There seems to be an inverse relationship between our awareness that we’re an unhealthy nation and clarity on what we, as individuals, can do to be healthier. One of the biggest reasons that we’re simultaneously more aware and less informed is the incessant barrage of news headlines and magazine ads telling us what’s good for us and what’s not, without ever including enough detail for us to make a truly informed decision. We hear a sound bite, form an opinion, and move on.
This is not science. It’s marketing.
As I discuss in Don’t Die Early, one of the most difficult things about adopting a healthier lifestyle was digging beneath the sound bites and separating the science from the marketing. Even when I tracked down scientific articles and medical studies, it seemed that no matter what topic I picked, I could find a source showing it was healthy for me and another showing it was unhealthy.
How does a person make sense of all this? How do we determine if a claim is backed by science or wishful thinking? And how do we separate science from marketing?
To separate the fact from the hype, let’s take a look at one often cited study that shows “whole grains can help protect people from diabetes.” This Harvard study, quoted innumerable times by heath experts, followed the eating habits of 43,000 men aged 40 to 75 for 12 years and determined that those who ate the least amount of whole grains had a 60% higher incidence of Type 2 diabetes.
The message is clear: If those who ate the fewest grains developed diabetes more often then we must eat more whole grains to reduce our risk of diabetes. It has to be true if Harvard says it’s true and countless nutritional experts are telling us to take heed.
If this is true, sign me up! I’m all for reducing my chance of Type 2 diabetes! Could it be that simple? Could anyone decrease his chance of Type 2 diabetes just by eating more whole grains.
Let’s take a closer look at the study, entitled White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and Women that was published in the Archives of Internal Medicine so we can see the science behind the headlines.
First of all, the title (conveniently missing from the sound bites and news articles), is a huge clue to the focus of the research: white rice and brown rice.
(Before we go any further, class, please raise your hand if you can guess which of these two foods is better to eat, white rice or brown rice? Take all the time you need…)
If you still haven’t guessed the focus of the research, the first sentence in the section entitled Background will provide the next clue:
“Because of differences in processing and nutrients, brown rice and white rice may have different effects on risk of type 2 diabetes mellitus.”
Hmm. This comparison between white rice and brown rice already feels far less compelling than the sound bite “eating more whole grains reduces the risk of diabetes.” The sound bite makes it sound like anyone can eat more whole grains and reduce their risk of diabetes but it looks more like the study is saying only those who eat white rice can reduce their risk of diabetes by eating whole grains.
For the sake of impatience, let’s cheat a little and sneak a peek at the conclusion:
“Substitution of whole grains, including brown rice, for white rice may lower risk of type 2 diabetes.”
I see. It’s not even as simple as adding whole grains to our diet to reduce the risk of diabetes; the study is talking about replacing white rice with brown rice. (This reminds me of the Folger’s commercials: We’re secretly replacing Mr. Smith’s white rice with brown rice.)
You see, due to the nature of nutritional research, especially clinical research in which two carefully controlled groups are compared, an item of interest is almost always studied in comparison to something else. It pretty much has to be this way. For example, a study showing health benefits from exercise must compare a group of people who exercise to a group of people who do not exercise (or who exercise considerably less). Without a point of comparison (in this case, those who eat white rice versus those who eat brown rice), such studies would be meaningless.
Unfortunately, the sound bites rarely talk about the “in relation to what?” part.
Instead of comparing a group of people who eat whole grains to those who have replaced all grains with vegetables, nuts, and berries, this study compared people who eat highly refined grains to those who eat whole grains. Of course whole grains are healthier than highly refined grains. This is probably not a surprise to most people—fewer things are less nutritious than highly refined grains.
By carefully controlling the comparison, studies like this can tell the truth without providing the complete picture.
Where the even greater subterfuge happens is when pro-grain interests argue that because whole grains are shown in this contrived comparison to reduce diabetes risk over highly refined grains that it’s a good idea to make whole grains a staple of our diet forever. And the sound bites and nutritional “experts” propagate this by stating “whole grains reduce your risk of diabetes” and using that as justification for telling us to eat plenty of grains.
As many have pointed out, this is analogous to advising everyone to smoke plenty of filtered cigarettes because filtered cigarettes are less likely to cause cancer than unfiltered ones, while conveniently overlooking the question of whether or not cigarettes of any kind are intrinsically healthful or harmful.
This sort of sleight of hand is useful in showing just about anything to be healthful—merely by controlling the comparison.
The observation that eating whole grains reduces the incidence of Type 2 diabetes as compared to those who eat highly refined grains instead is science.
Extending this rather obvious bit of science into a recommendation that we should eat plenty of whole grains is marketing.
Don’t confuse the two.
Don’t fall for something just because it’s shown to be an improvement over some carefully contrived baseline. Instead, dig deeper to find the truth behind the superficiality and strive for finding what’s best, not just what’s better. Always ask “in relation to what?” when you hear claims about something being “healthful,” or “good for you.”
It’s all relative.
Or as a physician cousin of mine is fond of saying “In the land of the blind, the one-eyed man is king.”