Fat Head Med?

      32 Comments on Fat Head Med?

A couple of weeks ago I received this brief email from Brent Pottenger, one of the founders of the Ancestral Health Symposium:

Hey Tom,

I’m sitting in endocrinology now here at Hopkins Med, and our class is watching both Super Size Me and Fat Head as a required activity!


Seth Roberts also shared this message from Brent on his blog:

Today, as a required activity for our Hopkins Med endocrinology course, we watched excerpts from Supersize Me and Tom Naughton’s Fat Head. Our professor then engaged us in a discussion comparing the two films. Our professor told our class that the lipid hypothesis is incorrect, said that the USDA Food Pyramid is the product of corn and wheat subsidies (and lobbies), and definitely stirred up some uneasy responses from my classmates.

What the professor said contradicted what they believe. Every professor before this has demonized saturated fat, meats, etc., so this was the first time someone questioned that belief.

No surprise there.  Seth asked how the med students expressed their unease.  Brent replied:

They expressed unease by getting up and leaving the lecture hall, by whispering in disgust to their neighbors, etc. — you could see it on their faces. Then, some of the more curious classmates who are always inquisitive followed up with genuine questions, wanting to know more about the validity to the statements made in Tom’s movie about Ancel Keys, the McGovern Report, the USDA, the science of the lipid hypothesis, etc.

Med students leaving the lecture hall rather than have their beliefs challenged … and you wonder why I don’t trust most doctors.  But cheers to the professor for challenging what they’ve already been taught, and cheers to the students who were open-minded.


32 thoughts on “Fat Head Med?

  1. DoctorSH

    I have fun with med students when doing an externship in my practice. They get uppity at first when I tell them that the lipid theories are rubbish. But by the end of four weeks I have most of them believing!

    We need more doctors like you.

  2. Oly

    Bloom’s Taxonomy — the bottom tier of that comprehension diagram is “Remember” the next up is “Understand – Explain”. 3rd tier is Apply then it gets to the upper tiers of Analyze etc. I refer to that chart when testing my own understanding of subject matter. The average doctor I’ve encountered operates at the bottom tier — they just are not masters of their craft. Therefore, they not only just don’t question pharma-reps and the latest advertisement-masked-as-science recommendations — they flat out can’t (at least not without adopting a scholarly drive). I just keep the polite smile on my face and hope the feeling that I’m working with the equivalent of a crappy tier I support agent isn’t showing.

    I think the really good doctors are busy writing papers or books, lecturing, fixing the problems caused by other doctors, drowning their disgust with their colleagues with a margarita from a beach somewhere. Thank goodness for the internet.

    A doctor told me that med students are taught to memorize, not to think like scientists.

  3. Tom Welsh

    “Med students leaving the lecture hall rather than have their beliefs challenged … and you wonder why I don’t trust most doctors”.

    I am seeing this kind of thing more and more, almost everywhere. In an online discussion about climate change, one group of people began criticizing “denialists” in the most scathing way. I pointed out to them that science is not an appropriate arena for fixed beliefs or dogma, and that Galileo and Semmelweiss (who first introduced sterile practices into hospitals, and was hounded to death for his pains) were virtually alone in holding their beliefs against the united body of “informed opinion”.

    Politicians are largely to blame, because they either don’t understand how science works or choose to ignore what they know. The idea that facts are unalterable and are either right or wrong – irrespective of who believes them – is anathema to politicians and businessmen, both of whom depend on convincing others of what suits them, regardless of truth.

    Well, they love the word “denialist” because that “ist” suffix sounds ominous … as in racist, sexist, etc. As Professor Robert Carter pointed out in one of his lectures on the topic, the proper word is “skeptic” and good scientists are supposed to be skeptics.

  4. TonyNZ

    So when someone tells you that you can’t be right because you don’t have a degree, will your reply now be “no, but people that teach people so that they can get degrees use my work in their lectures?”

    Good point.

  5. JasonG

    It’s funny how people take a common belief so personally. They defend their cause with the passion of a religious cult. Super Size Me appeals to angry, emotional students by demonizing a big, successful business, while Fat-Head appeals to reasonable people with unpopular logic. It’s clear which one is more popular.

    When I discuss low-carb with my friend, he retorts, “That goes against everything I was taught in my nutrition classes.” How can I argue with that statement? The close-minded arrogance is impossible to counter because logic, reasoning, and evidence is ignored.

    Thankfully not everyone is a lemming.

    A co-worker with a handful of health problems told me he pitched the idea of going paleo to his wife, who is dead-set against it because her mother is a nutritionist and insists meat and fat will kill them. The mother is also obese and unhealthy, according to my co-worker.

  6. desmond

    My 10-year old son just finished a required presentation (in Spanish class, for some contrived reason) on the Food Pyramid. I guess they have not updated the Spanish textbooks for “Mi Plato” yet. I told him it is very important for him to learn the pyramid… for the sole purpose of avoiding it. I don’t think my parents ever told me not to believe something I was taught in school, but it is a skill I am picking up. So kids, you have to know it, but you don’t have to accept it.

    My daughters are already very aware that not everything they read in a school book is true, and I’m glad of it.

  7. Galina L.

    My doctor supports whatever what improves health, so he is a big supporter of my LC diet. He told me he even read what people write about a nutrition on the internet. He is not exactly a LCarber, just “whatever is working for a patient…” guy.

    That’s the proper attitude to have. I occasionally hear from people on low-fat or vegetarian diets who tell me how much their health has improved, to which I reply, “If it’s working for you, stick with it. If it stops working for you, make a change.”

  8. Pierce

    You should try to get a hold of the professor for an interview. I live in the area and the Hopkins folks are far from publicity shy, at least in the local media. The fact that it’s one of the leading medical schools in the world doing this, not some Cayman island correspondence degree program, is pretty cool.

    Not a bad idea. First I have to find out his name.

  9. Violeta

    @ Mike….”the GREAT OZ,at least appears to be doing a re-think (money from a different direction) on cholesterol”

    It’s most likely the money from a different direction. On the other hand, with the re-think, the Great Oz may be paving the way to adding some serious cholesterol to his own meals as it seems that low-fat is not working all that well for him. He is still very lean but looking somewhat unwell lately…

  10. Richard Tamesis, M.D.

    Just because you get into med school it doesn’t necessarily mean that you are smart nor have an aptitude for critical thinking. SoCal appears to be full of them, at least in my area.

  11. Kathy

    I’m a little OCD in almost everything that interests me, then I usually burn out and move on to a new interest. I’m an information junkie (what did I do before the internet?). I just made a list of my supplements at my doc’s nurse’s request – there are 14. This is crazy. I’m doing the same thing that the doctors do, except that I “self-prescribe” supplements.

    So as these run out, I’m not replenishing them. Seems an easy way to gradually wean myself from this “addiction”. At least in a few months I’ll know if all that money was just wasted. Why am I telling you this?

    Because your blog is a rare tether to sanity in a increasingly crazy world. Thanks, Tom!

  12. labrat

    “Don’t just teach your children to read.. Teach them to question what they read. Teach them to question everything.” George Carlin

    I’m doing the best I can George. My daughter – a junior – is writing her research paper for her college writing class. It’s titled “Good Nutrition”? – the Low Fat Hypothesis.

    I think I’m rubbing off on her…….

    Maybe she’ll even influence her teachers to question their own beliefs.

    One can only hope.

    That’ll depend on the teacher. Some encourage critical thinking, others believe the “good” students are the one who parrot the teacher’s beliefs.

  13. Wolverine

    Funny how painful cognitive dissonance can be. That can be the only explanation for leaving the room. Doctors are able to keep the conflicting ideas separated in their mind by not thinking about them at the same time.

    I was kept alive on TPN (Total Parenteral Nutrition) for about 6 months (TPN is very high in dextrose). The doctors had to explain to me why a person cannot live indefinitely on TPN. They explained that the sugar would ultimately destroy the only six access arteries that they could implant catheters into. They told me it would only take about 2-3 years before the arteries would completely fail and I would die.

    I asked why if they knew this, they could still recommend diets high in starches, like grains and legumes. Of course at that point, they would simply leave the room. They also knew that the infused soy lipids (Intralipid) would destroy the liver inside 6 months to a year, but still recommend that patients supplement with “Ensures” – a product made from soy oil.

    In Europe, doctors infuse a lipid made from fish oil called “Omegavin”, which has never shown the same damage to the liver that Intralipid has. For some reason, the FDA will not allow the infusion of Omegavin in the U.S. except to children who have already sustained liver damage from the soy lipids. Adults are simply allowed to die at the point that their liver shuts down from the soy lipids.

    It must be tough to live with such conflicting data in your head.

    Some people compartmentalize information, others synthesize information. It’s the synthesizers who are more likely to both question and innovate.

  14. Vir-Gena Fowlkes

    My 13-year old son was just telling me, that in his Science class they are learning about the human body and how important fat is for it’s daily functions and to not consume a lot of carbs . Yet, in his Health class they are teaching that fat is bad, limit them and carbs are good, eat a lot. He said that taking the tests were difficult because of the conflicting information. Luckily he knows the truth. It starts early in school….. this miss information.

    It’ll be interesting when my daughters start taking tests in health class. I may have to be a pain in the butt and lobby very hard for a guest lecture spot.

  15. Rae

    Here shortly I will be moving and forced to take on the dreaded task of finding a new GP. In the past when shopping around for specialized doctors I always knew to keep looking when they said losing weight is just a matter of calories in and out when I brought it up. That will be my tactic again, but I’m sure I don’t have to tell you that far more fail that test than pass.

    I’d just tell a prospective doctor my total cholesterol is 205 and see if he or she suggests a low-fat diet and a statin.

  16. Ed Terry

    At my wife’s doctor’s office, they have a binder full of periodic newsletters from the Cornell College of Veterinary Medicine. The latest issue had an article on preventing and treating pancreatitis in dogs. It said that if a dog develops pancreatitis, with elevated triglycerides, it should be placed on a very low-fat diet and fed rice and pasta.

    One of the risk factors for canine pancreatitis is diabetes. Apparently, dogs fed too much fat and protein develop diabetes.

    Bang head on desk!

    Oh, those poor dogs …

  17. Erik

    Very interesting that an alternative or a competing paradigm was presented. I was taught about glycemic index in medical school, but not about well-formulated low carbohydrate diets. Thankful that there’s information on the internet, and based on the work of Gary Taubes, yourself, and others. That’s part of continuing medical education, non drug company sponsored!

    Gary Taubes and Christopher Gardner had an interesting discussion/debate recently at Stanford. I thought both had good points. I liked how Gardner, a vegetarian himself, cast doubt on Forks over Knives. Hadn’t seem it posted on my usual blog reading list.


    I listened to Gardner on Jimmy Moore’s show. He struck me as quite open-minded.

  18. Erik

    Additionally, as someone who peripherally looks after patients on TPN, I can confirm the high dextrose content and the insulin that is required to control it. Interesting comment about the fatty acid composition.

  19. JasonG

    All hope isn’t lost in schools. My English 101 text book for Wright College in Chicago had a David H Freedman article about bad science, a Thomas Sowell article about patriotism, and a neutral article discussing low-carb and low-calorie diets. I was pleasantly surprised by the selection of texts.

    Those are pleasant surprises indeed. David Mamet referred to Thomas Sowell as our greatest living philosopher.

  20. FlorianK

    As a medical student in Germany I wish we had a course like that!
    We had only one lecture on the topic of obesity (usual stuff). Afterwards I went to the Professor to find out what he thinks about low carb and he just said it works but he’s not allowed to use it for the treatment of his patients!

    Then I went to a bariatric physician in my university to see what kind of diets they recommend for their patients and to my suprise they tell them not to watch calories, but keep protein high (because of the saturation).

    It’s just ridiculous what we learn about nutrition in the university! In the first year they teach you all the biochemistry you need to know to become a low carb fan, but in the clinical part nobody remembers it! Why don’t these guys talk to each other?

    Well, at least you’ll end up being a doctor who knows better.

  21. Dana W

    Regarding the recommended diet for a dog with a history if pancreatitis…my dog has Addison’s
    disease, and is therefore more likely to have bouts of pancreatitis. The vet recommended a low fat corn-based dog food, with canola oil as the only added fat. He said a fatty or high protein diet will cause him to get pancreatitis.

    I fed him the food for a little while, but I knew better. I started feeding him a food consisting of raw meaty bones, veggies, and coconut oil. Now his electrolyte blood tests come out perfect every time, his skin does not flake, he is musular and trim, and has no ‘dog smell’ anymore. His teeth stay cleaner too! No bouts of pancreatitis since the diet change.

    Of course the vet thought the change in diet was unrelated. ‘Everyone knows a low-carb diet is bad! He’s doing well despite the diet!’ He still does get an injection every month since his adrenal glands do not make any hormones, but we have not had to adjust his dose since the diet change.

    My theory is a high carb diet increases the amount of stress hormone flucuations. I remember Dr. Mary Dan Eades (in Fathead) saying that high blood sugar being an emergency to the body, and when there is an emergency stress hormones are released.

    Anyway, I don’t listen to diet advice from my doctor, or from my dog’s doctor. And my dog and I are both healthier for it! It’s too bad doctors cannot think more logically about diet.

    Yet another paradox, exception, freak of nature, or however they choose to explain it away.

  22. TR

    1616 A.D.

    Professor Galileo: My observations indicate that planets, including Earth, revolve around the Sun.

    Audience: Rubbish! I won’t stand for this nonsense. Out of my way, I’m out of here and heading back to selling indulgences….behind quota.

  23. Lucky Joestar

    Tom’s quote:

    “A co-worker with a handful of health problems told me he pitched the idea of going paleo to his wife, who is dead-set against it because her mother is a nutritionist and insists meat and fat will kill them. The mother is also obese and unhealthy, according to my co-worker.”

    Ah, the power of belief! It took actually going low-carb to actually shake that long-held belief, but I’m more open-minded than most people. Ever since I started susbisting on tuna salad, I saw how much weight I lost, weight I had gained back when I was a vegan, and that was all it took to change my mind about fat and carbs.

  24. M

    It is a big step for people teaching nutrition to stop towing the party line. It’s quite confronting to realize that what you were taught in your science degree, then what you go on to teach students is incorrect. While we have the critical thinking skills to delve into the research and therefore discover fact from fiction, those qualifications are a barrier from looking into it in the first place.

    The difficulty of changing long-held beliefs was described perfectly in the book “Mistakes Were Made (but not by me).”

  25. hausfrau

    I don’t know if this is too off topic but I recently did a gestational diabetes test. I had a false positive my last pregnancy and another positive again last week so I have to do 3 hour fasting glucose test. Does anyone here know about the reliability of these tests? I read that %20 of these tests turn up positive but only %2 have diabetes. If this is true this test seems really unnecessary. Also isn’t drinking 100g of glucose pretty harmfull to mom and baby in itself? I asked this and the response I get from doctors is always “oh but its worse to not know if you have diabetes”. The whole thing seems like yet another establishment medicine witch doctor ritual. Does anyone here know where to get better info on this test than my doctors office will provide? So frustrating.

    I’m not sure on that one.

  26. John Owens

    Just a point to note about the things taught in schools and the effect of teachers.

    In the end, school is just a right of passage so that government and the general public can “classify” you. Being right isn’t always a good thing. Being a positive influence on the world around you is important, however you achieve it.

    Getting the kids to realize that passing the test and knowing the actual correct facts are not necessarily the same thing. I mean, not so long ago you’d get an A for saying the world was flat.


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