New tools sought in fight on obesity

September 12, 2012
San Diego Union-Tribune

An ambitious research program dubbed “the Manhattan Project of nutrition” by one of its founders launches Wednesday in San Diego with a goal of ending fad diets and curbing America’s obesity epidemic.

The Nutrition Science Initiative is a shot across the bow of conventional wisdom, arguing that much of what people believe to be true about what makes people fat is not grounded in rigorous research. So it plans to coordinate and fund some.

“Eat less, exercise more — the approach of the mainstream has been to pull that lever, over and over, and when it doesn’t work, to pull it harder,” said Dr. Peter Attia, the program’s 39-year-old president and co-founder. “What we’re saying is, ‘Let’s do a reset on that.’ Let’s look at the science.”

His premise is ruffling feathers in the local academic community — one professor at San Diego State University called it “derisive” — but it’s attracted about $5 million in seed money from a Houston-based philanthropic foundation concerned about scientific integrity and its impact on public policy.

The money will enable the nonprofit initiative, known as NuSi, to begin what it hopes will be a 12- to 15-year effort to reduce the prevalence of obesity in the United States from 35 percent to 15 percent. If that happens, the amount of money spent on health care in the country will drop, too, because obesity is a major risk factor in some of the leading causes of death: heart disease, cancer, stroke and diabetes.

“We’re sicker and heavier than any other nation on Earth,” Attia said.

There are, in Attia’s words, “a lot of great scientists” working on nutrition issues in the country — they have their own academic journals and conferences — but much of the work is underfunded and “simply unable to ask the toughest questions.”

He likened NuSi’s role to that of a football coach: putting the right players on the field, motivating them, coordinating their movements. Some of the work will be to help fund existing studies. Some will be to launch new ones.

NuSi, which has an office in Sorrento Mesa, will be guided by an advisory board of scientists and clinicians from across the country. One of them, Dr. Kevin Schulman, a professor at Duke University, said in a statement:

“Do we really have good science to support our dietary recommendations? The answer is convincingly no. The largest public health crisis in the United States is being addressed with the type of data that we reject in every other field of medicine: observational studies subject to selection bias and small scale, short-term clinical studies which can’t offer definitive results.”

The seed money is from the Laura and John Arnold Foundation, which funds projects in education, criminal justice, public accountability and research integrity. It has assets of $900 million. One of its recent projects was to create a “Giving Library” so that other philanthropists can learn more about nonprofits.

“Everything the Arnolds do is extremely fact-driven,” said Meredith Johnson, the foundation’s director of communications. “They know that in our society we rely on scientific research to guide our decision making. In some cases, it’s rigorous. In others, it’s weak and unreliable. They feel that in the field of nutritional science, it’s lacking.”

Donna Beshgetoor, a professor of nutritional science at San Diego State, said she applauded NuSi’s intentions and its goal of reducing the economic and social burden of obesity. But she questioned its attacks on other researchers.

“Their approach seems a little more derisive than collaborative, bashing the science of nutrition,” she said. “I strongly disagree that the science isn’t very rigorous or peer-reviewed. You’ve got people who have dedicated their whole careers to it.”

Attia’s own career began after he graduated from Stanford Medical School in 2001. He decided to be a surgeon but during his residency in Baltimore, he had a change of heart. “The system is broken,” he said. “I didn’t feel like I was making a difference. It was like I was putting pieces of tape on the screen door of a submarine.”

He went to work for a consulting company in San Francisco. Four years ago, he came to San Diego to take a job in a biotech firm run by a college classmate.

Around that time, he found himself struggling with his own weight. He’d gained 40 pounds, which he found “shocking” because he was exercising four hours a day and eating what he thought were the right foods, in the right amounts.

“That got me curious to understand where all the dogma about dieting and exercise was coming from,” he said.

His research led him to a book titled “Good Calories, Bad Calories,” by science journalist Gary Taubes, which argues that the key to health is the type of calories consumed, not the number. That made sense to Attia, who altered his own diet accordingly and lost the 40 pounds.

But Attia said his own success story isn’t why he quit his biotech job in January to co-found NuSi with Taubes. There are plenty of people who have lost weight using various diets. The point, he said, is that nobody really knows why some plans work for some people and others don’t.

NuSi’s goal is to end the uncertainty, and its own existence. “If I still have this job in 20 years,” Attia said, “it probably means I’ve failed.”