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

View episode show notes here: https://bit.ly/3HgjLMf

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:
00:00:00 - Intro
00:00:10 - David’s background, interest in obesity, and focus on evidence
00:08:44 - The moment when the obesity crisis was recognized, and the sloppy science that ensued
00:17:11 - What twins studies tell us about the genetics of obesity
00:20:36 - How doctors and scientists have historically approached obesity treatment
00:28:45 - Do surgical procedures for obesity prolong life?
00:34:08 - The ‘Obesity Paradox’
00:41:48 - Interpreting BMI and mortality data and considering confounders
00:49:54 - How body composition and ethnicity factor into consideration of BMI data
00:57:12 - Superior tools for measuring obesity at the individual level
01:02:31 - Using BMI data for actionable steps to combat obesity
01:06:55 - Why maintaining weight loss is more challenging than losing weight
01:18:44 - Differing perspectives on the utility of nutritional epidemiology
01:25:08 - A mouse study illustrating the impossibility of fully controlling for confounds in observational studies
01:29:59 - Limitations of nutritional epidemiology and how it can improve
01:42:06 - Addressing the obesity epidemic—the path forward and obstacles to overcome
01:53:28 - What David believes to be the most promising interventions we could take to address obesity and improve public health
01:57:45 - Reproducibility in science, normative and non-normative errors explained
02:05:27 - Rebuilding trust in science and differentiating between science and advocacy

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About:

The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 40 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).

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