meme Log

July 20, 2014

The Big Fat Surprise – Why Butter Meat and Cheese Belong in a Healthy Diet (9.0)

Filed under: Uncategorized — Lynn Fikstad @ 16:01

If I were new to the surprise about fat, this book would have shocked me. Before reading the book I had already read about a hundred nutrition books, many out of the mainstream after I realized the consensus views on nutrition were about as scientifically sound as cold fusion.

In the past few years I have changed my eating habits, eventually concluding that a high fat diet is likely the most healthy diet, at least for me based on my lipid panels. I believe my macronutrient makeup is now about 15-20% protein, 20-25% carbs, and hopefully around 60% fat. It is an upside down version of the half century long government recommendations. Believe me, consciously eating more fat is not a burden, and because of the anti-fat crusade drummed into me for the past 40 years, books like this one are helpful. I am almost over the discomfort of eating a delicious, high fat (saturated and monounsaturated fats) diet. I also try as best I can to limit in vegetable oil fats. I have never been overweight, but I dropped about 5 pounds after going on the high fat diet.

Fat is generally traded off with carbohydrates. You can balance things out with more protein, but there is only so much protein most people can tolerate or want. A high protein diet is probably not a good idea anyway (if your under 65), but that’s another story.

The author is not an anti-carb zealot and neither am I. She is cautious when making any claims and conclusions throughout the book. Even at the conclusion the take away from the book is, “a higher-fat diet is almost assuredly healthier in every way than one low in fat and high in carbohydrates”. For someone unfamiliar with the evidence, this seems like a statement made by a high-fat zealot. After reading the book, you will hopefully be convinced this prudent advice.

I highlighted almost 400 passages in the book, which is a lot for a book this size. In fact, I scanned through the book highlights and deleted about 25% of my earlier highlights to make them manageable. The book is so jam packed with interesting information that it is hard not to highlight a lot of it. And it is all supported numerous footnotes. I enjoyed this book, probably more than Gary Taubes’, Good Calories, Bad Calories which I enjoyed a lot and probably gave a 10.0.

The only reason I downgraded this one point is because there were a few statements made that I thought were completely unsupported by the evidence, and there were no references. I can’t even remember what they were so it seems unfair to even make this criticism. I remember thinking they were unjustifiably alarmist and many were in Chapter 9.

Here are the extensive notes I typed after reading the book, summarized for my own edification. Skip my notes and read the book since there are probably a lot of things I left out which are very important in understanding the evidence for fat.

Chapter 1 Introduction

  • Domesticated animals are higher in monounsaturated fats, not saturated fats.
  • Focusing on muscle is a relatively recent phenomenon (See Denise Minger’s YouTube video, “Meet your Meat” for a more extensive explanation of the benefits eating more of the whole animal (generally higher in fat and higher in glycine).
    -I just tried a beef heart and I can confirm that the heart muscle is definitely not like any other muscle cut. I would much prefer a ribeye. I have a hard time believing our ancestors left the ribeye for the vultures, but if you are constantly threatened by starvation, there probably were not too many gastronomes. But then again, I can’t understand people cutting off the fat of a good steak either.

Chapter 2 Why We Think Saturated Fat is Unhealthy

  • Bad science. First thinking a rabbit having problems with cholesterol tells us something about us. (dogs, by the way)
  • Neglected some evidence that the body may ratchet down its own production of cholesterol if there is enough in the diet.
  • Some governments have determined cholesterol isn’t a problem, but the US government still insists on a limit of 300mg per day (1.5 eggs).
    – I don’t think even Dr. Oz is still this closed minded.
  • The less saturated a fat is the more unstable it is. Saturated fats are the most stable, followed by monounsaturated fats, followed by polyunsaturated fats. Even trans fats are more stable than the vegetable oils we are over eating. However, these have other issues, which we learn in a later chapter are possibly not quite as bad as what we are now substituting them for.
    – It seems like with the anti-oxidant craze and the free radical paranoia, foodies should be a little leery of unstable oils.
  • The influence Keys had in the anti-saturated fat trope is fair and more interesting than I thought. Personality (and money) seem to have far too much influence in nutrition science (science is probably a misnomer). The six country study and the follow up study are all covered. Keys wanted his hypothesis to be proven wrong, no proven right. He seemed to have been able to bull doze almost every nutritionist and journalist. Keys and his studies are paradigm examples of how not to so science.
    • The 7 country study included Crete, but no mention was made of the intermittent fasting.
    • Further analysis of the famous 7 country study showed sugar had a higher correlation with heart disease than fat. This was promoted by John Yudkin. Keys, through nothing more than a strong, overbearing personality prevailed.
      – There must be something about a nutrition scientist that makes them easy to control!

Chapter 3 The Low-Fat Diet is Introduced to America

  • The AHA put out the warning about saturated fat and cholesterol in 1961, substituting for the relatively new vegetable oils. Reduction in total fat didn’t come until 1970. Keys was the primary influence on these recommendations
  • Some real nutrition scientists continued to question these recommendations. Ahrens noted that a high carb diet resulted in increased triglycerides, a better marker for heart disease.
    – My own triglycerides have never been high, but a high fat diet made them even lower.
  • Framingham was another study (started in 1948) that was unjustifiably used to support these recommendations. In 1961 it was found the high total cholesterol was a reliable predictor of heart disease. Weaker follow up numbers in late 1980’s were never publicized. Each 1% drop in cholesterol resulted in MORE heart disease. No one was even aware of this for the next decade. Framingham methodology was a mess anyway.

Chapter 4 The Flawed Science of Saturated versus Polyunsaturated Fat

  • When the saturated fat paranoia started in the 50’s, total fat was not much of a concern. Vegetable oils were to goto fat.
  • A constant anomaly from all the diet-heart studies was that people on low fat diets actually did not extent their lives. The lower the fat, the shorter the life.
  • Flawed studies, the Anti-Coronary Club trial, the VA Hospital Study, the Finnish Mental Hospital study, and the Oslo experiment, are the most cited.
  • Whenever saturated fat is removed from the diet, something replaces it. You are always studying 2 changes.
  • Initially vegetable oils (usually seed oils) were substituted. This generally lowered total cholesterol, but it was troublesome that it often increased the incidence of cancers. The famous MRFIT study is often cited. A number of studies show the lower the cholesterol the more cancer, particularly colon cancer (Framingham- men w/ cholesterol below 190 were 3 time more likely to get colon cancer than men with cholesterol > 220, a little known result). The lower the cholesterol, the worse it looked for cancer deaths.
    – I think this is likely from the instability of vegetable oils. It seems prudent to avoid them.
  • Hardening these (partial hydrogenation) produces trans fats. Now thought to be bad. Crisco (early 1900’s) stands for crystallized cottonseed oil. From 1960’s consumers were advised to replace butter with margarine and Crisco.

Chapter 5 The Low-Fat Diet Goes to Washington
– This is where things really get messed up, making it difficult to turn the disastrous conclusions of Keys and his followers around.

  • By the 1970’s the politicians got involved. McGovern, a follower of Pritikin, and a progressive staff member with no background in nutrition, Nick Mottern, decided how Americans should eat. Keys retired, but Mark Hegsted took up the crazed notion.
    – There was a bias against meat, and I suspect religious believers in the vegetarian life had something to do with it. This explains why the meat – colon cancer correlations were blown out of proportion.
  • The meat and cancer links are likely the result of known HCA carcinogens, generated when meat is cooked or fried, but this could have much to do with the oils used (unstable seed oils).
    – It seems prudent to avoid overcooking meat or seed oils.
  • In the 19th century Americans ate 4-5 times the butter and at least 6 times the lard than we do today. Also 175lbs of meat vs. 100lbs today (half of it chicken, probably skinless).
  • We primarily eat muscle meats today verses over a century ago.
    -Too bad hotdogs no longer include the offal.
  • The governments dietary goals in 1980 became:
    reduce: fat, especially saturated fat, sugar, and salt
    increase: carbs to 55-60 percent of the diet.
    – Aside from the sugar, this is upside down. Fat should be 55-60 percent (much of it saturated and monounsaturated, and carbs should be 30 percent or even less.
  • Some research shows cholesterol lowering drugs resulted in mood changes – depression and increased suicide rates. But they often concluded just by lowering cholesterol and the must also reduce heart attacks.
    – they have other properties including anti-inflammatory effects which could have an effect on

Chapter 6 How Women and Children Fare on a Low-Fat Diet
– Generally heart attacks are a man’s disease until women are post-menopausal. That is the reason for this chapter because the government pushed it on everyone.

  • The American Heart Association (AHA) actually recommended in 1995 to choose “snacks from other food groups such as…low-fat cookies, low-fat crackers…unsalted pretzels, hard candy, gum drops, sugar, syrup, honey, jam, jelly marmalade. –Thanks!
  • Charging a hefty fee for the AHA approval undoubtedly influenced their recommendations. It once was on Frosted Flakes, Pop-Tarts, Fruity Marshmallow Krispies. Today it remains on Honey Nut Cheerios and Quaker Life Cereal Maple and Brown Sugar.
    – I don’t understand how this organization has any credibility left.
    – Thanks to this hysteria, it is almost impossible to find some full fat dairy products. Costco still only sells low fat Greek Yogurt.
  • Ornish’s study on reducing arterial blockage on his no-fat diet plan has never been replicated.
  • Vegetarian Akikuyu men had more bone deformities, dental carries, anemia, lung disease, blood disorders. The Masai were more likely to contract rheumatoid arthritis.
  • Children eating low fat – 30% failed to meet RDA’s for B1, B12, E, thiamin, riboflavin, and niacin. Despite the American Academy of Pediatrics recommends 20-30% fat.
    – This was in 1998 and it is likely still true.
  • This chapter and likely others point out the most effective way to raise HDL (the good cholesterol carrier) is to eat saturated fat. Red wine and exercise will raise is some, but saturated fat is the clear winner.
  • Most women don’t know that there is evidence that a low fat diet may actually raise their heart disease risk. The more fat, the less likely women are to contract breast cancer, another unknown result from the huge Nurses’ Health Study.
  • Another huge study, The Women’s Health Initiative, showed a low fat diet did nothing for women and heart disease (maybe made it worse) but did increase obesity and diabetes.

Chapter 7 Selling the Mediterranean Diet
– Basically this chapter exposes how it became a rage (money and politics) and how it is better than a low fat diet but still nothing to cheer over.

  • Fancy conferences with lush hotels helped create the rage. If a journalist or researcher did not give glowing write-ups, they were not invited back by the IOOC (the olive lobby).
  • The diet became popular because it allowed more fat, and a more stable one than the polyunsaturated seed oils.
  • Olive oil could lower LDL and keep HDL intact. That is why it wins against the low fat diet. Even olive oil has not been consumed much before 100 years ago.
  • The Israeli study in 2008 compared a low carb diet, a low fat diet, and the Mediterranean diet. The Mediterranean diet had better results than the low fat diet, and this was publicized. What was not well known is the low carb diet (and thus relatively high in fat) won. Subjects lost more weight, blood lipids were better with HDL higher and triglycerides lower. These are currently recognized as the best predictors of heart disease. The unproven predictor of heart disease, LDL, was better for the Mediterranean dieters. There was no doubt that the low carb diet was the clear winner, yet this is the study most often cited by Mediterranean dieters.
  • Almost any traditional diet is likely better than a low fat diet. It is just that no one ever had the money to promote it.
  • Some of the Mediterranean studies seem likely to be fraudulent.

Chapter 8 Exit Saturated Fats, Enter Trans Fats

  • The Center for Science in the Public Interest (CSPI) decided trans fats in partially hydrogenated soy oil are much better than the fat in beef tallow, the common oil used by fast food fries but lard and palm oil were also used. Pressure mounted and beef tallow was out, vegetable oil in. They also convinced theaters to switch from butter and coconut oil to the same unstable partially hydrogenated vegetable oils.
    • Palm oil contains 50% saturated fat, palm kernel oil 86%, and coconut oil 92%.
  • Food companies, under pressure, replaced palm oil with trans fats.
  • Americans eat 1000 times more soy oil than they did in 1909.
    • Thanks to the government the tropical oils were taxed for the benefit of soy farmer (the tropical oil wars). The ASA (American Soybean Ass.) have pushed this from 1930 to 1980 when palm oil imports started to creep up. Palm oil from Malaysia is 15% cheaper than soy oil.
  • Palm oil has been shown to lower total cholesterol!
  • Those in Southeast Asia eating the tropical oils are relatively heart disease free
  • Taking tropical oils out of manufactured food causes a major challenge. The chances of matching the taste exactly are slim, but they do their best. One small change can require hundreds of modifications.
  • In the 1980’s virtually all palm oils had been replaces by trans fats.
  • Trans fats have been shown to accumulate in human tissues all over the body, the liver, the arteries, fat tissue, and the heart. These are in the actual cell membrane, not just the fat.
  • The AHA remained silent on trans fats until the very end.
  • Hydrogenated oils ramped up the uptake of calcium too, thus causing a deficiencies.
  • Those warning about trans fats could not get their papers published in scientific journals (Kummerow and Enig). This was from the 1950’s until the 1990’s.
  • Enig fought with Applewhite (Kraft Foods) over trans fats throughout the 1980’s and 1990’s.
  • Hydrogenation creates other dozens of other artificial fat isomers (different arrangement of the molecules in the chain) beside trans fats. These have not been studied.
  • The end of trans fats did not come from the industry entrenched scientists in the US, but from Holland. But new data didn’t bring an end to the trans fats, it was nothing more than advocacy.

9 Exit Trans Fats, Enter Something Worse
-This is a great chapter, given the history of nutrition science. Recommendations are made to avoid something thought to be bad, only to substitute something worse. Something worse than trans fats? I was very interested in this chapter.

  • Just as keys made himself famous by making saturated fat the enemy. Willett gained notoriety by making trans fats the new enemy.
  • In 1976 the FDA concluded trans fats contribute to heart disease
    – (this may be one of the least things to worry about considering they are actually modifying the cell membranes)
  • When trans fats became the villains, unlike Europe the US had no tropical oils to turn to, having also villainized these.
  • You remove trans fats and you probably need to find a multitude of ingredients to replace it. These are unlikely to be well tested. If only they had not made it impossible to use butter, lard, tallow, and tropical oils.

-Here is the something worse…

  • They found a new substitute by using something called interesterification, something oil chemists have been working on for decades.
    • All fatty acid chains are bound together on a glycerol molecule. There are three pitchfork-like connectors on these triglycerides. Remember, high triglycerides are much more predictive of heart disease than cholesterol. Interesterification works by moving around the fats on the pitchfork, using something akin to a hammer. It is expensive, so it was not a good option. But now it is about the only choice.
  • We don’t know if our food contains interesterified since it is listed on the label as just a kind of oil, usually soybean oil.
  • There are also some other complex chemical solutions that can act like saturated fats. Lecithin and sorbitan tristearate are two.
  • New sunflower seeds are bred to be higher in oleic fatty acid which will make them stable (called NuSun)
    -This seems like a good thing, but the author notes that sunflower oil is not used much
  • Some companies are fully hydrogenating these oils, which makes them waxy but removes all the trans fats.
  • Some (thankfully) are turning to palm oil. We are now importing about 5 times more than we did in 1980
  • The seed oils are liquid and turn rancid easily. But a bigger problem is their use in frying and cooking (see below)
  • They also create an Omega-6 Omega-3 imbalance. Far too many Omega-6’s (linked to mood disorders like depression). But these are about as bad as the other nutrition studies.
  • Fast food just moved to regular vegetable oils (probably cheap soy). When cooked, these oils oxidize and form aldehydes, known damage cells.
    • At Least hydrogenated oils didn’t do that!!!!
  • Because they are high in Linoleic acid, heating them oxidizes them and produces free radicals and degraded triglycerides.
  • The newly discovered oxidation product from these oils is hydroxynonenal (HNE). These have been shown to cause DNA and RNA damage, precursors to diseases like cancer.
  • Some restaurants will avoid much of this problem by using low-linoleic or high-oleic oils, but soybean and canola oils are still the cheapest.
  • Cholesterol seem mostly harmless when compared to this mess

10 Why Saturated Fat is Good for You

  • From 1971 to 2000 carb consumption has increased 25%
  • The American Diabetes Association are suggest a relatively high carb diet, fearing fat will make an already susceptible population subject to heart disease
  • The diet with best results in most of the experiments on macronutrient percentages is the 60% fat diet, more than double the current recommendations.
  • Some researchers suggest that fructose in fruit and other products are likely worse than those products high in glucose. This has not been well researched. There is some evidence that even whole grains and too much fruit could be problematic.
    – That is one set of studies that will take a long time to be funded
  • The fact that saturated fat raises HDL cholesterol has virtually been ignored while the fact that is also raises LDL cholesterol has been trumped up.
    • LDL cholesterol may not be that meaningful
    • probably because there are two types, the fluffy lipoprotein is thought to be harmless.
  • Eating saturated fat is healthier than eating carbohydrates
  • Summary
    • The evidence against saturated fat over the past 50 years was unsound
    • When the subfractions of LDL are included in studies, there is no negative effect on the increased LDL from saturated fat
      – And saturated fat raises HDL much better than exercise, red wine, or any known drug
  • Since 1980, thanks to the USDA, Americans have decreased their saturated fat by 14%, fat by 5%, and consumption of red meat has steadily declined, being replaced by chicken. Obesity has increased accordingly.
  • The CDC estimates that 75 million Americans have metabolic syndrome, an disorder of fat metabolism. This is ameliorated by eating more saturated fat.

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