Friday, 29 October 2010

Big Fat Fiasco

Tom Naughton does a fine job in this series of You Tube films explaining the car crash that is modern nutritional advice (go to his blog for the full sequence of five films).  He is a great communicator and with a bit of luck this talk (and his movie Fat Head), will get wider exposure. 

Part five is particularly enlightening, giving as it does, as concise explanation of the hormonal factors underlying obesity.  Naughton riffs on the idea that conventional wisdom about the cause of obesity ("you eat too much and do too little"), could just as easily be viewed from a position of character (national character has faltered in the last 40 years, we have become less inclined to participate in active pursuits and simply cannot stop ourselves from eating).  He then provides an alternative interpretation of the obesity phenomena - that of hormones. 

Finally he makes the same staggering conclusion as Gary Taubes; that we look at thin people and immediately assume that at some level (and normally at the level of personal 'character'), they balance 'calories in' with 'calories out'.  That unlike 'fatties', thin folk have enough self discipline to limit how much they eat, and to 'burn off' an excess through exercise.  But the staggering reality would appear to be that fat people ARE balancing 'calories in' with 'calories out'.  It is just that as the body's ready-supply of available energy is compromised (through excessive insulin-driven fat storage), fat people are driven to eat more, or expend less energy.

I guess an analogy would be if for some reason you had a container that you were required to keep topped up at the 1 litre mark.  Now you'd expect to have to add a small amount each day to keep the level topped up at 1 liter as water would evaporate.  If you had another container in the room which was exactly the same, you'd expect roughly the same level of water loss.  Now imagine that this second container had a small hole in its base through which water escaped (this represents the chronic shuttling of energy in to storage).  Although water loss through evaporation is the same between the two containers, total water loss in the second, holed container would be greater.  So you'd have to add more water to it to maintain the water level.

Of course in a biological system this is way more complicated.  So it might be that if a fat guy and a thin guy are given the same calories to eat, as less of those calories are available to satisfy the metabolic needs of the fat guy, the body, sensing a limited availability of energy, induces lethargy (ie, reduces 'calories out') - which we then interpret as 'weakness of character' and laziness.  Another complication, as Naughton notes, is the ability of a biological system to cannibalise itself.  That is why a fat mouse, with massive energy reserves but with chronically elevated insulin levels can starve to death.

I am sure there are several doctors and scientists out there who will  balk at the idea of having a comedian tell them about nutrition, physiology and scientific rigour etc.... but that is why as a society we are in the mess we are in.

I say we start with a targeted program of education.  We need to ask FAT doctors and FAT nutrition scientists why they are so goddam FAT!  We need to ask them to account for why they are seemingly unable to 'eat less and do more'.  We need to ask some pressing questions about black swans, bad science and BS.  Then, once reduced to tears, we should suggest they watch this presentation.  The mix of humour, shuttling as it does an 'educational payload', may then reach its target.

Well done Tom.

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