Is America the land of the heavy?
We should eat less meat, we should eat less fat.
the hefty?
Less beef, eggs, junk foods
the large, the roly-poly?
Most Americans must lower their cholesterol, whatever it takes
the chunky?
Eat oat bran
In other words, is America too fat?
After nearly 40 years of advice about what to eat and how to exercise,
millions of Americans are getting fatter. And that’s not all.
You have these massive increases of obesity and diabetes
that coincide with this epidemic of nutritional advice we’ve been given.
And the role our diets play is as confusing and controversial as ever,
leaving us once again with the question: “What should we eat for dinner?”
A stunned nation hears that its president is stricken with a heart attack.
The chief executive is rushed to Fitzsimmons hospital where he is immediately placed in an oxygen tent.
President Eisenhower was a very good example of what was happening with middle-aged men.
The president had been stricken by the greatest man killer: heart disease.
In the 1950s and 60s, Americans were having heart attacks at an alarming rate.
Nearly a million of us this year will die. Heart disease is an epidemic.
The average American male reaching adulthood had one chance in five
of having a heart disease before age 60. That’s a very high risk.
And top researchers like Dr. Jeremiah Stamler thought they knew a big reason why:
a diet high in saturated fat and cholesterol.
The nutrition committee was told that Americans are eating themselves to death,
eating too much of the wrong food. Dr. Jeremiah Stamler said this is an epidemic
that can be curbed only by a massive change in lifestyle.
But many researchers complained that the science was too controversial
to recommend major changes in diet.
Eight studies involving 5,000 patients failed to show hard medical evidence
that diet has anything to do with heart attacks.
The body also makes its own cholesterol.
That is why it’s impossible to prove that heart disease is caused by what we eat.
Some of the best scientists said,
“Look, this is a very controversial subject. It’s a very complicated subject.
You can’t just tell people to reduce the amount of fat in their diet, because diet is a trade off.”
If you reduce the amount of fat, you have to replace it with something.
I have pleaded in my report and will plead again orally here, for more research
on the problem before we make announcements to the American public.
Well, I would only argue that senators don’t have the luxury that
a research scientist does of waiting until every last shred of evidence is in.
Definitive studies could take years and cost hundreds of millions of dollars
and in 1980, the government issued the first dietary guidelines,
which called for cutting back on a variety of nutrients, including fat and cholesterol.
The physician’s perspective was look, you’ve got people who are sick and dying.
We have pretty good evidence that dietary fat is the problem.
We don’t have time to dot the I’s and cross the T’s.
We were reasonably secure that these recommendations were not being harmful.
The issue appeared to be put to rest four years later, with a landmark study that showed
that lowering cholesterol reduced the risk of heart attacks. But there was one problem:
the study also used cholesterol-lowering drugs, and the scientists assumed
that a low cholesterol diet could work as well.
When I interviewed the administrator who oversaw the trial, he said to me,
“Look, we confirmed that lowering cholesterol, at least by drugs, seems to reduce heart disease risk.
And we took a leap of faith.”
Scientists now have conclusive proof that lowering the amount of cholesterol, or fat,
that we eat can significantly reduce the chance of heart attacks.
Cutting all fat and cholesterol became a national obsession.
Cholesterol could be building up in your arteries.
Cholesterol is now thought to be a danger for everyone.
Even children, once they’ve passed their second birthday, should try to reduce fat
in their diet by 25 percent and cholesterol by 30 percent or more.
The gist of it was that if a food didn’t have fat in it, it couldn’t make you fat.
Bread, pasta, potatoes, rice, now become the base of the food guide.
We should eat more of the foods at the bottom of the pyramid, like bread and cereal,
and less of the foods at the top.
No cholesterol
All of the food companies think, “Ah-ha, now we have to talk about how our product cuts back on fat."
There was a whole line of Snackwells which had no fat whatsoever.
SnackWells was a very successful product because it was on the no-fat craze.
Low-fat dissenters like Robert Atkins, who said to eat meat and cheese
while avoiding carbohydrates, were branded as heretics.
The idea was that if you tell people to eat fat, saturated fat, you were going to kill them.
Telling people that pork rinds and sausage is good for you is an appealing way to sell books,
but I think it's irresponsible.
It was the equivalent of committing mass murder.
But even as Americans were cutting down on fat, a new health problem was emerging.
Americans are fatter than ever before.
Obesity is a major risk factor for heart disease, heart attacks.
There is an alarming report today about an increase in diabetes.
It really turned on almost like a switch in 1980. Obesity was stable for many decades.
So, what, what changed in 1980?
We put the whole country on a low-fat diet, and lo and behold we have an obesity epidemic
And that’s what started my research.
Science journalist Gary Taubes and doctors like Dariush Mozaffarian
soon began to question the conventional wisdom.
I started reading, myself, about the dietary guidelines,
and starting to look into the evidence, and I was stunned.
I was stunned to find that about 90 percent of the dietary guidelines were, basically, best guesses.
There was a small and growing minority of researchers who were coming to believe
that the problem in modern diets were the sugars and refined grains and not the fat.
If the American Medical Association had a nightmare, it was the possibility that Atkins was right all along.
It is one of the hottest battles in public health today: high carb versus high fat.
The evidence started accumulating that there's really
no association at all between total fat intake and heart disease or stroke.
The results might surprise you.
Consuming less fat did not reduce the risk of cardiovascular disease and cancer.
And many foods made to capitalize on the low fat craze had their own drawbacks.
If you looked at the calorie content, it was all high-calorie, lots of carbs.
If you take out the fat, the person’s going to eat more because there aren’t any signals
"I’m full, full, full."
We had an explosion of high carbohydrate, sugary foods,
and those have contributed to the obesity epidemic.
Obesity is growing faster than any other public health problem in U.S. history.
This is the law of unintended consequences. You just don’t know what’s going to happen
when you make your recommendation. You’re putting, in effect, the American public
on this grand experiment and you have no idea how it’s going to work out.
Dr. Stamler says his recommendations were misinterpreted. Those of us who were recommending
were recommending vegetables, fruit, and not special desserts.
Now facing an obesity epidemic,
the public continued to be inundated with nutrition studies and diet advice.
The raw food diet
Eat more butter, meat, and cheese!
Don’t eat sugar
What would Jesus eat?
And Taubes says one of the main sources of confusion is conflicting and inadequate diet science.
Past studies have rarely been large enough, long enough,
or the diets different enough to provide definitive answers.
If you search obesity, and or diabetes, you can pick and choose your research.
And say look, we should all be eating a vegan diet, or we should all be eating a ketogenic diet, or a fruitarian diet.
You pick it, you can find research to support it.
It's a huge problem with nutrition.
In 2012, Taubes co-founded the Nutrition Science Initiative to fund new, more rigorous studies
and try to find out not just what foods to avoid, but what we should really be eating instead.
Everyone agrees for the most part now that we shouldn’t be eating a lot of sugar
and white flour. And then the question is what do you replace those calories with?
Professor Christopher Gardner, who’s leading one of the studies,
is finding that the answer may be different for different people.
There’s this massive variability in response to the same diet. We had some women losing
60 pounds and some losing zero. So maybe it was the wrong question, which diet is best?
Maybe the better question was, is there a way to match different people
to a diet that they’re more pre-disposed to?
With the answer still unclear, Mozaffarian worries that the conventional wisdom
is being oversimplified again from “low-fat” to “just cut carbs and calories.”
We made a mistake, focusing on just total fat, and I think we’re in danger of making
the same mistake now. Now we have a public health crisis of obesity and diabetes,
and so everybody’s trying to do something.
A new government rule requiring big restaurant chains to post their calorie counts
The major focus now has been on calories. Just cut calories, portion size control.
Smaller portions of French fries
There are foods that have more calories that are good for us, that are good for obesity
and diabetes. There are foods that are fewer calories that are bad. It’s not just about
fat and it’s not just about calories. It’s about the quality of the food that you eat.
We have to stop thinking about single targets as though just focusing on one thing
will give us the answer.
Here we go again. Experts are changing their recommendations about what we shouldn't eat.
The Dietary Guidelines Advisory Committee now considers taking cholesterol
off the list of things we should avoid.
In 2015, a scientific advisory panel revisiting the dietary guidelines said there is actually
little evidence that high cholesterol foods lead to high cholesterol in our blood.
Cholesterol is still linked to heart disease, but what we've learned is that cholesterol
in our blood, most of it doesn't come from food, our body makes it on our own.
And when the new guidelines were released in January 2016, they did away with the cholesterol limits,
but still recommended cutting back on foods that are high in both saturated fat and cholesterol.
Among the recommendations, limit your intake of added sugars, often found in beverages and process foods,
and saturated fats to 10% of your daily calories.
Some experts were disappointed that the guidelines didn't adopt
all the recommendations of the advisory committee.
The guidelines could have a big impact at a time when more than two thirds of Americans
are overweight or obese. Meanwhile, Mozaffarian says nutrition science
has come a long way since the 1980s, as advances have led to a better understanding of the
importance of whole foods and eating patterns.
And, he says, we’re still learning the lessons of the past.
I think now we know about 50 percent of what we need to know. And we need to be
a little bit more modest, and not set strong guidelines for areas that we’re still not certain about.
We have to get the science right.