Fat. Healthy or unhealthy? Saturated vs unsaturated,
trans fat. Fat science, fat politics. Diets: low fat, Mediterranean, paleo, low
carb. Dean Ornish vs Robert Atkins. Gary
Taubes. These are covered in The Big Fat
Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet, by Nina
Teicholz. I was fascinated as I read about how the book turns conventional
dogma about fat upside down. Teicholz, a writer and apparently not a doctor or
nutritionist, spent ten years on this book and gives us about a hundred pages
of documentation, including notes and bibliography, for her assertions that the
last sixty years’ advice on fats have been wrong.
To quote the author, “The more I probed, the greater was
my realization that all our dietary
recommendations about fat—the ingredient about which our health authorities
have obsessed most during the pat sixty years—appeared to be not just slightly
offtrack but completely wrong. Almost nothing that we commonly believe today
about fats generally and saturated fat in particular appears, upon close
examination, to be accurate. “(p. 2).
Teicholz points out that once the low fat, low
cholesterol hypothesis was in place, it was very difficult to write or talk
against it. She goes through the history of America’s advice and experiments
about dietary fats. According to Teicholz, studies that contradicted accepted
belief were often not given credibility or not published; researchers were
unable to get funding for further studies. Even prominent experts in the field
were not believed. Meanwhile, Americans found themselves with growing epidemics
of chronic disease related to diet.
Much of the book examines the story of nutrition science regarding
dietary fats as its advice went from bad to worse. In the 1950s medical experts
looked for ways to reduce heart disease and came up with the idea that
saturated fat, or primarily animal fat, caused heart disease. Ancel Keys developed
what various writers have called the cholesterol hypothesis, which said that
high cholesterol caused heart disease. From that came the low fat diet, and
advice to replace fats with carbohydrates. Teicholz takes us from that to
saturated fat to polyunsaturated fat conclusions, bolstered by President
Eisenhower’s heart attack. Lots of science, both good and bad, appears here. Bad
or flawed science comes from studies which were designed with a particular
conclusion in mind, or studies with data points that support the hypotheses but
not the ones that do not, and other flaws of design, participation or follow-up.
Teicholz read and reported on a great many studies.
Sugar never got much study, according to this book.
Teicholz suggests that studies have shown that sugar causes heart disease, not
saturated fat. And so Americans went from the saturated fat veto to the low fat
diet, to trans fats and manufactured fats to the Mediterranean diet to high fat
low carb. At the end the Atkins diet wins after being scorned by doctors and
nutrition people for many years. The Atkins diet is characterized by high fat
meat and low carb vegetables. Teicholz reports the studies, large and small. She
credits nationally known food journalist Gary Taubes with breaking through the
accepted story because he is outside the system, not a doctor or nutritionist.
She also says she was able to write the book for the same reason.
Food manufacturers are not vilified in this book, but the
part they played in creating foods for these diets is told, as is the politics
of food that gave us the food pyramid. The USDA continues to say stay the course
and avoid saturated fats. Teicholz says that death from heart disease has
declined but the actual occurrence of it has not appeared to decline, possibly
because medical treatment has improved. She points out that Americans “have
experienced skyrocketing epidemics obesity and diabetes.” (p. 327). She says
that recent studies have showed the absence of negative effect of saturated fat
on heart disease, obesity or diabetes. She concludes that “bias and habit
present powerful, if not impenetrable, barriers to change.” (p. 326).
Teicholz does not address the effect of her conclusions
on the environmental consequences of trying to feed animals to millions of
people beyond saying that she recognizes it but environmental impact is not
within the scope of her book. She also does not advocate for or against
vegetarian diets but shows that they come up in studies of fats.
This book is one more addition to my library of ideas on
how to eat well as a way to stay healthy. I read other well qualified writers and
understand that not all agree with her dietary conclusions.
