![]() You can't expect large groups of trial subjects to change their diets that much for that long. The reports on low-fat diets that recently came out of the Women's Health Initiative have only added to the public confusion. We cannot do randomized clinical trials on these issues and expect to get clean, clear results. I don't think we're ever going to have the kind of evidence for diet and health that you can get for drugs and cigarettes. This is good advice (sugars have calories, but no nutrients) but no clinical trial can ever prove that following this advice prevents obesity. It is used to prevent giving useful advice-eat less sugar, for example. The term “evidence-based” is so overused in nutrition that it sends up red flags every time I hear it. Question: What about the need for more evidence-based interventions? More research needs to be done in this area, but I don't think randomized clinical trials are the best way to do it. This research suggests that we must change the environment in ways that make it easier for people to eat in a more rational way, such as making smaller portions the default choice or keeping candy out of sight. An environment that is full of these kinds of cues undermines people's ability to make reasonable decisions about how much they should eat, because nobody wants to be thinking about curtailing calories while they're eating. These cues can overcome any kind of cognitive information about healthy eating, and they completely overpower issues of personal responsibility. Brian Wansink at Cornell, for example, has demonstrated the power of external cues that make people eat more than they should 1-if you serve food in larger bowls people will eat more if you serve a whole sandwich instead of a half sandwich, people eat a whole sandwich even if they're not hungry and if you give people a big muffin they consume more calories than if you give them a small one. Question: Is the research community offering any useful directions for us?īrilliant behavioral research is coming from experimental behaviorists and economists who are looking at environmental cues and triggers for overeating. We need to change the environment so the default is to make healthier choices-offering smaller portions, for example. But the current food environment promotes unhealthful eating as the default. But to do so, you need to make food choices. And no government or health agency is helping them to put all the information together to demonstrate that precisely the same diet can be appropriate for almost all of those diet-related conditions, or explaining that you really don't have to worry much about individual nutrients or foods if you're eating halfway decently. They're confused about vitamins, transfats, low fat, Atkins diet, the glycemic index, and their effects on all the different diseases. People see the health claims and are deeply, profoundly confused. The labels proclaim about vitamins, or heart disease, or cancer, or immune system function. We noticed that practically every single product has a health message on it of one kind or another. I recently spent some time with a reporter from Time Magazine at a local Safeway supermarket where we went up and down the aisles looking at products. ![]() Obviously, health claims on package labels work splendidly. ![]() Question: What are the messages that seem to be getting through to consumers? What works? ![]()
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