#197 - The science of obesity & how to improve nutritional epidemiology | David Allison, Ph.D.

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Feb 28, 2022

David Allison, Dean of the Indiana University School of Public Health and a leading obesity researcher, dives deep into the complexities of obesity science. He discusses the origins of the obesity crisis and the pitfalls of nutritional epidemiology. Allison highlights the intriguing 'obesity paradox' and reviews twin studies that shed light on genetic influences. He questions the effectiveness of obesity surgical procedures and emphasizes the importance of rigorous scientific methodologies to rebuild trust in public health data.

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ANECDOTE

Origin of Interest

David Allison's interest in obesity began with Stanley Schachter's theories.
Schachter's experiments on external cues influencing eating intrigued him.

INSIGHT

NHANES-3 Impact

The NHANES-3 data in the early 1990s revealed a jump in obesity levels, prompting concern.
This led to increased funding and research, but also a rise in less rigorous opinions and advocacy.

INSIGHT

Twin Studies

Identical twins separated at birth show high BMI concordance (around 0.9).
This suggests strong genetic influences on obesity, beyond upbringing.

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Episode Description:

David Allison is an award-winning scientific writer who has been at the forefront of obesity research for the last 20 years. Currently the Dean of the Indiana University School of Public Health, he has also authored many publications on statistical and research methodology and how to improve research rigor and integrity. David’s focus on evidence and data brings forth an interesting discussion of what we know (and don’t know) about the science of obesity. He provides an insightful and unemotional explanation of the potential impact of nutritional epidemiology in public health while also explaining its many pitfalls and limitations. He offers his take on the path forward in addressing the obesity epidemic, and he closes with a lucid explanation for the evident lack of credibility in science and the steps we can take to change that.

We discuss:

David’s background, interest in obesity, and focus on evidence [5:00];
The moment when the obesity crisis was recognized, and the sloppy science that ensued [13:00];
What twins studies tell us about the genetics of obesity [20:30];
How doctors and scientists have historically approached obesity treatment [23:45];
Do surgical procedures for obesity prolong life? [32:00];
The ‘Obesity Paradox’ [36:00];
Interpreting BMI and mortality data and considering confounders [43:15];
How body composition and ethnicity factor into consideration of BMI data [50:30];
Superior tools for measuring obesity at the individual level [57:15];
Using BMI data for actionable steps to combat obesity [1:02:00];
Why maintaining weight loss is more challenging than losing weight [1:06:00];
Differing perspectives on the utility of nutritional epidemiology [1:16:30];
A mouse study illustrating the impossibility of fully controlling for confounds in observational studies [1:22:15];
Limitations of nutritional epidemiology and how it can improve [1:26:30];
Addressing the obesity epidemic—the path forward and obstacles to overcome [1:37:15];
What David believes to be the most promising interventions we could take to address obesity and improve public health [1:47:30];
Reproducibility in science, normative and non-normative errors explained [1:51:30];
Rebuilding trust in science and differentiating between science and advocacy [1:59:00];
More.

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