Saturday, June 22, 2013

Dieting on the bias

Oh, so many blog worthy topics in the past week or so! What shall we discuss? The recent decision by the AMA that obesity is now classified as a disease? The declaration by Chipotle that they've openly labelled their GMO ingredients? Dietitians for Professional Integrity posting a petition to change their organization's sponsor affiliations with the big food companies? A Monsanto scientist winning the World Food Prize? The very sudden passing of James Gandolfini?

All issues that deserve mention and most likely will be tackled in later posts. (Although not so impressed by the Chipotle story. Eating "natural ingredient" burritos that still contain more calories and sodium than should be ingested in a day doesn't really make them a healthier fast food.)

No, this post I think will tackle what I sort of intended this space to be: a discussion of research in regards to health and weight maintenance. And today I would specifically like to address confirmation bias in weight loss research. 

We tend to skew towards research that maintains our own beliefs. Even if we're trying to be objective (and it's something I strive to do in my librarian life), finding search results that don't match up to our pre-supposed ideas can often be hard to absorb.

Take that one step further and place that in one's business. Back in my corporate days, very often my clients would come to me with a statistic or result that they WANTED to see and it was up to me to find data that backed it up. And that didn't always happen. In fact, that's often the worst way to go about it. 

On this blog front, usually an article or report catches my eye and then I go searching for other material to create a topic. The reports I quote most often in my blog posts are of course the ones I want to talk about. Or I quote the particular data on which I want to focus. It doesn't mean there isn't a plethora of other studies that might contradict the research I quote, sometimes within the same report. This is especially true when it comes to weight loss research. In fact, weight loss, weight maintenance, diets, and all probably have some of the most contradictory reports. And confirmation bias increases when you consider the amount of non-scholarly or non-professional blog sites out there on this topic.

But there's been one recent incident that is worth mentioning.An article and editorial in Nature addresses the actions and reactions to the results of a recent study showing that being overweight (not obese) might be healthier for you in the long run, especially in regards to our standard BMI. Now this is not exactly something amazingly new. In fact, the results of this report were based on meta-analysis of the existing literature. And BMI is an inexact science, as I've mentioned here a lot. In fact, I even quoted this specific study in one of my earlier posts on BMI.

No, the above linked Nature pieces were written because of the reaction of another expert to this data, a well regarded Public Health official. He refers to these findings as "a pile of rubbish" as it contradicts his data. Not that the data from his reports are often found to be thorough.

There's a lot more to the story including some double standard publishing practices and the whole question of peer reviewed literature. On such a high level, this is truly disappointing. I often comment in my professional life on the "silos" of administration and research that I see, but this is siloing about research in the same field. It's really sad.

But even on a much less formal level, we keep seeing everyone trying to find the "quick fix" or to promote the weight maintenance program that "really works." And then seeing people cherry pick the same report to contradict each other.

I started researching weight maintenance about 2 years ago, once I hit my goal weight. And I was flabbergasted, even coming from a research background, to see such disparate results from almost the same data. Weight loss and maintenance is a subject so many people claim that want to get right, but more often they can also use it to prove why their maintenance did not stick. Or how the food industry has made us fat. Data shows it! It's not our fault! 

Despite all the new reports out there. Despite showing that people can lose weight responsibly and also admitting that most media images we see are NOT healthy and typical examples of body weight. Despite all the fretting about "healthy, organic" food. Despite all this...we still all find the easiest answer to satisfy our personal needs. 

Want to find data on the benefits of juice fasts? It's there! Or 500 calorie diets with excessive exercise and sweating? It's there, too! How about eating only like a Puritan? Sure! (I'm not linking to these, but you can find them).

It's obviously up to each one of us to find what works, and to hopefully try to be somewhat less biased when it comes to finding out what the studies can show us.

Which is why the "rubbish" comment was so disturbing. With all the crazy crap people try to sell as weight loss help, why disparage a peer who is saying that you should lose weight, just not be tied to BMI?

Sigh. That's why we can't have nice results.

My suggestion to those Public Health folks is to take a page from Quincy, M.E. on diets. HIM we listen to!



 References:

 AMA Says It’s Time To Call Obesity A Disease : NPR. (n.d.). NPR.org. Retrieved June 20, 2013, from http://www.npr.org/blogs/health/2013/06/19/193440570/ama-says-its-time-to-call-obesity-a-diseas

Flegal KM, K. B. (2013). Association of all-cause mortality with overweight and obesity using standard body mass index categories: A systematic review and meta-analysis. JAMA, 309(1), 71–82. doi:10.1001/jama.2012.113905 

Hughes, V. (2013). The big fat truth. Nature, 497(7450), 428–430. doi:10.1038/497428a 

Pollack, A. (2013, June 19). Monsanto Executive Is Among World Food Prize Winners. The New York Times. Retrieved from http://www.nytimes.com/2013/06/20/business/monsanto-executive-is-among-world-food-prize-winners.html

Satran, J. (2013, June 18). Chipotle Starts Labeling GMO Ingredients On Website Menu. Huffington Post. Retrieved June 20, 2013, from http://www.huffingtonpost.com/2013/06/18/chipotle-gmo_n_3460402.html

Shades of grey. (2013). Nature, 497(7450), 410–410. doi:10.1038/497410a

Stop junk food giants from taking over nutrition programs. (n.d.). Change.org. Retrieved June 20, 2013, from http://www.change.org/petitions/stop-junk-food-giants-from-taking-over-nutrition-programs

Top Science Journal Rebukes Harvard’s Top Nutritionist. (n.d.). Forbes. Retrieved June 20, 2013, from http://www.forbes.com/sites/trevorbutterworth/2013/05/27/top-science-journal-rebukes-harvards-top-nutritionist/


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