I love Brian Wansink and so was delighted to see his work celebrated quite prominently this past week. That is, I was delighted up to a point.
When I say I love Brian, I mean it quite genuinely, and both personally and professionally. Personally, we are friends. Brian could well have inspired the lyrics of "for he's a jolly good fellow." A good fellow, he most certainly is; and I can't recall ever seeing him other than jolly. In fact, he has the best, most contagious, goofiest laugh I have ever heard (well, with the possible exception of this guy).
Professionally, I am among the many who appreciate Brian's seminal contributions to public health. He is quite literally in a class by himself, since almost all the rest of us attempting to improve public health nutrition are trained in the health sciences. Brian's expertise is in marketing. Uniquely, he took what he was taught about manipulating behavior for profit, and converted it into a portfolio of compelling insights about how to sidestep just such manipulation, and utilize many of the same influences for good. He came over to the light side of the Force, in other words.
His insights are, indeed, unique and compelling. His research is stunningly clever. Overall, his work is relevant, pragmatic, and often brilliant. All of this makes me a fan as well as a friend, something of which Brian is, I am confident, well aware. (Actually, now I know for sure he knows -- because I shared this with him to get his OK before publishing it.)
But along with the well-deserved accolades, it's important to note that Brian is no nutrition expert. I suspect he would be among the first to say so. Training in marketing does not, to my knowledge, include metabolism, or biochemistry; dietetics, or physiology; pathology, or cell biology. Expertise in marketing might allow for unique understanding of how to influence what people choose to do with food, but it requires no expertise in what the foods chosen do to the people. Again, I am saying nothing with which Brian would disagree, so far as I know.
And so we come to it. The exuberant coverage of Brian's worthy work at MotherJones.com emphasized the potential for his efforts to influence food quantity, and seemed equally enthusiastic about highlighting, in word and picture, a relative insouciance about the food quality. The implication was that eating less is the same as eating well.
It is not, and I have a real problem the contention. For one thing, using cues artfully to eat lesser amounts of lousy food results in a diet that is, well: lesser amounts of lousy food.
Why isn't that good enough?
Well, if your only goal is to reach or maintain some particular weight, I suppose it might be. Despite all of the countervailing clamor, weight control truly is more about energy balance- calories in, calories out -- than anything else. Studies show weight loss with lesser amounts of junk, and weight gain with excesses of even good stuff.
But weight is not really what we care about, is it?
Like Brian, I am a father. And I can assure you that what my kids weigh is not my main concern. I want them to be healthy and vital. I want them to live long, and prosper. I want them to have the best possible chance for many years in life, and vibrant life in those years. Healthy people have more fun, and I want my kids -- to have fun. I think every parent does.
The trouble with being cheeky about food choice is that it belies everything we know about the profound influence of dietary pattern on health. Done badly, diet is on the short list of root causes of premature death and chronic disease. Done well, it is the opposite, contributing enormously to good health, and in clinical trials, to the prevention of diabetes, the prevention of myocardial infarctions, forestalling dementia, reversing coronary atherosclerosis, and causing even genes to behave better. If there is evidence that sitting near a window or using smaller dishware can do any of that, I would very much like to see it.
In the Blue Zones, those places around the world where whole populations live the longest and enjoy the best health, they eat well. Their diets are all variations on a common theme, which might reasonably be summarized in Pollanesque fashion as: food, not too much, mostly plants. The idea that Blue Zone blessings might be achieved by eating lesser amounts of junky food is at best a leap of faith, and at worst, a truly ominous boondoggle.
Two final considerations. First, I know of people who have lost over 100 pounds, and improved their health, by doing the very opposite of what is highlighted about Dr. Wansink's work. In other words, these people knew nothing at all about environmental cues or marketing manipulations, and less about how to reverse them, but used expert nutrition guidance to improve the quality of their food choices. One of the many virtues of "better" foods is that they help fill us up on fewer calories, essentially reverse-engineering the peril of foods literally engineered to maximize the calories it takes to feel full, as described so well by Michael Moss. Unlike clever strategies to reduce the portion sizes of junky foods, this approach -- trading up the quality of foods chosen -- actually improves overall diet quality, which in turn is likely to improve health, not just weight.
Second, having taken care of patients for 25 years, I have seen "taste bud rehab" run its course innumerable times. By shifting to more wholesome foods, and taking a little time to acclimate, you come to prefer them. I fully understand Dr. Wansink's reluctance to meditate over a grain of rice, or eat foods he doesn't like. But a considered approach to diet quality need require neither. It's not about eating foods you don't love; it's about coming to love the foods that love you back. Eating well cultivates a taste for eating well, and all the benefits that derive from doing so. The artful control of junk food portions achieves nothing of the sort, and instead potentially propagates the very palate that makes hyper-processed, copiously sweetened and salted foods appealing in the first place.
Frankly, I think the ideal is to combine Brian's fabulous insights about factors that influence what we choose and how much, with a well-informed approach to improving food and diet quality. There is power in both approaches, and that much more in putting them together. There is no need to choose.
When I checked in with Dr. Wansink directly before publishing this, he readily agreed with my contentions, and confirmed all of my suppositions. More importantly, he indicated how committed he is to translating his powerful insights into a movement to help people around the world, referring to the effort as his "Magnum Opus." Please visit SLIMbyDesign.org to learn more.
As fate would have it, I am working on my Magnum Opus, too: an effort to rally a global coalition of diverse experts (including Dr. Wansink) around the core truths and fundamental understanding we have of good nutrition, and put that knowledge to far better use. For more on that, please visit the GLiMMERInitiative.org, and join our True Health Coalition.
Brian's effort to address environments enveloping our food choices aligns beautifully with my own to address universal access to the truth about food, and by extension, true food, within those environments.
As hoped, Brian and I see eye to eye. The factors that influence what people choose to do with food matter, but so too do the foods chosen, and what they do to the people. We need not choose to focus on one of these, and neglect the other.
By juxtaposing Brian's laudable work with the wry suggestion that what foods we apply it to are all but irrelevant, the appreciation for Brian Wansink -- ran alarmingly amok.
-fin
Director, Yale University Prevention Research Center; Griffin Hospital
Editor-in-Chief, Childhood Obesity
President, American College of Lifestyle Medicine
Founder, The GLiMMER Initiative
Author: Disease Proof