Health & Nutrition by Michael R. Eades, M.D.

Dinner tonight at Casa Eades

Last Sunday the New York Times published a color spread on the US Department of Agriculture (USDA) data on the changes in food consumption in this country between 1970 and 2006, which got me to musing.

To the uninformed, which, sadly, probably means most people working in the nutrition industry and even those employed in a nutritional capacity at the USDA, these changes (all save two) seem to be in a positive direction. The intake of dairy products has decreased; the intake of vegetables has increased; the intake of red meat has fallen; the intake of fish, chicken and skyrocketed; the intake of fruit is up; the intake of grains has increased markedly; and the intake of vegetable fats has almost doubled. The only two negatives are that sugar and sweeteners have increased and overall food consumption has gone up by about 11 percent, or an addition 1.8 pounds per person per week.

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John Tierney, science blogger for the New York Times, was as taken aback by the abject stupidity hostility of the comments to his recent post on fat in the diet that included a response from Gary Taubes about the Israeli low-carb study as I was in my recent post about his post. He decided to post on the subject again, specifically addressing the comments quibbling with the findings on saturated fat. And he included more feedback from Gary.

What we have to keep in mind here is that nutrition is a science (or at least should be) and science is about generating hypotheses, making predictions from our hypotheses, and then seeing if they hold true. The relevant hypothesis here — i.e., what we’ve believed for the past 30-odd years — is that saturated fat causes heart disease by elevating either total cholesterol or LDL cholesterol, specifically. So our prediction is that the diet with the higher saturated fat content will have a relatively deleterious effect on cholesterol. We do the test; we repeat it a half dozen times in different populations. Each time it fails to confirm our prediction. So maybe the hypothesis is wrong. That seems like a reasonable conclusion. No one is proving anything here — as some of your respondents like to decry — we’re just looking at the evidence and trying to decide which hypotheses it supports and which it tends to refute.

The knee-jerk response — as exemplified by quite a few respondents — is to assume that sometime in the not-too-distant past, maybe the 1960s or 1970s, before this low-fat dogma set in, such trials, or far better trials, were done and found the opposite — that the higher the saturated fat in the diet, the lower the cholesterol and the better the cholesterol profile. Or the higher the saturated fat, the greater the mortality. But that’s simply not the case, as I point out in my book. In fact, I’ve been criticized (by Gina Kolata, among others) for going on and on in the book about all the different studies. But I did so precisely because I didn’t want to be accused of cherry picking the data. (I was anyway, but that’s just the nature of this business.) When Ancel Keys, for instance, reported in the 1950s reported that saturated fats raised total cholesterol, which they did in his studies, he based it on comparisons of butter fat to polyunsaturated oils in studies that lasted only two to nine weeks. (He also reported, curiously enough, that the saturated fats had no significant effect on LDL.)

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I want to discuss a couple of interesting follow ups from the Israeli low-carb study that I posted on a couple of weeks ago. But before I do, I’ve got to apologize for the lack of posting and comment answering for the past week or so. Since we got back from our trip our computers have been acting up. Our internet connection keeps drifting in and out. With the blogging software we use, if we try to save during a time that the internet isn’t connected, everything new gets lost. MD didn’t know that, so she actually managed to put up a post in between outages, which, I suppose, is the luck of the ignorant. I haven’t because I didn’t want to take the risk. Instead I’ve been beating my head against the ground trying to solve the problem. I finally gave up and called the cable company. The guy came out today and discovered that it was a faulty cable modem. He replaced it, so I’m back in business with a lot of catching up to do on all fronts.

One of the questions many people had about the Israeli study was why the recommendation to follow a vegetarian low-carb diet instead of a more meat-heavy low-carb diet? And, in view of this recommendation, what was the final diet the subjects on the low-carb arm consumed? [full text of the study]

Eric Westman, M.D. from Duke University corresponded with the lead author of the paper and asked these questions. Here is the response: Read more »

I’ve linked below to a video of a mainstream cardiologist being interviewed as to her thoughts on the best diet for a healthy heart. Listening to her, it’s easy to see what’s happened to mainstream thinking.

For years mainstream thinking was that the low-fat diet was the be-all and end-all for preventing heart disease. Whenever anyone brought up the idea that low-carb diets may be as effective if not more so than low-fat diets, that idea was dashed with the old ‘Show me the studies’ song and dance that the mainstream knew how to perform so well. As Gary Taubes presented so beautifully in Good Calories, Bad Calories, those studies had already been done years before, but were unknown to the mainstreamers of today. But over the past few years numerous studies have accumulated showing that the low-carb diet at the very worst equals the performance of the low-fat diet and at the very best stomps the performance of the low-fat diet in reducing putative risks for heart disease. Now, what is the mainstream to do?

This video answers the question. The mainstream has retreated to the all-things-in-moderation mantra. Let’s eat less and exercise more and we’ll all be thin and happy. And let’s don’t forget to cut sodium from our diets as well. Even though sodium is the most abundant electrolyte in our bodies, we need to be careful. And let’s forget about all those studies showing that salt intake doesn’t do squat in terms of increasing high blood pressure. Let’s just pretend those don’t exist.

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