An Interview With The Big Fat Surprise Author Nina Teicholz

Tricia Ward, Nina Teicholz


February 09, 2015 | Medscape Cardiology: What are the changes that you would like to see in food policy?

Ms Teicholz: I think the science exists to support two major changes in our dietary guidelines right away. One is to rehabilitate saturated fats. Take the limits off saturated fats. There were two meta-analyses[13,14] in the past 4 or 5 years saying that saturated fats do not cause heart disease. There really is no evidence that saturated fats cause heart disease. Our national nutrition policies should reflect that science and remove the limits on saturated fat so that we can enjoy full-fat animal foods. They are an important part of a diet, especially for children and women.

The other big change that could happen right away is to back off the high-carbohydrate diet that has been recommended by the government for 35 years. Back in the 1960s, before our epidemic of obesity and diabetes, Americans were eating about 40% of their calories as carbohydrates (potatoes and grains).[15] Now that's gone up to 50%.[16] The target was between 50% and 60%, and we've increased our carbohydrate intake quite a lot. I think there is a convincing body of science that excessive carbohydrates are not good for health and that restricting carbohydrates is the best bet for starting to reverse disease progression for obesity, diabetes, and heart disease. Backing off that high-carbohydrate goal, which is what the USDA dietary guidelines have had since 1980, would be an excellent step for American health, in my opinion. | Medscape Cardiology: Michael Pollan made a famous statement on food: "Eat food. Not too much. Mostly plants." But am I correct in thinking that you wouldn't agree with that? You would want a bit more meat.

Ms Teicholz: It's the "mostly plants"; there's just no scientific backing for that view. I fully agree with Michael Pollan's idea that we should be more in touch with our food, eat whole foods, and pay attention to where foods come from, and he writes about this in his book ( The Omnivore's Dilemma ). One of the chapters is about hunting a pig; I think it's a wild boar. Humans have lived on farms that were full of plants and crops, but they also had livestock. A dairy cow was the first thing on every farm, and chickens laying eggs. We can't ignore that that's part of our human history. | Medscape Cardiology: Having written this book, how have you changed your own diet?

Ms Teicholz: Your audience is science people, so they know that I'm just n = 1. I am irrelevant to this story. That said, I believe the science, and I've dramatically changed what I eat and what my family eats. We no longer eat much grains, and we don't eat a lot of rice. We don't eat a lot of potatoes (we have some). We are not afraid to eat red meat and a lot of eggs, and have only full-fat dairy. We start the day eating eggs, bacon, and sausage. We don't have cereal in the morning. We don't have orange juice. For lunch, it's tuna salad, chicken salad, egg salad, or leftovers. We snack on nuts and cheese. We don't fear the fat. I don't believe that the more fat you eat, the fatter you're going to get; I believe it is quite the reverse. | Medscape Cardiology: What would you like physicians to take away from this?

Ms Teicholz: I've spoken to a lot of doctors, and they are frustrated with the toolkit that has been given to them to help their patients lose weight and fight diabetes and heart disease. They tell their patients to go on a low-fat diet and eat more fruits and vegetables and eat more grains, reduce your fat, cut out any saturated fat. It's extremely rare that they see any sustained gains in their patients. Many of the doctors that I've spoken to have this a-ha moment where they realize that what they're prescribing simply isn't working. It's not because people are lazy or don't try hard enough or don't exercise enough. It's because the basic advice doesn't work. There's a growing population of doctors and nutritionists who have discovered the low-carbohydrate diet, which has a tremendous amount of science behind it (dozens of rigorous clinical trials involving thousands of people, some trials lasting up to 2 years). Carbohydrate restriction is a far better way to manage those chronic diseases. "Give it a try" is what I would I say to doctors.


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