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Don’t take dietary advice from non-experts

David L. Katz, MD
Physician
May 12, 2014
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A column entitled “The Questionable Link Between Saturated Fat and Heart Disease” appeared in the Wall Street Journal recently. To spare you any guessing about where this is headed, I’ll tell you right away: The column itself was pretty darn questionable.

The article starts off very dubiously when the author, Nina Teicholz, tells us that a now somewhat infamous study published in the Annals of Internal Medicine concluded, that “saturated fat does not cause heart disease.” I have read the paper in its entirety, and could not recall any such assertion. So I actually ran a search function on the text of the article, and that statement simply does not appear. So file this one, folks, in the “don’t believe everything you read” drawer.

The plot then quickly thickens, and goes on to curdle, for we learn at the end of the Wall Street Journal piece that Ms. Teicholz has a book due out, entitled The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. So whatever else the recent Annals paper is or isn’t, it was clearly a nice marketing opportunity for Ms. Teicholz and her publisher.

The recent Annals paper did not show that saturated fat is harmless, and it certainly didn’t show that it is beneficial. It did not even suggest the latter. Is lack of harm really the new standard in healthful eating? I didn’t get that memo. I thought we might actually be interested in food that was genuinely good for us. In any event, if you want to know what the study actually did show, I lay that out in detail, here.

Second, neither the Annals paper nor any other recent research on the topic suggests there is health benefit derived from adding butter, meat, or cheese to our diets. The weight of evidence is very much to the contrary. I know, because I reviewed it recently at the request of a peer-reviewed journal.

Third, Ancel Keys was not wrong — he was exploited by the collusion of Big Food, and our prevailing gullibility. Keys compared diets natively rich in plant foods and diets natively rich in meat, butter and cheese — and recommendations resulted from the differences in health he observed. He never suggested that we should start eating Snackwell cookies — but that is how our culture interpreted advice to eat less fat. Of course health doesn’t improve when you replace one way of eating fairly badly with another way of eating at least as badly. If you don’t get healthy by replacing Coca-Cola with Pepsi, it doesn’t prove that Coca-Cola was good for us all along, does it? That seems to be our tendency — and so we simply reap exactly what we sow.

Fourth, and finally, Ms. Teicholz seems inclined to play the iconoclast card. It’s getting old, frankly, but it generally does work to sell books. So she may well wind up rolling her eyes at this column on the way to cash her royalty checks. I guess that’s up to all of you.

But no, folks — more meat, butter and cheese will not promote your health. Neither will nonsense — no matter where it’s published.

I know that those of you inclined to believe Ms. Teicholz, either because you truly believe bacon cheeseburgers are good for you or because you just with they were, are rolling your eyes at me now. Some of you will likely go further, and post dissenting comments. I welcome those.

But then, inevitably, in a world where diets are embraced with religious zeal and we can’t seem to manage a separation of church and plate, there’s a group that let’s disagreement veer off into disparagement, turning differing opinions into excuses for ad hominem attacks.

Anticipating that, I think it’s important to note that whatever my character, the fact is: I am trained to do what I do. That matters in just the same way that it matters whether or not the captain has been trained to fly the plane. It doesn’t make you a good person or a bad person. It just means you have training and expertise in a particular area.

I am a trained clinical researcher who conducts and publishes studies, and analyzes the work of others routinely for the peer-reviewed literature. I actually teach and study nutrition, and have written textbooks on the subject that have had to run the gauntlet of diverse expert peers.

And — I don’t have a diet to sell. In fact, I am on record as asserting that no single diet is best — and that an optimal diet can be low fat or high, include or exclude meat, be lower or higher in protein, and so on. The theme of healthful eating is well established — the specific winner of the never-ending my-diet-can-beat-your-diet beauty pageant is not.

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I think that stuff matters, folks — whatever my character. Let’s focus on content.

Letting non-experts take over our kitchens produces a slower crash than letting them take over the cockpit. But we crash just the same. The result of endless squabbling about such issues as salt, sugar, carbs, or fat while ignoring the well-established fundamentals of feeding Homo sapiens well is a calamitously unnecessary loss of years from life and life from years over a span of decades. It’s a slow motion crash, but it’s a crash just the same.

So, yes — it matters that a journalist with a diet book to sell you was the one to tell us in Wall Street Journal what a recent study about fatty acid intake meant. Maybe she read the study, and maybe she didn’t. But either way, she has no formal training in nutritional epidemiology. And did I mention she has a diet book to sell you?

That’s the lesser issue. Here’s the greater one: remember Atkins?

He proposed more meat, butter and cheese in the 1970s. Yes, the 1970s — go ahead and look it up. You will note that his book that went into the stratosphere a little over a decade ago (much aided by another journalist with good intentions, but dubious conclusions, and a book to sell you, Gary Taubes) was entitled “Dr. Atkins’ New Diet Revolution.” What was it “new” in comparison to? The same diet first published in the 1970s.

So we might ask the question: if Atkins had the truth for us in the 1970s, why did we need a diet revolution in the 1990s? And if that revolution in the 1990s, which reached tens of millions in the early 2000s was really the answer — then why are we reacting to the same dietary déjà vu all over again in the Wall Street Journalas if it were some kind of epiphany?

We are flying in circles. If we had reduced our intake of meat, butter and cheese by eating more vegetables, nuts, fruits and legumes — we might be living in a Blue Zone by now. But we didn’t and we aren’t. We just started eating more starch and sugar. As we all know, America runs on Dunkin’ — tell them what they’ve won, Johnny!

So now, we can add back meat, butter and cheese (the consequences to the planet be damned, apparently) — and then what? We’ll be back where we were when we first recognized we weren’t where we wanted to be. After all, if our meaty, cheesy, buttery diets had been making us lean, healthy and happy in the first place — why ever would we have changed them?

So it’s “more meat” for the myopic, who can’t see far enough back to realize we’ve been there, done that — and it didn’t work out so well for us last time. It’s “more cheese” for the chumps who don’t recognize that the next great diet is one we’ve tried before. In fact, the title of the book by the Wall Street Journal columnist is almost shockingly like the title of Taubes’ piece in the New York Times Magazine from 12 years ago. In 12 years, our progress is nicely captured by going from a “big fat lie” to a “big fat surprise.” We fly in circles, and our kids pay the price.

It would be bad enough, frankly, if we fixated on genuinely new dietary theories while ignoring the latent potential of what we do truly know to prevent as much as 80 percent of all chronic disease. But what’s even worse is that after a delay of roughly a decade, we reliably forget the follies of our recent history, and fall in love again with some dietary has-been.

Or in other words, when it comes to our seemingly insatiable appetite for dietary nonsense, the one true expert is Weird Al Yankovic who presciently said: “Eat it! Eat it! If it gets cold, reheat it … ” I don’t know anything about Weird Al’s character, but the man can sure cook up a song!

Bon appétit, everybody.

David L. Katz is the founding director, Yale-Griffin Prevention Research Center. He is the author of Disease-Proof: The Remarkable Truth About What Makes Us Well.

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Don’t take dietary advice from non-experts
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