The joy of the angry email…really!

confusing-nutrition-researchSo, I was minding my beeswax the other night when an angry email from a researcher popped into my inbox. He did not appreciate the vague reference (I did not mention the title, the publication, or the researchers names) to one of his studies in my Seattle Times column that had JUST been posted to the Times website that day. Dude must be part bloodhound.

His angry email made me angry for two reasons. One, it was pretty clear he didn’t really read my article (just like there’s a difference between hearing and listening, there’s a difference between reading and reading, if you know what I mean). Two, his words conveyed the conceit of someone who treats humans as lab rats. My patients and my readers are humans, and they are not lab rats!

So, I did what any good student of mindfulness would do. [Cough.] I deleted the email, retrieved it from my trash folder, took a deep breath, and crafted a response.

And so we begin…

“Your recent article in Seattle time is unfortunate for a few reasons. The concept of Time Restricted Feeding is based on the science of circadian rhythm, which is so new that it has not yet made it to the text books in medical and nutrition science.”

I pointed out that if he had read my column carefully, he would have observed that my primary criticism was how other news outlets used his study to say that people could eat whatever they want as long as they stick to a set eating window. What you eat doesn’t matter? A mountain of nutrition research says otherwise. I employ intuitive eating in my work, so I fully endorse unconditional permission to eat, but that is not the same as “heck with it all” eating. In intuitive eating, permission is paired with attunement to the body’s cues for what, when and how much to eat.

I also pointed out that in my columns, I frequently offer a counterpoint to questionable news coverage in other mass media publications, especially when my patients come to me asking, “Is this true?” There is far, far too much nutrition confusion among the lay public as it is, when sensational headlines capitalize on emerging areas of science that don’t have a deep body of research yet, it helps no one.

Yes, I know my way around a research paper

“So, I hoped you would have done your homework before writing a provocative article.”

First of all, I don’t my article was particularly provocative. Rather, it was inserting a bit of sanity and food for thought (pun intended). And, um, I have. I have read many, many research papers on circadian rhythms and other methods of time-restricted feeding (such as intermittent fasting), and have written about those topics previously:

Chrono-nutrition: Matching your food to your internal clock

Despite the hype, intermittent fasting isn’t a magic weight loss cure

“Our paper from 2015 does not establish TRF as a solution. Rather it was a feasibility study.”

I am not the only one who has criticized the structure of his feasibility study, in part because of it’s extremely  small sample size (8 people) and lack of a control group (a group that did not actively participate, but is used as a comparison). A tiny feasibility study like this should not have received the media attention that it has because the results were absolutely not ready for prime time. It’s clinicians like myself who have to talk patients off the metaphorical ledge when preliminary research is publicized too soon.

“Nevertheless, there are many papers that have shown time-of-day specific effect of nutrition intake on weight gain/loss, glucose control etc.”

Yes, I’m aware of that, and I wrote about that research in my chrono-nutrition article, which I linked to in my current article so that online readers would have easy access to that information. If he actually read my article, he would know that.

Are you criticizing what you think you’re criticizing?

“Here is a suggestion for you. Please do more research on a topic and consult with the experts and scientists in the subject area before writing such misleading article.”

Researchers are in fact NOT saying “eat whatever you want, just eat it within this time window.” I’ve read enough research papers, and enough articles quoting some of those researchers to know that. Debunking that idea, which stemmed not from a research paper, per se, but from a specific article in a specific major newspaper, was the main point of my article. I really, really dislike being criticized for doing a “bad job” of writing an article that exists in the mind of the critic, but was not what I ever set out to write. (It’s similar to how I dislike it when someone leaves a bad book review on Amazon when the problem is that they wanted the book to be something that the author never set out to create. The problem is a bad choice on the part of the buyer/reviewer, not a bad job on the part of the author.)

And I know my way around a dense article with lots of citations and expert interviews, believe you me! Need proof? Go to the search page on the Today’s Dietitian website and enter my name in the search bar. Three pages of results will come up. With each article, you will find numerous citations (the number varies depending on the topic and the amount of research that’s been done on it).

Hey, I didn’t write the headline

“I did not find anything in your article with scientific basis that ‘breaks down the basis for TRF’.”

What I was breaking down was the myth presented in the aforementioned newspaper article. I should also mention that my suggested headline was “Restriction is still restriction, whether it’s time or calories,” not the “Breaking down the myth of time-restricted feeding” headline that my editors chose. So don’t spank me for that.

You may notice that I did not discourage readers from observing a 12-hour eating window, but since humans are not lab rats, and restriction often leads to bingeing (to some degree) because that’s how we’re wired (thank you body, for having survival instincts), I framed it as a series of questions for personal exploration.

If one of my patients is eating all evening because they aren’t eating enough during the day and end up primally hungry, then yes, that concerns me, but because they aren’t taking care of their needs earlier in the day. If someone is eating all evening because they use food to cope with their feelings, and haven’t cultivated any other coping mechanisms, then yes, that concerns me. Finally, if someone eats all evening but is barely aware that they’re doing it because it’s totally mindless, then yes, that concerns me. Because my patients are NOT lab rats, they are humans with thoughts and feelings and worries and stressors and quite likely a history of dieting and often a messed up relationship with food. That is not something that can be fixed by slapping on an eating window like it’s a Band-Aid!

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