The Cold War on Fat

Anyone dedicated to living a long time will have to do quite a bit of reading for two reasons.

Firstly the path to a healthy mind is identical to the path for a healthy body; you have to use it or you will lose it. Keeping the mind alert and at peak capacity is a function of giving it new puzzles and problems to solve.

Providing the mind with problems brings us to the second reason for all of the reading which is that no one should rely solely or even mostly on the advice that comes from the medical establishment and certainly not from the government. Both of these monolithic institutions claim that they are driven by what has come to be known as ‘the science’ and thus they are without bias. That bold claim is preposterous. The human beings that staff the research labs, medical offices and government agencies are susceptible to the same biases as the rest of us and there is also ‘the money’ and ‘the politics’ to consider.

In few places is bias more evident that in the realm of dietary guidelines put out by the US government. The idea that the government has dietary guidelines might surprise most Americans since they are not accustom to thinking of the government has an entity that tells them what to eat, but the United States Department of Agriculture does, in fact, publish food guides and these guides are important for a number of reasons. Here is how the most recent guide describes its purpose and mission:

“The Dietary Guidelines is designed for policymakers and nutrition and health professionals to help all individuals and their families consume a healthy, nutritionally adequate diet. The information in the Dietary Guidelines is used to develop, implement, and evaluate Federal food, nutrition, and health policies Dietary Guidelines for Americans, 2020-2025… also is the basis for Federal nutrition education materials designed for the public and for the nutrition education components of USDA and HHS nutrition programs. State and local governments, schools, the food industry, other businesses, community groups, and media also use Dietary Guidelines information to develop programs, policies, and communication for the general public.”

So you can go to the grocery store and buy whatever you find there, but what is on offer there as well as in the schools, hospitals, and any other institution that provides food or food ingredients will be heavily influenced by these guidelines. The authors of these guidelines state explicitly the methods and goal:

“An important audience is health professionals and nutrition program administrators who work with the general public to help them consume a healthy and nutritionally adequate diet and establish policies and services to support these efforts. Comprehensive, coordinated strategies built on the science-based foundation of the Dietary Guidelines—and a commitment to drive these strategies over time across sectors and settings…”

They state that they use the impartial evidence-based approach to developing food guides and then they publish them and use the many faceted departments of government to mandate adoption across the food industry to shape the dietary choices of all Americans and presumably, millions of others around the globe that are touched by US food policy.

Let us set aside for the moment the question of freedom and personal sovereignty when it comes to food and consider the claim that the food guides are based strictly on ‘the science.’ Is the guide an impersonal set of rules driven by provable and universal experimentation on what the human body, ALL human bodies need and should eat? That is what they claim.

There are dissenting voices include a doctor and writer named Nina Teicholz.

Teicholz is a biologist of some renown who was a vegetarian for over 25 years. She hails from Berkeley, California and attended by Yale University and Stanford so one might easily imagine her potential influences and ideas on public policy.

At a certain point in her career, she decided to go back in time and look at the scientific literature around the idea that eating animal fat was connected to having a heart attack. By itself, this was a somewhat controversial act. The cause and effect relationship between eating fatty foods and having a heart attack is so deeply ingrained in our ideas about food that there is a café in Las Vegas called ‘The Heart Attack Grill’ and the phrase ‘That is a heart attack waiting to happen’ is generally used in relation to fat consumption. Grocery stores are full (or at least used to be) of products labels low fat or no fat. In the milk section, one will generally find whole milk, 2% milk, and no fat milk. ALL of this comes from the government position on fat and its connection to negative health outcomes, primarily heart attacks.

Teicholz went on a long journey which took her back to the early days of research on the impact of dietary fat on the body. It was particularly of interest to see what the theories were because two facts seemed to be coming in to conflict with each other.

The first fact was that heart attacks and negative health outcomes were rising in the immediate post-World War 2 period. American men were dying from heart attacks at a rising rate and the government was looking for the cause. The accepted reasoning coalesced around dietary fat as the explanation for the rising heart disease and subsequent heart attacks. But there was another fact; older generations around the world consumed plenty dietary fat and did not have the corresponding heart disease. The French used butter and cheese as a core part of the national food heritage but did not have a corresponding rise in heart disease; this was referred to as ‘the French paradox.’

So, did dietary fat cause heart attacks or not and if it did then why not in everyone? Answers to these questions were what she was looking for.

Her investigations led to an influential food scientist named Ancel Keys. The term ‘influential scientist’ really ought to be considered an oxymoron if science and not scientists are the guide to outcomes. Nevertheless, the diet-heart attack link can clearly be traced by to a crusade conducted by Keys.

Keys was involved in many early 20th century medical experiments and is immortalized in the term ‘k-rations’ which he developed for the military; k stands for Keys. He supervised the Minnesota Starvation Experiment during World War 2 which was a study on calories restriction using conscientious objectors as test subjects. They were given varying levels of daily calories, including very low calories, but the war ended, and the men were released before the study was completed.

After the war, Keys was able to get a study funded by the US Public Health Service known as the Seven Countries Study and it was here that he developed, published and then for the following 25 years, defended the fat-cholesterol-heart attack link. Teicholz published her history of this and many other studies in a 2014 book called The Big Fat Surprise. The book has gone on to win many awards and she has continued with her work, most of which undermines the central thesis of Keys work. She claims that his findings were poorly derived and that he made up his mind and then went out and created the science that bolstered his opinion. He was intolerant of any other opinion and like so many prominent scientists, he ostracized and sought to negatively impact the career of any dissenters to his point of view.

Skepticism about Keys or doubts about any harm caused by animal fat has kept the US Department of Agriculture from sticking to the warnings about animal, dietary, or saturated fats. Epidemic levels of obesity in Americans including kids after the government started issuing guidelines have not created any movement to revise the guidelines to steer away from the idea that animal fat has negative health outcomes. Millions of pounds lost by people following what was called the Adkins, and later keto, diets have still not penetrated the government bureaucracy and I predict, will not. Science, economic, and personal interests all easily override science including the United States.

There are too many drivers to fully explain heart attacks and heart disease to pin them to one particularly food ingredient. The current CDC guidance on heart disease is already accommodating this reality and the no-fat and low-fat shelf space at the grocery store is shrinking. Predicting health outcomes is like predicting the weather or the stock market; too many variables on the margins make anything but the most short-term predictions impossible. Long term trends are detectable, but no one can predict what will occur in every human’s arterial system based on one data point like amount of saturated fat. And yet there it is, year after year in reports put out by the USDA; low fat is good, high fat is bad. 

Teicholz recently addressed a recent paper published in a medical journal that summarized the many additional scientific works that cannot replicate the message so ably delivered by Keys. The article has 16 authors from various universities around the US and is titled ‘Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?’ Here is the abstract which is worth quoting in full:

Abstract: The last decade has seen nearly 20 papers reviewing the totality of the data on saturated fats and cardiovascular outcomes, which, altogether, have demonstrated a lack of rigorous evidence to support continued recommendations either to limit the consumption of saturated fatty acids or to replace them with polyunsaturated fatty acids. These papers were unfortunately not considered by the process leading to the most recent U.S. Dietary Guidelines for Americans, the country’s national nutrition policy, which recently reconfirmed its recommendation to limit saturated fats to 10% or less of total energy intake, based on insufficient and inconsistent evidence. Continuation of a cap on saturated fat intake also fails to consider the important effects of the food matrix and the overall dietary pattern in which saturated fatty acids are consumed.

Thankfully, I am no food scientist; I’m just a guy that reads a lot and has my eyes open. I can also do some basic math and figure out that if 10% of our diet comes from fat, then the other 90% has to be something else. What might that be? A quick trip down the aisle at the grocery store reveals all; that fat has been replaced by low cost (meaning low cost to produce) carbohydrates and lots and lots of refined sugar. The fat that is still in many of these foods comes from vegetable sources such as corn oil. The sugar, incidentally, is corn too in the form of high fructose corn syrup. Thanks to those guidelines, these many foods can be marketed as ‘heart healthy’ since they are low in saturated fat, but in yet another stunning discovery I’ve made, people are fatter than ever. At about the same time the guidelines first came out, people began to gain more and more weight, obesity increased, Type 2 diabetes began to rise, and yet STILL heart disease is a leading cause of death in the United States and around the world.

Here is a fascinating short profile of Ancel Keys produced by the University of Minnesota:

Here is Nina Teicholz in a TED Talk about The Big Fat Surprise:

Here is the link to the most recent USDA food guidelines:

Here is the dissenting article about these guidelines:

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