“The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet” is the title of an important new book by Nina Teicholz, which has recently been released in the USA and is now available in the UK (1). The case against the official dietary recommendation to reduce saturated fat (SFA) is already very convincing (2,3). This book is another very valuable contribution which lends further support and reinforces the advisability of including adequate amounts of fat from animal sources in the habitual diet.
The author is an investigative journalist who started digging into the subject over 10 years ago. In the introduction she explains that the more she probed the more she realised that all the dietary recommendations about fat were not just “slightly off-track” but completely wrong. On close examination, it became clear to her that none of the commonly held beliefs about fat, and SFA in particular, are correct.
Nina explains that the flawed recommendations originated in the USA after World War II, because of the enormous concern about the one of the highest death rates attributed to heart disease on the planet. Nutritionists hypothesised that dietary fat, especially the SFA (because of its effect on cholesterol) was responsible. Unfortunately the hypothesis was accepted as fact before it was properly tested. As a consequence it became embedded as a key element of public policy and
“became immortalised in the mammoth institutions of public health.”
Because the importance of cholesterol as a risk factor for heart disease had been accepted as dogma, it was pretty well impossible to challenge it. For example, one of the outstanding nutrition scientists, David Kritchevsky, suggested in the 1980s that there should be a weakening of the recommendation on dietary fat and encountered hysterical opposition. Here is what he told the author:
“People would spit on us! It’s hard to imagine now, the heat of the passion. It was just like we had desecrated the American flag. They were so angry that we were going against the suggestions of the American Heart Association and the National Institutes of Health.”
This meant that anyone who had the temerity to challenge the official line was committing professional suicide. Applications for funds to support research, which might question the prevailing views on fat, were unlikely to be supported. Even if funds were obtained (eg from independent foundations) the researchers would find difficulty in publishing their results in scientific journals and they were rarely invited to serve on expert panels. By stifling opposition, the public was presented with what appeared to be a uniform scientific consensus.
Over the years the Americans have actually made substantial progress towards the implementation of the dietary guidelines. In particular, the amount of fat and SFA in the diet has declined and at the same time there has been a corresponding increase in the proportion of carbohydrates such as grains, rice and pasta. These dietary changes have been accompanied by a deterioration in the standard of public health as shown by a10-fold increase in the incidence of diabetes. Heart disease remains the leading cause of death in both men and women. These changes are along the same lines as those which have occurred in Great Britain (4).
The author has gone back to the original scientific papers and has provided a compelling case that the original recommendations on fat and on SFA just do not stand up to rigorous examination. There is a fascinating account of the role of Ancel Keys who was responsible for the Seven Countries Study which concluded that that there was a direct correlation between the amount of fat/SFA in the diet of different populations and the death rate due to heart disease. Even if this association was genuine, a correlation does not demonstrate cause and effect. However another research team showed that if data was taken from a much greater number of countries, then the correlation disappeared…..the points on the graph were all over the place. The Keys conclusion has been the foundation of the diet/heart theory, which underpins the dietary recommendations on fat and SFA. Despite the fact that it no longer has any credibility, it is still cited to support the status quo.
I have yet to see the entire book and will have to wait until I get hold of my copy. Nevertheless it is evident that Nina has done a very thorough job of evaluating the so-called evidence, which has been used to justify dietary recommendations, that have had a disastrous effect on public health. Because this thinking has dominated the position adopted by the World Health Organisation (WHO), these flawed recommendations have been incorporated in the national nutritional policies of most countries.
It must be emphasised that Nina is not the first person to cover this ground. In fact, she is only one in a long line of independent investigators who have reached virtually the same conclusion. However she does provide confirmation that when the issue is examined by a competent individual in an objective manner then there can be only one result.
What is especially encouraging about this book is the positive response to it. It is a New York Times Best Seller. A review in the Wall Street Journal commented that:
“Ms. Teicholz’s book is a lacerating indictment of Big Public Health for repeatedly putting action and policy ahead of good evidence. It would all be comical if the result was not possibly the worst dietary advice in history. And once the advice had been reified by government recommendations and research grants, it became almost impossible to change course (5)”.
All the indications are that this is a first class book and it will certainly help to bring about the fundamental change in the official dietary guidelines which ultimately is inevitable. It is ironic that a paper in the BMJ to-day notes that the incidence of pre-diabetes in England has increased 3-fold between 2003 and 2011 (6). If this decline in public health standards is to be reversed than this change cannot come too soon!
More detailed information is available in a comprehensive review by Dr Michael Eades which is well worth reading (7).
- “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet”(2014) by Nina Teicholz. Simon & Shuster New York