Welcome to the second annual "2018 Best Diet Writing" Anthology [AKA blog post with embedded hyperlinks].
Nearly every week, I send an email with links to recent stories, podcasts, articles, lectures, etc. titled This Week in Nutrition. While anything food related is fair game, it tends to include topics that have a direct relationship on how the ways that we eat impact health and wellness- also known as "nutrition" or, more controversially, "diet." From the pool of stories featured in TWIN, as well as other nutrition-related podcasts and articles, this compilation of work was created that represents some of the best diet writing in 2018. In my opinion, these insightful pieces should make even professionals in nutrition take a step back and reexamine their biases.
This collection focuses on articles that are fascinating in their own right, but also reflect some aspect of broader diet trends of 2018, be they the replication crisis in psychology and nutrition, the growth of non-medical food "sensitivity" tests, or how hospitals and tech professionals are reinventing what diets and dieting mean (and not always in a good way).
Like all of compilations, this list is pretty subjective. The inclusion criteria were that the piece had to:
Be published in 2018
Address a topic that could impact habitual diets
Or be about diet culture
Or inform on an area of nutrition science that is particularly relevant
And be a good read or listen
I also wanted to include pieces that were timely and covered a variety of topics. If you read this list and think of more great work, please share them with me at firstname.lastname@example.org!
"TWILLEY:..let’s skip forward to 1400s Venice to meet the author of the first best-selling diet book.
FOXCROFT: It was The Art of Living Long by a 15th century Venetian Italian merchant called Luigi Cornaro, and in fact this book is still in print. And he benefited because of the innovation of the printing press. So his book just went all across Europe.
GRABER: So much of success in life is timing. And Luigi hit it perfectly: a diet book, just as the printing press spread through Europe? How could he fail? But he didn’t write the book to get rich, he wrote it because of his own story."
The idea of altering dietary intake as a way to control body shape and size seems modern; an effect of a post-WWII environment of plenty in the West and subsequent weight gain over the past century. Cynthia Graber and Nicola Twilley walk through though the history of popular diets with help from Louise Foxcroft, historian and author of the book Calories and Corsets. And it turns out, dieting is older than you think. Much older. For example, though fermented foods and "drinking vinegars" are all the rage now, this trend was kicked off in the early 1800's by the renowned romantic poet and old-school social influencer, Lord Byron. This podcast episode does a remarkable job summarizing the history of popular diets and discussing how the (comparatively) more recent emergence of nutrition science informs more balanced dietary protocols like the DASH diet. It's definitely a must-listen for anyone who wants to understand the constancy of diet culture and the interaction between diets and celebrities.
"Not to toot my own horn, but I consider myself to be an intelligent, critical thinking person. I’m also an extremely critical person, and I’m pretty skilled at poking holes in most things (which, yes, can be a negative, but also makes me good at my job, so shh).
But as I read, the advice seemed so simple, so harmless, that I couldn’t stop thinking about it. Some of these women even had exactly the same conditions as I did, and they were apparently back to truly living their lives just because they changed their diet. It never occurred to me that the misinformation could be misleading, false, or even just well-intentioned but dangerous correlation-causation stuff.
Overnight I went (and ha, I haven’t written this for a while): vegan, gluten-free, 'sugar-free,' low histamine, high nutrient, anti-inflammatory, rotation…ermm…there was probably more but I don’t remember now."
Natasha Lipman is a journalist and social media influencer with chronic illness, and in this essay she discusses her own relationship to diet and wellness culture through the latter half of her 20's. In addition to reading this moving essay, it's worth following her Instagram and Twitter. Due to her work, I've become a lot more aware of disability (visible and invisible) and chronic illness and have tried (imperfectly) to expand my frame of reference and think more inclusively.
There is a distressing side to wellness that many don't see. Of the numerous people online who have claimed to have healed themselves with specific, often very restrictive dietary protocols, it's impossible to know who has truly seen lasting results, or if that person was even sick to begin with (see: The Woman Who Fooled the World). But these messages- true or not- can give unfounded hope to those with serious conditions and convince people to undergo unnecessary and difficult protocols or, at worst, to delay or refuse effective medical treatment. Plus, a culture that suggests we could all live "optimized" lives if we just ate the exact right things incorrectly implies that people who become ill are always to blame for their own conditions.
"Our analysis illustrates how conspiratorial narratives in science can distort the past in the service of contemporary
causes and obscure genuine uncertainty that surrounds aspects of research, impairing efforts to formulate good evidence- informed policies. In the absence of very strong evidence, there is a serious danger in interpreting the inevitable twists and turns of research and policy as the product of malevolent play- books and historical derailments. Like scientists, historians must focus on the evidence and follow the data where they lead.
...There was no 'smoking gun.' There was no 'sugar conspiracy'—at least not one which we have identified. Here, we offer a brief
review of postwar nutrition research on fat and sugar and attempt to explain the emergence of these conspiratorial stories."
The authors of this piece took a look at the criticism levied at Harvard's nutrition researchers, including Mark Hegsted, one of the preeminent scientists in nutrition's history. It turns out that Hegsted (while conducting studies funded by dairy) found that perhaps butterfat wasn't so good for the arteries. After accumulating evidence led him to suspect that the quantity or quality of dietary fat could impact heart disease risks by affecting serum lipid content, he was funded by the sugar industry to write a review of the existing heart disease research. Though one of his conclusions was that there was no strong evidence sugar directly contributed to heart disease, it did not appear to affect his opinion that total intake should be reduced. When he was later part of the first dietary guidelines committee, they recommended that Americans reduce their sugar consumption by 40%. So where is the conspiracy, as it is so popularly characterized today? The more likely account is that Hegsted was no fan of added sugar, but felt that the evidence of the time didn't support a causal link between intake and heart disease. Authors suggest that the conspiracy part of the story came with later, more dramatic, retellings of history and now this conspiracy theory has become widely accepted. (This topic is close to my heart, since I have done some similar work looking at misunderstandings around Ancel Keys.)
The authors of this article make the argument that "ahistorical accounts thwart our ability to critically evaluate the often long and zigzag process of scientific conjecture and refutation. They provide spurious cover for changes to policy by suggesting that old ideas are illegitimate. And, they advance a false impression that doing the 'right' kind of science will some- how avert the messy business of making policy based on incomplete evidence, public values, and democratic politics."
"Lone stars, on the other hand, hunt in packs and travel at surprising speeds, emerging from the leaf litter like a swarm of thirsty, galloping lentils.
'If you sit in the middle of the woods breathing out CO2, you’ll get a fan club of lone stars pretty quickly,' Hickling says. On top of lone stars’ rapacious mentality, Old Dominion’s Gaff says that after conducting a series of experiments, the bugs “seem to be invincible.'
...It only takes one bite from a lone star tick for an unsuspecting victim to develop a meat allergy that can last months, years, or even an entire lifetime."
The connection between a Lone Star tick bite, whose territory is expanding, and the subsequent development of a red meat allergy is the stuff of a carnivore's nightmares. Nevertheless, this article provides a fascinating insight into how humans' interaction with nature can affect our relationship with food, even in the most unexpected ways.
"Whatever else I achieve, I’m still a fat person who grew up in poverty. I’m a walking, talking example of a public health crisis, working to eradicate myself with government funding. It gets awkward.
In every meeting I go to, at every panel I sit on, eventually the conversation turns to obesity. People notice me, because they’re trained to see me as a problem. And so their eyes turn to me, and then I have to breathe through my feelings or I might beat someone to death with my iPad.
...Food justice is complex work. We want to give people healthy food that is relevant to their tastes and needs, but we work in neighborhoods where it hasn’t been readily available in decades. What they want, what they need, and what they know how to prepare varies wildly. Programs based on stereotypes or one-size-fits-all approaches are doomed to fail."
Overweight is a fraught topic and discussions around it often leave the humanity completely out of the conversation. And yet, for people in larger bodies, these conversations are full of implied judgement. In this piece Harmony Cox talks about her family's relationship with getting food on a limited budget growing up and how it ties to her work for food justice and bringing healthy options to her community.
"One reason for the discrepancy is “p-hacking,” the taboo practice of slicing and dicing a dataset for an impressive-
looking pattern. It can take various forms, from tweaking variables to show a desired result, to pretending that a finding proves an original hypothesis — in other words, uncovering an answer to a question that was only asked after the fact.
...But for years, Wansink’s inbox has been filled with chatter that, according to independent statisticians, is blatant p-hacking."
This is the photo that came up when I searched "statistics" on Wix images...
One of the most relevant nutrition stories to come out in 2018 covered the revelations about the Food and Brand Lab at Cornell. This was of particular interest to me since one of my mini-projects during the food service portion of the dietetic internships was to try and boost fresh fruit sales by using a Wansink tactic (I put fruit right by the register and then advertised for it. It worked). So for me it was surprising, and then disheartening, as the critiques began to come out demonstrating clearly that much of the data analysis leading to Wansink's headline-making studies had not been done in good faith. In addition to providing evidence for the need for more independent replication studies (and prioritizing publishing these studies), it also provides a strong case that folks from all areas of research learn proper statistical ethics and stick to them.
"When everybody can eat white bread, pasta, and white rice, how are people to distinguish themselves? In the United States, the answer is all too often to disdain grains and grain agriculture, and to dwell on the downsides of the civilization that they have supported."
This article is a must-read on how the growth and development of grains were a primary starting point for modernity. Laudan takes on the oft-referenced idea many nutrition-enthusiasts have embraced that agriculture has had a net bad effect on the life and health of humanity. With expertise and thousands of years of history, she unpacks the claim and finds that, in fact, the opposite is the case. As the ability to grow, harvest, and process grains accelerated, so to did human health, prosperity, and equality.
"Modern hospital food can, and often does, fail in two major ways: its nutritional quality and its gustatory appeal. That’s a problem, especially because according to Cordialis Msora-Kasago, registered dietitian nutritionist and spokesperson for the Academy of Nutrition and Dietetics, 30 to 50 percent of patients enter the hospital already malnourished — making feeding them all the more urgent."
In this longform, Washington describes her husband's and her journey through his treatment for recurrent lymphoma - a process that led to malnutrition. However, as he regained the ability to eat he advanced through the typical hospital "diet progression" - clear liquids to full liquids, to purees, to (neutropenic) solids. Many of us who have worked in hospitals likely know what happened - the provided food was not good. As she describes his recovery and her own work to revive his appetite by cooking and bringing food from home, Washington dives into the history of "hospital food" and where and how it has gone wrong, and ways to make improvements.
"Silicon Valley, not content with external devices, has pivoted to the self as its next great frontier. And in order for its vision of your body to take hold, it needs you to speak its language. Dieting is no longer a necessary problem of vanity, as it has been historically termed, but a problem of knowledge and efficiency—a rhetorical shift with broad implications for how people think of themselves. Where bodies might have previously been idealized as personal temples, they’re now just another device to be managed, and one whose use people are expected to master. We’re optimizing our performances instead of watching our figure, biohacking our personal ecosystem instead of eating salads."
Amanda Mull examines the culture built up around the "tech-ified" version of what is, essentially, dieting. In addition to renewing stigma of folks in larger bodies by implying that they aren't "optimized," the evidence underlying new-fangled diet personalization is no stronger than that for past diet trends. And what is the message people get when these companies ask questions like, "what if illness was optional?" Is the implication that all illness is simply the result of non-optimized choices a fair way to motivate healthy behavior?
"When you see advertising promoting “Food Intolerance” testing, it’s a test for immunoglobulin G (IgG). IgG antibodies signify exposure to products—not allergy. IgG antibody testing will identify what you ate recently – there is no correlation between an IgG test result and your ability to eat that food without distress. In fact, some research suggests IgG may actually be a marker for food tolerance, not intolerance. Given the lack of correlation between the presence of IgG and physical manifestations of illness, IgG testing is considered unproven as a diagnostic agent as the results lack clinical utility as a tool for dietary modification or food elimination."
If you haven't checked it out yet, Science Based Medicine is an amazing resource for checking out protocols or alternative treatments that you've heard of but want more information about. The health professionals who contribute share their expertise and refer to the scientific literature to let you know what's best practice and what's bogus. In this article, Scott Gavura explains the myth and science behind the extremely popular "food intolerance" tests.