Morgan Spurlock Watch

Attacking the Mac

Spurlock writes:

A Big Mac contains 30 grams of fat. Each gram of fat contains 9 calories. 9 x 30 = 270 calories from fat. Since a Big Mac packs 560 calories total, that means that nearly 50 percent of the calories in it are fat calories. That's 20 percent more than recommended. Some 16 percent come from saturated fat, so that's well over the recommended max, too. (p. 81)

Spurlock preforms this kind of breakdown for a number of fastfood items he considers unhealthy.

This is an odd way of going about the USDA dietary recommendations. Note the preceding phrase: dietary recommendations. No one food item will meet all of the USDA's suggestions. They weren't written to be be applied that way. The only way Spurlock's method of criticism would be applicable is if one were to eat a diet of nothing but Big Macs. Most people know better than that.

Save for wry, documentary filmmakers, I guess.

History Lesson

Spurlock writes:

Everybody in the world, in every culture, has known that overeating was bad for you. From the ancient Greeks to the modern age, we have been told to be moderate in our eating. In the Judeo-Christian tradition of which our society was supposedly founded and to which we Americans give so much lip service (pardon the pun), overeating wasn't just bad for you, it was bad, period. As in morally wrong.

[...]

In just the last thirty years, we've trashed those thousands of years of civilized tradition. In our new consume-consume-consume-and-consume-some-more culture, gluttony isn't a sin, it's a virtue. We're encouraged to eat, and eat more, and eat a big dessert on top of that. (p. 17)

This is so sweeping and misguided, it's difficult to know where to start.

First, the idea that "everybody in the world, in every culture" has "known that overating was bad for you" is simply a narrow, myopic, woefully simplistic view of history. It's also largely incorrect. If we were to make the kind of crude generalizations about historical conceptions of gluttony Spurlock makes, history would indicate Spurlock has it backwards.

To the extent that restraint was encouraged, it was due more to the scarcity of food than to health concerns. For a long time, gorging on your food supply simply wasn't prudent, given that it meant you likely wouldn't have anything to eat when winter came. If you were part of a community, gorging meant you were taking more than your share.

But among and within societies where food abounded, indulgence was well-practiced, and well-celebrated. The Romans loved their women curvy, and were famous gluttons. Vasts swaths of Western culture have found girth a sign of wealth and vigor, not sin and illness. Throughout the Middle Ages and the Renaissance, plump women with wide hips and a generous bosom were the epitome of beauty -- Rubens' nudes would have today's BMI-fascists apoplectic. Even as late as the 1800s, artisitc depictions of female beauty were generously proportioned.

Even throughout the first half of the 20th century, the picture of female beauty was round, curvy, and voluptuous -- what we today would probably straddle the overweight-obese threshhold on the BMI. Think Betty Grable, Mae West, or Clara Bow.

Spurlock not only botched his history, he botched the present, too. Contrary to his claim that social perssures today encourage obesity, it's only been in the last 40 years or so that Kate Moss, Twiggy, and Paulina Porzikova became standards of feminine beauty. It's also only in the last 40 years that bulimia and anorexia have become epidemic among teen and adolescent girls and, increasingly, among boys as well. Purging, starving, and scarfing down suppositories aren't exactly sympomatic of teens striving to fit in with a society that encourages gluttony.

Yes, we have more food choices as consumers than we ever have. But the idea that that is somehow indiciative of a licenscious attitude toward gluttony is preposterous. It's the result of our prosperity, and of social changes (more women in the workforce, for example) that call for cheap food quickly prepared.

Fat isn't encouraged today, it's loathed. If fat were chic, diet books wouldn't dominate the bestseller lists. Obesity wouldn't pervade the headlines. And each time I write about obesity, I wouldn't get email from people who tell how they're fine with government intervention into the refrigerator, because they find fat people repulsive, and they're tired of looking at them. L.A. Times reporter David Shaw writes in his book The Pleasure Police:

In recent years, the peasure police, as the pleasure police have gained ascendancy, that message has been no-so-subtly transmogrified from "You can" to "You should" -- or even "You must." More than ever, fat people are shunned and ridiculed, and anyone seen eating a large meal--or just, God forbid, a steak -- is made to feel stupid, if not downright suicidal. If you don't exercise enthusiastically and more or less constantly--if you don't think fitness is next to godliness--you're made to feel like a moral imbecile.

Spurlock seems to confuse the availability and abundance of food with the moral "okay" from society to scarf down as much of it as we can as quickly as we can. That's just not true. Prosperity gives us lots of choices. It doesn't tell us to choose them all. Or only the worst ones.

Today's society treats fat people with contempt. That's why so many of them want to get thin. Atain, it's why diet books do so well (Spurlock's fiancee just released her own vegan diet book on the heels of the popularity of Super Size Me). Of course, diets almost always fail (at a 90-95% clip, by most accounts). And repeatedly trying and failing to diet does much worse things to your health than remaining at a steady weight, even a heavy one. There's some evidence that it isn't being heavy that's unhealthy, it's the constant yo-yo dieting heavy people undertake in response to social pressures to get thin. You could make a good case that all this encouragement aimed at getting fat people thin not only isn't good for them, it may well be killing them.

The one period in history that did embrace the anti-gluttony attitude Spurlock finds "civilized" is Victorian-era England. Robert Clark writes of Victorian prudishness in his biography of James Beard:

"Stoutness, once symbolic of plenty and success, was increasingly viewed as a sign of excess, ill health, sloth, and a lack of self-control. Regulation of the body--through Houdini-like stunts, marathon fasts, and bizarre dietary cults--was a running theme of late Victorian and early-twentieth-century life."

Sound familiar? David Shaw adds:

It is no coincidence that repression of the appetite for food occured at a time when social forces also conspired in the repression of other appetites. In this, Victorians emulated the original Puritans, who insisted that man's appetite--any appetite--was his enemy, an ungodly force to be restrained, controlled and denied; bodily pleasure, whether taken between the lips or between the legs, was to be avoided at all costs.

Shaw also quotes social historian Joan Jacobs Brumberg, who writes in her book Fasting Girls:

Over and over again, in all the popular literature of the Victorian period, good women distances themselves from the act of eating.

[...]

To be hungry, in an sense, was a social faux pas. Denial became a form of moral certitude, and refusal of attractive foods a means of advancing in the moral hierarchy.

Is this really the "civilized" society Spurlock laments has passed us by? Frankly, I'm kinda' glad it's gone.

But I fear it's coming back, thanks to people like Spurlock, and in particular the nutrition activists he relies upon in the endnotes of his book. There's more than a nugget of Victorianism in today's busybodies who work to patrol our personal lives for bad habits. I think we're entering a kind of neo-Victorian age. This new brand of self-righteous piety crosses ideological lines. The left, generally under public health auspices, gets its dander up over issues like obesity and tobacco -- bad habits we typically associated with red-staters. The right, moved by moral outrage, wants to crack down on sexual licentiousness and recreational drug use, stereoytypically more common in blue states and urban areas. Both emphasis piety and restraint or pleasure and satiety. Both want to protect us from ourselves, from what they perceive to be the negative excesses of the pursuit of pleasure.

In fact, you might even say that today's prigs are worse than the Victorians. Today, they're ready to (or already have) used the state to suppress habits they find repugnant. The Victorians at least mostly relied on only shame.

The Big C

Cancer, that is.

Spurlock quotes someone from the "Vanerbilt University Online Wellness Center," who writes:

"According to studies conducted by the American Cancer Society . . .more than 20 percent of all cancer deaths in women and 14 percent in men ar linked directly to being overweight. Another 33 percent of cancer deaths are linked to poor diet and physical inactivity . . . that's a lot of people dying needlessly." (p. 15)

That study from the American Cancer Society made huge news. Most media outlets did just as Spurlock has done -- found someone who had read the executive summary, and quoted him. Few reporters read the actual study (or if they did, they ignored its findings). It's odd how rarely Spurlock cites an actual study. Instead, he usually cites a newspaper's account of the study, or something he found online, such as the Vanderbilt Online Wellness Center.

If he had looked at the actual data , he'd have found some pretty striking contradictions. For example, the study found that among people the government classifies as of "healthy weight," there were 4.5 cancer deaths per 1,000 people. But get this: Among people the government classifies as "overweight," there were only 4.4! If you're worried about cancer, it's actually healthier to be overweight than of "healthy" weight. Paul Campos and others have also pointed out that the study's data shows that women who are extremely obese actually have a lower risk of cancer than men who are underweight. As the Center for Consumer Freedom has put it, if risk from fat is our barometer, Roseanne Barr is at lower risk of cancer than David Spade. The study also concedes that being overweight actually helps prevent brain cancer, leukemia, lung cancer, and melanoma.

Here's what the study did: Among the extremely obese, deaths from cancer increase prett significantly. Incidence is higher, but deaths are also higher -- probably because cancer is more difficult to detect and treat in the very obese. In any case, in drawing its conclusion (the conclusion carried by most of the media), the study merely lumped the very high rates among the very obese in with the rates of the obese and overweight. It then compared the aggregate rates of those with the aggregate rates of those of "healthy" weight and the underweight. The former was higher. Therefore, we were told, being overweight puts us at greater risk of cancer. But the vast majority of Americans aren't obese, or very obese. They're merely overweight by government standards. And they aren't at greater risk for cancer, they're actually slightly at less risk.

This is how the public healty hysteria industry works.

There were data collection problems, too. The study was based on surveys. Researchers asked people how much they weighed at the time, and asked them to remember how much they weighed a year ago. The study was based on their answers, not on actual medical records. When the New England Journal of Medicine published the study, it actually published an accompanying editorial expressing reservations about the study's conclusions. Most media outlets went with the study's summary, ignoring its data tables and the accompanying editorial.

Moving on, Spurlock writes:

Specifically, diet and obesity have been linked to increased risk for breast, colon, endometrial, esophageal, and kidney cancer., (p. 15)

Linked by whom? Deaths from every one of those types of cancer is down over the last fifteen years, the very period over which we've been allegedly getting obese. In fact, of the ten types of cancer nutrition activists tell us are most strongly linked to obesity, deaths from nine of them are down (breast, kidney, gall bladder, stomach, ovarian, cervical, prostate, colon, and pancreatic). Only esophogeal cancer has gone up. See a few handy charts and graphs I made here.

In fact, deaths and incidence of cancer in general have dropped every year for the last fifteen years. And this, while we've all been getting fatter. Pretty strong correlative evidence that obesity isn't going to drive up our cancer rates.

My favorite part of Spurlock's passage on cancer comes here:

Diets high in animal fat seem to promote cancer and inhibit recovery from things like breast and colon cancer.

Where do people eat high-fiber, plant-based diets? The nonindustrial world, that's where. Where do people eat too much meat and fat? Guess.

Again, Spurlock longs for a culture more like those areas of the world untouched by capitalism. Have a look at this table. There are three columns. One is the name of the country. One is per capita GDP, a good indicator of a given country's "industrialization." And one is life expectancy, a good indicator of a country's overall well-being. I'm sure you can guess where the correlation lies. Big GDP equals long life expectancy. Small GDP equals early death.

Fast food and all, the people of the industrial world live about 25 to 30 years longer than the people of the non-industrialized world. There's no comparison. Progress and industry have bettered and lengthened our lives.

400,000

Spurlock writes:

Fat is deadly. Obesity-related illnesses will kill around 400,000 Americans this year--almost the same as smoking. (p. 13)

Spurlock comes back to the "400,000" figure, and the "second leading cause of death" idea several times in the book. Both are wrong.

Last April, the CDC released a report confirming what critics of the obesity hysteria have been saying for some time -- that 400,000 figure (revised from a similar 300,000 figure a decade ago) is a gross overestimation. The real number is closer to 100,000. And if you add in the lives saved by the protective effects of mild overweight, the number is closer to 25,000. Meaning that:

(A) The number Spurlock quotes here is off by a factor of fifteen.

(B) Those statistics about how many Americans are "overweight" by government standards don't mean a damned thing. Overweight is actually healthier than what the government says is the "ideal" weight. And overweight is much healthier than what the government calls "underweight."

Predictably, bureaucratic politics and turf wars are now at play. The CDC has been slow to embrace the new study, despite the fact that the agency commissioned it. The reason? The CDC's director was a co-author of the old study. There's some evidence now that the old study's flaws were known before it was ever released, but power politics trumped objections raised by other researchers during the peer-review process.

The New York Times, Forbes, Batimore Sun, USA Today, Rocky Mountain News, and Des Moines Register, among others, all slammed the CDC for letting politics trump good science. Several editorial boards and pundits (including yours truly) called on CDC director Julie Gerberding to resign.

In any case, these developments are a fine example of why it isn't wise to take every health scare pushed by the government at face value. When a study comes out that was funded by Philip Morris, people tend to read it with a good deal of skepticism. Perhaps that's appropriate. But perhaps it's time we looked at government studies the same way. They're plagued by the same biases, motivations, and slants that plague any privately-funded health research.

The new study came out about a month before Spurlock's book was published. So perhaps we should cut him some slack. My guess is that the book was already in printing when the new study came out. I'll look for a correction in the paperback edition.

On the other hand, it wasn't hard to find critics of the 400,000 study. if Spurlock had been the slightest bit curious about opposing viewpoints, he would have found enough criticism of the 400,000 number to at least have acknowledged in his book that the number isn't without its detractors. In fact, the CDC itself lowered figure to 365,000 early last year in response to many of those critics. That correction took place long enough ago that Spurlock has no excuse for going with the higher, 400,000 figure.

Poor People Don't Eat Artichokes

Spurlock writes:

The USDA reports that the cost of vegetables and fruit rose 120 percent between 1985 and 2000, while the price of junk like sodas and sweets went up less than 50 percent on average (p. 12)

This may be true, I'm not sure. Spurlock's source is a 2004 Seattle Post-Intelligencier article, and the reporter gives no specific source for the claim, other than the tag "according to the USDA."

Spurlock uses this same S-I article a number of times, but never bothers to doublecheck its assertions. He could have at least cheked with the USDA to verify.

If he had, he'd know that the USDA did commission a highly-publicized study on how much it would cost for the average person to get his full daily requirement of fruits and vegetables.

The answer? Sixty-four cents. Or, about twelve percent of the average American's food budget. There are "127 different ways to eat a serving of fruits and vegetables for less than the price of a 3-ounce candy bar," the study says. The notion that processed food is cheaper than fresh food was dismissed by the study, too: "Researchers found that nearly two-thirds of the fruits and vegetables studied were cheapest in their fresh form."

In fact, according to the USDA, per capita fresh fruit and vegetable consumption has gone up by 20% since the 1970s!

I know what you're thinking. "Doesn't the government count the potato as a vegetable? Isn't most of that increase probably due to french fries and potato chips?"

Actually, no. Check out this table from the USDA (from this report). Potato consumption is included in the "frozen" statisitics, not the fresh (as you might imagine, it is up, by about 21 pounds per year).

This makes sense. Revolutionary improvements in agriculture, shipping, and preserving fresh foods, together with a rapidly growing economy (there's all that awful "consumption" again), have created a market for diverse, fresh produce, and a means of satisfying it.

Typically, nutrition activists' response to this is to point out how hard it is for low-income people to access fresh fruits and vegetables. Indeed, that's Spurlock's next paragraph. He points out that low-income areas are often dotted with fast food joints and convenience stores, but few if any outlets for fresh produce.

Here, he's right. And I sympathize. But I have a solution: We have business models that can deliver good food at low cost to low-income people. They do it by stocking huge inventories at very small mark-ups, and by cutting costs just about everywhere they can. They're called big box stores, and they've been doing it all over the country, except in urban areas. The best in the business is Wal-Mart.

The problem is, every time Wal-Mart attempts to open a Superstore (the Superstores carry a full line of groceries, including fresh produce) in an urban area, it's people like Spurlock and his nutrition activist allies who raise holy hell to prevent it from happening. We've seen it happen in Chicago, Los Angeles, New York, and here in Washington, D.C.

People like Spurlock want low-income people to have access to fresh, preferably organic, cheap, diverse produce, but only if the means for delivering said produce isn't evil Big Box Retail. Sorry, but that's asking too much.

One nutrition activist I debated a few months ago had an interesting solution -- communism! Or at least a localized application of communism. Her comments on artichokes are particularly amusing.

UPDATE: In the comments section, Evan Williams says there's too much guilt by association in this post. He's probably right. But a subsequent commenter passes along this link, in which Spurlock expresses the very opinion of Wal-Mart I suspected he might. Williams is still probably right. But the post is ultimately right, too.

Income, Race, and Obesity

Spurlock writes:

But like so many health issues in this country (smoking, for one example), [obesity] has the worst impact among poor Americans, especially African Americans and Hispanic Americans. (p. 11)

Lots to address in so short a passage. First, a big reason why the poor disproportionately smoke is because local, state, and the federal government have levied excise taxes on cigarettes, a policy Spurlock and his ilk generally support. According to the Congressional Budget Office, such taxes do encourage people to quit, but the people who do quit tend to be higher-income, leaving a greater percentage of smokers in lower income brackets. Government efforts to discourage smoking, then, don't alleviate the black-white, rich-poor smoking gap, they make it worse.

As for the "obesity gap" between rich and poor, it simply isn't true, particularly over the last thirty years. It is upper income people who have gained the most weight since the mid-1970s. This data from a University of Iowa study released just about a month ago:

Percent Increase in Obesity Rates Since 1971:

Less than $25,000: increase of 144%

$25,000-$40,000: increase of 194%

$40,000-$60,000: increase of 209%

More than $60,000: increase of 276%

Obesity rates are similar across all income groups now, with the poorest quarter just 5.7% more obese than the richest.

Also, don't forget that this information comes from government surveys, which use BMI. So view eventthese statistics through your BMI BS-o-meter.

As for differences with respect to race, Paul Campos has pointed out that epidemiology tables show African Americans and Hispanics (particularly women) tend to be healthier at a weight 10-15 pounds heavier than white women. There are also cultural differences at play here that have nothing to do with evil Big Food. Black men, for example, don't put the premium on thinness in women that white men do. So black women tend to be heavier. As Campos notes:

Several studies have suggested that African American and Hispanic girls tend to have much more positive body images than white girls. For example, one University of Arizona study found that, while only 10% of the white teenage girls surveyed were happy with their bodies, 70% of the black teenage girls were happy with theirs (the black girls weighed more, on average, than the white girls). Is it a coincidence that black women are both far less obsessed with weight than white women, and seem to suffer no significant ill health effects from even extreme levels of fatness? Researchers have been unable to find a relationship between increased mortality and body mass even among African American women who are classified as “morbidly obese.”

Drawing Campos out a bit, to the extent that there is an emerging obesity gap on racial lines, it doesn't appear to be affecting mortality rates. Black men are closing the gap with white men when it comes to life expectancy, and black women are closing the gap with white women. All the while, however, blacks are getting disproporationately heavier than whites.

That's at least suggestive that obesity isn't the death-knell people like Spurlock have made it out to be, isn't it?

Kids and Fat

Spurlock writes:

Sixteen percent of American kids are now overweight or obese. As of September 2004, nine million American kids between the age of six and eighteen were obese. Kids are starting to clock in as obese as early as the age of two.

This is a complicated issue, but the gist of my complaint here is that there's no reliable way to measure "average" or "ideal" weight in kids. The statistics Spurlock cites use data from decades-old insurance tables. On those tables, arbitrary cutoffs along percentile lines classified this kid or that kid as "overweight" or "obese" -- kids in the 90th percentile, for example, were automatically considered dangerously overweight. Today, researchers still use those same tables, weights, and cutoffs from decades ago, but simply plug in the weights of today's kids against percentile cutoffs set decades ago. Since today's kids are maturing at earlier ages than kids of twenty or thirty years ago, they're naturally going to be heavier at earlier ages. Weighed against those older tables, then, today's kids are going to look fat.

I wrote the foreword to a forthcoming research paper by Dr. Paul Robison that covers this very issue (it'll be released on Monday). The meat of the paper: There's no real evidence that today's kids are dangerously overweight. There's no evidence that the weight most of them are carrying is unhealthy. And there's no real evidence that curbing marketing and advertising or access to junk food will help them lose whatever extra weight they are carrying. I'll post a link to the paper when it's released next week.

And as regular readers of my blog know by now, today's adolescent or teen is still 200-700 times more likely to have anorexia or bulimia than to have Type II Diabetes. So all of this focus on weight and food with respect to kids is probably doing a hell of a lot more harm than good.