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" On New Year&amp;#039;s Day last year, one of the biggest celebrity catfights of all time broke out\u2014if you follow high-profile epidemiolo\u00ADgists, that is. The Journal of the American Medical Association published a Centers for Disease Control (CDC) \u00ADmeta-analysis of 97 studies, suggesting that \u00ADpeople who are overweight by government BMI standards (though not obese) live \u00ADlongest. That&amp;#039;s right, fat people live longer. The results were counter\u00ADintuitive but not \u00ADreally &amp;quot;new news&amp;quot; in the world of nutrition; a meta-analysis is, by definition, a statistical summary of already-published research. The paper&amp;#039;s tone was matter-of-fact, the verbiage dry. The authors didn&amp;#039;t call people who toiled to stay trim \u00AD&amp;quot;suckers&amp;quot; nor suggest that we storm Cinnabon to pack on a few. But in response, scientists at \u00ADHarvard&amp;#039;s School of Public Health went, to use the scientific term, cuckoo for Cocoa Puffs. As the intellectual leaders in the war on \u00ADobesity, they railed against the study at academic meetings, organized a \u00ADsymposium to denounce it (at which they reportedly considered placing a Clint Eastwood\u2013style empty chair on the dais to represent the study&amp;#039;s lead author, Katherine \u00ADFlegal, who&amp;#039;d declined to join them), and by one account a pro-Harvard propagandist passed out anti-Flegal pamphlets at a lecture she gave\u2014a tactic usually reserved for ugly political campaigns. Heading the negative-ops team was Walter Willett, MD, chair of Harvard&amp;#039;s nutrition department, who presides over the famed Nurses&amp;#039; Health Studies and is considered the grandfather of modern \u00ADnutrition epidemiology. &amp;quot;This study is \u00ADreally a pile of rubbish,&amp;quot; he told National Public Radio, &amp;quot;and no one should waste time reading it.&amp;quot; Related: Karlie Kloss on How to Work Out While Traveling In person, Willett is charming. With a bushy white mustache and twinkling blue eyes, and wearing a gray-blue Mr. Rogers\u2013style cardigan the day I meet him at his Harvard School of Public Health office, a year after his \u00ADbattle royale with Flegal, he hardly seems the type to eviscerate his foes. I&amp;#039;m enjoying his company because he coauthored a book coming out this month, Thin\u00ADfluence. But his \u00ADaffable mien disguises sharp \u00ADelbows. Even \u00ADafter having a year to cool off, he stands by his &amp;quot;rubbish&amp;quot; \u00ADremark. &amp;quot;I think it is complete rubbish,&amp;quot; he confirms, somewhat gleefully. He goes on to character\u00ADize a recent meta-\u00ADanalysis published in the Annals of Internal Medicine that found no link \u00ADbetween \u00ADhigher consumption of saturated fat and heart disease as &amp;quot;a disaster on the order of Flegal.&amp;quot; He&amp;#039;d \u00ADalready written a critical commentary for the \u00ADAnnals, but as he discussed the flaws he saw in the work, he mused, &amp;quot;I think I&amp;#039;m going to write another [one].&amp;quot; There&amp;#039;s always a flood of nitpickers when a high-visibility journal runs a juicy study from a bigwig scientist like Flegal, who was among the CDC epidemiologists who &amp;quot;discovered&amp;quot; the obesity epidemic in 1994. After all, one of the points of publishing studies is to open up findings to competing ideas and data. And the Harvard group&amp;#039;s \u00ADcritiques of \u00ADFlegal&amp;#039;s work weren&amp;#039;t beyond the pale: They didn&amp;#039;t feel she&amp;#039;d corrected ade\u00ADquately for the effects on the data of smoking, illness, and age, for instance. Related: 6 Healthy Recipe Alternatives for Your Favorite Summer Dishes and Drinks Harvard&amp;#039;s own analyses, using the Nurses&amp;#039; Health and Health \u00ADProfessionals Follow-Up Studies, had repeatedly demonstrated that the thin\u2014and in some cases, the very thin\u2014enjoy the greatest longevity. Flegal&amp;#039;s \u00ADmeta-analysis (which, by the way, included the Harvard \u00ADstudies) showed, by contrast, that people with a BMI between 25 and 30, considered overweight by \u00ADgovernment standards, enjoy the lowest mortality rate; for a 5&amp;#039;4&amp;quot; \u00ADwoman, for instance, that&amp;#039;s between 146 and 174 pounds. An earlier Willett-coauthored meta-\u00ADanalysis of 19 studies had identified the optimal BMI as between 20 and 25, or 117 to 145 pounds for a 5&amp;#039;4&amp;quot; woman; and in a 1995 study based on just the Nurses&amp;#039; Health data, the Harvard team found the greatest longevity at a BMI below 19, which would put our 5&amp;#039;4&amp;quot; woman under 110 pounds\u2014\u00ADborderline anorexic. Underlying this altercation was a disagreement about the best use of data. Willett starts with a socio\u00ADeconomically homogenous subject pool and then further cleanses it to eliminate those who might confound the results. The goal is to isolate weight and mortality as much as possible from other factors associated with death (low income or \u00ADeducation, smoking, illness, etc.). The CDC crew, on the other hand, works from a more inclusive data set and then employs statistical techniques to correct for confounders. This, they believe, yields the most widely applicable results. Flegal, who spoke with me between lectures she was giving at, ironically, Harvard (and who is a charming and witty raconteur in her own right\u2014it seems a shame that she and Willett can&amp;#039;t be pals; they&amp;#039;re both so fun), sees their work as apples and oranges. &amp;quot;I don&amp;#039;t see this as a clear disagreement. I&amp;#039;m puzzled by [their response].&amp;quot; She thinks she&amp;#039;s pointing out that the elephant is gray, and Willett is arguing that it&amp;#039;s large\u2014both can be true. The CDC and Harvard have different aims in mind when they do studies: Flegal says she looks at her \u00ADstudies as simply &amp;quot;information. What you see is what you get. We&amp;#039;re not policy \u00ADmakers, and policy is not based on one meta-analysis.&amp;quot; Willett, however, is a doctor and sees his role as more prescriptive. Flegal wants to document the world; Willett wants to change it. Further, nobody was arguing \u00ADthat \u00ADbeing fat is a boon to one&amp;#039;s health. The hypo\u00ADtheses that scientists offered to explain why the CDC finding might be true are hardly enticements to pig out: Though being heavier makes you more likely to contract chronic conditions such as diabetes, cancer, and heart disease, it may also provide extra nutritional reserves to keep you from wasting away if and when those illnesses strike; overweight people may not become as frail as they age; moreover, BMI doesn&amp;#039;t define an individual&amp;#039;s health (e.g., very muscular people may have &amp;quot;overweight&amp;quot; BMIs). And the disputed differences in mortality risk will seem minor to anyone outside epidemiology: &amp;quot;The mortality rate is very low for young women,&amp;quot; \u00ADFlegal says. (According to the World Bank, the death rate for American women age 15 to 60 was a little under 8 percent in 2010.) Increasing or decreasing that number by a small amount still leaves the risk minimal. &amp;quot;It&amp;#039;s not statistically meaningless, but it&amp;#039;s relatively insignificant for the \u00ADaverage woman,&amp;quot; Flegal concludes. It wasn&amp;#039;t the hairsplitting that was so unusual in this case\u2014epidemiology is one of the messier sciences\u2014but the relentless, censorious nature of Willett&amp;#039;s opposition. He said that he was only thinking of the public good when he went after Flegal&amp;#039;s study\u2014that he felt her information was misleading and might harm public health. &amp;quot;It generates confusion [among laypeople],&amp;quot; he says. &amp;quot;And if you&amp;#039;re confused, it takes away a lot of the motivation to do things that would lead to a healthier choice.&amp;quot; He also sees darker forces at work. &amp;quot;There are lots of powers that would like to exploit inconsistencies to discredit science. Obviously, the food industry likes to say there&amp;#039;s an obesity myth\u2026. A lot of researchers have worked really hard to get answers that are as accurate as possible. And then to have someone undercut that effort and essentially dismiss it!&amp;quot; Related:  I Got DNA Tested to Determine My Skin Care Regimen  But the constant revision of &amp;quot;truth&amp;quot; is central to the scientific process, as the country&amp;#039;s top science magazine, Nature, suggested in a commentary rebuking Willett in May 2013. You can&amp;#039;t tell \u00ADpeople not to read a study just because you don&amp;#039;t think the results are good for them. &amp;quot;We&amp;#039;re scientists. We pay attention to data, we don&amp;#039;t try to &amp;#039;unexplain&amp;#039; them,&amp;quot; University of Colorado endocrinologist Robert Eckel told Nature. And as one \u00ADresearcher said to me, if the price for publishing data that contradicts established beliefs is character assassination, fewer academics will be willing to stick out their necks and offer up fresh thinking. There is one way, however, in which many of us might sympathize with \u00ADWillett: in his frustration with misinformation in general. On the season-four premiere of the IFC sketch show Portlandia, Kirsten Dunst is haunted by the ghosts of a \u00ADcouple who died of &amp;quot;confusion&amp;quot; after &amp;quot;not knowing which things were good or bad for them.&amp;quot; The haunting involves harassing Dunst with conflicting information about electrolytes, stretching, and sleep until she jumps out of a second-\u00ADstory window. If you&amp;#039;ve tried to keep up with both the pseudoscience of popular-diet gurus and the actual science that&amp;#039;s unfolded over the past 30 years, you probably want to jump out a window too. Related:  14 Ways to Get Bikini-Ready in 24 Hours  In the beginning, there was the low-fat dictum, which was revised to: cut out saturated fats but encourage vegetable fats\u2014unless your vegetable fats are trans fats, in which case they&amp;#039;re killing you. Oh, but while you&amp;#039;re eliminating butter, make sure you don&amp;#039;t add in too many \u00ADrefined carbs\u2014toss out those Snackwell&amp;#039;s! Sugar will kill you. Actually, maybe all carbs are the problem\u2014including fruit. Double up on your breakfast sausage, but drop the Wheaties. After all, \u00ADhumans were never designed to eat agricultural products. We&amp;#039;re hunter-gatherers: We should be eating wild game and greens. Nothing processed! What would possess you to eat sausage?!??! Fill up your plate with dandelion greens and elk. But wait! Actually, scratch the elk. Cut out meat. Meat will kill you. Except for fish. No, wait, fish is too high in mercury, and the seas are overfished. Okay, okay, you can eat small, stinky fish like anchovies and maybe a little chicken and eggs (as long as they&amp;#039;re humanely raised by a \u00ADlocal \u00ADfarmer with whom you are on a first-name basis), but you&amp;#039;d \u00ADbetter chuck dairy. It&amp;#039;s full of growth hormones that are giving seven-year-olds pubic hair. Unless you get organic, grass-fed, raw milk. But just know that raw milk can kill you. Actually, you know what? Go vegan. Go raw vegan. Go on a detox fast. Juice all your food. No, wait\u2014juice is too high in sugar. Get a Vitamix and make a breakfast smoothie out of avocados, foraged mushrooms, and kale. Gwyneth Paltrow&amp;#039;s kids love it! Wait! Stop! Put that down! Liquid calories are causing the diabetes epidemic. So just eat vegetables, fruits, beans, olive oil, anchovies, chicken, eggs, plain yogurt, sea vegetables, and whole grains. Except brown rice. There&amp;#039;s arsenic in it. Arsenic will kill you. And, obviously, don&amp;#039;t eat \u00ADgluten. Have a little wine with dinner, unless you care about getting breast cancer\u2014in which case, stop boozing and become vegan (you know, we already told you to go vegan\u2014pay \u00ADattention!). But go easy on the soy. Because it can kill you. Got that? National-security types who listen in on terrorist groups brace for something big when &amp;quot;chatter&amp;quot; increases. The year of bad blood between Harvard and the CDC has been a chatter-filled one in the weight-management world. Last summer, the American Medical Association declared obesity a disease, defying one of its own internal committees. The AMA&amp;#039;s \u00ADstated intention was to get \u00ADmembers to pay more attention to \u00ADpatients&amp;#039; weight, but opponents argued that the move would just bolster the diet industry, which already takes us for more than $20 billion per year. But those on the other \u00ADother side counter that to forfeit the war on obesity is to surrender to the processed-food \u00ADindustry (soft drinks alone are a $65 billion business). The culmination of all this chatter? It&amp;#039;s pretty anticlimactic. Almost as though all parties agreed not to detonate any more bombs, the slew of weight-loss books headed to shelves this summer has a milder, less hyperbolic cast than usual. There are no extreme Dukan-alikes, and the Paleo crowd seems to be hibernating. Is it possible that after much to-do about many things, we&amp;#039;ve reached the end of \u00ADdieting&amp;#039;s \u00ADbaroque period and the start of an age of enlightenment? You may be surprised to hear that one of those sensible &amp;quot;just do your best&amp;quot; books is Willett&amp;#039;s Thinfluence. He and his coauthors ask readers to construct their lives so that healthier choices come more naturally\u2014but there&amp;#039;s only one short sidebar in the entire 200-plus-page book that tells you what to eat. Moreover, Thinfluence doesn&amp;#039;t recommend a specific BMI, and many of its success stories feature people who got in shape and dropped pounds but are still overweight, BMI-wise. One thing is for sure: Willett is more generous toward the dieting public, at least these days, than toward his scientific adver\u00ADsaries. Past efforts to help Americans lose weight have neglected &amp;quot;the standpoint of the person who is in the middle [of all these negative dietary influences] looking out,&amp;quot; he says. While he believes that people have a responsibility to eat healthier and to exercise, he knows that can be an enormous challenge in the land of plenty. Related:  11 Ways to Rev Up Your Metabolism  Several other books make similarly measured, realistic arguments. In The Obesity Paradox, New Orleans cardiologist Carl J. Lavie, MD, tackles the Flegal-Willett imbroglio head-on and explains why he thinks both are right. (Though Willett&amp;#039;s hackles were raised by the title, Lavie could&amp;#039;ve called his book Can&amp;#039;t We All Just Get Along?) He points out that \u00ADnumerous studies of the chronically ill find that those who start out bigger live longer. He also shows that while being overweight is associated with illness, you can be fat but fit, as well as skinny but metabolically unhealthy (with high blood \u00ADpressure, blood sugar, and triglycerides, plus low &amp;quot;good&amp;quot; HDL choles\u00ADterol). He calls the \u00ADlatter TOFIs\u2014thin on the outside, fat on the inside. In The Diet Fix, Yoni Freedhoff, MD, a weight-management expert from Canada (you just know he&amp;#039;s going to be moderate, eh?), lays out his own ingeniously simple behavioral plan, inspired by the National Weight Control Registry, which tracks more than 10,000 people who&amp;#039;ve lost at least 30 pounds and kept them off for a year or more: Measure what you eat and write it down; eat breakfast and frequent, small meals; avoid processed foods and cook from whole ingredients; exercise daily. As for the all the food fights\u2014Atkins versus Paleo versus Mediterranean versus Ornish\u2014he says he doesn&amp;#039;t care how people shed pounds, because it just doesn&amp;#039;t seem to matter for successful losers. &amp;quot;Even if there were one diet proven to be head and shoulders above all others, you still wouldn&amp;#039;t prescribe it to every single person,&amp;quot; he says. &amp;quot;Because unless you like that diet, you&amp;#039;re not going to stick to it.&amp;quot; When I met with Willett, we talked about bias\u2014how our own sphere of influence can skew our vision; Willett says that he can forget that people still smoke, for example, because the whole area around the school of public health where he works is a smoke-free zone. Related:  What Happens When No One Knows What&amp;#039;s Wrong with You  I grew up in the same milieu in which Willett operates. My family lived in the Boston area, and my mother works in nutrition research at a Harvard-affiliated hospital (though never with Willett). She steered my brother and me away from margarine and other trans-fat foods long before the term had entered the public consciousness. Unless we were having a party, I don&amp;#039;t think we ever had a bottle of soda or a bag of Doritos in the house (much to my teenaged chagrin), and now that I&amp;#039;m an adult, it wouldn&amp;#039;t occur to me to stock those items either. As you might guess, Willett&amp;#039;s household is even more nutritionally beyond reproach. Forget about soda\u2014he and his wife, Gail, a former nurse, don&amp;#039;t have so much as a grass-fed burger in the fridge. Though she&amp;#039;s given over her career to teaching healthy cooking techniques, Gail has said Walt still gives her a hard time when she occasionally orders lamb at a restaurant. When I mention this, he admits it&amp;#039;s true, pleading, &amp;quot;I just have to think, Isn&amp;#039;t there an alternative?&amp;quot; And when I ask if he really never eats red meat, he squirms in his chair, visibly grossed out just thinking about it. &amp;quot;I no longer have a taste for it,&amp;quot; he says. &amp;quot;The thought of it isn&amp;#039;t actually appealing.&amp;quot; Given the chasm between Willett&amp;#039;s \u00ADreality and that of the country at large, it&amp;#039;s easy to imagine how he might consider anyone who&amp;#039;d minimize weight&amp;#039;s harmful effects as insane\u2014nearly criminal. &amp;quot;I think a lot of people have never known what it is to be fit and feel better,&amp;quot; he says, so when faced with a bowl of ice cream\u2014which, after all, is a pleasure\u2014they think, Why not? They can&amp;#039;t count on Willett to offer alternatives. He&amp;#039;s not daunted, he says, by people who think he&amp;#039;s a crank, nor by the vastness of the obesity problem. In fact, he says via e-mail that he has a paper coming out soon showing that the American diet is improving, which he attributes largely to his group&amp;#039;s research on trans fats. &amp;quot;Fortunately, epidemiologists are patient,&amp;quot; he says. &amp;quot;I think we can make progress, despite many powerful interests working against us.&amp;quot; "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.elle.com/beauty/health-fitness/advice/a14630/american-obesity-crisis/>