Sometimes I feel like King Canute trying to hold back the tide. It seems as if there is a never-ending stream of idiocy emanating from the ill informed washing in just to aggravate me. In today’s case it is a non-medical columnist for the Wall Street Journal who is in my sights. Normally I’ll give non-medical people a pass because most of them are simply parroting what they read in the papers and hear on TV, but in this case I feel the need to strike because this person actually writes a health column and, horror of horrors, answers medical questions.
I sat down this weekend to catch up on my reading and came across the following Q & A in the Health Mailbox section of an issue of the Wall Street Journal published last week.
Q: Is it true that less than a gram of partially hydrogenated oil per serving is bad for you? My wife has been cooking with more butter and less margarine in an effort to reduce trans fat. She also uses liquid oil anytime it can be substituted for a shortening or margarine. Biscuits and cookies just don’t work well with liquid oils. Is it reasonable to use shortening sometimes if it’s done within a diet that is not excessive in fat overall? –D.T.
You can read between the lines here that the guy asking the question has been brainwashed by the anti-fat establishment, who, remember, were the folks who foisted trans fats off on us in the first place by their constant whining about saturated fat. As we’ve discussed in other posts, nothing shortens like shortening made from a saturated fat–soft oils just don’t hack it. So, thanks to the anti-saturated fat bozos everyone starts using shortening made from trans fats, all the while patting themselves on the back for eating in a more healthful way. Problem is, of course, that trans fats are much worse for us healthwise than even the most vocal anti-saturated fat fools claimed saturated fats to be. Ah, the law of unintended consequences. It seems to always jump up and bite do-gooders in the you know where. So, getting back to our questioner, the poor guy is in a quandary. How does he minimize the fat in his cooking, avoid trans fats, and still make biscuits and cookies that look and taste like biscuits and cookies are supposed to? (As you might imagine, I would have answered his question a little differently. Uh, you don’t need shortening of any kind if you don’t make biscuits and cookies, and you shouldn’t be eating biscuits and cookies. Problem solved.)
The Wall Street Journal’s dietary guru answered a little differently:
A: Trans fat is bad for you, and there isn’t any known safe level of it. As a result, you should work hard to eliminate it from your diet completely. But while it’s a good idea to keep trans fat from creeping into your diet, a big concern today is how many consumers are now switching to foods high in saturated fats to avoid trans fats. Butter is high in saturated fat, so it isn’t a good alternative. [my italics]
The better plan is to find a trans-free-margarine. Margarines in the past were high in trans fat, but today some tub margarines are trans-fat-free. You have to read the label to make it doesn’t contain “partially hydrogenated oils.” Crisco, the shortening that was synonymous with trans fat, now makes a trans-fat-free version. But the label is confusing because the new version of Crisco is made with fully hydrogenated cottonseed oil. Trans fats are created when oils are partially hydrogenated to thicken them up. Fully hydrogenated oils don’t contain trans fat, but they are too hard to cook with, so the new Crisco is softened up by blending it with liquid oils. A trans-fat-free shortening is still a fat, but it’s an improvement, and a reasonable alternative.
The best way to avoid trans fat without increasing saturated fat is to choose liquid vegetable oils [my italics] or olive oil. Reduce intake of commercially prepared baked goods, most of which still contain trans fat. Avoid deep-fried foods at restaurants; most still use trans fat to fry foods. And avoid fats from animal sources, except for fish. [my italics]
If you’ve been reading this blog for long, you can imagine my reaction to this clap trap. First, who is this woman, Tara Parker-Pope, who is answering nutritional and medical questions for the Wall Street Journal, the daily newspaper with the second largest circulation in the country? Due to the tone of her answers I figured her for a Registered Dietitian, but nope, it turns out that she has a degree in Sociology from the University of Texas, and has spent her post graduate years working as a journalist. During her time in that profession she has been a city hall reporter in Austin, a transportation reporter for the Houston Chronicle, a European stringer for the Wall Street Journal, and has covered the television beat for the Wall Street Journal. She was part of a group that won a press club award for coverage of the federal standoff with the Branch Davidians in Waco, and she has written a book on the cigarette industry. All in all, not what I would consider an appropriate background for someone dispensing medical and nutritional advice in the country’s second most read paper. Other people must feel the same way. A couple of weeks back, I found the following question from a reader:
Q: How are you allowed to address medical questions of any kind? You are not a physician. –G.C.
Well put, G. C. Let’s see what she has to say.
A: Like other health writers, I don’t dispense medical advice to readers about their personal health situations. Instead I provide readers with medical information they can use to talk to their doctor and make decisions about their health. One of the biggest challenges of being a patient usually isn’t finding answers. It’s figuring out what questions need to be asked in the first place. The Internet and media reports can be excellent places to help patients figure out what those questions are.
In writing about health issues and answering reader questions I turn to some of the top doctors and most recognized experts in the field. I also rely heavily on information published in peer-reviewed medical journals. Anyone can search the medical literature through the PubMed search engine, provided by the National Institutes of Health, at www.pubmed.gov. Often I look for review articles and meta-analyses, which take a comprehensive look at all the research on a particular topic. Large randomized clinical trials or major ongoing observational studies are also reliable sources. [my italics] National advocacy groups often are excellent sources of information on specific health issues.
The Archives of Internal Medicine last year noted what it called a “tectonic shift” in the way patients consume medical information, with more patients looking for information online and in the media, even before talking with their physicians. The Health Information National Trends Survey tracks the online health activities for nearly 6,400 U.S. adults. The December 2005 analysis showed that although 62% of those surveyed said that their doctors were their most trusted information source, nearly 50% noted that they go online first with health questions. Only 11% go to their physicians first.
Sounds like a bunch of gobbledygook telling us she really doesn’t have the credentials to be answering such questions. But, answer them she does. As I highlighted with italics in her answer, she writes that she relies on clinical trials and major observational studies to support her answers. I wonder why she didn’t rely on a study from a major institution (Harvard) and published in a top tier scientific journal (American Journal of Clinical Nutrition) not long ago.
The study entitled Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women is just the kind of study I like, and not solely because it agrees with my biases. I like it because it measures an actual outcome–the progression of coronary artery disease–not simply whether or not some activity, say, diet, for example, increases or decreases a particular risk factor, which, in most cases, isn’t even a risk factor in the minds of many knowledgeable people.
Researchers followed 235 postmenopausal women with angiographically proven coronary artery narrowing for an average of 3.1 years and looked at the degree of progression (or lack thereof) as a function of diet. The changes in the diameter of the coronary arteries were evaluated using quantitative coronary angiography; the nutritional data was obtained–and here is the weak part of this study–using Food Frequency Questionairres.
Among the other things found when the data were analyzed:
A higher saturated fat intake was associated with a more favorable lipoprotein profile, including higher HDL, HDL2, and HDL3 cholesterol; higher apoprotein A-I; lower triacylglycerol concentrations; and a lower ratio of total cholesterol (TC) to HDL cholesterol (TC:HDL cholesterol).
These findings all fall under the heading of ‘putative’ risk factors, i.e., assumed risk factors. But even these putative risk factors improved as saturated fat intake increased.
What about actual changes in coronary artery diameter?
Among postmenopausal women with established CHD [coronary heart disease], greater saturated fat intake was associated with less progression of coronary atherosclerosis over an average follow-up of 3 y, whereas polyunsaturated fat and carbohydrate intakes were associated with greater progression.
As it turns out, the more saturated fat these women reported eating, the less their coronary disease progressed. Those who ate the most polyunsaturated fats, i.e., the vegetable oils Ms. Parker-Pope is so enamored of, had the greatest rates of disease progression. Same with carbohydrates.
It’s interesting to read the contortions the writers go through in trying to rebut this paper. (Click here for full text) The first line of this rebuttal sums up the predicament of all the low-fatters out there, including, I’m sure, our Ms. Parker-Pope:
It is an article of faith that saturated fat raises LDL cholesterol and accelerates coronary artery disease, whereas unsaturated fatty acids have the opposite effect .
An article of faith, indeed, because it is definitely not proven.
The take-home lesson of this post is to not believe everything you read in the newspaper, not even a venerable, prestigious paper such as the Wall Street Journal with mega circulation figures. I’m quite sure that before long I’ll receive a copy of this Q &A on saturated fat along with a letter from a reader asking how MD and I can reconcile what we wrote in our books with Ms. Parker-Pope’s response. I’ll be ready for them.