An Interview With The Big Fat Surprise Author Nina Teicholz

Tricia Ward, Nina Teicholz


February 09, 2015

Editor's Note: The role of dietary fat, particularly saturated fat, in coronary artery disease (CAD) has been debated. The 2013 American Heart Association/American College of Cardiology Guideline on Lifestyle Management to Reduce Cardiovascular Risk continues to recommend a diet comprising 5%-6% saturated fat. With meta-analyses challenging the notion that saturated fat intake increases CAD risk, perhaps it's no surprise that among the New York Times best-selling books in 2014 was The Big Fat Surprise: Why Butter, Meat & Cheese Belong in a Healthy Diet. The author, Nina Teicholz, spoke with | Medscape Cardiology. | Medscape Cardiology: Can you give our readers some background information on what prompted you to write the book?

Ms Teicholz: I am an investigative journalist. I worked for NPR for many years as their South American correspondent, among other roles. When I got into print journalism, I started doing a series of investigative food stories for Gourmet magazine. They assigned me a story on trans fats. That story, which came out in 2004, broke the issue wide open, and I got a book contract from it. In the course of writing that story and as I was researching the book, I spoke to a number of scientists who had been marginalized. These people told me an alternative story about dietary fats, about how basically everything that we had come to believe about fat was untrue. It wasn't just trans fats; there was a whole story about vegetable oils and saturated fats that seemed to turn everything that we thought we knew on its head. Once I realized that this was much bigger than trans fats, I reoriented my book to be about all fats. That led me down this exhaustive compulsive path because there's such a huge body of scientific literature about dietary fat and cholesterol, heart disease, and the history of it all. | Medscape Cardiology: Originally your book was just going to be on trans fats?

Ms Teicholz: Yes. It was a slow discovery that this story was much bigger than trans fats. | Medscape Cardiology: In science, it's common for an initial hypothesis to be tweaked or revised as data accumulate. The research on diet and heart disease, for example, has moved away from emphasizing dietary cholesterol and total fat. But in your book, you're suggesting that there is something more sinister going on with research data not being reported or the findings/researchers being disparaged. Can you comment on that?

Ms Teicholz: This is not a case of a hypothesis being tweaked. This is a complete overthrow of the most important hypothesis about how nutrition affects disease over the past 50 years. Starting in the late 1950s, the hypothesis has been that saturated fats cause heart disease. Then that was expanded to include all fats over the following decades. That hypothesis seems to be fundamentally wrong. It's not a matter of slightly shifting course but completely overturning it. This hypothesis basically became dogma and could not be reversed, even though (to use the language of science) there were many observations that could not be explained by this hypothesis. The most obvious one today is that the American population slashed its fat and saturated fat consumption by 11% and increased carbohydrates by 25%, according to our nutritional guidelines, but we have clearly not become healthier. Our health is far worse. I'm referring to the past 30 years since the US Department of Agriculture (USDA) dietary guidelines began, which is when the US government adopted that hypothesis.


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