An Interview With The Big Fat Surprise Author Nina Teicholz

Tricia Ward, Nina Teicholz

Disclosures

February 09, 2015

The question I have is: How did that hypothesis endure for so long? Basically it was adopted and institutionalized before the evidence was even remotely solid. It was based on very weak science. The American Heart Association adopted it in 1961,[1] and the National Institutes of Health, and subsequently the USDA, got on board. Then once the hypothesis became institutionalized, the entire federal government adopted it. At that point, it's very hard to reverse out. That's the simplest way I can put it.

I think it's also true that the hand of big food, particularly the vegetable oil companies, influenced that science. If there's any maleficence, it's on the part of those scientists who were willing to accept soft data and stick with it despite decades of evidence to the contrary. Scientists ultimately control the expert panels. They are the gatekeepers to policy, which is still true today. Scientists faced with the public panic about heart disease, then cancer, and then obesity were willing to settle on inadequate science. I lay the blame at the feet of the nutrition scientists who did not apply rigorous standards to the science they used to make or to recommend public policy.

theheart.org | Medscape Cardiology: In terms of dietary guidelines, there has been an acceptance that substituting carbohydrates for fats is not good. In your book, you go as far as saying that you can't eat a healthy diet if you don't eat meat or saturated fats.

Ms Teicholz: It's a bit of a subtle argument. There are two parts to it. One is that in many clinical trials, a diet that is low in carbohydrates looks better than a low-fat diet in terms of weight loss, diabetes markers, and heart disease. If you're going to eat a higher-fat diet, how do you get to that higher-fat diet? A higher-fat diet inevitably includes animal foods unless you're drinking bowlfuls of olive oil like Italian peasants did after World War II. Typically, a higher-fat diet means eating foods that are naturally high in fat, which are animal foods. That's the only way you get to the diet that performs the best in clinical trials for multiple disease outcomes.

It's also true that animal foods are more nutritionally dense than plant foods. The nutrients in them are more bioavailable. For instance, if you drink skim milk, you don't have the fat in the milk to absorb vitamins A and D in the milk. If you don't have the vitamins, you can't absorb the minerals. The calcium is not absorbed; it's turned into insoluble calcium soap in your intestine.[2] [Editor's note:There are data that vitamin D is bioavailable in skim milk.[3] Vitamin D is added to skim milk to aid calcium absorption.]

Animal foods are the best sources for choline—which the US diet is deficient in.[4,5] Folate, selenium, iron, and zinc are far more available in animal foods, and vitamin B12 is only available in animal foods. They are really important for nutrition, which is not the conversation that we're used to having. In the 1950s, all of nutrition science got hijacked by the question of how to help prevent heart disease in middle-aged men. That became the focus of all nutrition. The diet we all eat today, including children from age 3 years and women, is the diet that was designed to help middle-aged men fight heart disease.

Before the 1950s, the nation was in a panic over the rising tide of heart disease, but in the 1920s and 1930s, the question that nutrition science asked was: How do you best help children grow and women reproduce? That is the basic question for any human animal. And the foods that are best for reversing growth faltering in children and enabling healthy reproduction over many generations were whole milk, butter, and meat, which ironically became the foods that became condemned when we started to think about how middle-aged men might avoid heart disease.

The hypothesis was to avoid saturated fat and cholesterol, which is why we also avoided organ meats and shellfish and all of the rest.

theheart.org | Medscape Cardiology: Do you believe that people have to eat meat as part of a healthy diet?

Ms Teicholz: No. You can also get those nutrients through eggs and dairy. Meat happens to be extraordinarily nutrient dense (especially for iron and folate), but people can stay healthy eating some animal foods even if they don't want to eat meat. I think it's very hard to be healthy on a vegan diet—it just doesn't have the nutrients that you need to sustain human health.

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