Not so long ago, there was a
scourge upon the land. More American men were having heart attacks at a rate
not previously recorded. It was the late 1950s and 1960s, when the economy
was good and food plentiful. So why was heart disease on the rise?
Scientists
looked all over for a cause and solution. (The notion that the rising rates of cigarette
smoking may have been a contributing factor was discounted as the tobacco
companies claimed that cigarettes were harmless.)
Ancel
Keys, an ambitious, imperious, and charismatic scientist, believed he had the
answer: saturated fat. This appeared a reasonable theory since, at
the time, 50% or more of daily calories consumed in the American diet were
from saturated fats found in milk, eggs, cheese, cream, butter, bacon, and
steak.
Keys
pursued his hypothesis with vigor, traveling the world collecting data and
cherry-picking the results of his “observational” studies (not the gold
standard of medical research). He also successfully promoted his idea to the
American Heart Association (AHA), obtaining a chair on its nutrition committee,
despite the fact that he had no nutritional training.
In
an effort to eliminate any scholarly competition, Keys ridiculed a counter-theory
offered by British researcher John Yudkin. Through bullying and distortions,
he managed to have Yudkin’s information suppressed and his reputation
ruined. Yudkin believed that sugar, not fat, was a major contributing cause of
heart disease.
The
AHA incorporated Keys’ hypothesis into its 1961 dietary recommendations and
sold its “heart-safe” logo to food companies advertising the low fat content of
their products.
In
1977, a Senate subcommittee declared saturated fat the cause of heart disease,
despite the objection of one senator (also a medical doctor) who believed
more conclusive research was needed. The response from the subcommittee chair,
Senator George McGovern: “We don’t have time to wait for the evidence.”
In
1980, the die was cast. The first ever government set of dietary guidelines was
officially presented to the public. These guidelines, recommending a low-fat, high-carb diet,
influenced food consumption in schools, hospitals, the military, services for
the poor and elderly, and advice given by doctors to their patients for the
next 50 years. They were also adopted in the UK in 1983 and elsewhere.
Anyone
who deviated or disagreed was thought to be anti-science. In some countries,
doctors and nutritionists who didn’t follow government orthodoxy were
threatened with losing their license.
The
food industry accommodated the U.S. government edict by producing an
array of low- or no-fat snacks, cookies, cakes, and convenience foods. Saturated
fats from animals were condemned; unsaturated and hydrogenated oils from plants
were promoted as heart-healthy substitutes. Butter was out, margarine in. (Oddly,
fast foods, the dispensary of fatty meats and deep fried everything, seemed to
escape scrutiny.) What people didn’t notice – and no one pointed out – was that
food with reduced or no fat doesn’t taste very good, a problem the food
industry solved by replacing fat with lots of refined sugar and
carbohydrates.
What
was the result of this 50-year experiment to eliminate saturated fat from our
diets? The incidence of diabetes increased by 700%, one in three Americans
became obese, and over half the population suffered some sort of metabolic
syndrome. Even children got fat; one in five were considered obese in
2016, with a growing number suffering from diabetes and fatty liver disease,
once associated mainly with alcoholism. In other countries following the
Standard American Diet (SAD), similar health problems ensued. As for heart
disease, it remained the number-one cause of death in America.
The moral of the story: Beware
of governmental one-size-fits-all proclamations on health. There may be
political, economic, or other factors influencing the “science” used as a tool
for compliance.
Epilogue
Despite
billions of dollars spent on research over the last 50 years, no evidence has yet been found to
confirm the saturated fat/heart disease connection. But there has been much
research implicating sugar as a main contributing factor in many diseases.
This is what Yudkin had proposed in his 1972 book, Pure, White, and Deadly, in which he called sugar “a public
health problem… because of the unique nature of the compound.”
Excessive
sugar overloads the liver and pancreas, forcing production of more insulin than
the body can handle. The result is insulin resistance, which initiates a
cascade of events leading to chronic inflammation, metabolic syndrome,
diabetes, heart disease, fatty liver disease, and obesity.
America
now has the dubious distinction of being the fattest country in the world, followed
by Mexico, with no end in sight. As if that were not bad enough, sugar is
believed to contribute to leeching calcium and minerals from bones and
teeth; feeding cancer cells; disrupting the gut microbiome, which
controls much of our immune system; exacerbating behavior problems
and hyperactivity in children (along with the food dyes often present in sugary
kid foods); and contributing to emotional problems like
depression and anxiety for all of us.
Fat
is no longer the boogey man but rather is now recognized as important for good
health. Fat constitutes 60% of our brains and is essential in cellular
production, nerve myelination, and nerve conduction.
Scientists
have reclassified “good” and “bad” fats. Good fats, like omega-3 fatty
acids, are unsaturated fats found in olive and avocado oil, as well
as fatty fish, such as salmon, sardines, trout, and mackerel. Increasingly,
studies are looking at “bad” fats being found in the seed and vegetable oils,
such as canola, safflower, and soy, which are touted as “heart-healthy”
substitutes for saturated animal-sourced fats. Aside from being processed using
high heat, chemicals, deodorant, and bleach, they contain omega-6 fatty acids,
which can lead to inflammation and disease if eaten in large amounts. It is the
omega-6 fats that are found in most processed foods today.
Trans
fats, another byproduct of the effort to replace animal fat with
vegetable oils, is a manmade fat not found in nature. Margarine, once promoted
as a healthy substitute for butter, is a trans fat. Trans fats are made by
hydrogenating seed oils, a process that makes them solid at room
temperature. The commercial benefit of trans fats is that they
increase the shelf life of many foods (Twinkie, anyone?). However, they are
now considered dangerous and have been banned in Europe and partially in the U.S..
(As usual, the FDA makes exemptions for big industry, so trans fats are still
allowed in commercially-baked goods and fast foods.) Read your labels: If you
see “hydrogenated oils,” it’s trans and not good for you.
Unlike
sugar, which causes rapid fluctuations in blood glucose – thereby
causing an increased sense of hunger – fat keeps one’s blood glucose
level steady and maintains satiety. This may be why some
nutritionists are treating diabetics with high fat and protein
diets and seeing better results than diets still being proposed by
the American Diabetes Association (ADA).
How Did It Happen?
So
how did the officials get it so wrong? An honest mistake? Scientific evolution?
Sadly, the fat fable is a story we see repeatedly. And like all fables, it
involves human foibles, usually greed, power, and groupthink (think the Emperor’s
New Clothes).
In
2016, letters were uncovered revealing that at the height of the anti-fat craze
in the 1960s, the sugar industry paid Harvard scientists to publish articles
minimizing the effects of sugar while implicating the role of fat in heart
disease. (New York Times 9/12/16)
It
took 45 years to finally see the results of the Minnesota Cardiac Study,
which showed that an unsaturated fat diet had a higher mortality rate than a saturated fat diet! It was
only after a family of one of the study’s subjects started
demanding answers that the results were finally published, after
having been hidden since the study’s completion in 1973.
The
same thing happened with the results of the Sydney Diet Heart Study, conducted from
1966 to 1973. This study also showed increased mortality on a diet
rich in omega-6 fats and low in saturated animal fats. Both these
studies were conducted using random control trials, the gold standard of
scientific research. The “problem” with these studies was that their outcomes
contradicted the orthodoxy of the time.
What
role might the 1973 Corn Subsidy Farm Bill have played in how rigorously some
politicians pushed vegetable over animal fats? This legislation ultimately
provided the country with an abundance of four major crops, all of which were
then used to produce oils as alternatives to animal-sourced fats, such as butter
and lard. Corn was used not only as a “healthy” fat substitute
in the form of oil and margarine but also as a cheap sugar substitute
in the form of high fructose corn syrup. (We even got a cheap gas
substitute, ethanol, out of the deal.) We now have learned that HFCS suppresses
the hormone leptin, making us feel hungrier.
Scientists
and bad science are not exempt from blame. Nina Teicholz, in her book The Big Fat Surprise, suggests that the
notion that saturated fats caused heart disease was driven not by evidence
but by powerful personalities who influenced senior nutrition
scientists, insecure about their medical credentials, to seize
upon the theory and attack anyone who disagreed.
Where Do We Go from Here?
We
now face a public health crisis that threatens to bankrupt us, physically and
financially. Seventy-five percent of our healthcare budget is spent on treating
chronic illnesses, such as diabetes, hypertension, depression, and heart
disease, caused in large part by what we eat. Obesity rates alone should sound
the alarm that we are a country in crisis. The U.S. Department of Defense
reports that nearly one-third of 17- to 24-year-olds are too overweight to
serve in the military. The military spends more than $1.5 billion each year
treating obesity-related health conditions and filling positions vacated by
unfit troops. (Medical Express, 10-13-18)
No
new Senate subcommittee is being convened to rethink our diets or to admit that
the food pyramid presented to us in the 1980s may actually be upside down! No
politician would dare criticize or demand changes in a food industry that is
now controlled by six major corporations in the U.S. (and four in Europe) – or resist
the perks offered by their lobbyists.
We
may never be certain about the motivation behind the government recommendations
of the 1980s. But one thing we now know for sure: the Standard American
Diet is making us sick, and we cannot rely on big government, big food, or
big pharma to cure us. The organic movement is not new but is now gaining
popularity as people seek more control over their health and a return to whole
foods. Even the meat industry is offering “free range” animals as a way for us
to benefit from their better, non-corn diet.
Fast
food is convenient and ostensibly cheap, but consumers will pay a high price
long term. Maybe it is time to use the foods we’ve been gifted in our quest for
better health. As Maimonides said, “No disease that can be treated by diet
should be treated by any other means.”
