Q&A: The Atlantic’s James Hamblin
Dr. James Hamblin has a knack for making health information entertaining, but I wanted to have a serious conversation with him. As a senior editor at The Atlantic, he writes about behavioral health, culture, and preventive medicine. But at the Whole Grains: Breaking Barriers conference in November, Hamblin shared his insights about popular nutrition writing and the pitfalls of pseudo-science.
Here, his thoughts on eating by algorithm, the pursuit of going gluten-free, and why we should go easy on the almonds.
You once wrote, “I hope people don’t give up on nutrition science, because there is a sense that no one agrees on anything.” Another speaker at this conference said researchers should use the conditional when speaking because eventually their ideas “will be put in the trash.” How much confidence can we put in nutrition science?
We know a ton. But it’s fun to quibble over the nuances, like how much dairy is allowable. Which inevitably turns into, “Is milk killing us?” and “Should we be drinking no milk at all?” It’s good not to look at seemingly contradictory studies as a lack of progress when everything is constantly building on its own toward a better understanding. In almost no area of science can you speak without the conditional tense or without a caveat and still be completely responsible.
With all the research you review, do you ever feel confused? Or on the contrary, do you feel that you know exactly what you should be eating for optimal health?
There are little areas where I get confused, about things like the glycemic index that I’d love to see more research on, but on the whole I don’t feel confused. Just because one study contradicts something, you have to look at the weight of evidence. There’s also some false equivalence that goes on.
Last year, a study was published in the New England Journal of Medicine on the Mediterranean diet. It was a randomized controlled trial with a huge sample size and long duration, and the researchers were congratulated for conducting a study that is “nearly impossible to do well.” Is the bar for nutrition research so high that it’s borderline impossible to get good studies?
There are a lot of barriers to it, but I think we can expect better and better science forthcoming. It’s something that we have a history of having gotten wrong in the country, with Ancel Keys and the low-fat diets, and it’s an area where people want definitive good studies. For example, we should really know more about how much of this gluten-free stuff is placebo because placebo is a real and important thing. You have all these people who feel good about themselves and are paying attention to what they’re eating, and they think they’re happier, their minds are clearer and their stomachs are less upset, and I do think it’s largely due to placebo in most people. But assuming that they haven’t taken up eating terrible diets in pursuit of that gluten-free-ness then why spoil that for them?
We know unprocessed, whole foods are generally healthy, but caveats abound. Some experts say whole grains with gluten are harmful, and even some whole foods such as potatoes and bananas can be considered off-limits because they rank high on the glycemic index. What’s the best answer to “What should I eat?”
I know Dr. Katz is a proponent of Pollan’s “Eat real food, not too much, mostly plants,” but then you think about global sustainability and food production. Do we have the water and infrastructure to produce enough plants for people to eat? These are not calorically rich things. And does something like Soylent make sense? Can you just eat based on a nutritional algorithm? Maybe it’s not ideal, but it’s better than a lot of mass processed foods. It could be cheap and may be the way we should be thinking more in terms of providing food for the whole planet.
In learning about all of this nutrition science, you find it intrinsically linked to the climate and to sustainability in a way that a lot of people don’t think about. They’re just thinking, “Should I be eating more omega-3 fatty acids because of my heart?” I wrote about almonds, saying that all the nutrition things you read about almonds say eat tons of them, but 95 percent of our almonds come from California—where there’s a drought. I didn’t mean to suggest that people stop eating almonds, I just meant for it to be like, “Oh, interesting, I don’t even really think about the fact that there’s a drought and maybe I should go easy on the almonds.” People are going to increasingly have to think beyond nutrition to where our food is coming from, and that is going to factor into the healthiest diets of the future because the human population needs to not go extinct.
How can people differentiate pseudo-science from reliable research? Should the general public be on something like PubMed?
I’ve learned that the peer-review process is not as rigorous as I once believed it to be. Bad studies get published in journals. Academia puts pressure on people to publish, and to publish popular things, to have positive findings. You have to realize that there are personalities, and egos, and money that go into scientific research. Nothing happens in a vacuum and you have to take a single study for what it’s worth, and you have to take a single expert’s opinion for what it’s worth. Not every expert’s opinion is the same. People have their biases, and those are impossible to escape.
*This interview has been edited and condensed.