The Sad Sad Case of Taylor Townsend: Why Everything You Know is Wrong About The Effects of Nutrition, Exercise and Weight on Longevity

All I see is beauty and strength. Also, how bad do I want this tennis dress?!

Travesty: Taylor Townsend, the number one ranked junior girls’ tennis player in the world, the reigning Australian Open singles champion and the junior Wimbledon doubles champion, and last Thursday she won two matches at the U.S. Open’s junior tournament, was recently forced to pay her own way to a tournament because “her coaches had declined to finance any tournament appearances until she lost weight.” Even though she was performing at a consistently high level they not only refused to pay her expenses but demanded that she drop out of the girls’ nationals competition earlier this summer and “embark on a more strenuous fitness program” to focus on losing weight. She withdrew. Ultimately the USTA cited health concerns saying their priorities are Townsend’s “long-term health, number one, and her long-term development as a player.” But is her health really in jeopardy?

According to new research, the answer is pretty definitively no. But Townsend’s case highlights the disconnect between what we think we know to be true about diet, exercise and weight and what the research is actually telling us. Three research studies over the past few weeks dispute the conventional wisdom and previous research and have basically made gray matter explode in scientific brains all over the country.

I know, I know, research scientists contradict each other as often as magazines cite “a friend close to the couple” when reporting salacious rumors (definition of “friend”: someone who does not spread salacious rumors to gossip mags). But these studies going down are some of the granddaddies of research on the subject and some of the most cited, reported and repeated.

To begin, let’s agree on our end goal: To live a long, productive life with as many healthy years in there as possible. (Disagree? Feel free to tell me your end goal in the comments.) The trick of course is how to achieve that. On the surface it’s simple: Don’t fight a land war in Asia! Wax on/wax off! Fail to plan, plan to fail! This is what bumper stickers were invented for. But when you eliminate the obviously deadly stuff like smoking, drugs and texting while driving you’re left with a nuanced glut of information that leaves you with more questions than answers. Enter science. Prepare your brain to pop.

What you think you know: Calorie restriction by any means extends life and health. (Or: Calories and weight loss is just simple math.)

New research: What you eat is more important than how little you eat. (Or: All calories are not created equal.) 

In the realm inhabited by lab coats, mice and regression analyses it takes a lot for something to become iconic but if science really does mirror art then the rhesus monkey studies are the Andy Warhol painting John Lennon singing Amazing Grace of scientific literature. (Do I win for worst analogy you’ve read all day? Not yet? Keep reading, I’ll try harder.)  For the past 30 years scientists have been monitoring two different studies looking at the effects of mild starvation in rhesus monkeys. And for the past 29 years they’ve been concluding that the underfed monkeys lived longer than their sated counterparts. These studies have been the basis for dozens of diet plans, the launch pad for other studies and the entire ideology of the Calorie Restriction Movement (yeah, there is such a thing).

The problem is that now that the studies are completed, a confounding variable has been discovered and it changed everything. The monkeys in the studies were fed different diets. The first study used a refined diet – the Ramen noodles of monkey food, if you will. The second study used a more natural monkey diet. What they found was that the natural hippie monkeys lived way longer than their processed-food peers, regardless of caloric intake. “In physics, a calorie is a calorie,” says one of the researchers. “In nutrition and animal physiology, there is more and more data coming out that says that the state of the animal is going to depend more on where the calories are coming from.”

Another interesting finding was that while the researchers were able to extend the monkeys’ lifespans somewhat, they had much more control over their “healthspan” or healthy years of life. So you may not necessarily be able to control how long you live but the years you have will be healthier.

The good news: You don’t have to starve yourself to be really healthy. The bad news: the big problem with the Ramen monkeys? Too much sugar in their diets. So this may be a case where you can’t have your cake and eat it too.

What you think you know: Your workouts need to be sweat fests to be effective

New research: People who exercise moderately live longer than people who don’t exercise and people who exercise a lot.

Moderation – the bane of my existence! Yet again my old foe extremity has come back to haunt me. According to two new studies – one a case study, one longitudinal – there is definitely a “sweet spot” for exercise.

“Those who ran 1 to 20 miles per week at an average pace of about 10 or 11 minutes per mile — in other words, jogging — reduced their risk of dying during the study more effectively than those who didn’t run, those (admittedly few) who ran more than 20 miles a week, and those who typically ran at a pace swifter than seven miles an hour.

“These data certainly support the idea that more running is not needed to produce extra health and mortality benefits,” said Dr. Carl J. Lavie, medical director of cardiac rehabilitation and prevention at the Ochsner Medical Center in New Orleans and an author of the study. “If anything,” he continued, “it appears that less running is associated with the best protection from mortality risk. More is not better, and actually, more could be worse.”

His analysis echoes the results of another new examination of activity and mortality, in which Danish scientists used 27 years’ worth of data collected for the continuing Copenhagen City Heart Study. They reported that those Danes who spent one to two and a half hours per week jogging at a “slow or average pace” during the study period had longer life spans than their more sedentary peers and than those who ran at a faster pace.

This decidedly modest amount of exercise led to an increase of, on average, 6.2 years in the life span of male joggers and 5.6 years in women. “

The good news: A little goes a long way; You don’t have to kill yourself working out to increase your health and longevity! The bad news: Um, oops…

What you think you know: Overweight and obese people are less healthy and more likely to die than their normal weight peers.

New research: Overweight and mildly obese people have better health outcomes in fighting disease than do their lighter peers.

Actually this research isn’t super new nor is it the first study to come to this conclusion but people seem to still be perpetually shocked by it. Carrying a few extra pounds (extra as defined by the BMI scale) may actually be protective of our health. The New York Times writes of the so-called “obesity paradox”:

“In study after study, overweight and moderately obese patients with certain chronic diseases often live longer and fare better than normal-weight patients with the same ailments. The accumulation of evidence is inspiring some experts to re-examine long-held assumptions about the association between body fat and disease.”

The Times piece sites several more studies:

“One study found that heavier dialysis patients had a lower chance of dying than those whose were of normal weight or underweight. Overweight patients with coronary disease fared better than those who were thinner in another study; mild to severe obesity posed no additional mortality risks.

In 2007, a study of 11,000 Canadians over more than a decade found that those who were overweight had the lowest chance of dying from any cause.

To date, scientists have documented these findings in patients with heart failure, heart disease, stroke, kidney disease, high blood pressure — and now diabetes.”

The clincher (for those of you about to argue that surviving illness is not the same as living longer or healthier):

“In 2005, an epidemiologist, Katherine Flegal, analyzed data from the National Health and Nutrition Examination Survey and found that the biggest risks of death were associated with being at either end of the spectrum — underweight or severely obese. The lowest mortality risks were among those in the overweight category (B.M.I.s of 25 to 30), while moderate obesity (30 to 35) offered no more risk than being in the normal-weight category.”

Flegal was actually so reviled for reporting the conclusions of her research that it took her years to even find anyone who would publish it. She became a pariah in the scientific community. But I think the most telling piece – both of the emerging research and the attitudes toward it – lies in the headline change of the Times article. Currently it is entitled “In Obesity Paradox Thinner May Mean Sicker” but according to the URL it was originally titled “More Data Suggests Fitness Matters More Than Weight.” Same findings, subtle shift in slant.

The good news: “Whatever the explanation for the obesity paradox turns out to be, most experts agree that the data cast an uncertain light on the role of body fat. “Maintaining fitness is good and maintaining low weight is good,” Dr. Lavie said. “But if you had to go off one, it looks like it’s more important to maintain your fitness than your leanness. Fitness looks a little bit more protective.”

The bad news: That is a message that may take a long time to reach your family physician, however. “Paradigm shifts take time,” Ms. Bacon said. “They also take courage. Not many people are willing to challenge the weight conventions. They’re just too culturally embedded, and the risk of going against convention is too high.”

Conclusions

Taken together I think these three studies not only show the how misguided Townsend’s coaches are but also paint a very interesting picture of what it means to be healthy and what direction our public health policies should take. Instead of focusing on weight loss (and the attendant fat shaming), we should be encouraging people to eat unprocessed whole foods and exercise moderately. It sounds so simple when put like that. Where’s my bumper sticker?!

What do you think of Townsend’s case – have you ever been punished for gaining weight? I have lots of scientist readers (love you guys!) – did I miss anything or misinterpret anything? What do we need to do to get people to internalize the message that the thin-at-all-costs mentality is literally killing us?

41 Comments

  1. “Worried about her health” my ass. They just want another twiggy girl.

  2. I agree its not right to be focusing on her weight. But (and I am not sticking up for the USTA) growing joints and ligaments on kids have to be protected, if she’s not in physically fit she could be risking injuries that could end her career.

    • She’s the number one ranked girls tennis player in the world. The WORLD. Of course she’s physically fit.

    • I see your point about growing bodies needing extra care but the coaches specifically said they wanted her to focus on intensifying her training so unless they’ve got her in the pool then her joints and ligaments would still be under the same stress. Also, this whole pay-your-own-way thing smacks of shaming to me and that’s the last thing any teen needs when it comes to weight loss. (Now shoplifting on the other hand…;))

  3. The concern I might have about the last study you mentioned is that sometimes in BMI research the few people in a study who have super low BMIs (who are already or are about to become super sick – think cancer or another wasting disease) are combined with the normal weight group for analysis purposes because there aren’t enough people to break out a separate “super low BMI group”. Lumping a group of sick people in with the otherwise healthy normal BMI group can artificially make mortality for the normal weight group look worse than for the overweight group, which is also generally healthy. I’m not sure that happened in the study you mentioned because I didn’t read it, but it’s a possibility. I definitely don’t disagree with the general conclusion that there’s a U-shaped relationship between BMI and mortality where being on the very low and very high end are bad and being somewhere in the middle is probably what’s most important.

    • “sometimes in BMI research the few people in a study who have super low BMIs (who are already or are about to become super sick – think cancer or another wasting disease) are combined with the normal weight group for analysis purposes”

      I believe you that that’s the case sometimes, but it is not the case in this study.

    • Yes, there are a lot of confounding variables when it comes to mortality and no perfect measure for vitality. I freely admit that my knowledge of the above studies is not exhaustive but if you read Flegal’s stuff I think you’ll find it pretty convincing. In the murky realm of research, her’s seems to me to be pretty solid.

  4. The link between health and what we call fitness is certainly not as strong as we like to think. Fitness can be defined by a select set of abilities like how fast we can run or perform a workout.
    I think health is more of the blanket term for how well the mind and body functions towards the well-being and survival of the organism. In that regard it can encompass thousands of variables all of which are important. You can have 99% of your health in tip top shape but that 1% can still do you in.

    But I agree, it’s not possible to be able to simply look at somebody or take a look at one aspect of fitness and be able to tell if the person is healthy or not.

    • Love this: ” Fitness can be defined by a select set of abilities like how fast we can run or perform a workout. I think health is more of the blanket term for how well the mind and body functions towards the well-being and survival of the organism. In that regard it can encompass thousands of variables all of which are important. You can have 99% of your health in tip top shape but that 1% can still do you in.” Ah the one 1% 😉

  5. “What do we need to do to get people to internalize the message that the thin-at-all-costs mentality is literally killing us?” Thank you! I just thought that that was worth repeating. Because it’s not only less years, it’s years of weight and food and exercise obsession. What kind of life is that at all?

    I do personally kind of have trouble with the exercise study though. The others, okay. Eat whole foods, don’t obsess over being skinny. Got it (in theory at least!). I don’t know how to apply the exercise to my life though. What is moderation when you’re not running?! Is it bad to work out intensely 5 hours a week? That feels moderate to me but I’m a former over-exerciser so who knows. Do I have to trade kick-boxing for yoga when I love kick-boxing and hate yoga? What do I doooo? Haha, okay, I’m done!

    • I say keep your kickboxing! My general rule is that as long as exercise feels fun, doesn’t usually exceed an hour a day and you take sufficient planned rest days then you’re probably just fine. If it starts to feel compulsive or anxious or like work then it’s probably too much. I think their other point was moderation in intensity too. You don’t have to spin until puke to get the health benefits.

  6. I fail to understand why an elite athlete needs to be all sinew and muscle to be considered in top form. It seems like moderation is the key, with proper diet and exercise. Surprise surprise 🙂 Having a little extra weight on a healthy individual would give the body fuel and the ability to withstand hardship or disease. Makes sense to me. I wish we as a culture could separate healthy from skinny. They just aren’t the same thing…

    • “Having a little extra weight on a healthy individual would give the body fuel and the ability to withstand hardship or disease.” This was one of the theories bandied about to explain the findings. Something about metabolic insurance…

  7. This post makes me happy. For the past year, I’ve been working on eating intuitively, eating more whole foods and exercising regularly. My numbers at the doctor’s office, with the exception of my weight, are excellent. I have a doctor who isn’t concerned about what a weigh, but has given me guidelines for calories and target weight (which is above my preferred goal weight). She says she isn’t worried about my size and won’t be unless my other numbers suffer.

    I’m glad that my being happy with myself (body size and weight) as long as I’m healthy and active sounds like the best plan. Forget obsessing about being the societal ideal!

    • I’m so glad that you have a doctor who is on the same page with you and your goals! Judging from all teh e-mails I get those can be hard to find…

  8. It is my fondest wish that we will someday be able to separate physical fitness and healthy habits from weight loss. Seriously, I’d love world peace too, but if I had to choose on a personal level, I’d go with this.

    Conflating the two leads to so many problems – for one this ridiculous situation where being ranked #1 in a sport means less than being thin does. Think about all the people who give up on exercise (and healthy eating for that matter) because they don’t lose weight. What about the body getting stronger, or running more efficiently? Does none of that matter because our jeans size doesn’t decrease? Come on! What about folks who are naturally thin who think that exercise and healthy eating doesn’t matter or benefit them? I find that sad. Honestly, I really think we would all be better off if we exercised and practiced healthy habits for their own sake, rather than weight loss. /end rant.

    • +1 No one could have said it better.
      What about biologically- and age-appropriate fat stores on females? What about their lifelong reproductive health? What about modelling aptitude rather than appearance?
      And Charlotte? Thanks for starting my day with a Princess Bride quote! Always appreciated.

    • I agree with Lauren – love everything about this comment!

  9. I can’t believe her coaches are treating her this way. The professional tennis world should be in an uproar!
    Oh, and she should fire her coaches.

    I think back to the late 90’s and all the women who starved themselves to get the “Ally McBeal” look. Where are they now? What’s happening with their health? Did they do permanent damage to their hearts?
    Was it worth it?

    I’m like you: when I look at that picture I see a strong, beautiful athlete. I have to wonder what lense her coaches see her through.

    • That’s a good q. I know Portia Di Rossi has a book out about her eating disorder issues on that show and it did (maybe still is?) cause her a lot of grief.

  10. Wow, I think she’s gorgeous. Nice strong arms, big muscled legs, she looks like she could do some real damage out on that court. 🙂 Losing weight for her, looks like she’d just be flaying off flesh from her awesome quads.

  11. I would buy your bumper sticker!

    Fabulous article – absolutely loved it hon. Just more research to back up the wisdom of intuitive eating, a diet based on wholefoods and exercising in pleasurable moderation.
    Or – eating for joy + moving your body joyfully. Huzzah!

  12. Honestly, I think Taylor is beautiful the way she is, and an incredible athlete. Why does everything have to get down to an unrealistic idea of what people should weigh? So many athletes and actresses start out at a realistic, healthy, beautiful weight, and are then shamed into turning into stick figures of their former selves. It’s so sad. And a horrible message to send to the rest of us normal-weight gals who might prefer to be strong and healthy than to be ultra-thin.

    • “So many athletes and actresses start out at a realistic, healthy, beautiful weight, and are then shamed into turning into stick figures of their former selves.” So sad but so so true.

  13. Katharine Hepburn exercised vigorously for the bigger part of her life and lived to be 96 years old! And she was awesome. I much rather follow her example than the latest study…

  14. Very interesting Charlotte! Saying all that – I just try to be healthy & fit. I am going to keep doping what I am doing unless a doc says I have to do otherwise.. 🙂

  15. Argh… so many studies that contradict themselves. IMO, we’re all a bit different so we need to find what works for us. I run better on carbs (mostly complex, but some simple), fruit, veggies, nuts, seeds, and a little bit of plant oil and a little bit of organic meat and dairy. Zliten needs way more meat to feel good than I do. This lady reminds me of the Williams sisters in terms of muscles and fitness – and I certainly don’t think they need to lose weight. 🙁

  16. Urgh, she’s 16!!! yes she’s a world class athlete, world #1 in her field tells us that. I think John McEnroe and the USTA can go jump! Like he’s a great role model to aspire to?

    As for the research, this isn’t “new”. The sugar thing was lauded in the 70’s when the world went low-fat crazy because the SUGAR INDUSTRY passed the buck! And they’ve kept passing the buck since. The world health org tried to put recommended limits on the amount of sugar we consume but it got halted by bribes and backhanders from.. the sugar industry. Because otherwise we’d see the real culprit for our health – sugar NOT fat!
    And yet the FDA/USDA tells us that organic is no better than conventional food, when there are independent studies citing otherwise.
    Fitness professionals have been told that a calorie is a calorie, but those that delve further into nutrition and research/studies have known for a LONG time that this isn’t true. Real food, for real people! I’m wondering what our future generations will make of our current state of food, when we’re dug up centuries later with our additives and preservatives in our bodies would we even decompose?
    You;ve given me food for thought (ha) for lots of blog posts to come in the next few weeks! Thanks Charlotte!

  17. That is so sad about the tennis player. She looks fabulous! The rest of your post makes me happy. I eat mostly real food and I’m not an over exerciser by any means so thanks for the affirmation and for making hard to read studies easy!

  18. My take aways (and I kind of had them before I read this):

    -eat natural foods and leave the processed crap in the store.
    -move every day. but not too intensely. Limit the intense movement to about an hour a day.
    -everything else will fall into place.

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  20. I think the focus on her weight has a lot more to do with getting advertising endorsements than health.

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