The Guy From CSPI And The Guy from AHA Bravely Agree They’ve Been Right All Along

Back in June, the American Heart Association released a Presidential Advisory Report that I covered in posts titled The American Heart Association Bravely Admits They’ve Been Right All Along, part one and part two.

The lead author of the report was Dr. Frank Sucks … er, Sacks, who is a fine example of a scientist too firmly wedded to a particular hypothesis to ever be objective. Sucks was chairman of the AHA’s Nutrition Committee back when they were releasing guidelines warning us that saturated fats will kill us and vegetable oils (and Cocoa Puffs!) will save our lives.

He was the lead researcher on the DASH trial, which concluded that restricting salt produces “major” benefits for hypertension … even though the study’s own data showed that reducing salt intake by 75% led to a measly three-point drop in blood pressure.

Sucks .. er, Sacks was also a member of the National Cholesterol Education Program (the folks who decided we should all have a total cholesterol score below 200), and a member of the Whole Grains Council, which is generously supported by the grain industry.

In other words, you’d be hard-pressed to find someone more personally invested in the arterycloggingsaturatedfat! and hearthealthywholegrains! nutrition advice than Dr. Frank Sacks … with the possible exception of The Guy From CSPI. So naturally, The Guy From CSPI (or his organization’s newsletter, to be exact) recently interviewed Dr. Sacks to explain why they’ve both been right all along.

Here are some quotes from a CSPI article titled A refresher on fats:

Q: How strong is the evidence that saturated fat in foods like meat, butter, and cheese is harmful?

A: The evidence that saturated fat causes atherosclerosis and heart disease is compelling. It’s consistent across randomized trials, large observational epidemiologic studies, and animal studies.

This is, of course, complete poppycock. Consistent across randomized trials and epidemiologic studies?! Not even close. I’ve written about the glaring inconsistencies in the evidence in this post and many others.

Q: Why have some people heard that the evidence on saturated fat has gotten weaker?

Actually, CSPI Guy, the evidence hasn’t “gotten weaker.” It was never strong to begin with. But let’s see what Sucks has to say on the matter.

A: Some of the more recent studies take a standard epidemiologic approach, which is inadequate. Saturated fat seems to be harmless in those studies because it’s being compared, by default, to the typical American diet, which is high in refined, junk-food carbohydrates. They’re also linked to a higher risk of heart disease.

Ahh, I see! Recent studies – and apparently only recent studies – took a standard and therefore inadequate epidemiological approach! Gee, it’s nice to see a Harvard researcher finally speak out against drawing conclusions from observational evidence. Too bad Harvard spent decades scaring the hell out of people based on crappy observational studies.

Q: Why inadequate?

A: Let’s say you give someone advice to reduce their saturated fat. Well, what do they eat instead? If they just reduced their saturated fat, they’d lose weight, because they’d be getting fewer calories. That’s unlikely. So what do they actually do? In many cases, people who eat less saturated fat eat more refined carbohydrates.

Yeah, that tends to happen when you tell people bacon and eggs will kill them and then put the American Heart Association seal of approval on boxes of Cocoa Puffs. And Dr. Sacks was a big muckety-muck at the AHA back when that was happening.

A: But Walter Willett and Frank Hu—my colleagues at Harvard—devised a new epidemiology based on food substitutions that would occur in real life. And that’s really innovative.

Allow me to interpret that: Willet and Hu spent lord-only-knows how much time finding a new way to crunch the numbers so they can continue believing that 1) observational studies based on food surveys tell us anything meaningful, and 2) saturated fat is the killer they’ve always said it is.

Q: Didn’t you re-examine the clinical trials from the  1960s that assigned people to diets with different fats and then measured heart disease rates?

A: Yes. We separated them into core and non-core trials, because some were superb in quality, and some were kind of dreadful. So we set out uncontroversial criteria for a good clinical trial.

Allow me to interpret that as well: we looked at all the clinical trials and decided the ones that showed higher rates of heart disease after switching to vegetable oils just HAD TO WRONG, DAMNIT! So we put those in the ‘dreadful’ category. Then, after digging like crazy, we found a whopping four trials that seemed to suggest that switching to vegetable oils reduces heart disease. We labeled those ‘superb in quality.’ And our criteria are uncontroversial because we all agreed with ourselves.

Q: Is large LDL safer than small LDL, as some people argue?

A: No. It’s basically a non-issue. If you have a lot of big LDL, it’s no better than a lot of little LDL. In fact, big LDL is probably worse, because it’s loaded up with more cholesterol.

Q: Do high triglyceride levels cause heart disease?

A: We don’t have proof with triglycerides the way we have proof that LDL cholesterol causes heart disease. But the evidence linking triglycerides to heart disease is getting stronger.

Fascinating. Dr. Sacks believes we have proof that LDL causes heart disease, but don’t yet have proof triglycerides cause heart disease. Perhaps he missed this study and its conclusion:

Stepwise higher concentrations of nonfasting triglycerides were associated with stepwise higher risk of heart failure; however, concentrations of low-density lipoprotein cholesterol were not associated with risk of heart failure in the general population.

I suppose Sacks could dismiss the study as dreadful, but that could be embarrassing since it was published by The American Heart Association.

Q: What about coconut oil?

A: Some of the short-chain saturated fatty acids in coconut oil don’t raise LDL cholesterol. But they don’t counteract the effects of the oil’s longer-chain fatty acids, which do increase LDL cholesterol. So coconut oil raises LDL cholesterol in the same way that, say, butter does.

Ah, yes, in the Presidential Advisory Report, Dr. Sacks assured us that coconut oil is even worse for our hearts than butter because it’s higher in saturated fat. But Dr. Michael Moseley recently conducted a small study in which volunteers added 50 grams of butter, olive oil or coconut oil to their diets. A BBC article describes the results:

As expected the butter eaters saw an average rise in their LDL levels of about 10%, which was almost matched by a 5% rise in their HDL levels.

Those consuming olive oil saw a small reduction, albeit a non-significant drop, in LDL cholesterol, and a 5% rise in HDL. So olive oil lived up to its heart-friendly reputation.

But the big surprise was the coconut oil. Not only was there no rise in LDL levels, which was what we were expecting, but there was a particularly large rise in HDL, the “good” cholesterol, up by 15%. On the face of it that would suggest that the people consuming the coconut oil had actually reduced their risk of developing heart disease or stroke.

But there I go again, digging up contrary information. Dr. Sacks and The Guy From CSPI are worried that people like me are causing confusion:

Q: How can people avoid confusion?

A: If you want to sort out what is good scientific knowledge and what is speculation or biased, look at guidelines produced by the American Heart Association, American Diabetes Association, or American Cancer Society.

Riiiight. Because organizations whose very existence depends on generous contributions from the makers of vegetable oils and grain products couldn’t possibly be biased.

So what’s going on here? Are people like Sucks … er, Sacks and the The Guy From CSPI just pathological liars? Are they intentionally dishonest?

Actually, I don’t think so. I think we’re seeing yet another example of the phenomenon described in an excellent book I haven’t mentioned in quite a while: Mistakes Were Made (but not by me). The subtitle is Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts. That pretty much captures the subject matter.

The authors give many examples of the same basic behavior:

DNA evidence exonerates someone who spent 15 years in prison for murder, but the district attorney still insists he didn’t prosecute an innocent man. The lab screwed up, or someone tainted the samples, or the guy in prison must have had an accomplice whose DNA ended up on the victim.

A doctor’s procedure kills a patient, but the doctor insists the procedure was correct.  Some complication that was impossible to predict caused the death.

A therapist prods a young patient into “recovering” memories of sexual abuse that were supposedly repressed, but are later proven to be false.  The therapist insists the memories are accurate and rationalizes away all evidence that the abuse couldn’t have happened.

A woman stays married to a physically abusive husband, insisting to her friends and family that he’s really a sweet guy at heart and his behavior is his employer’s fault, or his parents’ fault, or whatever.

A researcher accepts generous funding from a pharmaceutical company, then fudges a few numbers in a study concluding that the company’s newest drug is wonderful, but tells himself the drug really is wonderful and the fudged numbers simply enhance the truth.

A boy who moves to a new school district and wants to fit in somewhat reluctantly joins a pack of bullies in tormenting a fat, weak kid … and the more he participates in the bullying, the more convinced he becomes that the fat, weak kid deserves every bit of it.

As the authors explain, humans are naturally inclined to engage in self-justification as a means to reduce cognitive dissonance. Most of us believe we’re basically decent and competent, and we selectively filter information and rewrite memories to support that belief. (People with low self-esteem do likewise to confirm their negative opinion of themselves, but that’s another matter.)

The result is that once we’ve chosen a path or a position, we’re quite brilliant at convincing ourselves the path or position is correct … and the longer we’re on that path, or the more public the position, or the more consequential the action, the more we’re psychologically driven to justify it.

DNA says the guy didn’t do it? That can’t be right! I’m a good person, and a good person wouldn’t railroad an innocent man, so he had to be involved in that murder.

The patient died the family are blaming me? That can’t be right! I’m a good doctor, and a good doctor wouldn’t make a mistake that killed a patient. It wasn’t my procedure; it was something else.

Does fudging a few numbers make me a dishonest researcher? No, I’m a good scientist. Those numbers were outliers, and I had to smooth them over so this life-saving drug can be approved and help people who need it.

I picked on a weakling just to fit in? No, that would make me a bad guy, and I know I’m a good guy. The weakling is pathetic and annoying and not a good person, so he had it coming to him.

You get the idea. I’m a good and competent person, but I made a stupid or harmful decision creates cognitive dissonance. So we convince ourselves the decision wasn’t stupid or harmful. We do that largely through confirmation bias; that is, by latching onto any evidence that we were right and ignoring or dismissing evidence that we were wrong.

So imagine you’ve spent decades very publicly promoting grains and vegetable oils as the key to health while warning people away from saturated fats. Imagine you’ve also received generous donations from the makers of grains and vegetable oils – which is fine, you tell yourself, because those funds merely help you fulfill your life-saving mission.

Now imagine the science is turning against you. New (and old but recently discovered) studies suggest that vegetable oils and grains are harmful to health, while animal fats and other saturated fats are either neutral or beneficial.

You only have a couple of choices. You can look in the mirror and say to yourself, “Oh my god. I’ve spent 30 years giving out advice that helped turn countless people into fat diabetics suffering from inflammation and autoimmune diseases they didn’t need to have.” Or you can tell yourself you’re a good scientist, the advice you’ve been handing out is actually beneficial, and those new studies can be ignored because they were conducted by people who are incompetent.

As the authors point out, Americans tend to forgive and sometimes even rally to support public figures who admit to their mistakes, take the blame, and sincerely apologize. Nonetheless, most public figures and organizations don’t go that route. They can’t admit to themselves that they were wrong, so they double down. They rationalize. They attack the critics. And so the correction, whatever it is, almost always happens as the result of outside forces.

That’s why whenever I receive one of those email petitions demanding that the AHA or USDA change their dietary advice, I toss it. They’ll never announce that they were wrong because their heads would probably explode as a result. All we can do is convince more and more of the public to stop listening to them. I’m pretty sure that’s already happening — even if Dr. Sacks and The Guy From CSPI have a psychological need to convince themselves we’re just confused.


31 thoughts on “The Guy From CSPI And The Guy from AHA Bravely Agree They’ve Been Right All Along

  1. George Henderson

    ” Saturated fat seems to be harmless in those studies because it’s being compared, by default, to the typical American diet, which is high in refined, junk-food carbohydrates.”

    I love this claim, because the CVD rate has supposedly fallen since the 1960s because the AHA and various government agencies and, you know, women’s magazines, relentlessly plugged a diet that lowers cholesterol.
    And now we find out that saturated fat and, most reliably, dairy fat (the most saturated fat in the diet) are no worse for CVD than the whole cholesterol-lowering diet change that saved the West from the CHD epidemic. And a bit better for some things, like the risk of diabetes or stroke or alcoholic liver disease.
    But no better, so hold the butter!

      1. Nowhereman

        And I guess we’ll just be doubling down on not listening to their nonsense anymore. As more proof that Paleo and Wisdom of the Crowds is affecting the market, behold:

        I found these at my local co-op and they’re great. A tortilla-style chip that is made grain-free, uses coconut and avocado oil and yet tastes oh so good! And like Jackson’s Honest Chips brand, this company is started by another family that created this originally for one of their own who has a serious medical issue.

        I’m seeing the gluten and soy-free products just exploding all over across several mainstream stores now where just even 10 years ago you might’ve gotten lucky if you could find a lone side counter, end cap, or drive aisle at a specialty health food store.

        1. Tom Naughton Post author

          Yup, the public is leaving the “experts” behind, and the “experts” still haven’t grasped that they can’t stop it.

          1. Walter

            But, slowing it down makes then $. If they were trying to protect their reputations they would back away slowly and after enough time had passed deny the every said it. Like CSPI did with transfats.

  2. JillOz

    There are people who change their conduct and recommendations once they realise they’re not working or cause harm, Wheat Belly’s Dr Davis being one of them, thank goodness!

    Many nutritionists and nurses etc are changing their view once they see how beneficial sat fats actually are and actually helping instead of harming people. So it can be done and is being done by various people who don’t think their ego should be subsidized by the whole world but who care about the content of their work.

    When you think your work is about your ego rather than what you DO, there’s danger there for others.

    1. Tom Naughton Post author

      I respect the people who are willing to change their minds. Tim Noakes, to name another, once wrote a book promoting the low-fat, high-carb diet. He had the courage to say he was wrong and change his advice.

  3. Bob Niland

    Diet and lifestyle are “you bet your life” choices, but even a heart attack doesn’t seem to get their attention. Here’s an update on the AHA’s recent embarrassment:
    Scrambling to restart a stopped heart  —

    I see no indication there of any willingness to consider that perhaps the AHA dogma is mistaken. On the contrary, I see confusion “There’s this unknown of what more I could change…” and a doubling-down on that dogma “He’s focusing even more on improving his nutrition, keeping his exercise routine as a priority…”.

    Schadenfreude is one thing, but these medical guild quacks are handing down advice that is maiming and killing millions of actually innocent victims.

      1. JillOz

        No matter how many instances or studies exist of wheat/grains being bad for you, the AHA types will push aside the information, ignore the informants, deride the practitioners and then wonder what the “mystery” is that makes people have heart attacks!

        No sympathy. Many people go through this operatic charade every day with no help and get bankrupted – if they’re lucky.

  4. Walter

    Actually the American Heart Assassins (AHA) and fiends are great for separating bad advice from good dietary advice. Just do the opposite of what the recommend.

  5. Tom Welsh

    “Eine neue wissenschaftliche Wahrheit pflegt sich nicht in der Weise durchzusetzen, daß ihre Gegner überzeugt werden und sich als belehrt erklären, sondern vielmehr dadurch, daß ihre Gegner allmählich aussterben und daß die heranwachsende Generation von vornherein mit der Wahrheit vertraut gemacht ist”.

    “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it”.

    Max Planck, Wissenschaftliche Selbstbiographie. Mit einem Bildnis und der von Max von Laue gehaltenen Traueransprache. Johann Ambrosius Barth Verlag (Leipzig 1948), p. 22, as translated in Scientific Autobiography and Other Papers, trans. F. Gaynor (New York, 1949), pp. 33–34 (as cited in T. S. Kuhn, The Structure of Scientific Revolutions).

    Paraphrased variants:

    “Die Wahrheit triumphiert nie, ihre Gegner sterben nur aus”.
    “Truth never triumphs — its opponents just die out”.

    “Science advances one funeral at a time”.

  6. Stealth

    “high in refined, junk-food carbohydrates.” The ship is turning, ever so slowly and imperceptibly. They always wanted to blame the FAT in the “typical American diet”, but now it’s carbohydrates (they qualify them as “refined, junk-food carbs”, but it’s still a step in the right direction).

    You are absolutely right that they will NEVER admit that they were wrong, but they will always be willing to say that “of course they were right all along” when they start claiming that those carbohydrates are bad news. Eventually, they will very, very quietly stop vilifying saturated fat.

    While it’s still way too slow for the millions who will suffer and die because of their bad advice, it is moving faster than I ever expected to see.

    1. Tom Naughton Post author

      I predicted years ago that the advice will change — it has to — but they’ll back away from their previous positions one baby step at a time. We won’t see a full turnaround until the old guard is dead and gone. Science advances one funeral at a time.

    2. Walter

      Ah, here is the escape route. If they demonize junk carbs and get a little quieter on the saturated fats, that could give them cover. Then they could eventually get to the point of accepting saturated fats since Americans won’t eat whole grains.

      I mean they gave in on enriched white flour products, since Americans just weren’t going to eat the whole grains. For example, my brother in law tried brown rice once and said “Never Again”. I presume he would like whole unground steamed wheat even less. Enriched grain products have in addition to the gluten problems, the breakdown of the cells and an unnatural combination of vitamins and minerals, the amount of which eaten varies widely between people.

      For this reason the Jaminets (Perfect Heat Diet) recommend washing the enrichment off of white rice, which they name as a “safe carb”.

      I actually made whole grain bread once. It rose nicely, but was still very dense and tasted bad.

  7. Emily

    I’m starting to get more and more angry with these people. Because of them, I spent nearly 40 years with horrible anxiety. God knows how many other little girls are lying awake at night feeling personal guilt over nuclear war because their parents thought giving them skim rather than whole milk would be good for them. Negative stress is unquestionably a huge driver of disease and death, not to mention how much it decreases the quality of life.

    I hope these people have as many sleepless nights as I did because of their advice. I’m not feeling at all generous any longer.

    And I’m still seeing this “low fat” garbage all over the place. Then we get a zillion concerned articles about how much more anxiety and depression today’s young people, especially girls, have than 50 years ago. I think one is causing the other.

    1. Tom Naughton Post author

      A crappy diet can certainly lead to a crappy mood. My daughters don’t seem to suffer from the angst that afflicts some of their peers. Part of that probably a reflection of us as parents — Chareva and I both have a positive outlook — but I’m sure the real-food diet helps as well.

      1. Emily

        Real food is great, but the disappearance of my anxiety took exactly one diet change: Switching from skim to whole milk. It’s not raw or even organic, because that’s too expensive for me right now. Getting heavy cream every day made me feel even better.

        There are studies that show stroke incidence decreases for women on diets high in dairy fat. I hope someone looks at this connection — dairy fat clearly gives some kind of protection to the brain, at least for women with ancestors who ate lots of dairy. That’s anathema to the AHA and etc., to vegans, and even to a lot of paleo types.

        Girls are good at hiding angst (take it from one who knows), and I’m sure your girls will have some. But I bet they will do far better than their peers, and thus not only have happier lives, but be poised to shoot to the top in whatever they choose to do.

  8. Firebird7478

    Are you or anyone else here watch Dr. Mark Hyman’s docuseries “Broken Brain”? Primarily a 7 part advertisement for functional medicine that deals with gut health and the gut brain connection.

    Pretty good information but I suspect a lot of what they recommend (consultations, tests) are out of the realm of affordability to a lot of people.

  9. Walter

    Remember this diet is what they recommended to family and friends which is probably the worst part and some may have religious objections to “saturated” [1] animal fats, like 7th Day Adventists or been trained at Adventist schools. Of course Veganism serves the role of religion in many Vegan’s lives. It practically has to among those Vegans who reject contact with the “heathen”. All their friends are vegans, they hang out only with fellow vegans, eat out only at Vegan restaurants etcetera. Hmm, worst than most religious people. Many Protestants have good friends who are Roman, Orthodox, or even Jewish.

    [1] Quotes because all natural fats are mixtures.

    1. Tom Naughton Post author

      It’s the personality type Eric Hoffer described nearly 70 years ago in his book “The True Believer.”

      1. Walter

        Don’t be surprised if Spurlock goes to a diet of meat and water. These types will (sometimes) go the most radical opposite side.

    1. Tom Naughton Post author

      Yup, I saw that. Crediting himself for getting rid of trans fats is a classic case of “Mistakes were made, but not by me.”

  10. Farside

    A slight mea culpa from our govenment

    Cholesterol. Previously, the Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day. The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol, consistent with the conclusions of the AHA/ACC report.2 35 Cholesterol is not a nutrient of concern for over-consumption.


  11. MarqueG

    Let’s name this path dependency. It’s institutionalized confirmation bias built in to a bureaucracy. It’s flavored with the sunk-cost fallacy.

    If you’re one of the figures leading an institution dedicated to promoting a particular point of view, you aren’t going to throw away your whole career — the years of med school worth tens of thousands, your long ascent up the academic and professional ladders — by seriously considering a competing, contradictory theory that lacks similar institutional heft and backing. And without public policy support to boot.

    On Earth Two we wouldn’t have made the big mistake after the McGovern nutrition commission of enshrining in federal rules and regs a dietary hypothesis that made the public into lab rats in an experiment. And thanks to path dependency, that has blinded the institutions such that they cannot realize the experiment’s results shriek that the hypothesis was wrong. On Earth Two we would never have become stuck on this failed course.

    Great blogging as usual, Tom. The recent reflections on Spurlock and Hollywood society were particularly interesting, btw.

    1. Tom Naughton Post author

      Thank you. A bit off-topic, but since I saw the culture from the inside, I figured I may as well write about it.

  12. chris c

    Someone called Willett “Walt Wallet”. That made I larf. Frank Hunilever I think was my own invention.

    Meanwhile in the UK some of the most militantly anti-low-carb dieticians are now indignantly claiming that they never recommended high carb diets for diabetes. And In Other News, the coalition of vegans and Industrial Food are now clamouring for a Meat Tax, which is more likely to happen than a sugar tax. Well sugar, Coke, breakfast cereal and industrially produced Omega 6 seed oils are vegan. Plant-based diets do not exclude industrial plants.


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