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Selling Diets or Telling Truths

We know what to eat; we simply keep refusing, across an expanse of squandered decades, to swallow it.
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The True Health Initiative was created because, and only because, there is one clear way of eating and living that massively promotes the longevity, vitality, and overall health of human beings, and well-being of the planet -- and a global coalition of experts, influencers, and thought leaders believes you deserve to know what it is.

Don't get me wrong, that "one clear way" is not a narrow way. It's not a specific, prescriptive diet of the "my diet can beat your diet" variety, any more than it is one specific kind of exercise. It is not, for instance, an argument for hiking but against biking, or for walking but against swimming. All exercise is good exercise. Which is best for whom may be less uncertain, but the fact that exercise in general is good for us is way past debate.

Diet is just the same. There are many variations on the theme of healthful, vitalizing, life-extending, sustainable diets. But the theme is way past debate.

It is the product of almost overwhelming volumes of scientific evidence of every description, from mechanistic studies in test tubes, to time trends in the populations of entire towns, regions and countries. That expanse certainly includes many randomized clinical trials, but frankly goes beyond them, too, deriving insights from what has worked for whole populations across generations. There are no randomized trials to show us that.

The theme is clear, and a global who's who, unprecedented in the world to the best of our knowledge, has come together both to say what it is, and to say that with regard to it: we agree.

That theme is spelled out here; and the experts tallied here. We are currently about 300 strong from 30 countries, but our ranks grow every week. If you have a hero in nutrition, preventive medicine, health promotion, public health, health journalism, sustainability, or the culinary arts -- there is an increasingly good chance you will find them among us. If they are not there yet, check back soon.

The reason for this assembly is because there is strength in unity. These days, everyone has a megaphone -- the Internet -- and every opinion is mistaken for expertise. That readily makes suckers of even normally quite savvy people.

The evidence? Not only are we sold every manner of lotion, potion, practice, and program for weight loss; not only are best-seller lists and morning shows routinely populated with false promises -- but none of this even needs to be new. The sellers know that media cycles come fast and furious, and filling them up with anything actually new would be quite taxing. Far better to reheat leftovers.

That is done all the time. A flagrant example is the famous, or infamous if you prefer, Dr. Robert Atkins. Atkins originally wrote his books about low-carb diets in the 1970s. They didn't attract a large following then, probably because there was not yet sufficient weariness with low-fat diet advice. We hadn't yet followed the basically sensible advice we had received about avoiding prevailing fatty foods down a rabbit hole to a vast cache of Snackwell cookies, and into a world of rampant obesity and diabetes.

By the 1990s, we had done exactly that. The "reduce fat" advice had never been bad, but the "eat low fat junk food" advice it was perverted into was an obvious disaster -- one we have been paying for, for years, with years extracted from lives, and life siphoned out of our years. So in those fat-war-weary '90s, Atkins published his "new" diet revolution, but with nothing much different from 20 years prior other than "new" stuck in the title, and the mindset of the public. Gary Taubes wrote a New York Times Magazine cover story about it in 2002, and the rest, as they say, is history.

Alas, history that keeps repeating itself. You know what they say: Those who don't learn from the follies of history are destined to repeat them. We seem never to learn.

It's not quite another 20 years since Atkins' heyday, and what's old is new again -- suggesting our already dubious memories are declining further. What's old is new not because it worked last time, but because we've forgotten that the false promises were false. This all plays out a lot like presidential campaigns, I suppose: over-promise, under-deliver, repeat, knowing that we -- the suckers -- never tend to notice. If hope is the thing with feathers, gullibility must be the thing with cleats -- dug in like a tick.

False promises related to weight, health, aging, and beauty are as lucrative for sellers as they are disastrously diverting for buyers. Diverting from what? From the time-honored truth; from what actually would work to add years to life, and life to years.

We, the True Health Initiative, are dedicated to putting a stop to that. As a global coalition, we have nothing to sell. We do not profit from this effort. We make no money, and run on philanthropic support. We all have day jobs, of course; as individuals, many of us have written books. We don't agree with one another about everything. We range from vegan, to Paleo, and all have passion for our personal priorities.

But we are united as a group just the same; a group purely of, by, and for health promotion by means of disseminating evidence-based, consensus-based truths. There are no ulterior motives. However far you have been led into the realm of doubt, distrust, or even disgust, because of countless reversals, constant hyperbole, frequent demagoguery, and perennial discord -- you really can trust us. Not any one of us, necessarily -- but rather all of us, joined together to defend the common ground of reliable, empowering knowledge.

We cannot, of course, invite every influential person to join us. Some such are just entirely wrong or plainly unworthy. For example, in our somewhat silly culture, Hollywood celebrities are routinely mistaken for health experts, and at times dispense advice that induces, among actual experts, something rather like projectile vomiting. We can't make room for those folks, no matter how large a following they may have.

We also cannot make room for scientists who refute the weight of evidence, for whatever reason. Maybe they have simply spent so much of their life scrutinizing some leaf of some tree, that they can longer see or acknowledge the forest. Maybe their motives are pure, but their vision blinkered.

Maybe, more ominously, they are fools, maybe fanatics, or maybe at times bona fide hucksters, who know the falsities they are peddling, but peddle just the same in the service of ill-gotten gains. The ranks of dissent are populated by different sorts, but they all potentially do harm -- implying reasons to doubt what we truly have ample cause to know, or that they uniquely know something the rest of us don't. (Evolution is another area where just this sort of toxic nonsense goes on.)

Often, their formula of cherry picking evidence, citing the literature selectively, and ignoring the often far more voluminous evidence that belies their provocations is as well known to us, their peers, as it is effective. This was certainly not invented for nutrition and health; it has forestalled action on climate change for years, for example, to the potential, grave peril of us all.

If you cite studies to people who don't read science, it can make you sound erudite. Do the same to those of us who read, and contribute, to that literature, and it becomes a Rorschach test -- we look at the same picture, but see very different things. We see someone preying on the vulnerable. The True Health Initiative exists to draw on the strength born only of global unity, and put a stop to that predation.

I write this in the proximal aftermath of a sad experience. We recently "expelled" the first, and I hope only, member of the Council of Directors of the True Health Initiative. This person is influential, and writes books that do very well, including one recently garnering the support of the "eat more meat, butter, and cheese" crowd.

The particularly sad part is that this person does, indeed, agree with the fundamental principles of diet to which the True Health Initiative is pledged; we believed that when he was invited to join, and he reaffirmed it to me directly. But that conclusion is only found once one gets past many layers of marketing that do the customary thing: promise the people what they want to hear, and make it sound like there is a brand, new, effortless solution.

The problem is that many, of course, never get past those layers to the fine print where the provisos, caveats, and reality checks reside. Many who never read a book hear about it in blogs, on morning shows, and in interviews. Consequently, the marketing messages can take on a life of their own, propagating false impressions, and the very confusion, distrust, and disgust the True Health Initiative hopes to help expunge from our culture.

We were very sorry to burn a bridge in this particular case, since our very business is building them -- but we can't very well fight the confusion that prevails if those within our own ranks are involved in promulgating it.

We are not, my friends, clueless about the basic care and feeding of Homo sapiens. How genuinely bizarre it would be if we were! We know what to feed cats and dogs, sheep and horses, toucans and tropical fish, after all. How unfathomable to be hopelessly befuddled about what to feed ourselves. We are not.

The optimal way of eating we know most reliably is not a narrow prescription, but a theme. That theme is not well defined by low-fat or high, low-carb or high. It is far better defined in terms of wholesome, minimally processed foods in sensible combinations, predominantly plants. That the same basic dietary pattern decisively linked to better human health is salutary for the planet, too, is good fortune for which we may all be thankful; we would have very hard choices to make if it were otherwise. As it is, the health of people and planet alike can be advanced one plate at a time.

We know what to eat; we simply keep refusing, across an expanse of squandered decades, to swallow it. Don't take my word for it. Listen instead to a chorus of unified voices spanning nations, disciplines, and even ideologies -- banding together on the basis of epidemiology -- to say: WE AGREE!

-fin

Director, Yale University Prevention Research Center; Griffin Hospital