Reading Nina Teicholz’s outstanding book The Big Fat Surprise was a bit like watching the movie Titanic. The story was long, but also so well written, I was never bored. And even though I already knew about the impending disaster, I found myself mumbling “Oh, no!” as each misstep brought it about – as if the story could end any other way. Maybe this time some hero would jump in and steer around that big iceberg so everyone could live happily ever after.
The iceberg in this story is the anti-fat hysteria that led to low-fat diets, SnackWell’s, cereal replacing eggs on many breakfast tables, hydrogenated oils replacing saturated fats in restaurants, whole milk being banned from schools, etc. Captain Ancel Keys set us on a direct course to hit that iceberg, and the nation’s health has been sinking ever since.
The book’s subtitle is Why Butter, Meat & Cheese Belong in a Healthy Diet, which gave me the impression I was about to start reading a hefty science book. There’s plenty of science in The Big Fat Surprise, but it’s more of a history book. It’s the story of how lousy science conducted by arrogant scientists and adopted by equally arrogant policymakers led to lousy decisions that produced lousy consequences. I doubt any Fat Heads out there still believe nutrition science is conducted by impartial researchers who aren’t already wedded to an outcome, but if so, reading this book will disabuse you of that notion. It’s all laid out here in a richly detailed story that runs 340 pages … the egos, the arrogance, the obsession with pursuing and (ahem) proving a single hypothesis, the scientific bullying, the corruption, and of course the ham-handed interference by the 900-pound gorilla known as the federal government.
The story begins (as covered briefly in Fat Head) with the spike in heart disease in the 20th century and the national obsession with finding both the cause and the cure. That’s when Ancel Keys stepped in to assure the medical world he had found the answer: high fat diets caused heart disease, so low-fat diets would prevent it. Keys had fallen in love with the Mediterranean region and its people during his post-war travels (he later retired to a villa in Italy), and perhaps largely because of that, he was convinced the Mediterranean diet (as he imagined it to be) was superior for human health.
The only problem, of course, was that Keys never had an accurate picture of what his poster-children for heart-health were actually eating. His data sets were ridiculously small, and one of his two dietary surveys from Greece was taken during lent, when religious Greeks (60% of the population) gave up meat and other animal foods containing saturated fat. As Teicholz writes:
Although he had observed only a small number of men on these early travels and had no particular method for measuring their diets, Keys wrote with assurance that total fat was “clearly” a “major factor” in the development of heart disease… Again, the numbers of people observed were miniscule, but Keys deftly knit together these skimpy data from far and wide into a picture that looked convincing.
Keys apparently knew his data was problematic. As Teicholz discovered during years of research for the book, Keys was happy to publish his conclusions in major journals, but he published his raw data in the Dutch journal Voeding, where it was likely to go unnoticed:
And no one has to read between the lines to get a sense of all the many technical difficulties Keys encountered. In Greece alone, three different chemical methods were used to analyze fats in the food samples, and their results did not line up … Yet in the Seven Countries report itself there is no indication that the data might be flawed in any way, and overall, it has been given a pass by researchers in the field for decades. When I tracked down the papers, it became obvious that Keys, in his ambition for the study, had done everything he could to bury its problems.
In a section titled The Sharp Elbows of Nutrition Scientists, Teicholz recalls how Keys and fellow lipophobe Jeremiah Stamler engaged in science as a form of combat. There was no such thing as a gentlemanly disagreement when Keys or Stamler was involved. People who questioned the Lipid Hypothesis were considered enemies who deserved to be crushed. And over the ensuing years, as both the American Heart Association and the U.S. government got on board with the Lipid Hypothesis, that’s exactly what happened: scientists who dared question the anti-fat hysteria would find themselves without grants to conduct research – in other words, without a paycheck. More and more of them learned to go along to get along.
When the McGovern Committee released its Dietary Goals for The United States – written by a young staffer with no background in health science — the policymakers were convinced they were encouraging Americans to return to the diet of the nation’s agrarian past, when heart disease was rare. After all, poorer Americans from previous generations couldn’t possibly have afforded to eat much meat, right?
Wrong. Obtaining meat in pre-industrial America wasn’t a matter of money; it was a matter of hunting – and there was plenty to hunt:
The endless bounty of America in its early years is truly astonishing … In the woods, there were bears (prized for their fat), raccoons, bobolinks, opossums, hares, and virtual thickets of deer – so much that the colonists didn’t even bother hunting elk, moose, or bison, since hauling and conserving so much meat was considered too great an effort.
(Now what kind of backwoods lunatic would eat a raccoon? Wait … never mind. Anyway…)
Records Teicholz dug up during her research show that as recently as 1909, poor Americans consumed an average of 136 pounds per year of meat, while wealthy Americans consumed an average of 200 pounds. Nor were early Americans year-round vegetable eaters for the most part. There were no refrigerators, and produce wasn’t shipped all over the country like it is today. People consumed most of their fruits and vegetables in season, period.
Despite little evidence that the McGovern Committee’s recommendations were based on real data or even an accurate version of history, the media jumped on board. When controversy over the low-fat, low-cholesterol guidelines arose, many media types portrayed it a battle between the good, impartial government and the big, bad meat and dairy industries. The McGovern staffer who wrote the Dietary Goals later admitted seeing it way.
Teicholz spends the next chapters recounting the many studies that tried and failed to provide credible evidence that the low-fat diet would reduce rates of heart disease. But of course by this time, the fix was in. The NIH and the American Heart Association had a near-stranglehold on funding for cardiovascular research, and both were on board the Good Ship Lipid Hypothesis and determined to steer it towards the iceberg. The anti-fat hysterics treated each failure not as evidence that they were wrong, but as evidence that they simply hadn’t conducted the right study yet.
The right (ahem) study turned out to be one in which a cholesterol-lowering drug produced a very slight decrease in heart attacks among high-risk men. From this – a drug study, mind you – the lipophobes announced they had the proof they’d been seeking to support their dietary hypothesis. In doing so, they were engaging in teleoanalysis – that is, deciding that if A is linked to B and B is linked to C, A must cause C. Saturated fats raise cholesterol, a drug that lowers cholesterol reduced (slightly) the rate of heart attacks, so saturated fat must cause heart disease.
No, it isn’t actually logical, but scientists, doctors, policymakers, the media and the public bought it. This was the study that led to the famous photo of frowning bacon and eggs on the cover of TIME magazine, which announced that cholesterol had been proved deadly.
I was aware of that part of the story before reading The Big Fat Surprise, although Teicholz goes into more detail than anything I’ve read on the subject. I wasn’t aware of how olive oil and the Mediterranean diet became the supposed saviors of our hearts and arteries. The brief version of that story is that researchers were wined and dined and dazzled by companies and governments with a financial interest in selling more olive oil:
The method involved inviting academic researchers, food writers, and health authorities into a slice of paradise: travel, free of charge, to some sun-kissed country around the gorgeous Mediterranean Sea for the purpose of a scientific conference. In Italy, Greece, and even Tunisia, scientists rubbed elbows with cookbook authors, chefs, journalists, and public officials. Harvard provided the scientific prestige, while Oldways organized the financing. During the 1990s, there as a steady rollout of these conferences, and they effectively served as a nonstop promotion vehicle for the Mediterranean diet.
And later from the same chapter:
Italy, Greece and Spain all contributed… In other words, nations and their industries promoted themselves by providing lavish perks aimed at buying the good opinion of experts who would ultimately advise the public on nutrition. The strategy clearly worked.
Indeed. Meanwhile, since those same experts had decided saturated fat causes heart disease, trans fats entered the food supply in a big way. If you’re my age or older, you may remember seeing packages in the grocery store bearing the words NO TROPICAL OILS! on the label. That was result of The Guy From CSPI and other anti-saturated-fat hysterics harassing food manufacturers into removing palm oil and coconut oil from their products and replacing them with hydrogenated oils – mostly hydrogenated soybean oil. The soybean industry, in fact, helped fan the flames of fear about tropical oils.
Bowing to increasing pressure from both the do-gooder organizations and Congress, the food industry reformulated their products to use hydrogenated oils instead of tropical oils or animal fats, thus making trans fats a significant part of the American diet … and yet nobody seemed interested in testing whether or not trans fats were actually safe for human consumption – at least not anyone in a position of power. There were isolated researchers sounding alarm bells – Dr. Mary Enig and Dr. Fred Kummerow, for example – but they were ignored or effectively silenced. The American Heart Association apparently printed 150,000 pamphlets warning the public that trans fats don’t lower cholesterol (the supposed benefit of vegetable oils), but then chose not to distribute them. (Anyone think their sources of funding had something to do with that decision?)
Some of those “Oh, no!” moments I mentioned earlier came while reading the chapter titled Exit Trans Fats, Enter Something Worse? You’ll recall that the brief version of the trans-fat story goes like this: researchers decided saturated fat was bad, and therefore assumed the hydrogenated oils that replaced them must be an improvement – no need to really test or anything like that.
Apparently that story is being repeated today: policymakers have finally accepted that trans fats are bad for our health, and therefore assume the liquid vegetable oils replacing them must be an improvement. But perhaps not. Perhaps liquid vegetable oils heated to frying temperatures are actually worse:
Gerald McNeill, vice president of Loders Croklaan, which is one of the country’s largest suppliers of edible oil, told me something scary. He explained that fast-food chains including McDonald’s, Burger King and Wendy’s have swapped out hydrogenated oils and started using regular vegetable oil instead. “As those oils are heated, you’re creating toxic oxidative breakdown products,” he said. “One of those products is a compound called an aldehyde, which interferes with DNA. Another is formaldehyde, which is extremely toxic.”
Aldehydes? Formaldehyde? Isn’t that the stuff that’s used to preserve dead bodies?
He went on to tell me how these heated, oxidized oils form polymers that create a “thick gunk” on the bottom of the fryer and clog up the drains… Partially hydrogenated oils, by contrasts, were long-lasting and stable in fryers, which of course is why they were favored. And beef tallow, McDonald’s original frying fat, was even more stable.
And it tasted great. So we’ve gone from good fats, to bad fats, to possibly worse fats that don’t even taste good – all thanks to Ancel Keys, The Guy From CSPI, and legions of other anti-saturated-fat hysterics who got an idea into their heads and refused to let evidence (or lack thereof) shake it loose.
The final chapter is titled Why Saturated Fat Is Good For You. Well, heck, you all knew that already, but it’s still worth reading the 50-plus pages as a reminder. And after spending the previous 300 pages learning exactly how that big ship was steered into an iceberg, it’s nice to end the story with a ray of hope. Reach for the bacon-wrapped life preserver, and perhaps all will be well.
I’ve barely touched on the detailed history Teicholz recounts in The Big Fat Surprise. This is a fascinating book, even if you already know the broad outlines of the story. I highly recommend you add it to your library.