There were two important publishing events in the field of nutrition this past week. One was bad science about what is good for you; the other was good science about what is bad for you.
The New England Journal of Medicine published a study on diet and heart disease that found significant benefits to cardiovascular health from eating a “Mediterranean diet.” The New York Times wrote, “About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet.” According to the Times article, “the magnitude of the diet’s benefits startled experts.”
(The Mediterranean diet groups ate the foods typically associated with that diet — e.g., fish, beans, peas, lentils, olive oil and wine — but also were allowed poultry and smaller quantities of red meat, soft drinks and baked goods. The control group was told to eat a low-fat diet, but the study reports the people pretty much just ate the diet they had been eating.)
One of the study’s authors told The Washington Post he’s going to begin another large study. In this one, everyone will eat the same Mediterranean diet — but the study will test the added effect of exercise, calorie restriction and body weight.
Hold on. The 30 percent reduction is good news. But what about the 70 percent who are sick and dying of heart disease while eating the Mediterranean diet? Doesn’t anybody care about them?
In reality, even that 30 percent reduction is a bit of a distortion. The study said, “Only the comparison of stroke risk reached statistical significance.” The Mediterranean dieters showed no significant reduction in heart attacks and deaths.
OK, that’s depressing. So let’s look just at the good news — the decline in stroke risk. Clearly, when the researchers saw the greater number of strokes in the control group, they concluded that it must have been something the people ate. But the Mediterranean dieters had strokes, too (and heart attacks and deaths). So if the members of the control group got their strokes because of something they ate, maybe the Mediterranean dieters got their strokes because of something they ate. They just had fewer strokes because they ate less of what causes strokes. But then — what is it that causes strokes? And could we please not eat it?
Please, scientists: What is the best diet if I don’t want to die?
They’re not telling.
Why not? One of the study’s authors said: “Usually, doctors tell you not to do pleasant things. But this is very tasty and easy to follow. You do not need to suffer for the Mediterranean diet.”
This man seems torn between being a scientist and being a menu planner.
This has to be frustrating for Dr. Caldwell Esselstyn, the author of a landmark study showing that a plant-based diet with whole grains, fruits, vegetables, beans and nuts — with no meat, poultry, fish or fats — can reverse heart disease.
The diet has worked in patients whose cardiologists told them they would not live out the year.
Disclosure: I’m a fan of Dr. Esselstyn’s. I have introduced him to some Washington policymakers, and I tried to help him get in touch with Bill Clinton after the ex-president had surgery to reopen a clogged artery in 2010. We failed to reach Clinton — or thought we had, until Clinton mentioned Esselstyn on a CNN interview when he was describing the diet he adopted after his surgery.
Esselstyn’s father had his first heart attack at 43 and died young. Esselstyn is 79 years old and looks like Zeus. He received his surgical training at the Cleveland Clinic, where he has been the president of the medical staff, a member of the board of governors, the chairman of the breast cancer task force and the head of thyroid and parathyroid surgery.
He has served as president of the American Association of Endocrine Surgeons. He also is an Olympic gold medalist and was awarded a Bronze Star for his work as an Army surgeon in Vietnam, which has nothing to do with it but is fun to say.
Esselstyn’s research into heart disease, begun in 1985, has been cited by Thomas Lee, M.D., the editor-in-chief of the Harvard Heart Letter, and endorsed by Dr. Bernadine Healy, former director of the National Institutes of Health.
The second important publication was Michael Moss’ new book, “Salt Sugar Fat: How the Food Giants Hooked Us.” In the book, Moss profiles Howard Moskowitz, who holds a Ph.D. in experimental psychology from Harvard. Moskowitz has perfected the practice of feeding customers snacks, gathering their responses and then using statistical methods to discover the perfect blend of salt, sugar, fat, textures, flavors and mouth feel to achieve the “bliss point” and create the biggest crave. In the book, Moskowitz reflects on his work: “Why do we crave chocolate, or chips? And how do you get people to crave these and other foods?”
Here’s the point: The food corporation scientists are using all their experimental savvy to maximize the addictive power of foods, while nutritional scientists flinch from discovering and publicizing the full healing power of foods.
True, people in good general health are not likely to deprive themselves of food they like based on something they read in a study.
But what about a young father with a stroke or heart attack who is determined to do everything possible to live so he can raise and support his kids? What can we tell him? “Try your luck with the Mediterranean diet. People on this diet have strokes and heart attacks and die, but it’s tasty.”
Much of the most highly publicized research into a healthy diet doesn’t try to discover what is optimal. In that sense, their research is trumped and skewed by the work of the corporate food scientists. The nutritional researchers don’t tell us what the healthiest diet is; they just recommend the healthiest diet they think we can bear to eat given how hard it is to deprive ourselves of the foods that the corporate scientists have taught us to crave.
Tom Rosshirt was a national security speechwriter for President Bill Clinton and a foreign affairs spokesman for Vice President Al Gore.