar Greenwashing alert.isn’t “natural,” healthy, or (probably) more delicious than other sweeteners.

Part I: Natural, My Foot—Agave nectar isn’t an “ancient sweetener” used by Native Americans, it was invented in the 1990s and involves a process almost identical to the one used to make High Fructose Corn Syrup.

Part II: What’s Wrong With Any High-Fructose Sweetener—Why agave nectar, with up to 90% fructose, isn’t a healthier substitute for sugar.

Part III: The Mint Julep Taste Test and Calorie Comparison—The results of a comparison between agave and simple syrup-sweetened mint juleps and some number crunching that shows you could theoretically cut a small number of calories by substituting agave for sugar, but not if you use the recommended amount, which is calorically identical.

Why Posting Calorie Counts Won’t WorkCalorie counts are already appearing on menus across the country, and will soon be required for most chains. This series explores why they won’t make Americans thinner or healthier. 

Another thing I didn't mention--many of the calorie counts are being posted as "ranges" that take into account all the forms of customization, which makes the numbers even less useful. What are you supposed to do with the knowledge that a burrito has somewhere between 400-1400 calories?Introduction—A brief run-down of the reasons I don’t think the policy will work as intended.

Part I: The Number Posted is Often Wrong—What you see on the label is not always what you get, and the difference isn’t entirely random. 

Part II: Most People Don’t Know How Many Calories They Burn—The problem of calorie ignorance isn’t one that can be fixed with an educational campaign—people don’t know how many calories they burn because they can’t know, because it changes, especially if they change their diets.

Part III: Calorie-restriction Dieting Doesn’t Work Long Term—A meta-literature review of three decades of research on calorie-restriction weight loss that shows again and again that by far the most common result of dieting is weight loss followed by regain. And an explanation of why the National Weight Loss Control Registry isn’t a representative sample.


Health

Probably my favorite post because writing it helped me get over/through that rough patch.When What I Want Isn’t What I Want: Temptation and Disordered Thinking/Eating—Not about nutrition, but about mental health and how easy it is to fall into into negative thought patterns about food and body image, even if you think you’re “beyond” all that

Salt Headlines That Make the Vein in My Forehead Throb—Irresponsible news media reporting about public health research, and especially comparisons between the relative merits of cutting salt  and quitting smoking, may be hazardous to my health

Stop Serving Assemblyman Felix Ortiz Salt in Any Form—A plea to the restaurateurs of New York to teach Mr. Ortiz a lesson handed down from fairytales about what it would be like to eat food without salt.Unless you are a rabbit or a chicken, cholesterol in your food does not automatically translate to cholesterol in your veins.

Things that Won’t Kill You Volume IV: Saturated Fat, Part II: Cholesterol Myths—No one, not even Ancel Keys, ever thought you should avoid dietary cholesterol. Volumes I: High Fructose Corn Syrup, II: Fruit Juice, III: MSG, and IV: Saturated Fat Part I went up in 2009.

Things That Might Kill You Volume I : Trans-fats—Why you might want to avoid trans fats, including things with “0 grams of trans fats per serving,” which still contain potentially non-trivial amounts.

HFCS Follow-up: What the Rats at Princeton Can and Can’t Tell US—A review of the study claiming rats consuming HFCS gained more weight than rats consuming table sugar

Food Policy & Politics

I'm still sometimes uneasy trying to choose between better-for-the-environment and better-for-animals and often end up buying Omega-3 enriched eggs because so far at least it seems like those eggs might be measurably different and healthier.You’re All Good Eggs: New research shows that specialty eggs aren’t any better for the environment or  more delicious—A review of the evidence for and against specialty eggs, concluding that they might be marginally more humane but come at an environmental cost.

Good Egg Update: Someone’s Keeping Score—Explaining the Cornucopia Institute’s guide to specialty eggs

A Food Policy & Politics Christmas Wish List—Seven things that might improve the U.S. food system

Robots

Who Says Robots Can’t Taste? On Cooking Robots and Electronic Noses—A survey of cooking robots and  anxieties about electronic incursions on the acts of cooking and eating

Ingredient Spotlight

The first three listed below were stand-alone posts without recipes. The others were also collected in the 2010 recipe retrospective, but I thought they might merit inclusion here, too, because they involved some research beyond just looking at a few recipes and cooking something.

I'm still not totally satisfied by what I was able to find--the active chemicals have been identified, but it's still a bit of a mystery how they work the way they do. The Sweet Science of Artichokes—Why they make things taste sweet after you eat them

Morel Time in Michigan—How to identify morels and tell them apart from vague look-a-likes.

Meet the Paw-Paw, aka the Michigan Banana—A tropical fruit for the American midwest, with its very own Johnny Appleseed. 

Two on the Tomato: The Official Verdict in the Fruit v. Vegetable Debate and The Case For Tomatoes as Dessert—On the Supreme Court case that ruled tomatoes a “vegetable,” and why there’s still a debate about them even though there are lots of other “vegetables” that are botanically fruits. And how to use them to substitute for sweeter fruits in dessert recipes.

Cheddar-Garlic Biscuits: In Defense of Garlic Powder—Why garlic powder is so maligned, and a culinary defense.

The saffron crocus--each bloom produces 3 pistils, which must be harvested by hand during the brief window when they bloom, before sunrise because the flowers wilt in the sun. Jonathan Franzen and Joël Robuchon-inpspired Rutabaga Purée—On the root vegetable’s biggest fans (some of whom use it as a curling rock), its many detractors, and its supporting role in Jonathan Franzen’s novel The Corrections.

Now in Season: Sour Cherry Pie—What makes sour cherries different from normal pie cherries, and the science of flaky pie crusts.

Deviled Eggs with Saffron Aioli—On the history of deviled eggs and why saffron is so expensive.

Pork Chops with Cider Reduction and Greens—A review of several theories on why pork is so often prepared or paired with apples.

Recipes with History

These were all in the recipe round-up, but again, they have something to offer aside from cooking instruction. New annotations to explain what else you might learn there.

Benedictines and Pimento Cheese Sandwiches for Derby Day—On Miss Jennie Carter Benedict of Louisville,  Kentucky and the shaping of an “American” cuisine for the emerging middle classI'm still tickled by the idea that a reality television show can have a soul.

Jook (Chicken and Rice Porridge)—On the cross-cultural phenomenon of prescribing bone broths and particularly chicken broth-based soups as a healing or restorative food.

Lemon and Herb Chicken Drumsticks—On the history of Labor Day and the relationship between food and holidays

Sourdough-risen Whole Wheat Bagels and the Sweetness of the Old World—On the fetishization of a humble roll with a hole, its origins in the Jewish diaspora and why you don’t have to use “malt extract” to make it authentic (but why some people think you do).

Introducing Ezekiel and How and Why to Make a Sourdough Starter—A brief history of sourdough starters and why so many of them are named “Herman.”

Buckeyes, Shmuckeyes, or if you prefer, Peanut Butter Bon-Bons—How buckeyes became Ohioan and Not, I suspect, bluffin' with her muffin. Ohioans became buckeyes, starring General Ebenzer Sproat and President William Henry Harrison.

Sourdough English Muffins: Of nooks and crannies and double-entendres—Muffin nationalism explained, and also how muffin became a slang term for women and various parts of their anatomy.

American Pumpernickel—Devil’s Fart Bread! The history of Old World and New World rye breads.

Baguettes, regular or whole wheat—On the history and Frenchification of long, skinny, crusty loaves of bread.

A Sourdough-risen Challah Trinity: Braid, Loaf, Knot—The history of challah from tithing to the temple to European decorative braided breads. 

Homemade Peeps and Chocolate-covered Marshmallow Eggs—On this history of the candy, from the therapeutic uses of the mallow flower to the contemporary, mallow-less confection.

Why Posting Calorie Counts Will Fail, Part III: Calorie-restriction dieting doesn’t work long-term for most people

Previously in this series: Intro, Part I, and Part II.

The article on "Making Weight Loss Stick" is by Bob Greene, the personal trainer and "fitness guru" Oprah first started consulting with in 1996. Sadly, I don't think that's *meant* to be ironic. Oprah 2005/2009

To test whether turning [fat people] into thin people actually improves their health, or is instead the equivalent of giving bald men hair implants, it would be necessary to take a statistically significant group of fat people, make them thin, and then keep them thin for long enough to see whether or not their overall health then mirrored that of people who were physiologically inclined to be thin. No one has ever successfully conducted such a study, for a very simple reason: No one knows how to turn fat people into thin people.
Paul Campos, The Obesity Myth (2004)

Diets do cause weight loss…in the short term

People who think calorie restriction dieting “works” haven’t necessarily been duped by the diet industry or seduced by the prevailing nutritional “common sense” that weight loss and gain are a simple matter of calories in vs. calories out. Many of them believe it because their personal experience seems to confirm it, often repeatedly. Of course, “repeatedly” is part of the problem. Weight cycling—losing and re-gaining 5% or more of one’s total body weight—isn’t what dieters or public health policy makers are shooting for. Even people dieting with a specific occasion in mind, like a wedding or a high school reunion, would generally prefer to achieve permanent weight-loss.

But almost a century of research has shown that dieting—which usually involves calorie restriction—is not the way to do that. Studies repeatedly find that while eating less causes weight-loss in the short term, a majority of participants in weight-loss interventions focused on diet gain most of the weight back within 1 year and the vast majority (90-95%) gain all of it back within 3-5 years. Approximately 30% gain back more than they initially lost, and there’s some evidence that people who’ve lost and regained weight have more health problems than people who weigh the same, but have never lost and regained a significant amount of weight.

This is not controversial. Virtually every study of weight-loss dieting that has followed participants for longer than 6 months has found that the majority of dieters regain all the weight they lose initially, if not more. In other words, Oprah’s high-profile weight fluctuations are not the unfortunate exception to most dieters’ experience, they are the rule. A gallery of pictures of Oprah through the years illustrates the most frequent and reliable outcome of dieting:

Oprah in The Color Purple Screen shot of the infamous "fat wagon" episode first aired in the fall of 1988, when Oprah strode on set in what she proudly declared were size 10 Calvin Klein jeans after an Optifast diet, wheeling a Red Flyer wagon full of lard representing how much weight she'd lost  At the Emmy Awards, holding her third for "Outstanding Talk/Service Show Host"  Holding yet another Emmy at the end of that impressively-muscled arm, shaped with the help of trainer Bob Greene

             1985                           1988                             1992                             1996

 At the party celebrating the first anniversary of O Magazine  At the Academy Awards, wearing Vera Wang Presenting at the Emmy Awards presenting at the 2010 Oscars, possibly on the way back down again?

              2001                            2005                          2008                            2010        

I am not concerned (in this entry) with why calorie restriction diets fail—there are competing theories and perhaps I’ll try to tackle them some other time. However, when it comes to evaluating public health policies aimed at the general population, like posting calorie counts on menus, it doesn’t really matter why the kind of behavior it’s designed to encourage fails, especially when it fails so spectacularly. Whether the problem is that 90-95% of people don’t have the willpower to stick to calorie-restricted diets or that most peoples’ metabolic rates eventually adjust or both or something else entirely, continuing to prescribe calorie restriction to individuals seeking to lose weight is futile at best. Given the health problems associated with weight cycling and psychological distress caused by diet “failure,” it’s probably also dangerous and cruel. More on that another day, too.

The goal of this entry is to provide a condensed-but-comprehensive overview of the evidence that convinced me that weight-loss dieting—and particularly calorie-restriction dieting or eating less—does not “work” for most people. By “work” I mean lead to significant weight loss—at least 10% of starting body weight—that lasts for more than 3 years (in keeping with the clinical definition of “weight loss success” proposed by the 1998 National Heart, Lung, and Blood Institute [NHLBI] Obesity Education Initiative Expert Panel proposed). I honestly tried to keep this as short as possible and bolded the “highlights” if you want to skim. However, if brevity is what you’re looking for, see this 2007 Slate article.


A Meta-Review of the Literature

Of course, I’m not the first person to try to figure out what kind of picture decades of weight-loss research was painting. I found 14 reviews of weight-loss research in peer-reviewed journals (Mann et al 2007, Jeffrey et al 2000, Perri & Fuller 1995, Garner & Wooley 1991, Jeffrey 1987, Bennett 1986, Brownell & Wadden 1986, Brownell 1982, Foreyt et al 1981, Wilson & Brownell 1980, Stunkard & Penick 1979, Wooley et al 1979, Foreyt 1977, Stunkard & Mahoney 1976). And they all say basically the same thing: calorie-restriction diets don’t work long-term. Here’s how three of the most recent ones came to that conclusion, and one meta-analysis that claims to challenge the consensus, although it turns out that all they’ve really done is redefine “success.” 

Diets Don’t Work—Mann et al 2007 (free full text): This review of 31 weight-loss studies by a team of UCLA researchers was aimed at developing recommendations for Medicare regarding obesity prevention and treatment. They were only able to find 7 studies of weight-loss dieting that randomly assigned participants to diet or control groups and followed them for at least two years (the “gold standard” required to make causal claims about the effects of dieting). And the “gold standard” studies did not support the claim that dieting promotes significant or long-term weight loss:

Across these studies, there is not strong evidence for the efficacy of diets in leading to long-term weight loss. In two of the studies, there was not a significant difference between the amount of weight loss maintained by participants assigned to the diet conditions and those assigned to the control conditions. In the three studies that did find significant differences, the differences were quite small. The amount of weight loss maintained in the diet conditions of these studies averaged 1.1 kg (2.4 lb), ranging from a 4.7-kg (10.4-lb) loss to a 1.6-kg (3.5-lb) gain. (223)

They also examined 14 studies with long-term follow-ups that didn’t involve control groups. The average initial weight loss in those studies was 14 kg (30.8 lb), but in the long-term follow-ups, participants typically gained back all but 3 kg (6.6 lb). Of the eight studies that tracked how many participants weighed more at the follow-up than before they went on the diet, the average was 41% with a range of 29%-64%, and in every case was higher than the percentage of participants who maintained weight loss. In other words, participants were more likely to regain more weight than they initially lost than they were to maintain their initial weight loss. Although Mann et al note several problems with these studies, like low participation rates in the long-term follow-ups, heavy reliance on self-reporting as the primary or only measure of weight, and failure to control for the likelihood that some of participants were already dieting again at the follow-up, those factors should have biased the results in the direction of showing greater weight-loss and better long-term maintenance, not less.

Finally, they looked at 10 long-term studies that didn’t assign participants to “diet” or “non diet” conditions randomly. In general, these were observational studies that assessed dieting behavior and weight at a baseline time and then followed up with participants to measure changes in behavior and weight over time. Of those studies, only 1 found that that dieting at the baseline led to weight loss over time, 2 showed no relationship between dieting at the baseline and weight gain, and 7 showed that dieting at the baseline led to weight gain.

Their recommendation to Medicare:

In the studies reviewed here, dieters were not able to maintain their weight losses in the long term, and there was not consistent evidence that the diets resulted in significant improvements in their health. In the few cases in which health benefits were shown, it could not be demonstrated that they resulted from dieting, rather than exercise, medication use, or other lifestyle changes. It appears that dieters who manage to sustain a weight loss are the rare exception, rather than the rule. Dieters who gain back more weight than they lost may very well be the norm, rather than an unlucky minority. If Medicare is to fund an obesity treatment, it must lead to sustained improvements in weight and health for the majority of individuals. It seems clear to us that dieting does not. (230)

Long-term Maintenance of Weight Loss: Current Status—Jeffrey et al 2000 (free abstract or full text with umich login): A review of 20 years of long-term weight loss studies that describes the weight loss and regain among patients who participate in behavioral treatments for obesity as “remarkably consistent” (7) which is visually represented by lots of graphs of different studies on the long-term results of weight loss studies that all pretty much look the same:

Very low calorie diets vs. Low calorie diets (Wadden et al 1993)  Fat restriction vs. calorie restriction (Jeffrey et al 1995)

Diet only vs. Diet + exercise (Sikand et al 1988) People who were paid $25/wk for successful weight loss vs. people who weren't paid (Jeffrey et al 1993)

Basically no matter what researchers do, most dieters achieve their maximum weight loss at 6 months and then gradually regain all or almost all of the initial weight lost within 3-5 years, if not faster. They conclude:

The experience of people trying to control their weight is a continuing source of fascination and frustration for behavioral researchers. Overweight people readily initiate weight control efforts and, with professional assistance, are quite
able to persist, and lose weight, for several months. They also experience positive outcomes in medical, psychological, and social domains (NHLBI Obesity Education Initiative Expert Panel, 1998). Nevertheless, they almost always fail to maintain the behavior changes that brought them these positive results. Moreover, as we hope we have shown, efforts to date to change this weight loss-regain scenario have not been very successful.

Confronting the Failure of Behavioral and Dietary Treatments for Obesity—Garner and Wooley 1991 (free abstract or full text with umich login): Like Mann et al, Garner and Wooley were seeking to translate the available evidence about weight-loss dieting into recommendations for treatment—in this case, best practices for mental health practitioners seeking to counsel and treat overweight and obese patients. They note that short-term behavioral studies consistently show that modifications in eating and exercise behaviors lead to weight-loss, but that as the duration of studies increases, “over and over again the initial encouraging findings are eroded with time” (734).

The authors are particularly perturbed that poor results are often presented by study authors as positive. For example, an 1981 study comparing standard behavioral therapy with a weight-loss drug, or the therapy and drug combined found that all of the treatment groups lost a significant amount of weight in the first 6 months, and then all of the treatment groups showed significant re-gain by the end of the 18 month follow-up.the consistency in the curves is really eerie after a while...the 6 month nadir, the gradual incline; also, it is completely baffling to me how someone could look at this graph and think the most notable part is the gap between the three treatments at 18 months

Instead of concluding that all of the treatments had failed to produce lasting weight loss, the authors conclude that these results provide hope for behavioral therapy, because that group showed the slowest rate of weight re-gain:

This most recent study provides grounds for optimism as to the future of behavioral treatment of obesity . over the long run, behavior therapy clearly outperformed the most potent alternative treatment with which it has yet been compared. (734 in Garner and Wooley, 135 in the original)

This pattern is nearly as consistent as the finding that weight is gradually regained and many individuals eventually weigh more than they did at the start of the treatment. After four years, nearly all participants in nearly all studies gain back nearly all the weight they initially lost: Adams, Grady, Lund, Mukaida, & Wolk, 1983; Dubbert & Wilson,1984; Kirschenbaum, Stalonas, Zastowny, & Tomarken, 1985; Murphy, Bruce, & Williamson, 1985; Rosenthal, Allen, & Winter, 1980, Bjorvell & Rossner, 1985; Graham, Taylor, Hovell, & Siegel, 1983; Jordan, Canavan, & Steer, 1985; Kramer, Jeffery, Forster, & Snell, 1989; Murphy et al. 1985; Stalonas, Perri, & Kerzner, 1984; Stunkard & Penick, 1979. And yet, the authors of those studies insist that the diet interventions are “effective,” sometimes claiming that if the subjects had not dieted they would weigh even more. They almost never admit that the treatments completely failed to do what they set out to do, which is produce a clinically significant weight loss that can be maintained long-term. When they do admit that the results are “disappointing,” they frequently call for more “aggressive” treatments like very low calorie diets (VLCD or <800 kcal/day) or supervised fasting (which is no longer approved because of the risk of mortality).

Garner and Wooley also evaluate studies that used VLCD, some of which involved Optifast, the protein shake that Oprah used to achieve her 67 lb weight loss in 1988. Just like with other calorie-restriction diets, people on VLCD generally lose weight initially, although drop-out rates are much higher than in other weight loss studies (50% or more). Participants who stick to the diet typically maintain the weight loss for about a year, but regain most if not all of the weight they lost within three years and many gain more than they initially lost (Swanson and Dinello, 1970, Sohar and Sneh, 1973, Stunkard and Penick, 1979, Johnson and Drenick 1977, Drenick SC Johnson, 1980, Wadden et al., 1983, Wadden, Stunkard, & Liebschutz 1988, Hovel et al., 1988). Based on all of those studies, they conclude:

Although the rate and magnitude of weight loss have been the basis for recommending the VLCD, its most remarkable feature is the speed of weight regain following treatment. (740)

Garner and Wooley found only two studies of weight-loss dieting that reported better long-term results, and both had extremely low rates of participation in the follow-up and relied on self-reported weights. For example, Grinker et al (1985) reported that 55% of the participants in a residential treatment program had maintained a 5-kg weight loss based on the responses of only 38% of the original participants. They suggest that it seems far more likely that the low participation in the follow-up biased the results than that those studies are right and all the other ones or wrong and conclude:

It is only the rate of weight regain, not the fact of weight regain, that appears open to debate. While this may be discouraging to the individual intent on weight loss, it should also provide some solace to the many individuals who have failed at dieting and have attributed the failure to a personal lack of will power. (740)

It is difficult to find any scientific justification for the continued use of dietary treatments of obesity. Regardless of the specific techniques used, most participants regain the weight lost. (767)

They make the following recommendation to mental health practitioners:

We suggest that at the least, if weight loss is offered, it should be done with full disclosure of the lack of long-term efficacy and of the possible health risks [which, as they explain, include physical and psychological risks correlated with weight fluctuation]. It is further recommended that alternative nondieting approaches aimed at improving the physical and psychological well-being of the obese individual be given priority over dietary treatments as a subject of research and that such treatments be offered on an experimental basis. (767)

Long-term weight-loss maintenance: a meta-analysis of US studies—Anderson et al 2001 (free full text): As the title suggests, this is a meta-analysis rather than a review article, meaning rather than summarizing and evaluating what other studies found, they lumped together the data from 29 different studies. 13 of the studies involved “very low energy diets” (VELDs), 14 involved “hypoenergetic balanced diets” (HBDs) and 2 involved both—in other words, they were all calorie-restriction diets, and about half of them required participants to eat less than 800 kcal/day. The authors claim that no long-term randomized, controlled studies were available, and it’s unclear why they didn’t think studies like Jeffrey and Wing 1995 (discussed below) should count.

They don’t provide details for any of the studies individually, but do disclose that the number of participants ranged from 6 to 504, the length of treatment ranged from 8 to 30 weeks, average initial weight loss ranged from 3.5 to 37.9 kg for women and 6.2 to 44.2 kg for men, and follow-up participation rates ranged from 50% to 100% with a median of 82%. In other words, these were very different studies. Here are the results of their aggregation of the data:

again, what they're focusing on is the relatively small loss maintained by year 5 rather than, say, the precipitous drop from year 1 to year 2

The average weight loss at 5 years for both VELDs and HBDs was 3.0 kg, or ~3.2% of the participants’ starting weight and 23.4% of their initial weight loss. Anderson et al conclude:

These average values are higher than those reported in earlier studies and indicate that most individuals who participate in structured weight-loss programs in the United States of the type reported in the literature do not regain all of the weight lost at 5 y. of follow-up.

Sure, not all of the weight, only 76.6% of it. It still seems to me like a perversion of the idea of “success” to claim that these results show that calorie-restriction diets are “effective.” The average initial weight loss was 14 kg. If you lost almost 31 lbs and then regained 25 lbs, would you consider your diet a long-term success? Mann et al wouldn’t. In the 14 long-term studies without control groups that Mann et al evaluated, they also note an average maintenance of ~3 kg. They just don’t think that’s very impressive:

It is hard to call these obesity treatments effective when participants maintain such a small weight loss. Clearly, these participants remain obese. (Mann et al 223)

Interpretation/equivocation aside, there’s still some discrepancies between their analysis and the consensus in the other reviews which I wish I could explain. It’s not like this was a study of a new treatment—they relied exclusively on existing studies, at least some of which were also included in the reviews of the literature discussed above. However, some of the studies they included must have reported (possibly significantly) better results to bring up the average. Since they didn’t evaluate the studies individually, it’s impossible to tell from their write-up whether those studies involved some sort of strategy that made calorie restriction dieting “work” (and somehow didn’t attract widespread attention) or whether the results in those studies were biased by low participation rates in follow-ups, self-reporting, or some other factor(s).

A Closer Look at the Studies Themselves

I have not read every single study referenced in the review articles, although I have at least glanced at many of them. The ones I chose to explore in further depth here either 1) meet the “gold standard” of randomized assignment to diet/non-diet conditions and at least 2 years of follow-up or 2) are too recent to be included in the review articles.

Long-term Effects of Interventions for Weight Loss—Jeffrey and Wing 1995 (free abstract or full text with umich login): This is one of the seven studies included in the first part of the Mann review. 202 participants between the ages of 25 and 45 who were between 14-32 kg above the MetLife standards for the “ideal weight” for their height were randomly assigned to one of five experimental groups:

  • a control group which received no intervention
  • a standard behavioral therapy group (SBT) that received instruction on diet (including advice on how to follow a 1000-1500 calorie/day diet), exercise (including the recommendation to walk or bike 5 days/wk with an initial goal of burning 250 kcal/wk and gradually increasing that to 1000 kcal/wk), and behavior modification (including keeping food and exercise diaries. This advice was given in weekly counseling sessions for the first 20 weeks and monthly sessions thereafter for a period of 18 months.
  • a SBT + food group, which received the same counseling along with premeasured and prepackaged breakfasts and dinners for 5 days/week for 18 months
  • a SBT + $ incentive group, which received the same counseling along with up to $25/week  for achieving and maintaining weight loss
  • a SBT + food + $ incentive group, which got the counseling, meals, and money

In addition to the 18 months of the study, the participants were contacted at 30 months (a full year after the study ended) for an additional follow-up, which was completed by 177 (88%) of the original participants. Here are the results:

 is this shape getting familiar? 

All the treatment groups lost weight during the intervention, achieving their maximum results at 6 months. However, by 12 months—even though they were all still receiving the treatment, they were beginning to regain weight. By 30 months, there was no significant difference between any of the treatment groups and the control group. The authors wheedle a bit, claiming the difference “approaches levels of statistical significance” (.08), but are honest enough to admit in the end:

The overall results of this evaluation reemphasize the important point that maintaining weight loss in obese patients is a difficult and persistent problem.

Preventing Weight Gain in Adults: The Pound of Prevention Study—Jeffrey & French 1999 (free full text): This more of a “failure of low-cost educational interventions designed to encourage weight loss” than a failure of weight loss dieting per se, but it’s still relevant because 1) the experimental group “got the message” communicated in the educational intervention but gained the same amount of weight over 3 years as the control group and 2) calorie labeling is essentially a large-scale, low-cost educational intervention. The idea that education will make people thinner relies on the assumption that people would not be (as) obese if they only knew they were gaining weight, that they should eat more fruits and vegetables, that they should reduce their consumption of high-fat foods, and/or that they should get more exercise.

But most people do know all those things. In this study, 228 men and 594 women employed by the University of Minnesota and 404 low-income women, all between the ages of 20-45, were recruited to participate in a 3-year study. Half of the participants were assigned randomly to a control group and the other half were assigned to the “intervention” group, which received a 2-4 pg monthly newsletter called Pound of Prevention. The newsletter emphasized five themes:

1) weighing yourself regularly (at least once a week)
2) eating at least 2 servings of fruit per day
3) eating at least 3 servings of vegetables per day
4) reducing the consumption of high-fat foods
5) increasing exercise, especially walking

In other words, “common sense” nutritional advice, although not explicitly calorie reduction. The newsletter included recipes, suggested particular areas/routes in the local areas for walking, and included a return-addressed, stamped postcard asking participants to report their current weight and also answer whether they had walked for 20 minutes or more, eaten 2 servings of fruit, eaten 3 servings of vegetables, or weighed themselves in the last 24 hours. Intervention participants were also invited to take part in a variety of activities during the three years, including 4-session weight control classes, aerobic dance classes, free 1-month memberships to community exercise facilities, walking groups, and a walking competition. Additionally, half of the “intervention” group was assigned randomly to an “incentive” group who were eligible for a monthly $100 lottery drawing for members who returned the postcards.

All participants were evaluated in annual physicals where they were weighed, their height was measured, their dietary intake evaluated using a standard 60-item Food Frequency Questionnaire, and they were asked about behaviors like exercising, eating fruits and vegetables, decreasing fat intake, using “unhealthy diet practices” like laxatives and diet pills or liquid diet supplements, weighing themselves, and smoking. At some point in the study, a questionnaire was administered to test “message recognition.”

Participation in the “intervention” group was high—68% of postcards were returned, 80% of the participants reported having read most or all of the newsletters at their annual visits, and 25% participated in one or more of the extra activities. The “message recognition” test was somewhat successful—the intervention group was significantly more likely to identify the 5 targeted treatment messages as being among the best ways to prevent weight gain; however, even 66% of the control group endorsed the treatment messages. The intervention groups were slightly-but-significantly more likely to weigh themselves and more likely to continue practicing “health weight loss practices” as measured by a 23-item questionnaire. However, changes in BMI, energy intake, percent of calories from fat, and rates of physical activity were not significantly different between the control and intervention groups. All participants gained an average of 3.5 lbs over the course of the 3 years.

In short, the intervention was a failure. The authors conclude:

It is easier to teach people what to do than to persuade them to actually do it…. The overall impact on weight itself…was very weak, indicating that stronger educational strategies are needed or, alternatively education alone is insufficient to deal effectively with this important problem.

Weight Maintenance, Behaviors and Barriers—Befort et al 2007 (free abstract or full text with umich login): Based on the abstract, this study sounds like a success, but under closer examination, not so much. The data was collected at a university weight loss clinic where participants were recruited to follow low-calorie or very low-calorie (500 kcal/day) weight-loss diets followed by a maintenance program. The “weight-loss” phase lasted for 3 months during which participants consumed prepackaged meals and/or shakes. The maintenance programs ranged from 6 to 21 months and consisted of weekly or bi-weekly meetings at the clinic during which participants were counseled to follow a structured diet plan with a daily calorie goal and exercise 150-300 minutes per week. In 3 out of 4 trials, the participants were also encouraged to continue consuming the shakes/prepackaged meals.

Out of 461 participants who started treatment, 44 dropped out during the 3-month weight loss phase and 211 dropped out during the maintenance phase. They sent follow-up surveys to everyone who completed the 3-month weight loss phase (n=417), and got 179 back (46.6.%). The more recently participants had been part of one of the studies, the more likely they were to respond to the follow-up survey. Responders had only been out of treatment for an average of 14 months.

Their claim that a “majority” of the participants maintained their initial weight loss is based on them lumping together respondents who had only been out of treatment for 6 months with people who had been out of treatment for 24 months or more, despite the fact that—just like in every other study of calorie-restriction weight loss—the results showed that most participants gradually regain weight. As they admit:

Compared to participants who were out from treatment for 24 months or longer, those who were out for less than 6 months (P<0.05) or for 6–12 months (P<0.01) had significantly greater weight loss maintenance, both in terms of kg and percent of baseline weight.

What they don’t say is that the percentage of respondents who report maintaining their initial weight loss drops off precipitously after 24 months.

no graph; perhaps it would have been too damning?

Of the 31 respondents who’d been out of treatment for 24+ months, only 25.8% had maintained a weight loss of 10% of their body weight or more and 48.4% had maintained a weight loss of 5% or more. That means out of the original pool of 417 who completed the 3-month diet, only 8 had proven capable of maintaining weight loss equal to 10% of their body weight for more than 2 years and only 15 had proven capable of maintaining a weight loss equal to 5% of their body weight. Other participants might be able to maintain their initial weight loss—that data isn’t available, but the trajectory certainly doesn’t look good. And that’s based on the half of the participants who participated in the follow-up—as Garner and Wooley note, the higher the rate of participation and the longer the follow up, the less weight loss on average is maintained.

What About the National Weight Loss Control Registry?

Several of the studies and at least one person who commented on one of the earlier posts in this series mentioned the National Weight Loss Control Registry (NWCR) as evidence that people can indeed lose weight and keep it off. I’ve never disputed that. Even in the studies that show the least hope for long-term maintenance, there are exceptions to the general trend. But that’s what they are: exceptions.

According to the NWCR website, they have over 5,000 members, all of whom have lost at least 30 lbs and kept it off for at least 1 year; however, most of them have done far better—registry members have lost an average of 66 lbs and kept it off for an average of 5.5 years. As the research above suggests, that’s not remotely “representative” of people who attempt to lose weight. On the contrary, the entire raison d’être of the registry is to figure out what’s different about the 5-10% of dieters who lose significant amounts of weight and keep it off. The goal is to identify strategies that might help other dieters, but as the researchers who run the registry admitted in a 2005 article (free abstract):

Because this is not a random sample of those who attempt weight loss, the results have limited generalizability to the entire population of overweight and obese individuals.

Indeed, the kinds of things the registry members do are generally the same things the participants in most weight loss studies are counseled to do (or, in clinical settings, forced to do): most of them follow a low calorie, low fat diet, eat breakfast every day, weigh themselves at least once a week, watch less than 10 hrs of TV per week, and engage in very high levels of activity—420 minutes per week on average. The NWCR has yet to figure out what makes those things work for them and/or makes them capable of sustaining those behaviors when for most people, they don’t/can’t.

Collecting 5,000 success stories does not prove that dieting “works” for most people let alone that it’s the norm. Somewhere between 45 million and 90 million Americans diet to lose weight every year, most of them by attempting to reduce their caloric intake. According to a survey conducted in April 2010 by a private consumer research firm on behalf of Nutrisystem, 30% of Americans have dieted repeatedly—an average of 20 times. Unsurprisingly, weight loss attempts are more common among overweight and obese people. If calorie-restriction dieting “worked,” America would be a nation of thin people.

Conclusion: Putting the burden of proof back where it belongs

Traditionally, researchers assume that a treatment is not effective until they have evidence that proves otherwise. The reverse is true in regard to weight-loss dieting: most people assume dieting is effective for long-term weight loss and challenge anyone who believes otherwise to prove that it doesn’t—not that that’s difficult, given the consistent failure of most weight-loss interventions to produce lasting results. I have not been able to find one long-term, randomized, controlled study that shows that dieting works (i.e. a statistically significant group of people following a calorie-reduction diet losing a clinically significant amount of weight and keeping it off for more than 3 years). Instead, what all the research to date shows is that the most reliable outcome of calorie-restriction dieting is short-term weight loss followed by weight regain.

I suspect the stubborn persistence in prescribing calorie-restriction dieting as a weight loss strategy in spite of the available evidence probably has a lot to do with dominant and deeply-engrained attitudes about fatness, meritocracy, virtue, and effort. People exhibit remarkable cognitive dissonance when it comes to the research on weight loss—they hold up exceptions as the rule and claim that the 90-95% of people for whom calorie restriction dieting does not produce weight loss must simply not be trying hard enough. 

Imagine this scenario playing out with any other condition—imagine that instead of weight, we were talking about some kind of rash that was widely considered unattractive and thought to be correlated with a variety of other health problems. There’s a treatment that showed promise in short-term trials. In virtually every study, most of the people who get the treatment experience significant improvement in their symptoms, with peak results around six months. However, in longer-term studies, there’s a reversal. Just as consistently, the vast majority of sufferers—at least 75% and usually closer to 90 or 95%—experience a gradual return of their symptoms. For approximately 30-40% of participants, their symptoms actually get worse than before they started the treatment. Only 5-10% show lasting improvement. Of course you would want to do more research to figure out why the treatment works for that 5-10%, but in the meantime, would you keep prescribing it to everyone with the same skin condition?

Even if the problem is that only 5-10% of them fail to use the treatment as instructed—say, it’s a topical cream that only works if you apply it every hour on the hour and people get fatigued, especially by trying to wake up at night to put it on. If 90% of the affected population can’t use the treatment effectively, the results are the same as if the treatment never worked in the first place. Well, except for that part where 30-40% of them end up worse off than before they started the treatment…

So even if the calorie counts on menus were accurate, and people could accurately and reliably estimate how many calories they burn, and they did choose lower-calorie options at least some of the time, and they didn’t compensate by eating more on other occasions…in other words, even if the calorie counts worked the way they were intended to, the best you could hope for would be short-term weight loss. There’s no reason to believe the policy—even under ideal conditions—would have a lasting effect on most Americans’ weight or health.

Why Posting Calorie Counts Will Fail, Part II: Most People Don’t Know How Many Calories They Burn

Introduction and Part I of this series.

click for USA Today article

Few stories that begin, “Many Americans clueless…” can really be called “news.” Nonetheless, a recent study made headlines earlier this month by confirming what research has shown time and again: most people don’t know how many calories they supposedly burn. The 2010 Food & Health Survey by Cogent Research asked respondents (1,024 adults “nationally representative of the US population based on the Census”) to estimate how many calories someone of their age, height, weight, and activity levels “should consume” per day. Only 12% got within 100 calories +/- their Estimated Energy Requirement (or EER, the formula currently used by the USDA) and 25% wouldn’t even venture a guess. The remaining 63% were just wrong. This seems to pose a problem for the claim that publishing calorie counts on menus will improve public health. Logically, if people don’t know if they burn 10 or 10,000 calories in a day, which is the range of estimates collected in another survey, conducted in 2006 at the University of Vermont (full text with UMich login), knowing how many calories a particular menu item contains probably isn’t going to do them much good. The campaign is called "Read 'em before you eat 'em" (the slogan in the little purple circle. Image from nyc.gov

The new calorie publishing policy actually includes a provision to help address this problem—in addition to the calorie counts of all menu items, menus will also have to publish the average daily calorie requirement for adults (2,000 Kcal). New York City also attempted to address the problem of calorie ignorance when it instituted its calorie count requirement by launching an ad campaign aimed at drilling the 2000/day calorie requirement into people’s heads.

But that’s not the kind of calorie ignorance I’m concerned about. For one, I don’t think the success of calorie counts in reducing obesity or improving public health depends on people keeping strict caloric budgets. Enough people have internalized the belief they ought to eat fewer calories that the numbers could be useful as a point of comparison regardless of how many people can accurately estimate how many calories they supposedly burn based on their age, height, weight, and activity level. Even if you’re under the mistaken impression that you’re Michael Phelps, if your goal is to consume less energy, choosing between the 250-calorie sandwich and the 350-calorie one is a simple matter of figuring out which number is smaller. IF calorie counts were accurate, and they inspired at least some people to consistently chose lower-calorie items, and at least some of those people didn’t compensate for those choices by eating more later or being less active, and some of them continued to burn the same number of calories despite eating fewer of them, then the counts would actually have the intended effect. The magnitude of the effect might be small, but it would be in the right direction.

Of course, that’s a big “if.” I already addressed the first condition (calorie counts are often wrong), and will be looking at the next two (people don’t order fewer calories but if they think they have they are likely to compensate later) in more detail in later entries. The problem of most people not knowing how many calories they burn is related to the third condition—the mistaken assumption that people will continue to burn the same number of calories even if they reduce the number of calories they eat.

In other words, the problem isn’t that too few people know that the average adult probably burns something in the vicinity of 2000 calories per day. The problem is that metabolism varies. It doesn’t stick to the formula based on height, weight, age, and activity levels. Most people don’t know how many calories they burn because they can’t know, because it’s dependent on lots of factors that formulas don’t and can’t account for. And one of the things that usually causes people to burn fewer calories per day is eating fewer of them. This starts to get at one of the other reasons I don’t think posting calorie counts will have the desired effect: it’s true that eating fewer calories often leads to short-term weight loss, but the vast majority of people either get hungry and can’t sustain the energy deficit or their bodies adjust to burning fewer calories and erases the deficit. Either way, almost all of them regain all of the weight they lost, and often more.

The Rise, Fall and Return of the Calories-in/Calories-out Myth

The idea that weight gain and loss is simple matter of calories in versus calories out also dates back to William Atwater (the turn of the 20th C. USDA scientist who was into burning food and excrement). Before Atwater, most people believed that the major nutrients in food were used in entirely different ways—proteins were thought to be “plastic” and used exclusively for tissue repair and growth, like little band-aids that the body could extract from food and simply insert where necessary; fats were similarly thought to be extracted from food and stored basically intact; only carbohydrates were thought to be transformed by digestion as they were burned for fuel. The discoveries that protein could be converted to glucose by the liver and that carbohydrates could be transformed into body fat were both seen as wildly counterintuitive and controversial. Some physicians continued to give advice based on the earlier principles as late as 1910. RMR = resting metabolism, which should probably be shaped more like a big empty question mark

However, in the last few decades of the 20th C., Atwater and others managed to convince an increasing number of people that a calorie was a calorie was a calorie—that all of the major nutrients could be burned for fuel and that any fuel not immediately consumed in heat or motion would be stored as fat. The idea of seeking an equilibrium between calories ingested and calories used was first advocated by Irving Fischer, a Yale economist who drew a parallel between Atwater’s new measure of food energy and the laws of thermodynamic equilibrium and market equilibrium. This theory had widespread appeal in the age of Taylorism and scientific management, which coincided with the first major national trend of weight-loss dieting and the aesthetic ideal of thinness represented by the Gibson Girl and the flapper.* Caloric equilibrium was a way to apply the same universal, rational logic thought to govern the laws of chemistry and the market to the body. From the 1890s through the 1920s, the calorie reigned supreme. As historian Hillel Schwartz says:

The calorie promised precision and essence in the same breath. It should have been as easy to put the body in order as it was to put the books in order for a factory” (Never Satisfied: A Cultural History of Diets, Fantasies, and Fat 1986, 135).

That human bodies don’t reliably obey this logic in practice didn’t matter then any more than it seems to matter to most contemporary advocates of caloric algebra. Skeptics noted, even then, that many fat people seemed to eat much smaller meals than thin people, and that some people could reduce their intake to practically nothing without losing weight while others seemed to eat constantly without gaining weight. But the theory of caloric equilibrium is powerfully seductive, not just because of its simple, elegant logic, but also because it seems to “work,” at least in the short term. People who reduce the number of calories they eat do tend to lose weight initially, often at approximately the predicted rate of 1 lb/3500 calories. That offers a kind of intermittent reinforcement. When it doesn’t work or stops working, people scramble to come up with excuses—either the dieter’s estimates of how much they were eating must have been wrong, or they were “cheating” and eating too much (more on this in the entry on why calorie-cutting diets fail).

However, caloric math hasn’t always been the dominant nutritional theory (despite what many people claim). In thefrom Atlas of Men, Sheldon's most popular book 1930s and 1940s, as weight-loss dieting became less popular and feminine ideals got a little plumper again, nutrition science became more concerned with the psychology of appetite—often relying on Freudian-influenced theories about how traumatic childhood experiences and sexual dysfunction might manifest as insatiable hunger—and a new theory of body types.

The theory of somatotypes was initially developed by William Sheldon in the 1940s as part of an attempt to use measurements of the body to predict personality types and behaviors, like criminality. He proposed a sort of three-part continuum between three extremes: the thin ectomorph, the fat endomorph, and the muscular mesomorph, based on the three layers of tissue observed in mammalian embryos. It was similar to the medieval medical theory of different physical constitutions based on the balance of humors (blood, phelgm, bile, etc.) but with a new sciencey gloss and some nationalist overtones—Sheldon noted, for example, that Christ had traditionally been portrayed as an ectomorph (supposed to be cerebral and introspective), and suggested that therefore Christian America would have a military advantage over the mesomorphic Nazis (supposed to be constitutionally bold and arrogant). Somatotypes were later used to customize diet and exercise plans, but at the time, they were primarily embraced as a way to describe and justify the apparent differences in peoples’ ability to be thin. Unlike the algebra of calories in/calories out, somatotyping suggested that no matter what they did, endomorphs could never become ectomorphs. They simply did not burn calories at the same rate, and their bodies would cling stubbornly to fat, especially in the abdominal region.

Sheldon’s theory, like many projects with eugenicist overtones, fell out of favor somewhat after WWII, especially after the embryonic tissue theory was discredited. However, his somatotypes live on, primarily among bodybuilders and competitive weightlifters, perhaps because they still need some way to explain individual differences in outcomes for identical (and rigorously-monitored) inputs. There are also subtler echoes in the idea that people have individual “set points” or genetic predispositions towards certain body types, which isn’t meant to imply that there’s no validity to those theories—I think it seems far more likely that there are genetic components to body size than that all family resemblances are environmental. However, as the new calorie labeling policy exemplifies, the universalizing logic of calories in/calories out is back with a vengeance. Almost every popular diet plan today, with the exception of paleo/low-carb/grain-free diets, is based on creating a calorie deficit (and in practice, many low-carb diets also “work” to the extent that they do at least partially by reducing caloric intake).

The point of this little history lesson is that the extent to which people ascribe to either the theory of calories in/calories out or the theory of intransigent body types seems to have more to do with what they want to believe than the available evidence. Calories-in/calories-out may appeal to Americans today for different reasons than it appealed to the enlightenment rationalist seeking to find and apply universal laws to everything. I suspect that it has a lot to do with normative egalitarianism and faith in meritocracy, e.g. anyone can be thin if they eat right and exercise. The idea of predetermined body types, on the other hand, appealed to mid-century Americans eager to identify and justify differences and hierarchies of difference. But in every case, the evidence is either cherry-picked or gathered specifically to support the theory rather than the theory emerging from the evidence, which is complicated and contradictory.

*Before the 1880s, the  practice of “dieting” and various regimens like Grahmism (inspired by Sylvester Graham), the water cure, and temperance were concerned more with spiritual purity or alleviating the discomforts of indigestion and constipation than achieving a particular body shape or size. Graham’s followers actually weighed themselves to prove that they weren’t losing weight, because thinness was associated with poor health.

So What?

Even if most people can estimate how many calories they burn on an average day now with some degree of accuracy, and the calorie counts help them eat fewer calories than they did before or would have otherwise, there’s no guarantee that they’ll continue burning the same number of calories if they continue to eat fewer calories, which they would have to do for the policy to have long-term effects. In fact, given >6 months of calorie restriction, most people appear to burn fewer calories or start eating more and any weight lost is regained. So either the calorie counts will change nothing about how people order at restaurants and there will be no effect on their weight or health. Or they will have the desired change on how people order… but there still won’t be any effect on their weight or health.

But boy am I glad we have easier access to that critical information.

Why Posting Calorie Counts Will Fail, Part I: The Number Posted is Often Wrong

Introduction to this series here.

image stolen from some article about the new policy that I lost track of because I had 70 tabs open  When you see 450 posted, that might really mean 530. Or more.

Publishing caloric values right on the menu seems straightforward and transparent. The numbers offer what appears to be a simple way to compare items no matter how different they are based on what many people believe is, as Margo Wootan said, the “most critical piece of nutrition information.”  But even setting aside for a moment the issue of whether the number of calories should be the most important factor governing food choices or all calories are equal, there are problems with the numbers themselves.

Give or take 20%…but almost always give

According to a recent study at Tufts where a team of nutrition scientists led by Susan Roberts used a calorimeter to measure the actual caloric value of 39 prepared meals purchased at supermarkets and restaurant chains:

Measured energy values of 29 quick-serve and sit-down restaurant foods averaged 18% more than stated values, and measured energy values of 10 frozen meals purchased from supermarkets averaged 8% more than originally stated. Some individual restaurant items contained up to 200% of stated values and, in addition, free side dishes increased provided energy to an average of 245% of stated values for the entrees they accompanied. (Journal of the American Dietetic Association; full-text is subscription only—here if you have UM library permission)

As Roberts told Time, she decided to do the study because when she was trying to follow the diet advice in her own book, substituting prepared or restaurant meals, “the pounds stopped dropping off. Just as suspiciously, she always felt full” (more on the idea the fullness means a diet must be failing when I get to the issue of why calorie-restriction doesn’t work for long-term weight loss).

It’s worth noting that the results of the study didn’t reach statistical significance “due to considerable variability in the degree of underreporting.” However, they “substantially exceeded laboratory measurement error” and—as noted above—the average discrepancy was 8% or 18% higher, it didn’t even out. However, the average is actually within the Federal regulations—from the same Time article:

Federal regulations are strict about the accuracy of the net weight of a package of prepared food, which must be at least 99% of the advertised weight. When it comes to calories, the count can be a far bigger 20% off. The Federal Government plays no role in checking the calorie claims in restaurants, which means it’s up to the states to handle the job — with the predictable patchwork results.

What Roberts’ research suggests is that calorie counts aren’t just wrong, they’re wrong in one direction. As anyone who’s ever tried to count calories knows, a difference of +18% could be devastating to a diet. Say, for example, you think you burn 2000 calories/day, like the supposed average American adult, and you’re trying to generate a ~250 calorie/day deficit through your diet. Assuming you continue to burn 2000 calories/day, that diet should make you lose about 1/2 lb per week or 26 lbs in a year. However, if you were actually eating 18% more calories than the 1750 you’ve budgeted, or 2065 calories/day, and the caloric algebra worked perfectly, you’d gain 6.8 lbs in a year instead.

Even if you’re being reductive, food is more than the sum of its parts

One factor that may work in the opposite direction: the method used to determine the caloric  content of food may systematically overestimate how much energy most people get from some foods. A quick primer on the calorie (most people who are reading this probably already know this, but since lots of people don’t): a nutritional calorie is a measure of the energy contained in food. The base unit, a gram calorie, is the amount of energy required to heat 1 gram of water 1 degree Celsius. A nutritional calorie is a kilocalorie (kcal) or “large calorie” (C), the amount of energy required to heat a 1 kg water 1 degree.

William Olin Atwater c. 1900 from the USDA via the Wikimedia CommonsHere’s the part a lot of people don’t know: the caloric value on labels is calculated according to the “Atwater system” named after the USDA chemist William Atwater, who spent his career burning food and excrement (cue Bevis & Buthead laughter). Based on the formula Metabolizable Energy = Gross Energy in Food – Energy Lost in Secretions, Atwater came up with average energy values for each macronutrient: 9 Kcal/g for fat, 4 Kcal/g for protein, 4 Kcal/g for carbohydrates, and 7 Kcal/g for alcohol. For the purposes of nutrition labeling, even though fiber is technically a carbohydrate, it’s subtracted from the total carb weight before the calories are calculated since it’s not digested.

However, there appears to be considerable variation within macronutrients. Sucrose burns at a lower temperature than starch and isolated amino acids vary in their heat of combustion. Additionally, the Atwater system doesn’t account for differences in how macronutrients behave in when combined—for example, fiber seems to change the amount of fat and nitrogen that turn up in feces, which suggests that its effect on caloric value might not be entirely accounted for by simply subtracting fiber grams from the total carbohydrates. And, as you might expect, “variations in individuals are seen in all human studies” (Wikipedia).

The differences between estimated calories and the actual caloric value (as measured by a bomb calorimeter like the one Roberts’ team used in their study, which still might not correspond exactly to how food is turned to energy in the human digestive tract–I’m not entirely sure how calorimeters account for fiber given that fiber is combustible even though it isn’t digestible) might not be very large—but perhaps more importantly, the discrepancies probably aren’t consistent. The Atwater system is probably more accurate for some foods than others, and seems especially likely to overestimate the energy value of high-fiber foods and distort the differences between starchy and sugary foods.

That might help to explain the discrepancy seen in studies on nuts: in controlled nut-feeding trials, people eating more calories in the form of nuts don’t gain the weight that they should based on their greater energy intake. Additionally, they excrete more fat in their feces (Sabate 2003, American Journal of Clinical Nutrition). This is similar to another issue I mentioned in the introduction—not all calories are the same—but it’s not actually the same problem. Non-random variance in the reliability of caloric estimation means that even if all calories were the same, the numbers on the menus might not be accurate, i.e. the way we estimate calories might not correspond reliably to the amount of energy people actually derive from the food they eat.

So what?

Well, this means that there are (at least) two possible ways that providing consumers with “more information” in the form of calorie counts might actually lead to worse decision-making:

1) Even if people do base their decisions about what to order on the posted calorie counts, they might end up getting many more calories than they want and eating more than think they are.

2) Certain kinds of foods—including high-fiber foods and nuts, which might be “healthier” than items with lower posted calorie counts according to more holistic metrics—might have misleadingly high calorie counts based on the Atwater system. That could dissuade customers from ordering them or restaurants from offering them in favor of less “healthy” foods that may  have lower counts based on the Atwater system but actually provide more energy.

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Why Posting Calorie Counts Will Fail: Introduction

Calories on menus are already a fact of life in New York City and were set to appear in a handful of states like California and Oregon in 2011. Instead, thanks to a provision in the health care legislation Obama signed in March, they’ll be required nationwide. The policy calls for all restaurant chains with 20 or more locations to publish calorie counts for all items on all menus. The policy also applies to vending machines, buffets, and bars. McDonalds menu with calorie counts from the website for the film Fat Head, click for info. I'm surprised to see that the fries actually aren't the best Kcal/$ bargain--the burgers and even the McChicken give you slightly more bang--or burn--for your buck. The profit margin on fries must be astounding.

The policy’s advocates and authors claim that it will reduce obesity rates and improve public health. In a press release from The Center for Science in the Public Interest, Margo Wootan, a nutritionist who helped write the calorie count part of the bill said:

"Congress is giving Americans easy access to the most critical piece of nutrition information they need when eating out…. It’s just one of dozens of things we will need to do to reduce rates of obesity and diet-related disease in this country…. Menu labeling at restaurants will help make First Lady Michelle Obama’s mission to reduce childhood obesity just a little bit easier.” (CSPI press release)

In an interview with the LA Times, she expanded on the logic of the claim: 

"People will be able to see that the order of chili cheese fries they are considering will be 3,000 calories.”

Well, probably more like 400500. But how could she be expected to know that before the law goes into effect?

Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale told the NYTimes that even if some consumers ignore the information, it will affect enough people to create a public health benefit. However, he also hedged his bet—saying that even if it doesn’t make people eat better, it’s an issue of rights as much as an issue of health:

“You don’t need a study that proves anything,” Mr. Brownell said. “You just have a right to know.”

Proof? Who needs proof? His disclaimer is savvy, because now in 5 or 10 years if obesity rates are still the same* or higher and there’s been no significant decrease in cardiovascular disease, diabetes, cancer, or any of the other conditions correlated (albeit often weakly) with obesity, Brownell can claim we’re still better off knowing than not knowing.

I’m not so sure. While I don’t think posting the number of calories is likely to have a significant, negative impact on public health, nutrition is one realm where more information isn’t always better. The usefulness of information always depends on its reliability, relevance, and people’s ability to place it in meaningful context. Calorie counts fail on all three measures, which is why I suspect the new policy isn’t going to have the desired effect on obesity rates or public health.**

Here are a few of the problems with calorie counts I’ll address in this series:

1) The number posted is often wrong (a problem for reliability)

2) Most people don’t know how many calories they burn (a problem for meaningful context)

3) Even though calorie restriction is a highly effective short-term weight loss strategy, it doesn’t work long-term (at least for 90% of dieters) (a problem for relevance)

4) Not all calories are equal (another problem for relevance)

Furthermore, the limited evidence available so far about how calorie counts on menus affect purchasing decisions based on the New York City law is mixed. That calls into question the mechanism by which the policy is supposed to improve public health. Apparently, knowing the calorie content of menu items doesn’t necessarily reduce the number of calories people purchase. And that’s before even beginning to try to measure whether purchasing fewer calories on single visits to restaurants actually leads to weight loss or if people just compensate by eating more on other occasions or eating more often.

One response might be: well, it can’t hurt. I’m also not so sure about that. While I don’t think it’s likely to make public health worse, by reinforcing the idea that your health (or your weight) is based on the number of calories you eat, it may prevent people from taking steps that would actually improve their health, which the preponderance of evidence suggests that calorie-restriction dieting will not.

Part I in this series, on why the number posted is often wrong, coming later today.

*The rate of increase in obesity has already been slowing down so even if it plateaus, that’s not necessarily evidence this or anything else is “working,” it may simply mean that obesity rates have reached an upper limit.

**Two separate issues which are often unjustly conflated. For more on that, see Paul Campos’ The Obesity Myth, J. Eric Oliver’s Fat Politics, Glen Gaesser’s Big Fat Lies, or Michael Gard and Jan Wright’s The Obesity Epidemic: Science, Morality, and Ideology—if you feel like I’ve said that before, it’s because I have. The reason I bring them up again and again is that they completely changed my thinking about nutrition, fatness, and health. The authors of those books all—independently—examined the evidence for the argument that obesity is dangerous and all reached the same conclusion: it’s not, and the belief that it is is based on some shockingly bad science. They also argue convincingly that the actual increases in Americans’ weight in the last few decades are actually quite modest (it’s the rate of people being defined as obese that’s trumpeted, not the amount of weight people have gained on average and some of the increase is based on changes in the definition of “normal” or “healthy” with no medical justification); that the correlations between obesity and disease or early mortality—many of which are quite weak—can be entirely explained by other factors that also happen to be correlated with BMI like differences in physical activity, income, and insurance status; and that weight-loss dieting, especially low-fat and calorie-restrictive dieting, do more harm than good. You don’t have to take my word for it. Substantial portions of the books are available for free online, as are many of the studies they cite (including the CDC study that revised the widely-cited statistic that overweight and obesity causes 300,000 deaths per year in the U.S. and said, effectively, “Actually make that 26,000 and by causes we mean correlates with.”)

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You’re All Good Eggs: New research shows that specialty eggs aren’t any better for the environment or more delicious

Next year, I will decorate Easter eggs and they will have faces. See 39 other pictures of egg face dioramas at The Design Inspiration by clicking on image

Two articles about eggs published last week have rocked my commitment to paying the specialty egg surcharge. I’m still tentatively on the organic, cage-free, local egg bandwagon for animal welfare and health concerns, but I have to admit that even those reasons may be a little flimsy. The four main reasons given for the superiority of specialty eggs are:

1. They’re better for the environment
2. They taste better
3. They’re produced in a more humane way
4. They’re healthier

There may also be an argument for supporting local producers who might employ less exploitative or abusive labor practices, although that’s not guaranteed. In order to help offset the increased labor requirements of non-conventional practices, small and local farms often rely on unpaid interns and family members, including children. Not that I think it’s a major ethical abuse to have your kids gather eggs, but I often feel at least a little pang of sympathy for the kids—often Amish, sometimes very young-looking—manning farmer’s market booths alone. So I’m deliberately tabling the labor issue because 1) I suspect that the issue of labor conditions at small, local farms vs. big, industrial ones is, like so many things related to the food industry, complicated and 2) it’s nowhere near the top of the list of most consumers’ concerns about eggs.

1. Green Eggs vs. Ham

On June 1, Slate’s Green Lantern reported that specialty eggs (cage-free, free range, and organic) have a greater environmental impact than conventional based on land use, greenhouse gas emissions, and feed efficiency (measured by kg eggs laid/kg feed). The article also noted that according to life-cycle analysis, a recent review article by two Dutch researchers found no consistent or conclusive difference between the environmental impact of pork, chicken, milk, and eggs. Beef requires more land, water, and feed, but pound for pound (or kilogram for kilogram—most life-cycle analyses are European), the review, “did not show consistent differences in environmental impact per kg protein in milk, pork, chicken and eggs.”

The Lantern didn’t evaluate the transportation costs “since the majority of the impacts associated with chicken-rearing comes from producing their feed.” For local eggs, the reduced transportation costs might help balance out the increased feed requirement, but that’s just speculation. For cage-free, free-range, organic, or vegetarian eggs, transportation costs probably further increase the relative impact because not only do they travel just as far or farther than conventional eggs to get to the market, there are probably costs associated with transporting the additional feed they require.

I don't remember where I first heard the story about the egg yolk-inspired label, but it's documented in multiple places, including Red, White, and Drunk All Over and the biography of The Widow Cliquot by Tilar MazzeoMy initial response was basically:

Well, that’s too bad, but efficiency be damned, if it takes more feed and produces higher ammonia emissions to treat chickens humanely and produce healthy eggs with yolks the vibrant orange-yellow of a Veuve Cliquot label, so be it. I know specialty eggs are better, I can see and taste the difference.

2. Golden Eggs

Not so much, apparently. The very next day, The Washington Post published the results of a blind taste test of “ordinary supermarket-brand eggs, organic supermarket eggs, high-end organic Country Hen brand eggs and [eggs from the author’s own backyard chickens].” Blindfolded and spoon-fed, the tasters—two food professionals and six “avocationally culinary” folks with “highly critical palates”—struggled to find differences between the eggs, which were soft cooked to ensure firm whites and runny yolks.

And apparently, this isn’t a new finding. It replicates the results of years of research by food scientists:

Had Pat Curtis, a poultry scientist at Auburn University, been at the tasting, she wouldn’t have been at all surprised. "People’s perception of egg flavor is mostly psychological," she told me in a phone interview. "If you ask them what tastes best, they’ll choose whatever they grew up with, whatever they buy at the market. When you have them actually taste, there’s not enough difference to tell."

The egg industry has been conducting blind tastings for years. The only difference is that they don’t use dish-towel blindfolds; they have special lights that mask the color of the yolks. "If people can see the difference in the eggs, they also find flavor differences," Curtis says. "But if they have no visual cues, they don’t."

Freshness can affect the moisture content, and thus the performance of eggs for some applications, especially recipes that rely heavily on beaten egg whites like meringues or angel food cake. But probably not enough for most people to notice. The author also tested a simple spice cake with super-fresh eggs from her backyard versus regular supermarket eggs. The batters looked different, but once the cakes were baked and cooled, they were indistinguishable.

3. Do They Suffer?

Given how self-evidently cruel battery cage poultry production seems, I’m not entirely sure that “free-range” is as meaningless as people like Jonathan Safran Foer have argued. Sure, “cage free” chickens might never see daylight, and the range available to “free range” chickens might be a dubious privilege at best—a crowded concrete lot exposed to some minimal sunlight would fulfill the USDA requirements. But I don’t think it’s entirely marketing gimmickry, either. For one thing, if there were really no difference, the specialty eggs wouldn’t have a larger carbon footprint.

The animal welfare argument relies on the assumption that either chickens have a right not to experience pain or discomfort or that humans have a moral obligation not to cause them pain, or at least wanton, unnecessary or excessive pain. The debate about animal rights/humans’ moral obligations to animals is too big and complicated for me to cover in any real depth here, but I tend to believe that we ought to try to minimize the pain and discomfort of anything that seems capable of suffering. I used to draw the line at the limbic system—i.e. fish and invertebrates might respond to pain but don’t process it in a way that rises to the level of suffering, whereas birds and mammals can suffer and it’s often pretty apparent when they do. However, as it turns out, the boundaries of the limbic system are “grounded more in tradition than in facts,” and there are unsettled questions in my mind about what constitutes suffering and how to evaluate it. 

Even renowned animal rights theorist Peter Singer has gone back and forth about oysters over the years. I suspect that David Foster Wallace was right when he concluded that what guides our behavior in these matters has more to do with historically and culturally-variable forms of moral intuition than any objective criterion for “suffering”:

The scientific and philosophical arguments on either side of the animal-suffering issue are involved, abstruse, technical, often informed by self-interest or ideology, and in the end so totally inconclusive that as a practical matter, in the kitchen or restaurant, it all still seems to come down to individual conscience, going with (no pun) your gut” ("Consider the Lobster” footnote 19).

I hate relying on “I know it when I see it” standards, because I suspect we’re all inclined to see what we want to, but I don’t have a better answer. My gut says that chickens can suffer and that being able to flap around a concrete lot is better than never getting to move at all. However, my gut also says that chickens are pretty stupid creatures, and it might be an entirely reasonable thing to care more about the environmental impact of egg production than the happiness and well-being of the chickens.

4. Eggs Good For You This Week

Health is the issue that matters most to most consumers (see: The Jungle), and unfortunately, the available research on conventional vs. specialty eggs is frustratingly inconclusive. The most common assertion re: the health of specialty eggs concerns omega-3 fatty acids. I’ve mentioned this in passing and will try to devote some more time to it soon, but for now, I’m tentatively convinced that omega-3s are healthful and low ratios of omega-6:omega-3 are optimal.

Some studies have suggested that chickens raised on pasture—i.e. who get at least some of their nutrients from plants, especially clover or alfalfa—produce eggs with more omega-3 fatty acids and vitamins A and E (and less cholesterol and saturated fat, not that that probably matters). However, specialty labels like “cage free,” “free range,” and “organic” don’t mean pastured and the results of the nutritional analysis of eggs bearing those labels don’t provide very clear guidelines about what to purchase.

A 2002 comparison between five different kinds of specialty eggs and conventional eggs found differences between them, but none that lead to a simple characterization of specialty eggs as healthier:

From Cherian et al in Poultry Science 81: 30-33 (2002)

The "animal fat free and high in omega-3” eggs (SP1) had the highest percentage of omega-3 fatty acids and lowest ratio of omega 6: omega 3, and the cage-free, unmedicated brown eggs were also significantly better by that measure. However, the Organic-certified free-range (SP2) and cage-free all-vegetarian-feed eggs (SP4) had similar omega-3 content to the regular eggs. While some of the differences might be due to the feed, the authors note that the age, size, and breed of the hen can also affect the composition of fats and nutrients.

The study also showed that the shells of some of the specialty eggs were weaker, which supports other research showing more breakage and leaking in specialty eggs than conventional and my anecdotal experience of typically having to set aside the first few cartons I pick up because they contain cracked eggs.

Additionally, a 2010 USDA survey of traditional, cage-free, free-range, pasteurized, nutritionally enhanced (omega-3), and fertile eggs also concluded that:

Although significant differences were found between white and brown shell eggs and production methods, average values for quality attributes varied without one egg type consistently maintaining the highest or lowest values. (Abstract here, no free full text available)

In sum, if you can get pastured eggs (either from your own backyard or a farmer whose practices you can interrogate or even observe), they might be a little better for you than conventional. But after reading all this, I still found myself thinking: But what about the color difference? Doesn’t a darker yellow yolk mean the egg itself is healthier? Apparently not:

Yolk colour varies. It is almost completely dependent upon the feed the hen eats. Birds that have access to green plants or have yellow corn or alfalfa in their feed tend to produce dark yolks, due to the higher concentration of yellow pigments (mainly carotenoids) in their diet. Since commercial laying hens are confined, lighter and more uniformly coloured yolks are being produced. Yolk colour does not affect nutritive value or cooking characteristics. Egg yolks are a rich source of vitamin A regardless of colour. (from Wageningen University)

The record on other health concerns like salmonella and dioxin and PCB content is mixed:

4A: Can you eat raw cookie dough if it’s organic?

The salmonella thing is reminiscent of the e coli in grass-fed beef thing: some people actually claim organic chickens have no risk of salmonella. One UK study allegedly found salmonella levels over five times higher in conventional caged hens than in birds raised according to Soil Association organic standards (which are comparable to USDA Organic certification). 23.4% of farms with caged hens tested positive for salmonella compared to 4.4% of farms with organic flocks and 6.5% with free-range flocks. The explanation proffered is that the spread of the disease is inversely related to flock size and density. No link or citation for the study itself.

A 2007 UK study that tested 74 flocks (59 caged and 15 free range) from 8 farms, all of which had been vaccinated against salmonella, found a smaller but still significant difference: 19.4% of cage chicken house samples and 10.2% of free-range chicken house samples taken over a 12-month period tested positive for salmonella. However, they also noted a high degree of variation between flocks, and that the longest continuously-occupied houses were typically the most heavily contaminated. It’s possible that some of the results of other studies can be attributed to the fact that free-range or organic hen operations are likely to be newer and differences between them and conventional may diminish as time goes on.

On this side of the Atlantic, the results seem to show the opposite. A 2005 USDA study that tested free-range, all-natural antibiotic-free, and organic chicken meat (and contamination in chickens themselves has been linked to salmonella in eggs) found salmonella in all three groups at higher rates than in past years’ surveys of commercial chicken meat:

A total of 135 processed free-range chickens from four different commercial free-range chicken producers were sampled in 14 different lots for the presence of Salmonella. Overall, 9 (64%) of 14 lots and 42 (31%) of 135 of the carcasses were positive for Salmonella. No Salmonella were detected in 5 of the 14 lots, and in one lot 100% of the chickens were positive for Salmonella. An additional 53 all-natural (no meat or poultry meal or antibiotics in the feed) processed chickens from eight lots were tested; 25% of the individual chickens from 37% of these lots tested positive for Salmonella. Three lots of chickens from a single organic free-range producer were tested, and all three of the lots and 60% of the individual chickens were positive for Salmonella. The U.S. Department of Agriculture Food Safety and Inspection Service reported that commercial chickens processed from 2000 to 2003 had a Salmonella prevalence rate of 9.1 to 12.8%. Consumers should not assume that free-range or organic conditions will have anything to do with the Salmonella status of the chicken.

Additionally, a 2007 analysis of fresh, whole broiler chickens by Consumer Reports found that 83% tested positive for campylobacter or salmonella, and that chickens labeled organic or raised without antibiotics were more likely to harbor salmonella than conventionally-produced broilers:

We tested 525 fresh, whole broilers bought at supermarkets, mass merchandisers, gourmet shops, and ­natural-food stores in 23 states last spring. Represented in our tests were four leading brands (Foster Farms, Perdue, Pilgrim’s Pride, and Tyson) and 10 organic and 12 nonorganic no-antibiotics brands, including three that are “air chilled” in a newer slaughterhouse process designed to re­duce contamination. Among our findings:

  • Campylobacter was present in 81 percent of the chickens, salmonella in 15 percent; both bacteria in 13 percent. Only 17 percent had neither pathogen. That’s the lowest percentage of clean birds in all four of our tests since 1998, and far less than the 51 percent of clean birds we found for our 2003 report.
  • No major brand fared better than others overall. Foster Farms, Pilgrim’s Pride, and Tyson chickens were lower in salmonella incidence than Perdue, but they were higher in campylobacter.

Ultimately, salmonella is a always a risk when dealing with chicken or eggs and it’s not clear that specialty eggs are any better than conventional. If you’re concerned about salmonella, cook your food to 165F or stick to vegan options. You know, like peanut butter.

4B: What’s in the grass?

One final concern: a 2006 Dutch study found that free-range eggs in Europe have increased levels of dioxins and PCBs (which fall under the category of dioxin-like compounds), apparently because they are present in the soil in both residential and agricultural areas. “Dioxins” refer to a wide variety of compounds and they vary in toxicity; the term is basically just shorthand for environmental pollutants. On the one hand, they’re everywhere and we probably can’t avoid them so who cares? On the other, many are fat soluble so eggs are of greater concern than, say, apples.

There’s not really enough research on this to draw any conclusions. Which just pains me to type for what feels like the umpteenth time, because, seriously, is there ever conclusive research? Can we ever really know anything about anything? I like to think we can, but I’ll be damned if I don’t feel like every time I try to find more information about any kind of nutritional claim, the answer turns out to be “well, that’s complicated” or “well, the research on that isn’t conclusive.” Sometimes I really just want to see a chart that says YES! THIS IS THE RIGHT ANSWER! IT IS RELIABLE AND ACCURATE AND CONTROLLED FOR ALL POSSIBLE VARIABLES.

So just in case you might be wondering if I’m trying to be deliberately indecisive or vague in service of whatever ideological position that would even promote: I’m not. When I find conclusive results, I will share them with you in very excited caps lock. 

So Here’s The Deal

If you care more about climate change and efficient resource allocation than chicken welfare, buy conventional eggs; if you care more about chicken welfare, buy cage-free, free-range, Organic, or perhaps ideally, local. Taste and health-wise, there’s no clear difference, although I know that won’t prevent some of you from believing there is (remember the chocolate yogurt with “good strawberry flavor”?) Perhaps the biggest lesson is that, once again, the foods some people think are objectively superior for all kinds of reasons  may not be, and attempting to eat “better” is way more complicated than simply choosing the “green” alternative.

Don’t Drink the Agave-Sweetened Kool-Aid Part III: The Mint Julep Taste Test and Calorie Comparison

taste tests are an excellent excuse to double-fist your cocktails

Earlier in this series: Why agave nectar isn’t a "natural" sweetener and Why it isn’t healthier than table sugar or high-fructose corn syrup

As promised, this entry addresses two final questions about the difference between agave nectar and sugar: 1) whether it tastes different and perhaps better in some applications and 2) whether it’s a good way to cut calories because it’s sweeter than sugar. The answer to both is yes in theory, but not really in practice.

The Claim: Agave Nectar tastes different/better

Agave nectar definitely tastes different than sugar, which is probably due mostly to the trace minerals that remain after the liquid harvested from the cactus is centrifuged, concentrated, filtered, coagulated, treated with activated charcoal, and then treated with heat or enzymes to hydrolyze the inulin into its constituent fructose molecules. However, the flavor is mild. Clotide of Chocolate & Zucchini used it as a substitute for honey in a recipe for marshmallows specifically because the flavor is less pronounced than honey:

I decided to use agave syrup, a more flavor-neutral sweetener that can be found in natural food stores.

However neutral, as long as it’s different, I’m willing to accept the possibility that it might taste better in some applications. But based on the Derby Day taste test, mint juleps aren’t one of them.

Part of the inspiration for the taste test was an entry on Cooking Issues about a blind taste test of margaritas sweetened with agave nectar or simple syrup, with the following results:

The consensus was that the agave nectar drink was deeper, more complex, had a longer finish, and was more tequila-y (in the sense of blanco tequila), than the simple syrup one. The simple syrup was deemed cleaner and fresher tasting. Three people said they outright preferred the agave nectar until Nils said, “It depends, during the daytime or at the beach I’d prefer the simple syrup, at night at a bar or with food I want the agave.” Everyone could agree to that.

They used a refractometer to make sure the amount of sugar in the two mixtures was the same, which required them to water down both the agave and simple syrups (4:1 water:syrup). Their mixes contained the same amount of tequila, lime juice, and ice, but the simple syrup one contained 22 g more water (about 3/4 oz) based on the refractometer’s measure of how much sweeter agave was. Not perfectly controlled, but I agree that you wouldn’t really expect 3/4 oz water distributed over multiple taster portions to affect the taste much.

“Deeper” was also how the friend who hosts the annual Derby Day party (and makes some of the best fried chicken I have ever had) described the agave-sweetened mint juleps he had had in the past. So my expectation—the hypothesis of this little experiment, I suppose—was that agave nectar is sufficiently different in taste from sugar to noticeably affect and perhaps improve the taste of cocktails.

you can see why this wasn't a double-blind experiment; agave does not look like simple syrup The Contenders: Agave Nectar in the French Press, Simple Syrup in the pitcher

In advance of the party, my friend made a simple syrup that was 1:1 white sugar:water and steeped a bunch of mint leaves in both that and about 12 oz. agave nectar. Neither of us has a refractometer, but the bottle of agave claimed that it should be substituted for sugar using a 3:4 ratio. Since it wasn’t diluted at all, it was substantially more viscous and sweeter than the simple syrup. There was some discussion of diluting the entire pitcher and then measuring out the cocktails very carefully with 3/4 as much diluted agave syrup as simple syrup and marking glasses randomly and having people fill out ballots. But in the end that seemed like too much effort and possibly still not completely controlled, so we decided just to let people mix their own drinks to taste.

I prepared a side-by-side test by pouring about 1/2 oz of simple syrup into one cup and about 1/4 oz of the agave syrup into the other, diluting the agave to about the same level as the simple syrup, topping both with about 3x as much Jim Beam as syrup, and trying to add about the same amount of ice to both cups. This was in no way a controlled experiment. However, once mixed, there was no visually-apparent difference between the two. I knew I had gotten a few more mint leaves in the agave-sweetened one, but to anyone else, it would have been basically impossible to distinguish.

how much more summery and breezy do the sunglasses in the background make them look? they totally look like they belong in kentucky in early may instead of michgan in early may.I took a sip of each and couldn’t tell any difference at all. So I had two other people taste them, without telling them which was which—including the host who had claimed that agave made for a “deeper” drink, and they couldn’t tell any difference or identify which was which either. It was even almost a double-blind because I kept losing track of which one was in which hand and having to peer into the glasses to compare the number of mint leaves.

The syrups themselves definitely tasted different, although the difference is difficult to describe—the flavor of the agave is almost a little caramelly, not as different from white sugar as brown sugar is but comparable to turbinado or “raw” sugar. Also, the sweetness seems thinner or purer than the sweetness of sugar, although that may be entirely the product of my expectations for how fructose might taste different than sucrose. Still, the fact that we could taste the difference in the syrups despite the fact that both were steeped in mint suggests that what masked the taste difference in the cocktails was the bourbon, ice, and/or dilution of the sugars in water.

The results have made me question whether the taste difference in both the Cooking Issues margarita test and my friend’s previous agave-sweetened julep experiences really did have something to do with the amount of water in the cocktail. The Cooking Issues mixes were 445 g (simple syrup) and 423 g (agave) including the ice, 255 g and 233 g without. Perhaps 22 g water—which would have been between 5-10% of the mixture depending on how much the ice melted—really did affect the taste. That certainly might explain why the tequila was more prominent in the agave-sweetened drink, and why it tasted “deeper” and “more complex.”

Although agave is more viscous than simple syrup, it dissolves even in cold drinks much more easily than granulated sugar. That might be better grounds for a defense of its superiority  than the difference in flavor: agave might be a way to make drinks sweet without diluting them as much as you do when you add simple syrup. However, if the issue is dilution, you should be able to get the same effect by making a less dilute simple syrup, if necessary, by cooking it down. Cooking it could also produce caramelization, which might mimic the flavor of agave for applications that might benefit from that; using turbinado sugar might have the same effect. And either of those options might be worth considering if you really think agave tastes better but you’re at all concerned about your liver. However, in general, I think the difference in flavor and concentration of sweetness is not likely to be significant enough to outweigh the potential health risks.

The Claim: Agave Nectar is sweeter so substituting it saves calories

Fructose is sweeter than any other naturally-occurring carbohydrate. According to Wikipedia, pure fructose is about 1.73 times sweeter than sucrose. That may call into question the Cooking Issues refractometer, or their use of it to control for sweetness, because it judged their agave nectar to be 1.77x sweeter than the simple syrup. Agave nectar is supposedly between 56-90% fructose and 8-20% glucose, so it should never be sweeter than fructose. Madhava says its agave has approximately 1.4x the sweetening power of sugar, which seems far more likely. I’m not super familiar with refractometers, but from what I can tell, they measure sugar content and not the type of sugar, so something with a lot of lactose could still get a high reading even though it wouldn’t taste nearly as sweet as something with the same concentration of glucose, sucrose, or fructose. So another possibility for the perceived difference in the Cooking Issues taste test might be that the agave-sweetened margaritas were less sweet and that’s why they tasted more like tequila, deeper, and more complex.

Anyhow, the caloric content of agave nectar varies based on the plant it comes from and the method used to hydrolyze the inulin, but in general, 1 Tablespoon contains 60 calories whereas 1 Tablespoon of sugar contains 45 kcal. That’s largely a difference of density—a tablespoon of agave is 21 g (part of that is moisture, but Madhava claims that 77% is solids, so that’s 16.17 g) and a tablespoon of sugar is only 12.5 g. Most of the suggested substitutions I’ve seen, including the one on the Madhava site and the back of the bottle we used for the mint juleps, call for 3/4 cup agave nectar for 1 cup of sugar or honey. 3/4 cup agave (252 g total; 194 g solids) @ 60 calories/T = 720 calories, which is exactly the same as 1 cup sucrose (200 g) @ 45 calories/T. So if you follow the manufacturer-recommended substitution, there are no caloric savings. 

It’s possible that the 3/4 cup agave = 1 cup sugar is an incorrect substitution. Given that fructose is sweeter than glucose, you should be able to use less agave than sugar (based on the weight of the solids, not just volume) to achieve the same level of “sweetness.” However, the nutritional information of agave-sweetened products vs. their sugar and HFCS-sweetened alternatives also suggests that in practice, people end up using the caloric equivalent rather than the sweetness equivalent. Wholemato Ketchup, which is sweetened with agave, contains 15 calories per 17 g serving, which is 5g less than sugar-sweetened Hunts, but exactly the same as HFCS-sweetened Heinz. From what I remember, Hunts actually tastes sweeter than Heinz, which may account for the difference between the two “normal” brands; having never tasted Wholemato and being somewhat disinclined to buy it, I can’t say whether it’s sweeter than Heinz or not. Nonetheless, no real savings here either.

15 calories per Tablespoon (17 g) 20 calories per Tablespoon (17g)15 calories per Tablespoon (17 g) 

Just to give agave full benefit of the doubt, I decided to calculate how many calories you’d save if you substituted how much you should be able to use to achieve the same amount of sweetness, rather than how much people actually seem to use: if agave is 1.4x sweeter than sugar, you should only need 143 g (in solids) to achieve the same amount of sweetness as 200 g of sucrose. That would require 186 g agave nectar, or 8.9 Tablespoons for every cup of sugar, closer to 1/2 cup for every 1 cup of sugar than 3/4 cup. Those 8.9 Tablespoons would contain 531 kcal, or about 190 fewer calories than the cup of sugar. If a “serving” of whatever you’re making contains 1 Tablespoon of sugar, the agave-sweetened version would contain about 12 fewer calories per serving than the sugar-sweetened equivalent (for 2 T sugar, 24 fewer calories, for 3 T sugar, 36 fewer calories, etc.)

So yes, in theory you can save around 12 calories per serving (or more for very sweet drinks and desserts; 1 T is just the “serving size”) by using agave nectar instead of sucrose or HFCS. But in practice, it’s not clear that that actually happens, and you definitely shouldn’t be misled by the difference in the volume of the recommended substitution. 3/4 cup agave is calorically identical to 1 cup sugar. Also, none of that changes the fact that it’s probably nutritionally worse.

HFCS Follow-up: What the Rats at Princeton Can and Can’t Tell Us

Ed called my attention to last week’s press release about the study at Princeton currently getting some mass media attention. The press release claims:

Rats with access to high-fructose corn syrup gained significantly more weight than those with access to table sugar, even when their overall caloric intake was the same. 

i know it's a squirrel, not a rat. apparently no one's gotten a rat to do this and then circulated it with the right keywords to match my google search. this image likely not original to: http://ybfat101.com/notyourfault.shtmlThat’s pretty surprising, given that other studies have suggested that there is no difference between HFCS and sucrose. The Princeton study doesn’t offer a definitive explanation for the difference they found, but they suggest that it may have something to do with the slightly greater proportion of fructose in the HFCS.

As I noted in the first post on high-fructose corn syrup, HFCS-55, which is the kind used in soft drinks and the Princeton study, has roughly the same proportions of fructose and glucose as table sugar. Table sugar, or sucrose, is composed of fructose bonded to glucose so it’s a perfect 50-50 split. HFCS-55 contains 55% fructose, 42% glucose, and 3% larger sugar molecules. There’s a lot of evidence that fructose is metabolized differently than glucose, and may promote the accumulation of fat, especially in the liver and abdomen. Indeed, that’s why I believe that agave nectar is probably nutritionally worse than table sugar. Still, I’d be pretty shocked if a 5% increase in fructose could produce a statistically significant difference in weight gain, unless the rats were eating nothing but sugar-water. And they weren’t—in both of the experiments reported in the original study, the rats had access to unlimited “standard rat chow,”

Experiment 1: Rats Who Binge?

In the first experiment, 40 male rats were divided into four groups of ten. All of them had 24-hour access to rat chow and water. Group 1 was the control, so they just had chow and water. Group 2 had 24-access to an 8% solution of HFCS (.24 kcal/mL), which the press release claims is “half as concentrated as most sodas”. Group 3 had 12-hr access to the same HFCS solution. And Group 4 had 12-hr access to a 10% solution of sugar dissolved in water (.4 kcal/mL), which the press release claims is “the same as is found in some commercial soft drinks.” The two things of note so far are that none of the rats had 24-hr access to sucrose-sweetened water, and that the concentration of the sucrose was nearly 2x that of the HFCS syrup.*

Why the 24 hr vs 12 hr groups? According to the study:

We selected these schedules to allow comparison of intermittent and continuous access, as our previous publications show limited (12 h) access to sucrose precipitates binge-eating behavior (Avena et al., 2006).

In other words, they fed the sucrose group on a schedule that they already knew would cause binging. And they didn’t include a 24-hr sucrose group to control for that.

That helps to explain the results: the rats that had 24-hr access to HFCS-water gained less weight than either the rats who had 12-hr access to sucrose-water or the rats that had 12-hr access to HFCS-water. So according to the experiment, it’s better to consume some HFCS than it is to binge on sugar (not, obviously, how they chose to frame it in either the formal write-up or the press release).

Princeton rats

The only difference between the four groups in the first experiment that was statistically significant at a p<0.05 was between the rats who got chow only and the rats who got 12-hr HFCS. There was no statistically significant difference between the rats who had 12-hr access to sucrose-water and the rats who had 12-hr access to HFCS-water. There wasn’t even a significant difference between the rats who had 24-hr access to HFCS-water and the chow-only rats. So the only basis for the claim in the press release that HFCS is worse than sucrose is the fact that the rats with 12-hr HFCS got a “significant” amount fatter while the 12-hr sucrose rats didn’t. Even though the 24-hr HFCS rats didn’t either.

I am not the only one who’s picked up on this—both Marion Nestle (a vocal critic of the food industry) and Karen Kaplan (not, as far as I can tell, a shill for the Corn Refiners Association) also dispute the claim that this research demonstrates anything conclusive about HFCS vs. sucrose. The lead researcher replied to Nestle’s post, and rather than addressing the discrepancy between the 12-hr and 24-hr HFCS groups, he merely corrects her assumption that the 24-hr rats should be fatter:

There have been several studies showing that when rats are offered a palatable food on a limited basis, they consume as much or more of it than rats offered the same diet ad libitum, and in some cases this can produce an increase in body weight. So, it is incorrect to expect that just because the rats have a food available ad libitum, they should gain more weight than rats with food available on a limited basis. –Bart Hoebel

Which just makes it all the more baffling why they didn’t include a 24-hr sucrose group. Additionally, according to their results, binging or “consuming more” doesn’t explain the results, because:

There was no overall difference in total caloric intake (sugar plus chow) among the sucrose group and two HFCS groups. Further, no difference was found in HFCS intake and total overall caloric intake in the groups given 12-h access versus 24-h access. Both groups consumed the same amount of HFCS on average (21.3±2.0 kcal HFCS in 12-h versus 20.1±1.6 kcal HFCS in 24 h), even though only the 12-h group showed a significant difference in body weight when compared with the control groups.

The only explanation they offer for these results is the slight difference in the amount of fructose the rats in the HFCS and sucrose groups consumed. But even that relies on the idea that the HFCS rats did not feel as satisfied by their sugar water and compensated by eating more:

…fructose intake might not result in the degree of satiety that would normally ensue with a meal of glucose or sucrose, and this could contribute to increased body weight.

Unless satisfaction itself makes rats thinner.

Experiment 2 (Males): Wait, Where’s the Sucrose?

In the first part of the second experiment, 24 male rats were divided into three groups of eight. Again, all three had unlimited chow and water. Group 1 had 24-hr access to the HFCS-solution, Group 2 had 12-hr access to the HFCS-solution, and Group 3 was the chow-only control. Sucrose, you’ll note, drops out entirely. According to the study:

Since we did not see effects of sucrose on body weight in Experiment 1 with males, we did not include sucrose groups in this long-term analysis in males.

But there were no effects of HFCS on body weight on the 24-hr schedule! The omission of sucrose from this experiment makes as much sense as the omission of a 24-hr sucrose group in the first one. The lead researcher’s reply to Marion Nestle’s criticisms offered no further clarification about this choice. 

We explain in the article that we purposefully did not compare HFCS to sucrose in Experiment 2 in males, because we did not see an effect of sucrose on body weight in males in Experiment 1.

This study went on for 6 months instead of 2 months and, as the table above shows, the groups with both 24-hr and 12-hr access to HFCS-water gained a significantly greater amount of weight than the chow-only rats. This time, the 24-hr HFCS rats gained more weight than the 12-hr HFCS rats.

Experiment 2 (Females): Sucrose is back (still only 12-hr)! But chow is limited.

In order to “determine if the findings applied to both sexes,” they also ran a slightly different version of the second experiment on some female rats (n unknown). The control group, as usual, got unlimited chow and food. Group 1 got 24-hr access to HFCS-water. The remaining two groups got 12-hr access to chow (“to determine if limited access to chow, in the presence of HFCS or sucrose, could affect body weight”) and either 12-hr access to HFCS-water or 12-hr access to sucrose-water. Yeesh. How about testing one thing at a time, guys?**

So this time, only the rats with 24-hr access to HFCS gained a significantly greater amount of weight than the chow-only rats, which flies in the face of the claim that rats with limited access to a palatable food eat more. And the 12-hr sucrose rats actually gained slightly more weight (though not a statistically significant amount) than the 12-hr HFCS rats.

In other words, the findings in the three studies were completely inconsistent. For male rats in the short term, 12-hr access to HFCS induces significant weight gain but 24-hr access to HFCS does not. For male rats in the long term, both 12-hr or 24-hr access to HFCS induces significant weight gain, but they didn’t test sucrose. For female rats in the long term, only 24-hr access to HFCS with unlimited chow induces significant weight gain and limited chow, HFCS, and sucrose do not. And yet, based on this, they claim:

In Experiment 2 (long-term study, 6–7 months), HFCS caused an increase in body weight greater than that of sucrose in both male and female rats. This increase in body weight was accompanied by an increase in fat accrual and circulating levels of TG, shows that this increase in body weight is reflective of obesity.

Despite the fact that Experiment 2 didn’t even test the long-term effects of sucrose consumption on male rats, and 12-hr HFCS (albeit with limited chow) didn’t cause significant weight gain in female rats.

As Usual: Needs More Research

Based on the results of all three experiments, they conclude:

Rats maintained on a diet rich in HFCS for 6 or 7 months show abnormal weight gain, increased circulating TG and augmented fat deposition. All of these factors indicate obesity. Thus, over-consumption of HFCS could very well be a major factor in the
“obesity epidemic,” which correlates with the upsurge in the use of HFCS.

Despite the fact that obesity has also increased in many countries where HFCS is virtually never used, like Australia. According to a 2008 USDA paper:

Australia and the United States have a high and rising prevalence of obesity. They have opposite sugar policies: virtually no distortions affect Australia’s use of sugar, whereas sugar policy in the United States taxes sugar use. Sugar consumption per capita in Australia has been flat from 1980 to 2001, after which it increased by 10%-15%. Sugar is the major sweetener consumed in Australia.

The fact that the experiment doesn’t seem to show that HFCS is necessarily worse than sucrose doesn’t mean the findings aren’t intriguing. I really do want to know, for example, why rats with 12-hr access to HFCS gain more weight in the short term than rats with 24-hr access to HFCS, but the 24-hr HFCS rats gain more in the long term. And if, as they claim, the rats in all the groups consumed the same number of calories—which Nestle doubts because, "measuring the caloric intake of lab rats is notoriously difficult to do (they are messy)”—why were there any differences at all at the end of the trials? If none of the rats are eating more (and indeed, it seems that in some cases the HFCS rats were eating slightly less), what is the mechanism causing them to gain more weight, at least on some feeding schedules?

Does the concentration of the sugar have anything to do with it? In his reply to Nestle, Hoebel says:

Eating sucrose does not necessarily increase body weight in rats, although it has been shown to do so in some studies, usually employing high concentrations of sucrose, such as 32%. Our previously published work, has found no effect of 10% sucrose on mean body weight. At this concentration, rats seem to compensate for the sucrose calories by eating less chow.

I want to know if that’s true for HFCS as well. And did the difference in the concentrations of the HFCS and sucrose drinks have anything to do with the difference in the rats’ weight in this study?

Or does it maybe have something to do with sucrase, the enzyme that splits the fructose and glucose in table sugar? From what I’ve read, sucrase is present in the human digestive tract in sufficient amounts that it doesn’t rate-limit the absorption of those sugars in sucrose compared to the consumption of free fructose and glucose. But is it somehow involved in metabolism or appetite-regulation?

So rather than answering any questions about HFCS vs. table sugar, this really just raises a lot of new ones.

*It’s also not clear why they gave them different concentrations of sweetener. You’d think they would make them both soda-strength, or at least calorically equivalent.

**The failure to control for multiple variables does, in fact, complicate their ability to make any conclusions about gender difference:

In the present study, male rats maintained on 12-h access to HFCS also gained significantly more weight than chow-fed controls, while female rats maintained on 12-h access did not. It is possible that this can be accounted for by the fact that these males had ad libitum chow, while the females had 12-h access to chow. It is possible that the lack of chow for 12 h daily suppressed weight gain and TG levels
that might have otherwise been elevated in the female 12-h HFCS access group. This would indicate an effect of diet rather than a gender difference.

Don’t Drink the Agave-Sweetened Kool-Aid Part II: What’s Wrong With Any High-Fructose Syrup

Who knew agaves grew in so many different flavors?

In the first post on agave nectar, I focused primarily on why it’s no more “natural” than high-fructose corn syrup, which is a delicious irony given how both sweeteners tend to be portrayed. But that isn’t necessarily a reason to avoid agave nectar. “Natural” is at best an imperfect heuristic for healthiness or environmental friendliness, and has no inherent relationship with deliciousness. But, as I also suggested in the first post, agave nectar is certainly no better health-wise than other sources of sugar, and the fact that it’s much higher in fructose than most sweeteners (70-90% vs. ~50%) gives me reason to believe it may actually be worse for your health than sucrose or HFCS-55.

So Don’t Drink the Agave-Sweetened Ketchup Either. Because That Would Be Gross.GRANOLA-WASHING

Perhaps the most baffling thing is how many people seem to think agave nectar doesn’t count as sugar. For example, the rave review of Wholemato Organic Agave Ketchup in Men’s Health, contrasts it with the “liquid candy” that is HFCS. And then implies that the even-higher-fructose agave-sweetened condiment is healthier than “fatty” butter (it’s like someone at Men’s Health was specifically trying to give me apoplectic fits): 

This ketchup forgoes the high-fructose corn syrup and uses agave nectar, preserving sweetness without clobbering your fries or hot dog with liquid candy…. Slather it on your sweet potatoes as an alternative to a fatty slab o’ butter.

Note: The review is only available on the Wholemato site because the “read more” link is broken, but I’m not inclined to think it’s a fabrication as the other links on their “buzz” page are legit and you can find nearly-identical, equally-apoplexy-inducing claims about Wholemato Ketchup at The Kitch’n, Girlawhirl, i like granola, and Well Fed Man, among others.

There are also people who claim to have given up sugar, but who still eat agave nectar. Some excerpts from the comment thread on Nicole MacDonald’s resolution to give up sugar in 2010:

Jennifer: I went sugar-free at 16 to help my psoriasis & still don’t have it, 8 years later .
I don’t miss it at all. If I want to make a cake or anything I will use agave nectar … you realise there are so many interesting & alive foods out there you can enjoy without compromising your health!! xx

Nicole: I have to admit that in the first few weeks I baked a lot using ingredients like honey, agave and brown rice syrup. Cookies are my favorite to make, and I have a long list of recipes on my blog to the right. I also drank a lot of flavored tea with honey added and that seemed to cure some of my cravings.

Beth: I stopped eating sugar last year and its worked out pretty well. As long as I can have natural sugars which are found in fruits, then I’m totally satisfied.

Not All Things That Occur Naturally In Fruit Should Be Consumed In Quantity. Like Cyanide.

Beth is certainly not alone in thinking that “sugars which are found in fruits” are healthier than other sugars. People are frequently resistant to the idea that fructose might be unhealthy because, as the name so conveniently reminds them, it’s found in fruit. Or, if they’ve been sold on the idea that HFCS is poison and fructose has something to do with that, they sometimes suggest that there must be different kinds of fructose. Take, for example, the comment by Dave on this post by ThursdaysGirl, which expressed some reservations about agave nectar:

[. . .] you say Agave is 70% fructose, ok, so that means that means a teaspoon of Agave (about 4 grams) has about 2.8 grams of fructose… Hmmm, a small tomato has about 2.6 grams of fructose in it, the same as a carrot!… so, by your ridiculous logic, you should run away from tomatoes and carrots as fast and as far as you can! OMG, never eat another tomato! And don’t even get me started on Apples!

Remember, HFCS, regardless of what the lying chemists say, is not a natural source of Fructose. It is a man made molecule. It is illegal to call High Fructose Corn Syrup “All Natural”. I wonder why… Agave can be found both All Natural and Organic!!! Small amounts of Fructose actually help metabolize Glucose better, plus its low glycemic, has natural inulin fiber which is amazingly beneficial [. . . .]

I would trust the Mayo Clinics recommendations as regards to High Fructose Corn Syrup… it is poison. But really, Apples, Carrots, Tomatoes etc all bad for you? Stop it.

It’s actually not illegal to call HFCS “natural.” The FDA has been notoriously unwilling to define “natural” aside from the essentially meaningless distinction between “artificial” and “natural” colors and flavors—which Eric Schlosser talks about extensively in Fast Food Nation (pp. 121-131). As of July 2008, HFCS is “natural” for the purposes of food labeling. You can read all about the ongoing legal debates here. However, that hasn’t stopped people from trying to differentiate “natural” fructose, like the stuff in fruit, from “chemically-produced” fructose, like the stuff in HFCS. The problem is that they can’t seem to agree which side the fructose in agave nectar is on.

As you might expect, the agavevangelists are on the side of “natural.” According to Kalyn’s Kitchen Picks :

It’s been a long time since I discovered a new product that rocked my world in the way agave nectar has done…. The sweet taste in agave nectar comes from natural fructose, the same sweetener found in fruit (not to be confused with high fructose corn syrup which has chemically produced fructose.)

On the other side, there’s Rami Nagel, whose Natural News article been widelycirculated and cited by people on both sides of the agave nectar debate. According to Nagel, agave nectar is composed of bad, man-made “fructose,” which he claims actually has a completely different chemical formula from the sugar in fruit, which he calls “levulose”:

We all know that the chemical formula for water is H2O: two hydrogens and one oxygen. The opposite would be O2H, which is nothing close to water. Likewise, man-made fructose would have to have the chemical formula changed for it to be levulose, so it is not levulose. Saying fructose is levulose is like saying that margarine is the same as butter. Refined fructose lacks amino acids, vitamins, minerals, pectin, and fiber. As a result, the body doesn’t recognize refined fructose. Levulose, on the other hand, is naturally occurring in fruits, and is not isolated but bound to other naturally occurring sugars. Unlike man-made fructose, levulose contains enzymes, vitamins, minerals, fiber, and fruit pectin. (Similar claims here and here)

However, levulose is just an alternate name for fructose. A search for “levulose” on Wikipedia automatically redirects to their fructose entry. ChemBlink claims they’re synonyms with the exact same molecular formula and structure:

levulose/fructose...not quite as catchy as tomayto/tomahto 

And even the earliest examples from the OED reveal that the terms are completely interchangeable: 

1897 Allbutt’s Syst. Med. III. 386 Cane sugar is partly left unchanged, partly converted into glucose and lævulose. 1902 Encycl. Brit. XXII. 721/1 Glucose and fructose (lævulose)the two isomeric hexases of the formula C6H12O6 which are formed on hydrolysing cane sugar.

With “levulose” eventually giving way to “fructose” by the the 1970s:

1974 Nature 10 May 194/3 Although it is true that some bacteriologists are extremely conservative in the names they use for carbohydrates, surely nobody now uses ‘levulose’…in preference to ‘fructose’ these days.

A PubMed search for “levulose” also turned up 30,398 articles about (surprise!) fructose. The twenty articles that actually had “levulose” in the title were almost all translations, mostly from German.

So no, there is no difference between “naturally occurring” and “chemically-produced” fructose (and if the fructose in HFCS is the latter, so is the fructose in agave). Nonetheless, Dave and Rami Nagel are both at least partially correct. Fructose/levulose may not contain enzymes, vitamins, minerals, fiber, and fruit pectin, but the fruits that contain levulose/fructose certainly do. And there’s no reason to believe that eating a small amount of agave nectar, say a teaspoon, with similar amounts of fiber, protein, and other nutrients as would be found in a tomato or carrot would have a different or worse effect on the body than the vegetables themselves.

Fructose and Your Liver

Just because fructose isn’t necessarily bad for you in the amounts present in most fruits and vegetables, that doesn’t mean it’s a healthier substitution for other sugars. The evidence from studies on humans is still pretty scant. However, in a 2008 study where 23 subjects got 25% of their caloric intake from either fructose-sweetened or glucose-sweetened beverages for 10 weeks, the subjects who drank the fructose-sweetened drinks showed signs of decreased insulin sensitivity (a sign of diabetes) and increased fat in their abdominal regions, especially around their heart and liver, which is associated with cardiovascular disease (here’s the study itself or a translation from WebMD).

We’ve known for over 50 years that fructose is metabolized differently than glucose. Once it enters the body, it’s taken up by the liver, so it doesn’t raise blood sugar levels as much as glucose. It bypasses the step that insulin regulates, so diabetics can digest fructose about as well as non-diabetics. Which initially sounds good, especially for diabetics; however, more recently, fructose has been shown to have the same effects as alcohol on the liver:

I won't pretend to understand everything that's going on here, except that it illustrates the various processes and feedback mechanisms that cause fatty liver disease. From “Fructose Takes a Toll” in the August 2009 Hepatology (login required)

As a recent article in Physiological Review notes:

Fructose was initially thought to be advisable for patients with diabetes due to its low glycemic index. However, chronically high consumption of fructose in rodents leads to hepatic and extrahepatic insulin resistance, obesity, type 2 diabetes mellitus, and high blood pressure. The evidence is less compelling in humans, but high fructose intake has indeed been shown to cause dyslipidemia and to impair hepatic insulin sensitivity.

So while probably harmless in small amounts, it’s certainly not a “healthy” sugar or a free pass to eat sweet things without potential/likely health consequences.

I’ll do a follow-up eventually about the claim that you can use less of it because it’s sweeter. There are lots of conflicting claims about how much sweeter it is and how much less of it you use that I’m still trying to sort out. So far, I’m not at all convinced that the small caloric benefit is a reasonable trade-off for the risks of increased fructose consumption. I’ll also address one final defense: at least in some applications and to some palates, agave nectar may taste better. I admit to being a little skeptical, but a friend has promised to arrange a blind taste-test of mint juleps made with agave nectar, simple syrup, and a 50-50 agave nectar/brown rice syrup blend. That won’t happen until the national day of mint julep drinking, which falls on May 1, 2010 this year. So, until then, I’m going to take a little break from reading and writing about agave nectar.