How the Sugar Industry Shifted Blame to Fat

This still makes my blood boil. Anahad O’Connor reported in the NY Times a couple of years ago:

The sugar industry paid scientists in the 1960s to play down the link between sugar and heart disease and promote saturated fat as the culprit instead, newly released historical documents show.

The internal sugar industry documents, recently discovered by a researcher at the University of California, San Francisco, and published Monday in JAMA Internal Medicine, suggest that five decades of research into the role of nutrition and heart disease, including many of today’s dietary recommendations, may have been largely shaped by the sugar industry.

“They were able to derail the discussion about sugar for decades,” said Stanton Glantz, a professor of medicine at U.C.S.F. and an author of the JAMA Internal Medicine paper.

The documents show that a trade group called the Sugar Research Foundation, known today as the Sugar Association, paid three Harvard scientists the equivalent of about $50,000 in today’s dollars to publish a 1967 review of research on sugar, fat and heart disease. The studies used in the review were handpicked by the sugar group, and the article, which was published in the prestigious New England Journal of Medicine, minimized the link between sugar and heart health and cast aspersions on the role of saturated fat.

Even though the influence-peddling revealed in the documents dates back nearly 50 years, more recent reports show that the food industry has continued to influence nutrition science.

Last year, an article in The New York Times revealed that Coca-Cola, the world’s largest producer of sugary beverages, had provided millions of dollars in funding to researchers who sought to play down the link between sugary drinks and obesity. In June, The Associated Press reported that candy makers were funding studies that claimed that children who eat candy tend to weigh less than those who do not.

The Harvard scientists and the sugar executives with whom they collaborated are no longer alive. One of the scientists who was paid by the sugar industry was D. Mark Hegsted, who went on to become the head of nutrition at the United States Department of Agriculture, where in 1977 he helped draft the forerunner to the federal government’s dietary guidelines. Another was Dr. Fredrick J. Stare, the chairman of Harvard’s nutrition department.

In a statement responding to the JAMA journal report, the Sugar Association said that the 1967 review was published at a time when medical journals did not typically require researchers to disclose funding sources. The New England Journal of Medicine did not begin to require financial disclosures until 1984.

The industry “should have exercised greater transparency in all of its research activities,” the Sugar Association statement said. Even so, it defended industry-funded research as playing an important and informative role in scientific debate. It said that several decades of research had concluded that sugar “does not have a unique role in heart disease.”

The revelations are important because the debate about the relative harms of sugar and saturated fat continues today, Dr. Glantz said. For many decades, health officials encouraged Americans to reduce their fat intake, which led many people to consume low-fat, high-sugar foods that some experts now blame for fueling the obesity crisis.

“It was a very smart thing the sugar industry did, because review papers, especially if you get them published in a very prominent journal, tend to shape the overall scientific discussion,” he said.

Dr. Hegsted used his research to influence the government’s dietary recommendations, which emphasized saturated fat as a driver of heart disease while largely characterizing sugar as empty calories linked to tooth decay. Today, the saturated fat warnings remain a cornerstone of the government’s dietary guidelines, though in recent years the American Heart Association, the World Health Organization and other health authorities have also begun to warn that too much added sugar may increase cardiovascular disease risk.

Marion Nestle, a professor of nutrition, food studies and public health at New York University, wrote an editorial accompanying the new paper in which she said the documents provided “compelling evidence” that the sugar industry had initiated research “expressly to exonerate sugar as a major risk factor for coronary heart disease.”

“I think it’s appalling,” she said. “You just never see examples that are this blatant.”

Dr. Walter Willett, chairman of the nutrition department at the Harvard T. H. Chan School of Public Health, said that academic conflict-of-interest rules had changed significantly since the 1960s, but that the industry papers were a reminder of “why research should be supported by public funding rather than depending on industry funding.”

Dr. Willett said the researchers had limited data to assess the relative risks of sugar and fat. “Given the data that we have today, we have shown the refined carbohydrates and especially sugar-sweetened beverages are risk factors for cardiovascular disease, but that the type of dietary fat is also very important,” he said.

The JAMA Internal Medicine paper relied on thousands of pages of correspondence and other documents that Cristin E. Kearns, a postdoctoral fellow at U.C.S.F., discovered in archives at Harvard, the University of Illinois and other libraries.

The documents show that in 1964, John Hickson, a top sugar industry executive, discussed a plan with others in the industry to shift public opinion “through our research and information and legislative programs.”

At the time, studies had begun pointing to a relationship between high-sugar diets and the country’s high rates of heart disease. At the same time, other scientists, including the prominent Minnesota physiologist Ancel Keys, were investigating a competing theory that it was saturated fat and dietary cholesterol that posed the biggest risk for heart disease.

Mr. Hickson proposed countering the alarming findings on sugar with industry-funded research. “Then we can publish the data and refute our detractors,” he wrote.

In 1965, Mr. Hickson enlisted the Harvard researchers to write a review that would debunk the anti-sugar studies. He paid them a total of $6,500, the equivalent of $49,000 today. Mr. Hickson selected the papers for them to review and made it clear he wanted the result to favor sugar.

Harvard’s Dr. Hegsted reassured the sugar executives. “We are well aware of your particular interest,” he wrote, “and will cover this as well as we can.”

As they worked on their review, the Harvard researchers shared and discussed early drafts with Mr. Hickson, who responded that he was pleased with what they were writing. The Harvard scientists had dismissed the data on sugar as weak and given far more credence to the data implicating saturated fat.

“Let me assure you this is quite what we had in mind, and we look forward to its appearance in print,” Mr. Hickson wrote. . .

Continue reading.

Nordic walking

I’ve now been Nordic walking for a while, and I am extremely happy with it. I used a Nordic Track ski exerciser for years, and I liked it a lot because it provides an excellent full-body workout—but it also requires significant apartment space. I knew, though, that I had to find some way to exercise. My life had become almost totally sedentary, each day going by with me in my chair—reading, writing, watching movies. There’s an unsettling, even alarming, consensus of medical and scientific judgments that a sedentary lifestyle is unhealthful to the point of shortening one’s life. Since I enjoy my life, I’d rather go in the other direction. That meant finding an exercise to do daily.

The best motivation for doing an exercise is that the exercise is enjoyable

The idea of making a necessary task enjoyable has always made sense to me (cf. my guide to DE shaving), and it’s even more important that a repeated task be enjoyable. Exercise is definitely something I (and you) should do — but if it’s not actually enjoyable, doing it becomes difficult. Rather than being pulled to it, one must push himself to do it. That requires willpower, and I like to save that resource for when it is really needed. If I find an exercise that is enjoyable and that attracts me, I won’t need to use any willpower to do it daily because doing it is more fun than not doing it.

The American Academy of Orthopaedic Surgeons, in its guidelines for starting an exercise program, also stresses that your exercise program should be something you enjoy. They write, “Your goal is to establish an exercise routine you enjoy. Make sure your first activity sessions are fun and not tiring.”

Beyond being enjoyable and apartment-compatible, an ideal exercise for me satisfies 5 additional criteria:

1. I can do it by myself—it doesn’t require other people (team sports or even just, say, a tennis opponent);
2. I can do it anywhere—it doesn’t require me to go to a special facility (a court or a gym or fitness center or playing field or pool or lake or the like);
3. I can do it whenever I want—it doesn’t require that I be some particular place at a scheduled time;
4. I can do it with minimal recurring expense—it doesn’t require a monthly membership fee, for example; and
5. It’s specifically a cardio exercise. Strength training is fine, and flexibility exercises are good, and balance exercise (standing on one foot while brushing your teeth, for example) are important as you age, but my specific goal is cardiovascular health, and cardio/aerobic exercise is the only route up that particular mountain.

Bicycling was enjoyable, and when I bicycled to work, the activity fitted nicely into my daily routine, but I don’t plan to be biking anywhere (and bicycles also take up a fair amount of apartment space). I did plan to walk (and had already started), and the more I learned about Nordic walking, the more I thought it would make the walk more enjoyable and also a better exercise by engaging the muscles of my upper body. (I find full-body exercise much more enjoyable than exercise that does not involve the full body.) Moreover, a pair of Nordic-walking poles occupies only a tiny amount of apartment space.

In the course of a month of Nordic walking, I found I had gradually increased the walk duration to just over an hour—about 8000 steps—simply because I enjoyed it so much. (My plan originally was to walk for 30 minutes, but now I really enjoy the longer walk.)

Important: I recently realized that I had happened upon something significant in the paragraph above, but it didn’t sink in to the point that I explicitly recognized it. It is this: Focus on consistency (walking every day), and let speed and duration take care of themselves — you don’t need to think about them because they will improve on their own, so long as you are consistent in walking every day. (See this post on the compounding of effect of small but consistent gains: “Many a mite makes a mickle.”)

To achieve consistency, I found the idea of “priority” useful. In the evening, when I think about what’s on my plate for the next day, I say to myself, “Well, my main priority is to take a walk.” And each morning when I awaken, I think “Today’s priority is to take a walk.”

I don’t worry about how fast or how long I walk, but focus solely on making sure that I do take a walk. If I walk every day, then as my strength and my fitness improve, I will gradually find myself walking longer and faster because I feel like it, not because it’s a goal. The only goal is to go for a walk each day. That is the priority.

Update 9/24/2023: The NY Times had a good article on the importance of walking speed (see this post, which has a gift link to the article), and I recently realized the importance of duration. As I resumed walking on 9/1/2023, following a surgery-induced layoff, I began by walking 1.5 miles a day, which over a couple of weeks took first about 28 minutes, then 27 minutes, then 26 minutes. Then I started walking 2 miles a day, and that took around 36 minutes. After 5 days of that I was feeling much stronger — that is, not so tired after the walk — so I went to 2.7 miles, around 46 minutes.

What I think happens is that the training effect (improvement in lung capacity, diaphragm strength, heart strength, blood volume, density of capillary network, muscular strength, and so on) does not start until you have spent a certain amount of time at at least an aerobic level of exertion. (I vaguely recall that, once your heart rate is in the aerobic zone, the training effect starts after 15 minutes.)

Once the training effect begins, after this warm-up period, the benefits start to accrue. If the warm-up period is roughly the same for all those walks, by increasing the duration, I’m increasing the amount of time spent with the training effect active, so improvement in stamina is fairly rapid. That’s my speculation, but I did notice a rapid improvement in stamina once I went from a 26-minute walk to a 36-minute walk, and I’m interested to see what a 46-minute walk will do. (That also implies that quitting the walk too soon means little improvement — for example, quitting 15 minutes after reaching an aerobic heart rate would mean little or no training effect takes place.)

I got to thinking about why Nordic walking is so much more enjoyable for me than regular walking. I think it’s because Nordic walking gives me something to do, as it were. In regular walking, my feet and legs have something to do (walking) but the rest of me is just along for the ride, so I found I needed some sort of distraction—listening to music, for example, or to audiobooks. But because my hands, arms, shoulders, and back are also involved in Nordic walking, I’m more fully engaged, so I no longer need distraction: I actively enjoy the walking itself.

Update 4/23/2022: I recently began using an exercise tracker, which provides a plethora of information about the walk and has resulted in an increase in both motivation and enjoyment. More info at the link. And a further update 9/24/2022: I upgraded the exercise tracker to a better model in the same line.

Sources of information and Nordic-walking poles

Here are some useful links for basic information:

• Difference between Nordic walking poles and trekking poles — basically, Nordic walking poles are for exercise — they engage your upper body and generally increase cadence and stride length — while trekking poles (as described in this article) are for support and balance. Both are useful, but for different purposes. Montem makes good trekking poles and sells direct to consumers, eliminating markup. (Montem also makes a Nordic walking pole, but I’ve not tried them.)
• Nordic walking technique & equipment
• Choosing a Nordic walking pole
• Exel Nordic walking poles
• Exel All-Terrain tip (video, best with sound off)
• Leki Nordic walking poles
• Komperdell Nordic walking poles
• Nordixx Nordic walking poles (Canada)
• Montem Pro Walker Nordic Fitness Poles (US and readily ships to Canada)
• Skiwalking Nordic walking system (US)
• Nordic walking song 🙂 (video, best with sound on — illustrates good walking technique: note arms are mostly straight, swinging like pendulums, and hands do not grasp the handles but hold them loosely, with fingers open at the end of the swing)

Specific health benefits

There are health benefits in using the poles (and see also this detailed research study), although the primary benefit I sought was to make me look forward to going for a walk. Still, the upper body effects are not negligible; this chart from that research study shows much greater upper-body muscle activity when Nordic walking poles are used:

Kenneth Cooper, MD, of Aerobics fame, tested Nordic walking and found that it increased the number of calories burned by 20% compared to walking without Nordic walking poles—and “without significantly affecting the rate of perceived exertion by the participants.” Thus in using his table of point values for regular walking, multiply the point values by 1.2 (20% increase) if you are Nordic walking. He recommends a minimum of 35 points per week for men, 27 points per week for women, with the exercises at least 4 days a week and at most 6 days a week. (Note the importance of one rest day a week: it’s possible to overdo cardio exercise.)

UPDATE: 26 Mar 2022 – I got an exercise tracker on 15 Feb, and now have abandoned the Cooper point system. Cooper points only indirectly take into account fitness, for example. My exercise tracker (note: later replaced with this one) does provide information on time and distance, so I can easily figure the Cooper points, but it also tracks heart rate and uses that information, along with my age and sex, to compute a PAI score.

The goal is to keep your PAI at 100 or better. Exercise and even daily activity will earn PAI points, and you can accumulate them. However, points expire after 7 days, so you must maintain a certain level of activity to keep your PAI at 100 or better. It took me 4 days to reach 100 PAI, and since then I have maintained the 100 level. I like the PAI better then Cooper points because the PAI feels like a better measure of my activity effort, and it also easily accommodates light days (short or slow walk) and rest days (no walk). (Still, as noted above, consistency of exercise is key.) As my fitness has improved, I’ve noticed that PAI points are not so easily gained, but I’m also not so tired from the effort. Here’s an example of the readout. /update

My daily Nordic walk (currently 4.1 miles in 1 hour 10-15 minutes), done 6 days a week, adds up to 43.2 points per week if I were simply walking, but since I use Nordic walking polls, it’s 54.7 points (20% more), comfortably above the minimum required for the benefits of the training effect. More details on the aerobic aspect are in the post at the link, along with information on Cooper’s 12-minute fitness test.  Also: note the risks of abruptly curtailing a walking program.

Types of Nordic-walking poles

Nordic-walking poles come in three types (and see also pole considerations):

• one-section (not adjustable, so you have to buy the right-length pole for you),
• two-section (adjustable, so the same poles can be used by persons of different height; also useful in determining the ideal length for you), and
• three-section (same idea as two-section poles but can be collapsed smaller for packing in a suitcase or backpack—trekking poles are virtually always three-section poles because they are often carried lashed to a backpack).

The ideal (IMO) is the one-section pole, and I now have a pair from Exel, the Finnish company that started Nordic walking in the first place. The one-section pole has the pleasing simplicity of no moving parts. The two-section pole seems better than the three-section in terms of vibration and strength, the three-section pole’s only advantage being its shorter length when collapsed. (Three-section poles are often named “Traveler” or the like.)

The foot of the pole is a carbide spike for walking on grass or dirt and a removable (and replaceable) rubber paw for walking on hard surfaces like pavement or tarmac. Exel has an interesting variation: a one-piece all-terrain tip — see video above.

Update: My Komperdell Nordic walking poles just arrived! Update later: And I now have upgraded to Excel Pro Curve poles, which I like a lot.

Update 2: What I learned in my first formal lesson. As is typical of self-taught practitioners, I fell into some common (and easily corrected) errors. And since Nordic walking, like (for example) rowing and swimming, consists of continual repetition of the same actions, any flaws in technique are multiplied by the number of repetitions and thus their cost grows over time. Update: Second lesson and what I learned.

Update 3: I just recently observed that the poles do indeed push one along. Comparing a walk without the poles to a walk earlier in the day when I used the poles, I found that without the poles I walked more slowly and more effort was required.

The video below shows the basics of using the poles, and more instructional videos are on this page.

UPDATE: This is me with my new Exel Pro Curve poles. It’s not evident in the video, but I am pushing back firmly (with my arm straight, so using my shoulders and back) with each step, pushing myself along.

The Trump administration used threats at a world forum to try to block a measure … that endorsed breast-feeding. Health officials were stunned.

Trump continues to be a bull in a china shop. Andrew Jacobs reports in the NY Times:

A resolution to encourage breast-feeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly.

Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes.

Then the United States delegation, embracing the interests of infant formula manufacturers, upended the deliberations.

American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

When that failed, they turned to threats, according to diplomats and government officials who took part in the discussions. Ecuador, which had planned to introduce the measure, was the first to find itself in the cross hairs.

The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced.

The showdown over the issue was recounted by more than a dozen participants from several countries, many of whom requested anonymity because they feared retaliation from the United States.

Health advocates scrambled to find another sponsor for the resolution, but at least a dozen countries, most of them poor nations in Africa and Latin America, backed off, citing fears of retaliation, according to officials from Uruguay, Mexico and the United States.

“We were astonished, appalled and also saddened,” said Patti Rundall, the policy director of the British advocacy group Baby Milk Action, who has attended meetings of the assembly, the decision-making body of the World Health Organization, since the late 1980s.

“What happened was tantamount to blackmail, with the U.S. holding the world hostage and trying to overturn nearly 40 years of consensus on best way to protect infant and young child health,” she said.

In the end, the Americans’ efforts were mostly unsuccessful. It was the Russians who ultimately stepped in to introduce the measure — and the Americans did not threaten them. . .

Continue reading. There’s much more. And it’s disgusting.

Odd to feel thankful about how Trump is afraid to cross Russia.

Kevin Drum comments: “You have to give them credit: big business gets what they pay for when they buy a Republican administration. But even big business can’t overcome Trump’s love for Vladimir Putin.”

Chiseled Face synthetic, Strop Shoppe Vivace, iKon 102, and Paul Sebastian

Very satisfying shave this morning: the two-day-stubble shave. The very nice brush I bought a few years back from Chiseled Face Groomatorium made a fine lather from Strop Shoppe’s Vivace, and the 102 is unparalleled in comfortable and efficient stubble removal. A splash of Paul Sebastian aftershave, one of my favorites (and sold on Amazon, FWIW) and the day is launched.

I’ve been looking at Exel Nordic walking poles—those of a fixed length. Have to order from the UK, though.