Thursday, 14 December 2017

The terrible perils of large wine glasses

Wine drinking in the good old days

It's around this time of the year that the British Medical Journal publishes its annual spoof article to show that it's got a sense of humour. These parodies become harder to spot every year as the quality of its general output diminishes. This 'study' is a case in point.

As reported by the BBC and others, the BMJ has got into the Christmas spirit by moaning about the size of wine glasses. The lead author of the offending article is Theresa Marteau, a nanny state halfwit who ticked enough temperance boxes to be put on the alcohol guidelines committee.

Over the years, Marteau has somehow found a way of getting grant money to carry out worthless research into the size of wine glasses, fizzy drink bottles and tableware (see here, here, here and here for a small sample). She generally concludes that people eat/drink more from larger plates/glasses and, being a meddling ratbag with too much time on her hands, thinks that the government should do something about this.

The BMJ article is her latest attempt to rally doctors behind her mad campaign. After describing the Christmas period as 'the culturally legitimised deviancy of festive drinking', she offers a series of guesses and hunches about the 'population health' impact of large wine glasses .

Environmental cues such as the design of drinking glasses—particularly their size—may also have contributed to increased drinking, particularly of wine... 

...plate sizes have increased over the past 100 years, likely contributing to the prevalence of obesity and overweight... 

The amount of alcohol people drink, particularly wine, has increased sharply since the 1960s. Along with lower prices, increased availability, and marketing, larger wine glasses may have contributed to this rise through several potentially co-occurring mechanisms.

...the amount of pure alcohol that wine drinkers consume has likely risen in line with larger glasses.

The only thing Marteau et al. are able to show convincingly is that wine glasses have got bigger in the last 300 hundreds. 

According to this chart, the average size of a wine glass is currently 450ml and some wine glasses exceed 800ml. 

Obviously, people are not putting a pint of wine in their glasses. If Marteau et al. spent a bit more time drinking wine and a bit less time worrying about it, they would know that drinkers prefer big glasses because it helps the wine breathe and releases the aroma. 

Perhaps unwittingly, the BBC have used a picture of modern wine glasses which nicely illustrates typical servings.

There is a slight acknowledgement of the benefits of larger glasses when Marteau et al. say...

Larger wine glasses can also increase the pleasure from drinking wine...

To any reasonable person, that would be case closed. If it improves wellbeing, it should be encouraged. But Marteau et al. immediately follow this by saying...

...which may in turn increase the desire to drink more.

Hilariously, they cite one of Marteau's own studies to support this assertion but, alas, it doesn't actually support it at all...

RESULTS Wine drunk from the larger, compared with the smaller glass, was consumed more slowly and with shorter sip duration, counter to the hypothesised direction of effect.

CONCLUSIONS These findings provide no support for the hypothesised mechanisms by which serving wine in larger wine glasses increases consumption.

You'd think peer review would pick things like this up, wouldn't you? 

Having made the mundane observation that wine glasses have got bigger, they have to admit that...

We cannot infer that the increase in glass size and the rise in wine consumption in England are causally linked. Nor can we infer that reducing glass size would cut drinking.

But a total inability to demonstrate cause and effect is no reason not to legislate in the world of 'public health' and so they conclude that...

...regulating glass size as part of local licensing regulations would expand the policy options for reducing drinking outside the home. 

I can only assume that this means they want it to be illegal to sell wine in a glass that the government thinks is too big. The intention of this epic micromanagement of people's lives is, it seems, to denormalise large wine glasses... 

Reducing wine glass sizes in licensed premises may also shift the social norm of what a wine glass should look like, potentially influencing the size of glasses people use at home—where most alcohol, including wine, is drunk.

'What a wine glass should look like', FFS!

Encouraging [forcing? - CJS] wine producers and retailers to make non-premium bottles of wine available in 50 cL and 37.5 cL sizes, with proportionate pricing, may also encourage drinkers to downsize their wine glasses so that one bottle fills more glasses.

Yeah, that'll work.


Should we pay women to breastfeed?

I say no.

Wednesday, 13 December 2017

Kick out the killjoys

Newsnight recently asked me if I'd like to say something for their two minute Viewsnight slot. I decided to talk about health panics and the need to defund the nanny state. Here it is...

I was also talking about Killjoys on the Tom Woods podcast this week. You can listen to it here.

Don't forget that you can download the book for free. There's a link in the sidebar of soundness to the right.

Tuesday, 12 December 2017

Austria cancels smoking ban

The good news just keeps on coming...

Austria stubs out looming smoking ban in name of 'freedom'

Austria’s far-right Freedom party has announced that a planned ban on smoking in all bars and restaurants that was due to come into force in 2018 will be scrapped.

Party chief Heinz-Christian Strache said the reversal was agreed in ongoing talks to form a coalition with the conservative People’s party (OVP) following elections in October.

“I am proud of this excellent solution in the interests of non-smokers, smokers and restaurant owners,” Strache, who had made the move a key campaign pledge, said on social media.

“The freedom to choose lives on. The existence of restaurants (particularly small ones) has been secured. Thousands of threatened jobs have been saved,” said Strache, himself a smoker.

I don't know enough about Austrian politics to know whether the Freedom party are really on the 'far-right' or whether this is exaggeration by the Guardian. If they are then they have a considerably more enlightened view of smokers' rights than the last far right party that was in charge there.

Saturday, 9 December 2017

Laughing at Aseem Malhotra

The British Dietetic Association has published a list of the Top Five Celeb Diets to Avoid in 2018 and it is no great surprise to see Aseem Malhotra's ridiculous Pioppi Diet make the cut.

...the authors may well be the only people in the history of the planet who have been to Italy and come back with a diet named after an Italian village that excludes pasta, rice and bread – but includes coconuts – perhaps because they have a low carb agenda. The suggestion that this Italian village should be associated with recipes for cauliflower base pizza and rice substitute made from grated cauliflower or anything made using coconut oil is ridiculous. It also uses potentially dangerous expressions like "clean meat" and encourages people to starve themselves for 24 hours at a time every week... The traditional Mediterranean diet is a healthy choice but this had been hijacked here. Fasting may help weight loss but the only reason their other advice is likely to help people lose weight is because it involves eating less food and calories.

Malhotra has been in meltdown ever since, frantically retweeting every nutter who thinks that Big Grain is out to kill them. In the food faddist equivalent of the bat-signal, he sent out an urgent request for back up to every diet guru on Twitter.

By the time the BBC covered the story, he had settled on the excuse that dietitians are stooges of the food industry (or that part of the food industry that sells carbohydrates)...

"One has to question the financial links and influence of various food companies on the BDA. In my view, they cannot be trusted as an independent source of dietary advice." 

Almost everybody in nutritional science has worked out that Malhotra is a fame hungry crackpot who should not be taken seriously (even Action On Sugar). In a sane world, his latest outburst would be enough to end his media career, but that may be too much to ask.

It's been a vintage week for loyal readers of this blog. First, Simon Chapman got rekt in the Australian senate, then Stanton Glantz was handed a lawsuit. In the meantime, we discovered that Jamie Oliver is unhappy and now Malhotra has been ridiculed by nutrition experts on the BBC.

What next? Will Public Health England's office burn down? Will Martin McKee develop smallpox? Will Deborah Arnott fall down a manhole? Anything seems possible.

The Pioppi Diet is currently available on Amazon for the knockdown price of £4.00.

Thursday, 7 December 2017

Stanton Glantz accused of sexual harassment

From the San Francisco Examiner...

A former UC San Francisco doctoral researcher Wednesday filed a lawsuit alleging sexual harassment by a prominent tobacco control activist and tenured UCSF professor Stanton Glantz that spanned nearly two years.

The lawsuit also alleges that Glantz retaliated against his former mentee, Eunice Neeley, after she complained about him to the university’s administration by removing Neeley’s name from a research paper.

Neeley accused Glantz of consistent inappropriate behavior that included staring at her body, making comments directed at Neeley referencing sex, making sexual remarks about other women to Neeley while at the workplace, and making racist remarks about Neeley, who is black.

The UCSF Board of Regents is named as a defendant in the lawsuit filed in San Francisco Superior Court for allegedly failing to take action against Glantz after Neeley notified the university about the harassment.

...According to Neeley’s lawyer, Kelly Armstrong, Glantz is a current employee of UCSF. He rose to prominence for his research on the effects of secondhand smoke on the heart, and has authored numerous publications on secondhand smoke and tobacco control.

Neeley purports that Glantz used his tenure to intimidate his students from reporting his sexual harassment and emotional abuse. According to the lawsuit, Glantz was known to have told multiple students that as a tenured professor, “You can rape the vice chancellor’s daughter and still have a job.”
... The lawsuit alleges that the university was made aware of Glantz’s misconduct but failed to “take meaningful action to protect Neeley and other females from further sexual harassment.”

Armstrong said that Neeley wasn’t the only victim of Glantz’s misconduct.

“We believe there are multiple witnesses and victims to the sexual harassment by Glantz,” she said.

Buzzfeed has more details. You can read the full lawsuit here.

I look forward to hearing Stan trying to blame all this on the tobacco industry.

Happy Christmas everybody!

Wednesday, 6 December 2017

Senator Leyonhjelm on Simon Chapman

Jurassic wowser Simon Chapman talked so much bollocks in Australia's recent e-cigarette inquiry that Public Health England sent a letter to the Senate to correct his 'series of factual errors' (see below if the link doesn't work).

This week, Senator David Leyonhjelm picked up the baton and delivered a speech that I think many readers of this blog will enjoy...

Saturday, 2 December 2017

Who will check the fact-checkers?

In the post-truth world in which we supposedly live, the rise of professional fact-checkers is welcome. The BBC's More or Less is the pick of the bunch, but it's only 30 minutes on Radio 4 for a few months each year. Online, Full Fact does a great job of picking apart the numbers of the day. 

Channel 4's FactCheck is less impressive but it can be useful when it isn't buckling to political activists (as it did last week when it changed the headline and website address of this article).

And then there is the BBC's Reality Check which is sort of a fact-checker, but also sort of a rough guide to the issues people are talking about. Its premise seems to be that it provides a cool-headed look at The Facts which you wouldn't get from the rest of the media (like, er, BBC News). Last night it put out an article which illustrates the potential for abuse when journalists set themselves up as arbiters of The Truth.

Written anonymously, the article is titled 'Reality Check: Why ban fast food within 400m of schools?'and is about Sadiq Khan's idiotic plan to protect chicken shops from competition tackle obesity.

What does the research show? There's quite a lot of evidence that having fast food nearby leads to more obesity in adults.

I happen to be familiar with the research in this area. There is indeed a lot of evidence, but very little of it makes a convincing case that living near a fast food shop leads to more obesity in children or adults. But there is one particular UK study that campaigners often cite because it claims to have found a link - and that's the one that BBC Reality Check focuses on: 

There is, for example, this research from Cambridge, which found that people living closest to the largest number of takeaway food outlets were more than twice as likely to be obese than of normal weight.

This study concluded that: 'Exposure to takeaway food outlets in home, work, and commuting environments combined was associated with marginally higher consumption of takeaway food, greater body mass index, and greater odds of obesity.' But there is something rather interesting about it that was picked up by the statistician Jeremy Franklin. He noticed that:

After reading the interesting article by Burgoine et al. I was at first irritated by the lack of a table to compare the characteristics (as shown in Table 1) of participants grouped according to quarters of take-away environment... Usually one would expect such tables in order to assess the comparability of the groups with respect to possible confounders and for a direct, unadjusted comparison of outcomes, respectively.

Then I discovered this information in Web table 3 of the online appendix. Here, we see systematic differences between quarters with respect to education, smoking and car ownership...

What surprised me even more in Web table 3 was the fact that mean take-away consumption was slightly inversely correlated with combined take-away availability, varying between 36.3 g/day in Q1 and 34.2 g/day in Q4. This contrasts completely with the results of the multivariate analysis (Fig. 1) in which a significant positive correlation between take-away availability and consumption was obtained. Moreover, In Web table 3 mean BMI is almost constant in all quarters of take-away availability, contrasting with the significant positive correlation between take-away availability and BMI derived from the multiple linear model (Fig. 2).

In other words, there was no difference in obesity rates between those who lived near fast food outlets and those who didn't. Moreover, the people who lived near them actually consumed slightly less takeaway food. Here's the data that was tucked away in a supplementary file:

The findings presented by the authors are entirely the result of changes they made to the data in their attempt to control for other variables.

Perhaps some of these adjustments were appropriate, but we are required to put a lot of faith in the researchers before we accept their conclusion. And their conclusion is really that obesity rates are not actually higher near takeaways but they would be were it not for confounding factors.

A further point of interest is that the study included supermarkets as a source of takeaway food. When the authors excluded supermarkets in their sensitivity analysis, they were unable to find any association with between takeaway food and obesity, even after adjusting the data. They admitted that excluding supermarkets meant that 'the associations between combined take-away food outlet exposure, consumption of take-away food and body mass index were attenuated towards the null’.

As Franklin says, 'The expression "attenuated towards the null" is an understatement: no association remains at all, in agreement with the simple univariate comparison.'  

The Cambridge study is therefore hardly the most compelling evidence that having fast food nearby leads to more obesity.

But the Reality Checkers have two other pieces of evidence to make the case. The first is a survey conducted by Brent council, asking secondary school pupils how far they would be prepared to walk to a fast food shop. It didn't included any measure of obesity or health and, as the BBC acknowledges, 'the differences between the likelihood of children having lunch from a takeaway outlet if they attend a school close to one or further away from one were fairly small and the results were skewed by most of the children surveyed not actually being allowed off-site at lunchtimes.'

Finally, there is this:

Another report on the subject found that the food available near schools did have some effect on pupils' choices but that it was only a small effect.

That's putting it mildly. The association between proximity to takeaways and an 'unhealthy diet' was tiny (0.003, 95%CI 0.001 – 0.006) and the study didn't even attempt to find an association with obesity.

So much for there being 'quite a lot of evidence that having fast food nearby leads to more obesity'. The most revealing thing about the BBC article is not how weak the evidence it cites is, but the failure to mention all the other evidence.

For example, this study found that 'obesity prevalence was highly significantly negatively related to the densities of both FFRs [fast food restaurants] and FSRs [full service restaurants]' and this study found that 'away from home food expenditures negatively affect BMI and that BMI is negatively related to the percentage of the food budget spent away from home'.

This study from the UK found that fast food consumption was negatively associated with obesity (ie. those who eat it most often have the lowest body mass). Although the authors made significant adjustments to the data, they were not able to find a positive association. The raw data is shown below.

This US study concluded that 'Proximity of "fast food" restaurants to home or work was not associated with eating at "fast food" restaurants or with BMI' and this US study found 'no association between child overweight and proximity to playgrounds, proximity to fast food restaurants, or level of neighborhood crime.'

And this study from the UK didn't find an association between takeaway outlet density and obesity except among 'the least educated'.

The evidence that living near a takeaway (or near lots of takeaways) is not at all strong. It is mixed and conflicting, with many results supporting the null hypothesis. In their literature review of 2010, Fraser et al. found that...

... of the 12 cross-sectional studies which looked at FF [fast food] outlets in relation to overweight or obesity, six found a significant positive association, two had significant negative results and five showed no association. Of the studies which showed a positive association between FF outlets and weight/BMI, one only found an association in non-car owners, one found an association in adult females only, one found a significant association between increased number of FF outlets and increased obesity but also decreased obesity if closer to a FF outlet, and one found an association between weight status and FF exposure in schools. The other study with a positive result aggregated their individual level data to perform a county level analysis. All six of these studies used self-reported heights and weights to calculate BMI. The longitudinal study found no association between density of FF outlets and BMI change in children.

Faced with this murky picture, BBC Reality Check chooses to simply assert that there is 'quite a lot of evidence that having fast food nearby leads to more obesity in adults' and the quotes Prof Naveed Sattar from Glasgow University who offers the kind of opinion you'd get from a bloke in a pub.

"When I was a child we had a fish and chip shop about 200m from my school and lots of us went there - if it had been a bit further away maybe they wouldn't have bothered.

"It's pretty obvious that if you make things easy people will gravitate towards them."

So much for a reality check.

Friday, 1 December 2017

Torturing the data the Australian way

Today is the fifth anniversary of plain packaging in Australia. If you're a regular reader of this blog, you'll be aware that it was a flop. I've written an article for City AM picking at the scab of this policy because it is important to audit 'public health' measures to see if they fulfil the promises that their advocates make for them. They rarely do.

No one has does more to expose the junk science used to justify plain packaging in Australia than the economist Sinclair Davidson. He has made a short video showing the various tactics used to torture the data. It's well worth a watch...

Sinclair was in the UK earlier this year and I invited him to the IEA to share his findings. You can see a video of that here.