A Big Fat Debate

The low-fat trend finally appears to be on its way out. The notion that saturated fats are detrimental to our health is deeply embedded in our Zeitgeist—but shockingly, the opposite just might be true. For over 50 years the medical establishment, public health officials, nutritionists, and dieticians have been telling the American people to eat a low-fat diet, and in particular, to avoid saturated fats. Only recently, have nutrition experts begun to encourage people to eat “healthy fats.”

This past December, the Los Angeles Times reported that excess carbohydrates and sugar, not fat, are responsible for America’s obesity and diabetes epidemics. One of the lead researchers in this field, Dr. Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health, said, “The country’s big low-fat message backfired. The overemphasis on reducing fat caused the consumption of carbohydrates and sugar in our diets to soar. That shift may be linked to the biggest health problems in America today.” Another expert, Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health, said, “Fat is not the problem.”

Last month, Martha Rose Shulman of the New York Times Recipes for Health section, wrote that she’s taken the “no low-fat pledge.” Shulman writes, “I took a pledge the other day that will surprise my longtime followers. It even surprised me. I pledged to drop the term ‘low-fat’ from my vocabulary.”

Shulman, an influential food and recipe writer with over 25 books to her name, has long promoted low-fat and light cooking, but now writes, “There are many recipes in my cookbooks from the 90s that now look and taste dated to me. I’ve put back some of the oil and cheese that I took out when editors were telling me to keep total fat at 30 percent of total calories–a concept that is now obsolete even among policymakers.”

She and a room full of “nutrition scientists, dietitians, doctors, chefs and food service titans” recently listened to experts on nutrition debunk some of the common fat myths. Dr. Dariush Mozaffarian, who co-directs the program in cardiovascular epidemiology at Brigham and Women’s Hospital and Harvard Medical School and is an assistant professor at the Harvard School of Public Health, was also there and said, “No randomized trial looking at weight change has shown that people did better on a low-fat diet. For many people, low-fat diets are even worse than moderate or high-fat diets because they’re often high in carbohydrates from rapidly digested foods such as white flour, white rice, potatoes, refined snacks and sugary drinks.”

These are clear indications that an important tipping point in the mainstream understanding of fat and nutrition is underway. But it did take some time. Back in 2002, Gary Taubes wrote about it in the New York Times magazine, laying out a fine deconstruction of the low-fat premise presented to the American people. He pointed out that the science behind this recommendation was never proven and was actually based on “a leap of faith” (more on this here).

In 2001, Dr. Hu, writing in the Journal of the American College of Nutrition, noted, “It is now increasingly recognized that the low-fat campaign has been based on little scientific evidence and may have caused unintended health problems.” Or, as Michael Pollan pithily puts it in his In Defense of Food, “The amount of saturated fat in the diet may have little if any bearing on the risk of heart disease, and the evidence that increasing polyunsaturated fats in the diet will reduce risk is slim to nil.”

This brings up several important issues in the fat debate. It is still widely held that what matters are the types of fat we consume. Even in Shulman’s article on her fat re-education, there are contradictions—it’s clear she just can’t get her head around the idea that saturated fats may indeed be healthy. She writes, “Saturated fat—the kind found in animals and dairy products, as well as in any hydrogenated fat—is also regarded as a less healthy fat because it raises L.D.L cholesterol, or ‘bad’ cholesterol in the blood, and this kind of cholesterol is related to heart disease. But even saturated fat is not so bad compared to refined carbohydrates, the doctors say, and if we were to eliminate it from our diet we would also be eliminating many foods that are also rich in healthy fats, like fish, whose omega-3 fatty acids are vital to good health.”

But as Pollan points out, the idea that saturated fats are a less healthy fat just isn’t true, as the picture is fairly complex. Indeed, most foods are composed of a many different types of fats. For example, half the fat found in beef is unsaturated and most of that fat is the same monounsaturated fat found in olive oil. Lard is 60 percent unsaturated and most of the fat in chicken fat is unsaturated as well, according to Taubes 2008 book Good Calories, Bad Calories.  In his New York Times article he writes, “Even saturated fats–AKA, the bad fats—are not nearly as deleterious as you would think. True, they will elevate your bad cholesterol, but they will also elevate your good cholesterol. In other words, it’s a virtual wash.” Taubes continues, “Foods considered more or less deadly under the low-fat dogma turn out to be comparatively benign if you actually look at their fat content. More than two-thirds of the fat in a porterhouse steak, for instance, will definitively improve your cholesterol profile (at least in comparison with the baked potato next to it); it’s true that the remainder will raise your L.D.L., the bad stuff, but it will also boost your H.D.L. The same is true for lard. If you work out the numbers, you come to the surreal conclusion that you can eat lard straight from the can and conceivably reduce your risk of heart disease.”

Nearly every day new research and studies come out debunking popular fat myths; despite this, misinformation persists. On the Mayo Clinic’s Web site, saturated fats are lumped in with trans-fats under the banner “harmful dietary fat” and the site claims that saturated fat can increase your risk of cardiovascular disease and Type 2 diabetes.

The link to cardiovascular disease is tenuous at best—the idea being that saturated fats raise your cholesterol and triglyceride levels which in turn leads to cardiovascular disease. But according to the most recent studies, including one reported in the Los Angeles Times article, this is not true. “Contrary to what many expect—dietary fat intake is not directly related to blood fat. Rather, the amount of carbohydrates in the diet appears to be a potent contributor,” Marni Jameson writes.

And during a symposium called “The Great Fat Debate: Is There Validity In the Age-Old Dietary Guidance?” at the American Dietetic Association’s Food and Nutrition Conference and Expo, four leading experts agreed that replacing saturated fat with carbohydrates is likely to raise the risk of cardiovascular disease. Dr. Walter Willett said, “If anything, the literature shows a slight advantage of the high fat diet.”

And as for diabetes, there is no data to support the notion that a high-fat diet increases the risk for diabetes. Again, if anything, the opposite appears to be true. In a 2008 study reported in the Los Angeles Times article, obese men and women with metabolic syndrome (a precursor to diabetes) that went on a high saturated-fat, low-carb diet saw their triglycerides drop by 50 percent and their levels of good H.D.L. cholesterol increase by 15 percent.

But old dietary habits die hard and convincing people that what they’ve been told for the past 50 years is just plain wrong, is a hard sell. Not only that, but the continued recommendations to eat low-fat versions of foods (as in the USDA’s latest dietary guidelines and on the Mayo Clinic’s Web site) don’t help. Americans are confused about nutrition and disease and it’s only getting more complex with corporations claiming to make healthier foods (see Mark Bittman’s take on McDonald’s oatmeal and my take on Wal-Mart’s health washing).

Keep in mind, there is one type of fat that is implicated in high cholesterol, atherosclerosis, heart disease, and diabetes: Trans-fat. Trans-fats raise bad cholesterol, lower good cholesterol, and increase triglycerides, they also promotes inflammation and insulin resistance, according to a 2000 article in the Journal of the American College of Nutrition. This points to the one basic axiom that always hold true: Eat real, whole foods and nothing else—now, if we could only just all agree on what those are.

Photo: Johnny Stiletto on Flickr


79 thoughts on “A Big Fat Debate

  1. Potatoes – Not nearly as bad as people think.

    As far as sugar and other carbs goes, they only get stored as fat if you don’t run a caloric deficit. In other words, it’s the calories.

    All we do in society is look for the villain, the smoking gun, because we don’t want to face the fact that we’re the problem, not the food. We either eat too much food, burn too few calories, or a little of both. You can get heavy on protein, too, if you go over on calories.

    We are programmed to eat as much as we can, because for most of our existence, food has been scarce. Limiting our consumption and/or wasting our energy on fun and sports go completely against our instincts.

    Cheetahs don’t go on fun runs. Every meal is absolutely necessary for them.

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  3. Excellent article. I do hope America’s approximately 70,000 registered dietitians are starting to experience some cognitive dissonance regarding the dietary advice they’re obliged to dispense.

    Something needs to be done about the Dietary Guidelines for Americans (DGA) before dietitians will feel truly free to correct their stance on dietary fats. The latest iteration of the DGA is official government policy for all of the public health system. All the outside criticism in the world will accomplish little so long as the dietitians who control the Center for Nutrition Policy and Promotion (CNPP) feel obliged to support the industrial food agenda.

    What’s particularly disturbing is the close working relationship the CNPP maintains with the International Food Information Council Foundation (IFICF). Both organizations are staffed with dietitians trained by a system that permits the industrial food system to exert considerable influence on the content of dietetics education, both initial and ongoing. Here’s what the IFICF says:

    “We bring together, work with, and provide information to consumers, health and nutrition professionals, educators, government officials, and food, beverage, and agricultural industry professionals. We have established partnerships with a wide range of credible professional organizations, government agencies, and academic institutions to advance the public understanding of key issues. For example, we have a long-standing relationship with the U.S. Department of Agriculture Center for Nutrition Policy and Promotion as part of the Dietary Guidelines Alliance, a public-private partnership focused on the U.S. Dietary Guidelines for Americans and the MyPyramid Food Guidance System.”[1]

    Ah yes; the Dietary Guidelines Alliance. What does it do? In their words:

    “In 2002, the Alliance identified portion size and dietary fats (saturated fats and trans fats)
    as priorities for consumer message development. Given the growing concern with obesity, energy balance emerged as a main priority of the partnership. Consumer research on energy balance messaging was conducted in 2004.

    In 2005, the sixth edition of the Dietary Guidelines for Americans and MyPyramid food
    guidance system were released. Subsequently, the Tool Kit was evaluated and updated based on the new science and dietary guidance. In 2006, the materials were tested with dietitian and consumer audiences to ensure relevance.”[2]

    Here is the Dietary Guidelines Alliance Membership:

    The American Dietetic Association
    Grocery Manufacturers Association
    International Food Information Council
    National Dairy Council
    National Pork Producers Council
    The Sugar Association
    Food Marketing Institute
    Grain Foods Foundation
    National Cattlemen’s Beef Association
    Produce Marketing Association
    Society for Nutrition Education
    Wheat Foods Council

    In the final analysis, the fact that the CNPP has close ties to the IFICF which maintains close ties to academia and is extensively involved in the ongoing education of dietitians suggests that the industrial food system has a strong influence on every aspect of the Dietary Guidelines revision process. It’s sort of a closed, circular feed back loop that prevents relevant scientific findings from being properly utilized in the formation of public policy.

    References
    1. http://www.foodinsight.org/about-ific-and-food-safety.aspx
    2. http://www.sne.org/documents/Dietary_Guidelines_Alliance.pdf

  4. I remember back in the 1980’s when the government and big universities urged people to switch to industrial margarine. I can only shake my head in sadness as I watch people buy palm oil loaded non-dairy creamers and processed “vegetable oil spreads”. Just eat the real thing in moderation for good health! My grandparents thrived on whole milk yogurts, fresh cream from our cows and a glass of milk with dinner. They actively farmed into their 90’s and were strong. Eat real and be strong.

  5. Once again the fad diet advice has been wrong. Why then should we believe a low carbohydrate diet is good for us?? If history is any teacher in a few years science will prove that low carb diets are a fad and in fact harmful as well.
    It would seem that diabetes is the big boogeyman that is used to scare everyone into compliance with the latest fad diet. But diabetes is a genetic disease and you don’t get diabetes from eating carbohydrates. If you already have diabetes a specific diet can reduce symptoms but diet neither causes it nor can it cure it. The diabetes rate has remained constant and not increased as is often stated. What has increased is the efforts to identify diabetes in the large percent of the population that was unaware they had it. Some dishonest people use this fact to claim diabetes is on the rise so you must follow the latest fad diet or you will “catch” it. Not true!

  6. “Americans are confused about nutrition and disease” you write. I surely am. I read Taubes latest book and then looked up reviews of it and left with my head spinning. You sound awfully certain about your revisionist views. But then so do many other people with opposing views. As someone with heart disease, I take this stuff seriously. Whom to believe??

  7. I have to take issue with the conclusions reached by this article. To put it simply, replacing saturated fat with monounsaturated and/or polyunsaturated lowers the risk of heart disease.

    What bothers me, and why I feel the need to comment, is that the idea that SFA (saturated fatty acids) have gotten a bad reputation is not supported by science. With all due respect to Ms. Wartman and Mr. Pollan, their opinions printed here are unsupported.

    Ms. Wartman quotes members of the scientific community as stating that replacing SFA with refined carbs is not beneficial. This is supported. However, it is also supported that SFA are not desirable. What Ms. Wartman depicts as misinformation is actually based on far more science than she presents in this article. The DGAC of 2010 reports, “The consumption of certain fats, such as saturated fatty acids (SFA) and trans fatty acids, is associated with a poor lipid/lipoprotein profile and increased risk of cardiovascular disease (CVD).”

    “Metabolic studies have established that it is the type of fat, rather than total fat intake that affects common intermediate risk factors, such as serum lipid and lipoprotein levels (Hu, 2001). Results from controlled clinical trials and epidemiological studies have shown that replacing SFA with unsaturated fats is more effective in decreasing CVD risk than is reducing total fat intake overall (Smit, 2009). Additionally, prospective cohort studies and secondary prevention trials provide methodologically strong evidence that consumption of n-3 fatty acids from seafood and plant sources has a significant cardio-protective effect and decreases cardiovascular mortality (Mozaffarian, 2008;; Mozaffarian and Rimm, 2006).”

    Additionally, a systematic review of the latest evidence showed, “Dietary SFA replacement (5-7% of energy) with either MUFA (Berglund, 2007;; Lichtenstein, 2005) or PUFA (Chung, 2004;; Kralova, 2008;; Lichtenstein, 2005) significantly decreased total and LDL cholesterol.”

    Ms. Wartman also refers to the work of Dr. Hu. This work does not exonerate SFA from a link to diabetes. In fact, Hu established that SFA increased diabetes risk-factors. Also from the DGAC, “The Hu review concluded that higher intake of PUFA (and potentially long-chain n-3 PUFA) were beneficial, whereas higher intakes of SFA and trans fatty acids impaired glucose metabolism and increased insulin resistance.”

    I hope my comments help clarify the reality of scientific understanding and the basis for current recommendations to limit saturated fat. Unlike polyunsaturated and monounsaturated, saturated fat has no known health benefits and is scientifically linked to several major health problems.

    Replacing saturated fats with refined carbs is not synonymous with reducing saturated fat intake. There are three main fats. Polyunsaturated, monounsaturated, and saturated. Saturated fats are still unhealthy.

    I am disappointed in Civil Eats for publishing this story without the appropriate corrections/clarifications. That being said, I have been enjoying your blog for quite some time and wish you the best of luck in the future.

  8. Just another swirl of the whirlwind of confusion. “Carbs are poison!” says one. “Wrong!” says another. “It’s all simply calories in, calories out…diet and exercise.” “Wrong!” say others. “Fat is the problem.” “Wrong!…” And on it goes. I have no idea who’s right. Someone could do everyone a huge public service by sorting it out once and for all.

  9. HUGE amounts of disinformation exist. Hydrogenated oils are big money because they are cheap crops, many or most of which are now GMO. Hydrogenation is done because these cheap oils have no appreciable shelf-life, unlike saturated oils like olive and coconut which last for months with no alteration.

    Saturated fats are not unhealthy. There was ONE study done which was then used by the greed/industry to scare people away from saturated fats – and it used HYDROGENATED coconut oil. There is never a reason to hydrogenate coconut oil; the study was useless at best. It’s the hydrogenation that creates a non-food molecule which interferes so severely with metabolism.

    I believe the former comment is probably actually propaganda provided by a well-paid PR firm working for Big Agriculture. How about, instead of quoting a lot of studies that anybody with a brain should by now realize CAN WELL be paid-for non-science – how about we use a little common sense?

    America has had a low-fat diet shoved into its psyche for decades now. Look around you. Is it not completely obvious that doesn’t work? Is it not completely obvious to dieters that yes, they may lose weight in the short term, but nothing is done to correct their metabolic syndrome, hence the very famous yo-yo effect?

    Meanwhile, look at rural Southeast Asian populations for example, who use coconut oil almost exclusively. Do you see a lot of gross obesity? Are there reports of ramnpant heart disease, stroke, diabetes? Uh…no…

    A website like civil eats is sure to have attracted many trolls who are paid by big industry to submit comments attacking its articles as well as people who comment favorably. Please realize this is a highly organized, highly-funded practice called astroturfing (fake opinion as opposed to actual grassroots).

  10. To clarify, when I said “previous comment” I meant #7 as opposed to #8 which got posted while I was writing.

  11. The important issue with macronutrients is knowing how the body processes them. In order to form triglycerides, the body needs three-carbon backbones, which can only come from carbohydrates. If one doesn’t consume carbohydrates, then triglycerides can’t be synthesized.

    Furthermore, consumed triglycerides and free fatty acids (saturated and unsaturated) are metabolized by the process of beta-oxidation; they are not “stored” in adipocytes (fat cells) or in the blood, as would be intuitively assumed.

    Carbohydrates need to be consumed, of course, otherwise muscle protein will be broken down to maintain blood glucose.

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  13. I recall seeing a graph years ago that superimposed US per capita consumption of margerine since WW2 with US per capita rates of heart attacks. The two graphs (each trending upward) were almost identical.

    It is dangerous making too much of such a correlation, since they could each have been driven by some 3rd external factor (increased consumption of all food? Increased promotion of all processed foods? Increased consumption of toasted bread?) Still, the graphs were so similar, that it was really startling.

  14. Michael Bulger is not quite correct. The “poor lipid/lipoprotein profile” means that saturated fat consumption leads to higher LDL.

    Higher LDL is correlated to heart disease.

    Anyone else see where the gap in logic could be?

    LDL comes in different sizes, large fluffy and small dense. LDL’s function in the body is to carry cholesterol to damaged arterial walls to facilitate healing. It is the small dense LDL that may get trapped in the damaged tissue which promotes plaque buildup (and therefore heart disease). The type of LDL that increases from saturated fat intake is the large fluffy LDL.

    So high LDL is not itself a negative indicator. You can request a VAP test to get an idea of what size your LDL is when you get your blood work done.

    As long as Doctors and some shoddy scientists continue to equate higher LDL with heart disease without concern of LDL size, it will be easy to cherry pick studies suggesting that saturated fat is bad. They’ve been doing it for 50 years, after all.

    This may well be the cause of the obesity epidemic, as increased carbohydrate consumption (particularly fructose) and the addition of trans fats have caused a widespread insulin resistance epidemic, which then leads to weight gain, metabolic syndrome, and type II diabetes.

  15. Glad to see that Civil Eats has the courage to come out! So many nutritionists, physicians, and researchers see the light but are afraid their medical associations and/or government funding will dry up if they don’t tow the low-fat line. Thank you for stepping up to the vanguard of science.

  16. Let’s run through the answers to these comments:

    “Once again the fad diet advice has been wrong. Why then should we believe a low carbohydrate diet is good for us?? :”

    Two things:
    1) There is plenty of anthropological examples that indigenous people thrived on diets with little carbs available. As a counter example, there are no vegan societies as it significantly reduces the ability to reproduce.

    2) You could just try it for a week and find out. Just eat red meat and leafy vegetables while drinking nothing but water or tea for a week, whenever you feel at all hungry, and you’ll lose weight. Does this prove anything? Mostly proves that blaming saturated fat for obesity is nonsense.

    “The diabetes rate has remained constant and not increased as is often stated.”

    Where is your evidence for this? Never heard this claim before.

    “I read Taubes latest book and then looked up reviews of it and left with my head spinning.”

    I think you underestimate how much of an anti-lowcarb movement there is driving people to put in bogus reviews without actually exploring the points. Low carb recommends higher animal consumption which means it makes vegans/vegetarians (mainly PETA and their associated institutions) angry. Plus, it makes any one in the established nutrition space look stupid since what they’ve claimed as the truth is opposite of what is said to be wrong in the book. Creates a significant bias to attack in reviews, without actually/fully reading the book.

    Not to mention that the newest book is the simplified version of his original book on the subject “Good Calories, Bad Calories”, and those simplifications are easier to attack. I’d check the reviews on the original book to get a better impression of how people feel about his claims (the original is painfully dense with research to the point where it’s hard to seriously argue with).

    As for the last comment:
    Additionally, a systematic review of the latest evidence showed, “Dietary SFA replacement (5-7% of energy) with either MUFA (Berglund, 2007;; Lichtenstein, 2005) or PUFA (Chung, 2004;; Kralova, 2008;; Lichtenstein, 2005) significantly decreased total and LDL cholesterol.”

    Here is a good point to that, one issue with meta analyses is that you can cut and pick your studies to try to confirm your biases”

    Quote from Michael Eades blog on this (he is a writer of the low carb protein book, so has as much bias as any of the scientists):
    “For those who don’t know, meta-analyses are compilation studies in which researchers comb the medical literature for papers on a particular subject and then combine all the data from the individual studies together into one large study. This combining is often done to bring together a collection of studies, none of which contain data that has reached statistical significance, to see if the aggregate of all the data in the studies reaches statistical significance. I think these types of meta-analyses are highly suspect, because they can lead to conclusions not warranted by the actual data.”

    You may be right though that the studies are accurate, I can’t say one way or the other.

    When thinking about this entire issue, two things to note:

    * Going against the hypothesis that saturated fat is evil doesn’t win you any friends (look at how bitterly Atkins has been attacked and defamed for his claims), so it’s promising that there is any research saying saturated fat isn’t bad from the mainstream establishment. It’s important to understand that in academics there is serious pressure to comply to the claims of advisers and peers if they want to keep their academic reputation intact.

    * Low-carb is literally one of the easiest things to personally test. The results are fast enough to see in a week, and you can easily do a before and after blood test to see that your lipid profiles improve as well. Plus, long term complications are not a serious worry; for example, societies like the Eskimos have survived on meat and root diets, which says that there are at least no serious complications from long term compliance.

  17. Great article. As a doctor who also holds a master’s degree in exercise science and has had well over 20 years of experience with exercise science, nutrition, training, fitness and natural body building, this is spot on advice and correlates with all the latest science.

    For years, our country has been loading up on refined sugars and refined carbohydrates while avoiding fat and look what has happened….over 1/3 of the U.S. is clinicaly obese, over half the population is overweight and 1/3 has self-inflicted diabetes(not genetic people, it’s time to start facing yourself and stop acting like a victim of genetics…), high blood pressure, poor blood chemistry and is in a terrible state of overall health.

    You have to get rid of the flour products such as bread, pasta, cereal, cookies, cakes, crackers, potatoe chips and other refined products and get your nutrition from a predominance of green, leafy vegetables, moderate servings of whole fruit(not sugar enhanced, refined fruit juices or similar products) and lean healthy fish, chicken, beef, eggs and similar lean, healthy sources of protein and fats and drink water only.

    And remember, “if you do what you’ve always done, you’ll get what you have always gotten”…then ask yourself “how well has this worked for me so far?”

    Simply look to those who are lean, strong, healthy and look years younger than they really are and pay attention to what they eat and how they eat. You’ll find they eat a diet of lean, healthy proteins and fats and lots of green, leafy vegetables, without all the starch and refined carbs and they drink nothing but water.

    This is what hollywood celebrities eat to stay lean, strong, young and attactive and this is what fitness enthusiasts and natural body builders have been doing for decades.

  18. Except there are naturally occurring trans-fats which are quite benign.

    The dietary landscape is indeed complicated, but mainly because special interest groups and the government have chosen to stubbornly support one view, despite the lack of evidence for it’s efficacy.

  19. It’s sad that nutrition and food has gotten to be so controversial. Nutrition research is extremely complex, because of the complexity of food. There are all kinds of problems with the papers cited above – what were they using for saturated fat? Were they confusing a purified fat with natural fats with all their attendant nutrients? Were they controlling for the pro-inflammatory omega-6 fats? Were they looking at “cardiac risk” or actual morbidity and mortality over time? Were they relying on assumptions from other research, that actually is also questionable? The article above makes no mention of the problems that can come from our excessive intake of omega-6 vegetable oils. As a retired and reformed (liberated) dietitian I find it much more convincing to study the diets of healthy groups of people eating traditional diets, which often included plenty of natural animals fats.

  20. Great article. I’m glad someone is sharing this well-documented knowledge with the sustainable food community.

  21. Pingback: A Big Fat Debate low-fat trend finally appears to be on its way out | Health Impact News

  22. Yet another unintended consequence of the switch to a processed carbohydrate rich diet: fructose malabsorption. I have been suffering for years from “irritable bowel syndrome,” which is doctor-eze for “we don’t know what’s bugging your G.I.” Last week I got tested for fructose malabsorption (I had to insist, my doctor did not want to bother doing the test.) Turns out I am extremely sensitive to fructose. Go figure. According to the data on modifying your diet to avoid fructose, fructans (long chain fructose polysaccharides such as high fructose corn syrup,) are the biggest problem – the fructose in actual fruit is not as big a problem.

    From one study “During the last few decades, reports conflict about whether sugar intake has increased, but a consistent finding in US studies is that the proportion of sugars made up by fructose is increasing. Contributing to this is the increased consumption of fruit juices and the use of high-fructose corn syrups (which contain 42% to 55% fructose) as sweeteners in many manufactured foods, particularly in the United States. The proportion of energy from caloric sweeteners during the last 4 decades has increased 22%, more than 80% of which can be attributed to increased consumption of soft drinks and/or sugared fruit drinks.” (October 2006 – Journal of the American Dietetic Association.)

    So, maybe the biggest threat to the US economy is actually the fact that 50 years of poorly done nutritional science, and cherry-picking of bits and pieces of science that favor the goals of the processed food industry, has produced a population that is fat, diabetic, arteriosclerotic, and grumpy due to IBS.

    [Note: I believe that nutritional science is an important field, and I do not intend to suggest that it should go away. However, the way it has been done in the past, and the way the results of nutritional studies have been publicized, definitely needs a major overhaul.]

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  24. Scott #19: Your message is muddled. First you say saturated fats don’t cause heart disease and then you tell people to eat lean meats. We eat too much muscle meat in this society, not enough organ meats and not enough fat. It’s caused our amino acid intake to go all askew, and if you eat too much lean protein not backed by either carbs or fat, you’re a candidate for rabbit starvation.

    A lot of these apparently “lean and healthy people” are skinny-fat and burning up their lean tissue. Look to people who appear sturdy, who have good resistance to disease, and whose faces are well-developed and then watch how THEY eat.

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  30. Thank you for repeating what Naturopathic Physicians have been saying for years.
    Eat Real Food, not processed products.
    Eat it the way it comes from the natural world.
    Allow our food animals to grow at their natural pace, on their natural diet and we will benefit from their meats.

  31. As some are mentioning here, the recent science is most certainly more accurate than the self serving science of the past 50 years.

    Take for instance the study out of Duke University in October of 2009, saturated fat does NOT contribute to heart disease.

    How can old foods cause new disease?

    Disease and human frame demise began with the incorporation of Agriculture and this is very well cited.

    Personally, I only consume those foods that I could consume in their raw natural state.

  32. When one looks at the literature and discovers that the most accurate blood lipid measurement easily done – the atherogenic index of plasma – which is the log10 of tag/hdl, where a high number is bad and low is good, one will discover that ldl doesn’t even come into it. the amount of tag and hdl can more accurately predict if a lipid profile is atherogenic or not. high tags or low hdls are worse
    and what raises tags or lowers hdl? refined carbs. what increased hdl? fat. what lowers tags? reducing carb intake

    if youre smart, dont use easily oxidised fats for cooking (PUFA) and eat natural whole foods you will do miles better than almost anyone else

  33. @GoneWithTheWind: Diabetes is not hereditary. Risk factors can be passed on, in which case the interesting question becomes, “what sorts of diets tend to trigger diabetes?” Gary Taubes has written persuasively about the issue in Good Calories Bad Calories.

    @Michael: The author of the post differentiates between trans-fat and saturated fat. Does each of these studies do the same? If they are lumped together, I would not be surprised to see SFA appear unhealthy. I would be interested to hear what SFAs were used in these studies.

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  35. Unfortunately, eating saturated fat is not beneficial and does increase heart disease. Replacing meat with fish, nuts, and vegetables, is a heart-concious choice. (Replacing saturated fat with junk cereals and soda does not, but you can’t use that as evidence that saturated fat is healthy.)

    I apologize to the “Certified Nutrition Educators,” the “naturopathic physicians,” and the other belief-oriented contributors. Despite our best wishes, in order for something to be true it has to.. well, be true. These things are often demonstrated by science, as the link between saturated fat and heart disease has been.

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  37. David Brown: I’m in a masters program in training to be a dietitian, just so you know, week before last one of our professors put up the new Dietary Guidelines and asked “So, what do you all think of these guidelines”, and then stood back and smiled as we all ripped into them. We are not sheeple, I promise, we do question. The problem is that the Guidelines are put out by the USDA, which is charged with promoting American agricultural products, and they define agriculture as sugar, grain, dairy, etc., leaving out fruit and veg. As long as they are writing the guidelines the guidelines will be worthless. Write your representatives, please, and put these guideline under the responsibility of medical professionals!

    Ann: Actually, Michael Bulger’s comment was completely reasonable. Although I will not have done a full literature review of the topic until the end of this semester, from what I have seen in the literature so far it is perfectly in line with the current scientific consensus (which is, yes, opposed to the government-message-consensus).

    Simon Moon: Thank you for a useful comment, I’m going to look up how types of fat affect particle size. I have a family member with high LDL (and no other problems) and we just found out that his particle size is large (relief). But why? I must know!

  38. Kristin, many thanks to you for writing this. It’s high time the food movement got its nutrition facts straight; I’m overjoyed that you’re beginning the process here on Civil Eats.
    Thank
    the

    food gods.

    CBM

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  40. @Misty (#33) – you say “Personally, I only consume those foods that I could consume in their raw natural state” I hope that you are not eating all such foods raw. That a food could be eaten raw, and actually doing so are two very different things.

    The data from nutritional anthropology is absolutely clear – Human numbers skyrocketed after we began cooking. Cooking makes available a spectacular number of calories that are otherwise unavailable in the “natural” world. In addition it neutralizes plant poisons, destroys pathogens, breaks down cell structures in food products, destroys enzymes that make nutrients unavailable, etc, etc, etc. Plants do not want to be eaten, and are full of toxins that are designed to stop us from doing so. Our clever use of fire foiled the plant’s defenses.

    The “raw food” movement is about a misguided as anything in the history of food, with the possible exception of Fletcherizing.

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  43. I read this with great interest. But I would push back a bit on some of the comments about saturated fat in particular. For example, most low-meat and vegetarian diets are fairly low in saturated fats. Would you advise a vegetarian to eat more saturated fat? If so, would it be from meat or dairy or tropical oils? I spent a while going back and forth comparing this post to the new edition of the Dietary Guidelines and wrote it up at U.S. Food Policy. Parke

  44. Holly,

    Glad to hear dietitians are not sheeple. However, most are not biochemists either. The biochemists have known for decades that saturated fats are not a health hazard, that any supposed connection between saturated fat intake and heart disease is due to failure to distinguish the effects of saturated fats from omega-6 trans fats.[1]

    Excessive omega-6 intake is a more likely cause of clogged arteries due to inflammation. Here’s what a prominent heart surgeon thinks:

    “I trained for many years with other prominent physicians labeled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.

    The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.

    It Is Not Working!

    These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.

    The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.

    Despite the fact that 25% of the population takes expensive statin medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.

    Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.

    Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.[2]

    As noted earlier, it’s the biochemists that seem to be better at sorting things out. Dr.Bill Lands, for example, has shown that the ratio of omega-6 to omega-3 in tissues predicts the likelihood of developing heart disease.[3]

    Then, there’s a 2009 article entitled “Dietary Fat Quality and Coronary Heart Disease Prevention: A Unified Theory Based on Evolutionary, Historical, Global, and Modern Perspectives” that neatly summarizes the current state of knowledge of the connection between fat intake and heart disease. Interestingly, or perhaps appallingly, “The only long-term trial that reduced n-6 LA intake to resemble a traditional Mediterranean diet (but still higher than preindustrial LA intake) reduced CHD events and mortality by 70%.”

    Finally, as early as 1999 National Institutes of Health scientists were recommending reduced intake of omega-6s to increase the effectiveness of omega-3s. Here’s what they said:

    One recommendation deserves explanation here. After much discussion consensus was reached on the importance of reducing the omega-6 polyunsaturated fatty acids (PUFAs) even as the omega-3 PUFAs are increased in the diet of adults and newborns for optimal brain and cardiovascular health and function. This is necessary to reduce adverse effects of excesses of arachidonic acid and its eicosanoid products. Such excesses can occur when too much LA and AA are present in the diet and an adequate supply of dietary omega-3 fatty acids is not available. The adverse effects of too much arachidonic acid and its eicosanoids can be avoided by two interdependent dietary changes. First, the amount of plant oils rich in LA, the parent compound of the omega-6 class, which is converted to AA, needs to be reduced. Second, simultaneously the omega-3 PUFAs need to be increased in the diet. LA can be converted to arachidonic acid and the enzyme, {Delta}-6 desaturase, necessary to desaturate it, is the same one necessary to desaturate LNA, the parent compound of the omega-3 class; each competes with the other for this desaturase. The presence of LNA in the diet can inhibit the conversion of the large amounts of LA in the diets of Western industrialized countries which contain too much dietary plant oils rich in omega-6 PUFAs (e.g. corn, safflower, and soybean oils). The increase of LNA, together with EPA and DHA, and reduction of vegetable oils with high LA content, are necessary to achieve a healthier diet in these countries.

    References
    1. http://www.ajcn.org/content/80/5/1102.full
    2. http://members.iimetro.com.au/~hubbca/new_page_1.htm
    3. http://www.youtube.com/watch?v=dgU3cNppzO0
    4. http://thepaleodiet.com/articles/Dietary%20Fat%20Quality%20%20CHD%20August%202009.pdf
    5. http://www.jacn.org/cgi/content/full/18/5/487 Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids which was published in Journal of the American College of Nutrition, Vol. 18, No. 5, 487-489 (1999)

  45. Right on, right on! For the most part, refined carbohydrates are an invention of the 20th century. I’m preventing diabetes by teaching people how to tell the difference between real food and manufactured calories at “Your Health is on Your Plate.” Add me to your blogroll!

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  47. Pingback: More Fats Please!

  48. Pingback: A great article: A Big Fat Debate « Smiles in the Kitchen

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  50. “Ms. Wartman quotes members of the scientific community as stating that replacing SFA with refined carbs is not beneficial. This is supported. However, it is also supported that SFA are not desirable. What Ms. Wartman depicts as misinformation is actually based on far more science than she presents in this article. The DGAC of 2010 reports, “The consumption of certain fats, such as saturated fatty acids (SFA) and trans fatty acids, is associated with a poor lipid/lipoprotein profile and increased risk of cardiovascular disease (CVD).””
    Part of the problem with some of the older literature on SFA is that they are lumped in with trans fats. Naturally saturated fats are not the same as artificially created ones, the hydrogenated fats. That’s partly how coconut oil got such a bad rep (undeservedly) for so long: feeding trials on rabbits with fully hydrogenated coconut oil in a study intended to show what deprivation of essential fatty acids did for totally herbivorous rabbits. And no, a full reading of *all* the literature doesn’t support demonizing animal fats and other naturally saturated fats. See Taubes, Uffenskov, etc etc.

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  54. Pingback: Fat is not the problem

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  57. Pingback: If you work out the numbers, you come to the surreal conclusion that you can eat lard straight from the can and conceivably reduce your risk of heart disease.” « Lessons in Farming

  58. Pingback: “If you work out the numbers, you come to the surreal conclusion that you can eat lard straight from the can and conceivably reduce your risk of heart disease.” « Lessons in Farming

  59. Pingback: Finally, the USDA names names in its dietary guidelines | Grist

  60. toGoneWithTheWind – I am not a dietician, in the industry or a doctor. BUT I can assure you a high carbohydrate diet DOES give you diabetes. and stopping eating it does CURE diabetes. I saw it myself, doing tests and changing my diet.

    why talk about something you don’t really know about as if it were true?

  61. Pingback: Fat: Not As Bad As We Thought | Earth Eats - Indiana Public Media

  62. Hi Kristin, thanks for writing on this incredibly important topic. I would love to add you to our press list if you will send me your contact info. I am the publicist for The Weston A. Price Foundation, who is directly challenging the USDA dietary guidelines and their fat and salt strictures.

    Here’s the link to our recent press conference (including powerpoint), which is just under two hours long. This can also be downloaded as an MP3 file (audio only) or as an M4v video for mobile devices like the iPad and iPhone 4:

    http://blip.tv/file/4861084/

  63. It has been scary to watch the decline in the health of our children as it has been recommended that they eat increasingly low-fat, high-carb diets from toddlerhood on. I am hopeful that we will all come to our senses that man-made “food” is not what our bodies and brains were designed to use before it is entirely too late. Fats and cholesterols are essential nutrients, especially for the proper growth of our children.

  64. Pingback: Real Food Blog » The Low Fat Craze May Be On The Way Out

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  66. I am very suprised that people still believe diabetes is caused by eating sugar (carbohydrates). A common old wives tale 60 years ago but it still persists. Please get your health information from somewhere other then the internet. The internet is a great source of information and a great source of disinformation. If you can’t tell one from the other then you will be mislead.

  67. I’d always thought that the reason you weren’t supposed to eat fat was that it has more than twice the number of calories as a gram of protein or carbohydrates, so that an x-calorie serving of beef looks and feels like a joke next to the same number of calories in cod or pasta.

  68. Pingback: Civil Eats » Blog Archive » A Big Fat Debate | Best of X

  69. Re: Scott #72

    Please run, RUN!, to your friendly neighborhood bookstore and buy, then read, Gary Taubes’s Why We Get Fat. It will answer all your questions.

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  74. It’s pretty clear that calorie counting doesn’t work, and similarily that ‘the exercise more’, ‘eat less’ philosophy doesn’t work either… it’s not about how much you eat and all about what you eat.

    For me the only advice for losing weight is cut back heavily on sugar and carbs, find your threshold level, e.g. how
    much carbs can you eat without gaining weight after reaching your ideal weight… Then you’re yo-yo dieting days are
    over.

    As for fats I do belive that the more fat you can replace your carbs with, will speed up your weight loss, since you
    get satisfied very fast and stays full longer…