Retrospective #436: “Science advances one funeral at a time.”

Below the sub-header “Helped America Eat Better,” my subject’s photo stares me in the face every day when I sit at my laptop. It is a photo from an old NYT’s obituary page, and the newspaper page is there to protect the work table from damage. It is prophetic and motivational, and it inspires me to address “the state of things.”

My parents taught me to “never speak ill of the dead” so, while I’m going to violate that sage advice with this piece, I will try not be hurtful to the departed personally. Before you say, “Bless your heart,” know that my feelings – my enmity, really – toward the myopic vision of my subject, heralded by the NYT with an 18-column-inch obit, is that society still viewed him in such exalted status even as late as 2017. This man, like so many of his colleagues, actually failed to help us “eat better.” But the NYT piece was an obituary, not an opinion piece.

I am reminded of one of my favorite last lines in a movie: Joey Brown’s line in “Some Like It Hot” (see this YouTube video excerpt). Brown proposes marriage to Jack Lemmon, cross-dressing to avoid a mafia hit squad. Lemmon finally replies, in exasperation, that he’s in fact a man, to which Brown replies, “Well, nobody’s perfect.”

From the NYT obit: This doctor, a “surgeon, clinician, researcher, teacher and author, was pre-eminent in the study of obesity and nutrition.” Besides his MD, he had a doctorate in nutritional biochemistry from MIT and “largely spent his career at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston.” He was professor of nutrition at Harvard, and at Beth Israel was chief of the Nutrition/Metabolism Laboratory and Director of the Center of Nutrition Medicine. This man was clearly at the apex of the “nutrition establishment.”

Yet, “what really put him and his colleagues on the world map were publications highlighting inadequate nutritional management of people in the hospital – so-called ‘hospital malnutrition,’” said a former colleague. How did he do that? “He helped develop nutritious liquid diets (Ensure, and others), supplementing them with protein…” In other words, he and Harvard profited handsomely from this misguided commercial collaboration.

He also correlated poor nutrition with obesity – a no-brainer there, but note again this dependency of Harvard nutrition “experts” on epidemiology, or “correlation,” rather than a scientific interest in “causation.” His solution, and this is a quote: “Advocate lower-fat diets and help develop gastric by-pass surgery and nutritional liquid diets.”

I’m not suggesting that this good doctor had a Mephistophelean streak; I’m sure he intended well, but like Ancel Keys before him, and others still in positions of  influence (e.g. Walter Willett, recently retired from Harvard), he rose to power in the politics of the academy by buying into the “eat-less, exercise-more, a calorie-is-a-calorie” meme that is only now beginning to show wear at the edges because of the weakness of the scientific evidence supporting it.

His obituary writer noted that “weight loss benefitted patients with type 2 diabetes.” Now, there’s a scientific breakthrough! His obituary also described five strategies the good doctor “developed during four decades of encouraging patients to shed pounds: 1) Make time to prepare healthy meals, 2) Eat slowly, 3) Consume evenly sized meals, beginning with breakfast, 4) Do not skimp on sleep, and 5) Weigh yourself often.” Not bad advice, but pretty banal accomplishments, if you ask me. Forty years of “encouragement…to shed pounds.”

I also think that evenly sized meals sounds too much like “balanced” to me. And nutritious liquid diets like Ensure, even if supplemented to 15% protein, are still 60% highly processed carbohydrates. “Carbohydrates” are not mentioned even once in the entire encomium. The emphasis instead is on calorie intake: “Even a small decrease in caloric intake could result in healthier weight,” he is quoted as saying. He summed it up: “Sustained weight loss requires a three-pronged approach: Cut the calories, eat quality food and exercise.”

As Max Planck, the German Nobel-prize winning physicist said in 1906, “Truth never triumphs; its opponents just die out.” Another paraphrased variant is, “Science advances one funeral at a time.” May this doctor rest in peace.