Man Bites Dog II

Well, the fallout continues over the sloppy JAMA studies purporting to show that reducing fat in the diet doesn’t prevent heart disease, colon cancer or breast cancer.

The New York Times followed up the front page, main headlined article with the lead editorial the next day titled “Low-Fat Diets Flub a Test” devoted to the same topic.

The editorial starts off

The more we learn about nutrition, the less we seem to know. That is the clearest lesson to emerge from a large study of low-fat diets that has left diet aficionados thoroughly confused.

For decades or more, medical lore has suggested that a low-fat diet can yield substantial health benefits. Millions of Americans have tried to reduce the fat in their diets, and the food industry has obligingly served up low-fat products. Yet now comes strong evidence that the war against all fats was mostly in vain.

As far as I can tell, the only “diet aficionados” who are “thoroughly confused” are those pinheads who bought into the low-fat diet to begin with. The New York Times has it right in the second paragraph: “For decades or more, medical lore has suggested (my italics) that a low-fat diet can yield substantial health benefits.” Precisely. Medical lore, not science. And has suggested, not has shown.

The Letters section of the paper carried a number of missives from outraged low-fatters who insist on going down swinging. Their anguished cries almost leap off the page.

I’ll excerpt a few quotes from physicians.

A doctor at the Yale School of Medicine writes:

The difference in these interventions was modest; the advice to cut fat without attention to kinds of fat, questionable; and subject compliance, limited.

My convictions in the fundamentals of a healthful diet [read: low fat] are unshaken.

A couple of docs from Memorial Sloan Kettering Cancer Center opine:

The results of the Women’s Health Initiative study cannot be regarded as proving that eating less fat does not reduce a woman’s risk of getting breast cancer.

It is too soon to dismiss these findings as negative, and further follow-up of women on this trial is needed.

A physician from Indianapolis weighs in:

Reports on the study of a low-fat diet on breast cancer would have more appropriately stated that the study was flawed in implementation since participants were unable to maintain a low-fat diet.

As a consequence, wide reporting of the results of this study as if it had been properly executed could have widespread health consequences, like reducing the availability of lower and no-fat foods.

Now the funny thing about all this is that these folks are all acting like it’s been proven that the low-fat diet is the healthiest diet around. They know in their hearts that this is the case, and now comes this study saying it might not be so.

I’ve got a newsflash for them. The low-fat diet has never, ever been shown to be the optimal diet. It was all an hypothesis to begin with. It sounded like a good thing, so based on virtually no evidence the nutritional establishment began issuing edicts that to be healthy everyone should restrict the amount of fat they eat. We’ve all been part of a giant experiment, the hypothesis of which is that the low-fat diet is good for us, for the last 25 years. And what have we learned from this giant national experiment? Well, obesity has more than doubled, type II diabetes is now at epidemic proportions, the incidence of cardiovascular disease hasn’t declined and we’re, in general, a much less healthy lot.

If you want to see the shoddy science (or even the lack of any science, shoddy or otherwise) that went into the formulation of the low-fat scheme we’ve all been enmeshed in, read Gary Taubes’ article “The Soft Science of Dietary Fat“, which was published a few years ago in Science, America’s most prestigious and influential scientific journal.

As I reported yesterday, I don’t think these are particularly good studies. They are indeed flawed. But I’m glad that they are getting the coverage they’re getting because the low-fat diet has gotten a free ride for far too long.

The power of the New York Times to influence the entire nation can not be underestimated. Let me show you what I mean.

Forget about Banting, Brillat-Savarin, Thompson, Cleave, Pennington, Yudkin and all the rest of the old timers. Let’s start with physicians using and writing about low-carb dieting since the 1960s. In 1961 Herman Taller, M.D. wrote Calories Don’t Count, followed by Blake Donaldson, M.D. who wrote Strong Medicine. In 1967 Irwin Stillman published his mega bestseller The Doctor’s Quick Weight Loss Diet, then came Robert Atkins, M.D. with his Dr. Atkins’ Diet Revolution in 1972. Herman Tarnower, M.D. came along shortly thereafter with his The Complete Scarsdale Medical Diet. There was a long dry spell, then MD and I published Protein Power in 1996. All these authors are (or were) practicing physicians who had adopted a low-carbohydrate diet into their practices and found that it worked beautifully. They all wrote books based on their experiences and described in what form the low-carb diet had worked best for them and their patients. And although some of them sold more books than others, none had really put low-carb on the map other than as some kind of fad diet out on the fringe.

Now, remember, all these above mentioned physician authors had been to medical school and post graduate training, had had hands on experience with thousands of patients, had somehow stumbled into the low-carb diet, discovered its efficacy, and judiciously used it to treat patients. And they were all called frauds, quacks, hucksters, fad diet promoters, and worse. And were for the most part ignored.

Then on Sunday, July 7, 2002 an article appeared in the New York Times Magazine titled “What if it’s all Been a Big Fat Lie,” written by Gary Taubes, a journalist. Suddenly, virtually overnight the low-carb diet was in. It was the greatest thing since sliced bread. And all because a journalist at the New York Times said it was okay.

Now, I know Gary Taubes pretty well, and I can tell you that he is an extremely bright guy. But he isn’t a physician; he’s a journalist. He’s never taken care of a single patient and never will, but he’s the direct cause of more people going on low-carb diets than anyone in history because he had the New York Times as a platform.

Given the power that the New York Times wields, it’s easy to see why all the low-fatters are uneasy. Their goose is cooked because the New York Times has put its reverse imprimatur on their beloved low-fat diet.

And the New York Times continues to pile on. As I write this at 10:30 PM Pacific Time tomorrow’s paper is already online, and there is yet another article bashing the low-fat diet. This one, titled “Another Fad Hits the Wall” relegates the low-fat diet to fad status. The death knell for low-fat products is ringing.

Last year, 12.8 percent of all the new products churned out by food companies were emblazoned with a low-fat or fat-free label, according to ProductScan Online, everything from low-fat tortilla chips to cheese slices, peanut butter, refrigerated dip and hot dogs.

But with a new study this week indicating that a reduced-fat diet may not help ward off heart disease or cancer, marketing experts and some food companies say that the days of the low-fat phenomenon are numbered.

“It’s over,” said Linda Gilbert, president of HealthFocus International, a market research firm that specializes in health trends. “Interest in low-fat foods is way down from where it was at its peak.”

If the low-fatters hadn’t had such a long run I might actually feel sorry for them.

But they aren’t giving up. Now the shift is going to be away from focus on fat content to focus on types of fat, specifically saturated fats and trans fats.

As the New York Times editorial stated:

Meanwhile, experts in nutrition and chronic diseases have moved on to a new consensus: it is not the total fat but the kind of fat you eat that is important. Many groups recommend that people cut their intake of “bad” fats, like saturated fats and trans fats, and increase their intake of “good” fats, like those found in vegetable and fish oils.

And that’s just what worries me. They can count me on their side on the trans fats issue, but not the rest. I’m firmly convinced that saturated fats, far from being unhealthy, are actually good for us. And I’m worried that this shift of focus in the direction of kinds of fats instead of amounts will lead people to increase their intake of vegetable fats, which I think are dreadful.

These are interesting times nutritionally in which we live.

 

Image: Provence by Kazimir Malevich 1912