A Coke Fueled Controversy
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A not so new relationship
The Times writes: “In response to a request made under the state Freedom of Information Act, the University of South Carolina disclosed that Dr. Blair had received more than $3.5 million in funding from Coke for research projects since 2008.” Dr. Blair has not worked at The Cooper Institute since 2006.

The journal PLOS Medicine published an analysis of beverage studies not long ago that found the ones funded by the sugar industry, the American Beverage Association, and the major soda companies were five times more likely to find no link between sugary drinks and weight gain than studies that avoid potential financial conflicts.

In one video, Dr. Blair appears on camera stating, “Most of the focus in the popular media and in the scientific press is, ‘Oh they’re eating too much, eating too much, eating too much’—blaming fast food, blaming sugary drinks and so on. And there’s really virtually no compelling evidence that that, in fact, is the cause.”

The issue here is partly one of selective reportage. The relationship between diet, exercise and maintaining a healthy body weight is indeed nuanced. For example, it seems every other month there is a new argument for low-carb diets overturned by yet newer evidence that low-fat diets are more effective, and vice versa. What we do know is that in the real world, a diet that an individual finds pleasant enough to adhere to is probably best.

But there is also mounting evidence that exercise may not contribute to weight loss as much as restricting calories, for several reasons. (Exercise increases appetite, to name just one, making it too easy for even very active people to over-consume calories.) To leave off this fact is to turn a blind eye to what is increasingly thought of as established science.

We also now understand that dieting alone can cause the metabolism to slow down—starvation diets don’t work, and ultimately result in binging after willpower gives way to ravenousness. A two-pronged strategy of calorie cutting and exercise is therefore important; and certain types of foods (such as those high in fiber) can make the calorie cutting side easier than, say, eating lots of refined carbohydrates.

Fats need to be consumed sparingly, as they are easy to overeat since they contain almost double the calories per gram as carbohydrates and protein. Yet because they are so filling, there is evidence that healthy ones like nuts can stabilize or even lower caloric intake, when eaten mindfully.

By downplaying these dietary factors and focusing entirely on exercise as the single biggest determinant of weight management, the GEBN muddies already murky waters that the public needs every assistance in clarifying.

Exercise and diet together
What we know from the decades-old Blair et al. meta-analyses of exercise and mortality rates is that age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men. Similar patterns were seen in women.

Yet people who exercise are perhaps more likely to also eat healthier. Blair’s data controlled for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, and parental history of coronary heart disease; it says little about what the subjects were eating.

It does appear that when a body moves regularly, a kind of system maintenance occurs that could indeed facilitate other healthy behaviors (dietary choices, as well as the efficient workings of all the body’s internal mechanisms). This is what Stanford University geriatrician Walter Bortz II, MD, refers to as “the oboe’s A.” He refers to exercise as rather being like the note that sets the orchestra (the body’s main systems) into finely tuned synchronization at the start of a concert, and keeps them playing smoothly with each other. The heart, brain, thyroid and more all “hear” the tone of exercise and harmonize in health.

A tone problem?
No doubt exercise is extremely important. It can not only maintain health but reverse some of the damage done by an unhealthy lifestyle. According to a new meta-analysis of six randomized trials published in Pediatrics, exercise training can help improve vascular function in overweight and obese youth.

Still, the tone that the GEBN has struck in news releases and on its website seems to lean toward the extreme: “The media tends to blame the obesity epidemic on our poor eating habits. But are those French fries really the culprit? Dr. Steve Blair explains that you shouldn’t believe everything you see on TV.”

Yes, those French fries are—partially at least—the culprit. And so such statements ultimately better serve the corporations producing the world’s least healthy foods than they do the public—or Dr. Blair’s legacy as a brilliant researcher who has contributed truly important work.

In a personal correspondence, Cooper Institute founder Dr. Kenneth H. Cooper said, “Cooper believes that both obesity and inactivity are challenging issues/problems our country is facing. Exercise is a large part of resolving the problem but is not the sole solution. We believe in moderation, and I have developed eight specific steps that when practiced habitually will help you stay healthy for a longer amount of time.”

Of those eight steps, the second one is making healthy dietary choices: “Eat healthy most of the time,” they write on their website. The Cooper Institute suggests eating healthy 80% of the time and “have that cookie the other 20% of the time.”

They add, “Eat more fruits and vegetables daily. There is an adage, ‘Five is fine, but nine is divine,’” referring to daily one-half-cup servings. “Research shows that by doing this, you can lower your blood pressure and cholesterol and are at a lower risk of stroke, heart failure, osteoporosis and kidney stones.”

The other seven steps are:

  • Maintain a healthy weight
  • Exercise most days of the week
  • Take the right supplements for you (such as a good multivitamin)
  • Stop smoking
  • Control alcohol
  • Manage your stress
  • Get a regular, comprehensive physical exam

In other words, a balanced, comprehensive approach. 

Global Energy Balance Network, https://gebn.org/

JAMA, 1989, Vol. 262, No. 17, pp. 2395-2401

Pediatrics, Aug. 2015, http://pediatrics.aappublications.org/content/early/2015/08/05/peds.2015-0616

The New York Times, Aug. 9, 2015, http://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-scientists-who-shift-blame-for-obesity-away-from-bad-diets/?ref=health&_r=0

Cooper Aerobics, “8 Healthy Steps,” http://cooperaerobics.com/Health-Tips/8-Healthy-Steps.aspx

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