Wednesday, March 29, 2006

What you eat does not determine your health

There have been several insightful comments posted in response to my rants. One thread in particular has generated a lot of back and forth, and I'd like to bring it out from hiding under the comments heading of the C-section post.

The discussion is about the role of lifestyle in promoting health and you can read the beginning of it below. I'd like to respond specifically to the comments of Marcus from Fixin' Healthcare. I want to thank him for being willing to engage in this debate, since he undoubtedly has many other commitments on his time.

I'll not quibble about various specific claims, like whether processing food concentrates calories and whether that has a meaningful impact on intake or health. However, I will return to the larger point. There is really not much scientific evidence to suggest that what you eat has any impact on health (besides specific dietary deficiencies) and that the amount that you eat (except at the extreme of morbid obesity) has an inordinate impact on health.

Basically, I am taking issue with the claim that you can meaningfully affect your health by manipulating your dietary intake.
As you know, nutrition does not lend itself to the types of clinical trials that we would consider scientific evidence or proof. Much of the evidence comes from identification of biochemical pathways and non-rigorous epidemiological observations."
Nutrition does not lend itself to cross-over double blind studies, that's true. However, there is a panopoly of statistical tests and measurements that can provide evidence for specific claims, and even that kind of evidence is lacking in the case of dietary intake and health.

When it comes to the study of specific metabolic pathways, I would argue that extrapolating from in vitro experiments to dietary recommendations for entire populations is entirely unjustified.

The bottom line is this: individuals gain minimal, if any, control over their health by changing what they eat.


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