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Aaron Carroll’s new book asks: Can “bad food” be good for you?
When I was a kid, there was a seasoning called Accent. Both its TV commercials and its canisters featured a little horn with the slogan: “Wake up the flavor.” We poured that stuff on everything (except for our Captain Crunch), often accompanying our culinary adventures by making little horn sounds.
It turns out Accent was pure MSG. Who knew? And yet we lived to tell the tale. Neither me nor my siblings ever got headaches as kids. Or ever get headaches as adults. Indeed, we seem to have acquired some headache immunity from using this stuff. (Correlation, not causation, a good researcher would say.)
The reason, as you’ll learn in The Bad Food Bible, is that MSG isn’t bad for you, even apparently in the quantities we devoured. (Yes, we know – you get a headache when you go to a Chinese restaurant. That could be your imagination, or you may be one of the few people with a sensitivity to it, just like a few people have sensitivities to other foods.)
MSG isn’t the only maligned food. Is butter good for you or bad? Milk? Artificial sweeteners? Organic foods? Sugar? Meat? Red meat? Tuna? Coffee? Wine? Eggs? Salt?
Oh, and don’t forget gluten. Turns out, virtually every one of these foods has been studied in depth…and here the studies in both directions are summarized and sourced.
How does this apply to wellness vendors?
Wellness vendors – and I’m looking at you, Interactive Health – want to micromanage our diet in so many ways that most employees just tune their advice out. This book reveals that tuning vendor wellness advice out is probably the right response in most cases. Not all, but most.
We’ve shown repeatedly that wellness vendors, once they move beyond eat-more-broccoli-olive oil-nuts-and-fruit, are usually peddling very controversial or decidedly incorrect unsolicited dietary advice. Not that they care, because they show huge savings no matter what they do. One study – so seminal that it became part of Kate Baicker’s infamous “Harvard study” meta-analysis – found massive short-term savings by advising diabetics to swap out fats in favor of carbs. Not surprisingly, that study qualified the author for a coveted spot on the Koop Award Committee. Apparently bad advice is part of the Koop Award’s DNA.
What that study did and what Interactive Health does should not be called “dietary micromanagement.” Rather, it should be termed “dietary micromismanagement.” Interactive Health’s advice to non-hypertensive diabetics and people at risk for diabetes is exactly that: swap out the whole milk for skim milk and cut way back on the salt. As a previous column noted, that turns out to be exactly the opposite of what they should do.
So what should we eat…and what shouldn’t we?
The great philosopher Dan Quayle once uttered the immortal words: “The role of the Vice President can be summed up in one word: to be prepared.” Likewise, with the exception of sugar and soon-to-be-extinct artificial trans fats, the book can be summed up one word: chill out.
Author Aaron Carroll, part of The Incidental Economist (the country’s leading health economics blog), lays out the case for OK-in-moderation for most controversial foods. This guy doesn’t have an ax to grind – except when it comes to skewering people who have an ax to grind. He goes after faddists, extremists, and people who ignore research with a zeal approaching ours in exposing dishonest wellness vendors (and I’m looking at you, Interactive Health…and Wellsteps and Fitbit and about 50 others).
Since The Incidental Economist’s positioning is that of arbiter, not advocate – the go-to place for evidence-based answers no matter what the evidence shows – their answers on these topics are highly credible and carefully sourced. (Hence their smackdowns of the Koop Award Committee and wellness vendors are even more credible than mine.)
The answers boil down to: stop knocking yourselves out trying to be perfect. You are probably stressing more over your diet than you are gaining from fine-tuning your diet. Yes, there are a few things to avoid, like added sugars (but you knew that, or if not you would as soon as you play a round of Quizzify). Or, if you have a predisposition to hypertension due to history or ethnicity, you might want to go easy on the salt. (Most people needn’t – there is a reason your taste buds welcome the flavor).
So live a little, let your employees live a little, and know there are really only a few things that all the evidence says you truly need to avoid: trans fats, added sugars, and Koop Award-winning wellness vendors.
New York Times 3, Wellness 0
Seems like the only people who hate wellness more than the reviled right-wing media are the reviled left-wing media, specifically the New York Times.
For the third time in the last 16 months, their economics blog has slammed wellness. This posting is about how “voluntary” wellness programs are anything but voluntary. If the incentive is high enough, a program is forced, even if the Business Roundtable pressures the EEOC into redefining “forced” as “voluntary.” Like if I park in a towaway zone here in Boston, I am forced to move my car or face a $200 fine. Moving the car in no way would be considered a voluntary act on my part. And yet fines for refusing to participate in wellness programs can be ten times that figure and still be considered “voluntary.” The column goes into great detail about how forced programs are not voluntary.
This column comes roughly a year after their last smackdown, the first line of which was:
We’re unsure how much clearer they can get, but even so, Ron Goetzel, who never steps out of character, misrepresented their conclusion.
- NYT: “We’ve said it before, many times and in many ways — workplace wellness programs don’t save money.”
- Goetzel interpretation: “The New York Times columnists…answered the question ‘Do Wellness Programs Work?’ with ‘usually not.’ “
If “voluntary” can mean “forced,” then I guess “no, never” can mean “usually not.” You know wellness is in trouble when even Ron Goetzel’s misrepresentation of their position says wellness doesn’t work.
NY Times 1, Goetzel 0 (“Incidental Economist” obliterates wellness)
If you want a preview of Monday’s big wellness debate, look no further than a 3-way exchange (us, New York Times, Ron Goetzel) from late 2014.
First, our November 25th Health Affairs blog did for the wellness industry what Upton Sinclair did for meatpacking. Despite its Thanksgiving-week publication date, it became the #1 most-read for November and #12 for all of 2014, in Health Affairs. (This was the article generating the famous Los Angeles Times moniker for wellness: Scam.)
Next, New York Times “Incidental Economists” Austin Frakt and Aaron Carroll had a field day with their followup column. It should be read in its entirety. It’s basically a cut-and-pasted version of our own, with some hilariously scathing color commentary (and we have always said the greatest value wellness vendors deliver is humor).
Their lead line says it all:
“We’ve said it before, many times and in many ways: workplace wellness programs don’t save money.”
Finally, let’s look how Ron spun their elegant smackdown, using his best Goetzel “The Pretzel” twisting and turning of their words:
The recent Health Affairs Blog post by Al Lewis, Vik Khanna, and Shana Montrose titled, “Workplace Wellness Produces No Savings” has triggered much interest and media attention. It highlights the controversy surrounding the value of workplace health promotion programs that 22 authors addressed in an article published in the September 2014 issue of the Journal of Occupational and Environmental Medicine titled, “Do Workplace Health Promotion (Wellness) Programs Work?” That article also inspired several follow-up discussions and media reports, including one published by New York Times columnists Austin Frakt and Aaron Carroll who answered the above question with: “usually not.”
Four observations about that one paragraph presage Ron’s strategy for Monday.
First, How do you translate Frakt and Carroll saying: “We’ve said it before, many times and in many ways: workplace wellness programs don’t save money” into: “usually not”? Simple, you reference the December “follow-up discussion” by these NYT columnists…but then link to a previous discussion, in September. (Try the link — really.)
Second, our article didn’t “highlight the controversy surrounding” the value of wellness. Our article “highlighted” that pry-poke-and-prod wellness has no value. There is no controversy. We have a proof — now backed with a $1-million reward, in case anyone doesn’t understand the meaning of proof.
Third, Ron writes: “22 authors addressed this” in September 2014. Ron needs to understand that math is not a popularity contest. It doesn’t matter how many wellness vendors want to protect their revenue stream, because the rules of math are strictly enforced. This is a typical Goetzel tactic, sort of like Claude Rains saying: “Owing to the seriousness of this crime we’ve rounded up twice the usual number of suspects.” In any event, two of the non-wellness-vendor authors were horrified to learn that this article had endorsed the Nebraska fraud as a “best practice.”
Finally, he appears to conflate the Journal of Occupational and Environmental Medicine with Health Affairs. The latter is the most respected journal in health policy (impact factor: 4.966), which is why our essay got picked up so broadly. The former is largely a wellness industry mouthpiece with an impact factor of 1.630. Sort of like the old tag line for Hustler: “The Magazine Nobody Quotes.”
What he will try to do is sow doubt, the classic last resort when the facts all go the other way. You saw it from the tobacco industry, and more recently from climate change-deniers. He will bring up all his articles and all his authors and say they are all “peer-reviewed” and say that there is “evidence” on both sides. He’ll use words like “controversy” and “discussion” when in reality it’s settled science (and more importantly, settled math) that prying, poking and prodding employees is nothing more than the Wellness Vendor Full Employment Act, and it’s time to repeal it.