Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine

by Robert H. Lustig

Nutritional epidemiology is fraught with controversy. Recently, there have been calls to curtail nutritional research because it is hard to do properly. For most nutrients, patient recall is the only method for estimating consumption, and people forget, especially about items that they think aren’t good for them. Furthermore, analysis of data is always suspect since correlation is not causation. In order to determine causation in research, you need one of two kinds of studies. The first is called randomized controlled trials (RCTs; this is the gold standard for drug evaluation), but nutritional studies can’t be controlled very easily, because with prospective (following patients over time) studies it’s hard to alter people’s diets for any length of time. When one nutrient goes up (e.g., carbohydrate), another goes down (e.g., fat).