Nutrition is politics

Journalist Virginia Hughes pointed me (and all her twitter followers) toward an interesting piece in the Times. In it, “opinionator” Mark Bittman makes some rather provocative statement about cow’s milk.  According to Bittman, we drink too much of it.  In the U.S., where obesity is becoming the norm, there’s some truth to this. Milk is rich in calories and should be consumed by adults in moderation.  In kids it is an important staple. What are his arguments against milk, and where do they come from? Are they convincing?

First he tries to shock us with large numbers, and by converting volume into weight:

Until not long ago, Americans were encouraged not only by the lobbying group called the American Dairy Association but by parents, doctors and teachers to drink four 8-ounce glasses of milk, “nature’s perfect food,” every day. That’s two pounds! We don’t consume two pounds a day of anything else; even our per capita soda consumption is “only” a pound a day.

First of all, “until recently” renders the rest of the sentence moot. “Until recently” barbers performed surgery. “Until recently” beta blockers weren’t recommended in heart failure. And the fact that it was recommended by a milk producers lobbying group shouldn’t surprise us. I don’t know of any of my colleagues who recommends that our adult patients drink 32 oz of milk daily.

In fact the real recommendations are more subtle: the U.S. Department of Health and Human Services recommends three cups per day of low fat or fat free milk products which can include milk, yogurt, cheese, or soy milk.

So far, his arguments against milk are simply “it seems like a lot”.  Perhaps he’s saving his better arguments.

Or not. His next argument is that many Americans are lactose-intolerant. So what? If you are lactose intolerant and want to drink milk, you can by lactose-free milk. You can eat yogurt. If you still don’t want milk, no one is making you. Most people, after linking their abdominal distress to milk, will use their brains and substitute something like soy milk for cow’s milk. This does not invalidate dairy recommendations.

He then goes on to state that water is “nature’s perfect beverage”. By what measure? If we are speaking simply of hydration, then milk and water are about equivalent. If we are talking about other nutrients such as vitamins and minerals, water is empty. Of course, it’s also empty of sugar, which may be a good thing.  Right?

But, says Neal Barnard, president of the Physicians Committee for Responsible Medicine, “Sugar — in the form of lactose — contributes about 55 percent of skim milk’s calories, giving it ounce for ounce the same calorie load as soda.”

That’s a deceptive statistic from an unreliable source. First of all, the Physicians Committee for Responsible Medicine is an animal rights front that advocates vegetarian and vegan diets for just about everyone.  Their interest is not in nutrition, but in how our eating habits affect animals.  The statement is also very deceptive.  An 8 oz glass of milk has about 122 calories. An 8 oz coke has about 100. So Coke is better, right? Well, no. about 100 % of Coke’s calories comes from sugar (26g per serving). The same glass of milk contains only 12g of sugar. About 1/3 of milk’s calories comes from sugars, the other two thirds of fats and proteins. Coke an milk are comparable only in calories, perhaps the most misleading of facts.

Next argument, some people have bad milk allergies. OK, true. And some people are allergic to walnuts. If you’re allergic to it, it’s pretty clear that no one would recommend 3 oz per day of milk. Foolish argument.

He goes on to give an anecdote from his past on how dairy seemed to give him heartburn, but he made changes suggested by a doctor who wrote a book on “detoxification”.  This same doctor writes about the supposed auto-immune basis to all disease, and appears to be into some deeply flawed autism work.

So far, Bittman has quoted a deceptive animal rights front and a doctor who has no special knowledge of dairy and nutrition but does have some questionable associations.

Bittman’s ideas about milk are largely wrong, are based on opinions not of experts but of non-experts with an ax to grind, and are on their face based more on ideology and anecdotes than science.  As a science writer, he has some explaining to do.

_____________

Before you pull some sort of “Milk Shill Gambit”, I don’t work for anyone who would benefit from milk sales. I don’t personally drink milk since I’m lactose intolerant. I do love yogurt though.

 

NB: Apparently he’s not a “science writer”. I would call the piece an attempt at science writing based on it’s content. As either food, nutrition, or science writing, it fails.

14 Comments

  1. nice analysis. Question though, why IS dairy considered a required category of food? Why do we make recommendations based on food type rather than nutrient (i.e. ‘get X % from high protein foods like ___ get Y % from high fiber foods like ____ )

    • Michael Pollan summarized it as (though I am paraphrasing admittedly) “food is good, nutrients are bad…except for the supplement industry”. Basically, you can’t expect the food industry to fund reseach to prove their products dangerous. (Some universities even get in on this: Illinois grows a good share of the country’s soybeans…and their state colleges tend to, unsurprisingly, research the health benefits of soy products, but not the risks of trans fats in partially hydrogenated oils.)

      Chocolate, for instance, is candy, not medicine, regardless of what one study showing statistically nonsignificant benefits says.

      And if nothing else, data, like suspected criminals, will confess to anything once sufficiently tortured. So you get a study showing that fruits and vegetables reduce risk of diabetes relative to white flour touted as proof that diabetes isn’t related to carbohydrate at all!

      The newsmedia also have two odd tendencies. The first is confirmation bias. Much of science proves…nothing. Specifically, we thought we had something, but after this study, we have nothing. To make matters worse, since they don’t know the concepts of statistical significance (In medicine, this is a risk ratio of 3.0.) and number needed to treat, popular media are generally an abysmal source of medical information, even ones like Men’s Health and Prevention, The second, I’ll call neophilia. The media tend to think newer studies overturn older ones.

  2. Well, there’s probably political reasons, but also take a look at Michael Pollan’s concept of “nutritionism”. If we look at foods rather than just their constituents, we may be able to find better dietary advice. Milk is both nutrient and calorie dense, and is a good food for many people. People who don’t drink it (of which I am one) need to work on finding better sources of the nutrients, hopefully from foods rather than from supplements.

    • bronironi

       /  July 16, 2012

      Okay. Couldn’t we have nutritional requirements that just suggest ‘nutrient dense’ foods then? Or X % ‘very nutrient dense’ Y % ‘somewhat nutrient dense’? etc….

      Part of my reason for these rambling thoughts is that I’m thinking about human food use in history. Cows were domesticated in a few different parts of the world, but in others they were never domesticated, yet people managed to have healthy diets (and stay lactose-intolerant). Not that I think we should ignore the foods available to us! But it does make me think about other ways of formulating these categories.

    • Plus, supplements are kind of…The phrase “return of the old medicine show” comes to mind. Supplements are innocent until proven guilty, exactly the opposite way we treat drugs.

      Hilariously, disclaimers saying “not evaluated by the FDA” just make people swallow it more.

  3. humgums

     /  July 16, 2012

    Bittman’s ideas about milk are largely wrong, are based on opinions not of experts but of non-experts with an ax to grind, and are on their face based more on ideology and anecdotes than science. As a science writer, he has some explaining to do.

    Not to make any apologies for Bittman, but he’s no science writer. He writes about cooking and food. And lately, he’s gotten away from good recipes and started to preach about his opinion of good eating habits. I liked the old Bittman better.

    • My bad

    • I’ve seen worse. Men’s Health had an article a few years back about circumcision to prevent HIV in Africa. (The data are statistically nonsignificant at rr=1.4 and nnt=73 in South Africa, over nine thousand outside Africa, and condoms are cheaper.) Ignoring economics or efficacy, PEPFAR is going ahead with it, so I’ll focus on their summary of the history of circumcision. It was not done in pre-Columbian America, despite their claims otherwise. Also, the world won’t end this year, one does not “smoke” peyote, and “native remedies” in the health food store either have their origins lost to time or began in the old medicine shows.

      *sigh* And we were starting to get along, Rodale. When your founder died, you stopped telling us to take over a hundred supplements, so what gives?

  4. saffronrose

     /  July 17, 2012

    There are enzymes in a number of forms that the lactose-intolerant who still want the moo are able to take, and find easily as well.

    I’m not sure if I am, or if something else is causing the unsociable amount of gas I seem to pass some days.

    • There’s also fermented dairy products. That’s how, for instance, the Maasai are able to drink milk.

      But where does that leave me? I have a family history of diabetes. Are grains (which tend to be poor sources of micronutrients, and there’s no known minimum threshold for carbohydrate intake) necessary to me? (Especially given that the food pyramid graphic has a very white image of cereals.) Do I really need 60% of my calories form carbohydrate? Since diabetes is linked to ethnicity, and PCRM claims milk is racist (and yes, Neal Bernard has the audacity to tell minorities what is and isn’t racist), why aren’t they handling this?

  5. chris

     /  July 26, 2012

    Thought you’d like to know that Mark Bittman has posted a follow-up to his article on milk, but it gets worse :

    “You’d think that with a grapevine’s worth of anecdotal stories and at least some studies linking dairy to physical problems, few people began this kind of self-testing at the suggestion of their doctor — unless, that is, their doctor was in the ‘alternative’ camp.”

    Did you guess why?

    “As for medicine: for many doctors drugs are the answer to almost every condition, a situation that suits Big Pharma just fine.”

    I don’t mean to denigrate the idea that dietary changes can have a profound effect on health, but I find the “medical-pharmaceutical-industrial complex out to keep you sick and profit from your illness” story extremely tiresome.

    I really enjoy your blog, by the way.

  6. AnyBeth

     /  July 26, 2012

    What happens when he finds out about the \”basic 7\” from the (early 40s to mid 50s), where milk products (or alternatives) composed not one but two food groups? And one of the groups was butter/margarine? (That was for vitamins A and K, I think — I don\’t have the resource where I first saw it handy.) Then again, the guide was developed during rationing, when there wasn\’t much margarine to be had. Also, it doesn\’t say how much to eat of any group, just \”some\” and \”In addition to the Basic 7… eat any other foods you want\” — big differences from other USDA nutrition guides. In use until recently, for a given definition of \”recently\”.

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