Food Ink 17
When Science Fails Us, (Mis)Truths About Fat, and More Lies
(8 minute read)
Hello friends and farmers,
Here it is, a day later than the usual Friday cadence but still keeping the streak alive with this fourth consecutive weekly newsletter.
This one marks the halfway point of my two-month experiment, and I hope you're enjoying it. I would love to hear your thoughts on the past few editions - what you liked, what you didn't, anything that stood out or surprised you, or any kind of feedback you have. Hit reply and let me know, I read every response!
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🤥 It's been 20 years since this article, "What if It's All Been a Big Fat Lie?", was published in the New York Times. Reading it now, I'm struck by just how slowly our collective knowledge changes and evolves.
We're more connected than ever, the news cycle is constant and instantaneous, almost 5 billion people can plug into the hive mind of the Internet, a place we used to refer to as the information superhighway. And yet, we still can't seem to come up with a definitive answer to the question of what constitutes a healthy diet.
In 2022, the mainstream, almost incontrovertible truth still seems to be that fat is bad, cholesterol is bad, red meat is bad. All this despite the growing body of evidence disproving these claims (and a growing number of crazies, like me, experimenting with the opposite extreme of high-fat, high-cholesterol, all-meat; in case you missed my 30 day carnivore experiment from a couple years ago, it's a dense but worthwhile read).
It took until 2015 for the Dietary Guidelines Advisory Committee to report that "cholesterol is not considered a nutrient of concern for overconsumption." (The DGAC is the body that provides a report to the federal government every 5 years detailing its scientific recommendations for the US Department of Health and Human Services and USDA’s joint development of the Dietary Guidelines for Americans).
Even still, the final 2015-2020 Dietary Guidelines for Americans diluted the impact of this would-be momentous change: "The Key Recommendation from the 2010 Dietary Guidelines to limit consumption of dietary cholesterol to 300 mg per day is not included in the 2015 edition, but this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns."
Even worse, the 2020-2025 guidelines dialed that back still further, seemingly reverting to their old position, recommending "dietary cholesterol consumption to be as low as possible without compromising the nutritional adequacy of the diet."
This watered down representation, and the subsequent repeal, of the shifting view of the evidence is characteristic of the American inability to admit fault or wrongdoing and our propensity to double down even, or especially, in the face of opposition. Indeed, a lack of accountability seems to be such a rich part of our national history as to define us today. But I digress.
This article about dietary fat and cholesterol, and their widely accepted yet surprisingly dubious contribution to our health woes, offers a window into the confusing and polarized world of nutrition science. This passage sums it up pretty well (emphasis mine):
"To study the entire physiological system involves feeding real food to real human subjects for months or years on end, which is prohibitively expensive, ethically questionable (if you're trying to measure the effects of foods that might cause heart disease) and virtually impossible to do in any kind of rigorously controlled scientific manner. But if researchers seek to study something less costly and more controllable, they end up studying experimental situations so oversimplified that their results may have nothing to do with reality. This then leads to a research literature so vast that it's possible to find at least some published research to support virtually any theory. The result is a balkanized community -- "splintered, very opinionated and in many instances, intransigent," says Kurt Isselbacher, a former chairman of the Food and Nutrition Board of the National Academy of Science -- in which researchers seem easily convinced that their preconceived notions are correct and thoroughly uninterested in testing any other hypotheses but their own."
Science, carried out in this way, might not be considered all that different from religion. Like religion, science is a framework used to seek explanations for natural phenomena. But good science implies the development of falsifiable hypotheses, systematic experimentation, the questioning of established views, and scientific rigor. Without these, good science becomes folk science. Indeed, additional information often fails to change an established view and in fact has the opposite effect of deepening the commitment to that view. In this way, the world of nutrition science is as much about faith and what we choose to believe as is religion. For example:
"... the N.I.H. spent several hundred million dollars trying to demonstrate a connection between eating fat and getting heart disease and, despite what we might think, it failed. Five major studies revealed no such link. A sixth, however, costing well over $100 million alone, concluded that reducing cholesterol by drug therapy could prevent heart disease. The N.I.H. administrators then made a leap of faith. Basil Rifkind, who oversaw the relevant trials for the N.I.H., described their logic this way: they had failed to demonstrate at great expense that eating less fat had any health benefits. But if a cholesterol-lowering drug could prevent heart attacks, then a low-fat, cholesterol-lowering diet should do the same. "It's an imperfect world," Rifkind told me. "The data that would be definitive is ungettable, so you do your best with what is available.""
A leap of faith. It begs the question, "How many leaps are embedded in what we commonly accept as scientific consensus regarding diet?" After all, as reported in this article "the experimental tools we have to study [the regulation of appetite and weight] are still remarkably inadequate." And yet we'll assert strong claims and make national dietary recommendations based on the selective research to which we choose to lend our credence:
"Pete Ahrens, whose Rockefeller University laboratory had done the seminal research on cholesterol metabolism, testified to McGovern's committee that everyone responds differently to low-fat diets. It was not a scientific matter who might benefit and who might be harmed, he said, but "a betting matter." Phil Handler, then president of the National Academy of Sciences, testified in Congress to the same effect in 1980. "What right," Handler asked, "has the federal government to propose that the American people conduct a vast nutritional experiment, with themselves as subjects, on the strength of so very little evidence that it will do them any good?""
It turns out, much of the nutritional guidance we've received, internalized, and dutifully followed over the past few generations may have been bad advice.
"If the alternative hypothesis is right... the public health authorities told us unwittingly, but with the best of intentions, to eat precisely those foods that would make us fat, and we did."
I feel compelled to invoke Hanlon's Razor here, the idea that what is often attributed to malice is usually more easily explained by incompetence or mistakes. Yet I can't help but suspect that there's more to it than that.
When institutions fail us, to understand why, it can often be helpful to follow the money:
"... calorie for calorie, [starches and refined carbohydrates] are the cheapest nutrients for the food industry to produce, and they can be sold at the highest profit."
Fat is bad. Cholesterol is bad. Red meat is bad. These aren't objective truths. They never were. These are ostensibly consensus opinions rooted in some amalgamation of ego, politics, panic and desperation (of the unprecedented heart disease epidemic that swept our nation in the 1960s), individual and collective hubris, bias, cherry-picking, and industry meddling. More broadly, they are a result of incentive structures that value profit over public health, a system designed to center economic activity, not humanity. This narrow window through which we view many things has contributed to a wealth of mistaken outcomes that we're faced with today.
And because of a similar narrowness, in scope in this case, i.e., "the exclusive focus on adverse effects of fat," the answers still appear inconclusive, even contradictory.
"In all five studies, cholesterol levels improved similarly with both diets [a high-fat, low-carbohydrate Atkins diet and a low-fat, low-calorie diet], but triglyceride levels were considerably lower with the Atkins diet. Though researchers are hesitant to agree with this, it does suggest that heart-disease risk could actually be reduced when fat is added back into the diet and starches and refined carbohydrates are removed."
At the same time, "the fact that Atkins himself has had heart trouble recently does not ease my anxiety, despite his assurance that it is not diet-related." (Atkins later died in 2003 from complications after a slip and fall accident.)
🧈 On a very related note, I've been reading The Big Fat Surprise by Nina Teicholz, which is probably the seminal work of the modern era regarding our collective misinformation about dietary fat. I'm only a few chapters in, but it is already a wellspring of knowledge, context, and history painting a compelling picture of how we may have gotten it oh so wrong. (Again, emphasis mine).
"Once ideas about fat and cholesterol became adopted by official institutions, even prominent experts in the field found it nearly impossible to challenge them. One of the twentieth century’s most revered nutrition scientists, the organic chemist David Kritchevsky, discovered this thirty years ago when, on a panel for the National Academy of Sciences, he suggested loosening the restrictions on dietary fat.
"We were jumped on!" he told me. "People would spit on us! It’s hard to imagine now, the heat of the passion. It was just like we had desecrated the American flag. They were so angry that we were going against the suggestions of the American Heart Association and the National Institutes of Health."
"This kind of reaction met all experts who criticized the prevailing view on dietary fat, effectively silencing any opposition. Researchers who persisted in their challenges found themselves cut off from grants, unable to rise in their professional societies, without invitations to serve on expert panels, and at a loss to find scientific journals that would publish their papers. Their influence was extinguished and their viewpoints lost. As a result, for many years the public has been presented with the appearance of a uniform scientific consensus on the subject of fat, especially saturated fat, but this outward unanimity was only made possible because opposing views were pushed aside."
😊 Delight No. 6: I recently rewatched The Trial of the Chicago 7. Again. Since its release in 2020, I must have watched the film nearly half a dozen times already. The writing is so captivating (Aaron Sorkin), the performances compelling (particularly Sacha Baron Cohen, Eddie Redmayne, and Frank Langella), and it spotlights an iconic trial from the 60s era of activism that bred today's factions within the Democratic party (roughly represented by Hillary Clinton on one side and Bernie Sanders on the other).
There's one line from the film that gets me every time. When a reporter asks Jerry Rubin, a leader of the Youth International Party on trial played by Jeremy Strong, "Why won't Bobby Seale let anyone represent him?", he responds, "You've posed that question in the form of a lie."
The quick wit, awareness, and intelligence compressed into just 10 words is astounding. It's the kind of line that I could only hope to compose after many passes and likely hours of revising and editing and distilling a thought down to its absolute essence. It's what I like about writing, because it affords me many chances at any given sentiment, sentence, even a single word to get it right, before I hit send.
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Betting the farm,
Edlin