Sunday, March 30, 2008

Does fat-phobic orthodoxy damage the public health?

The three issues that concern me most are the quality of the food supply, the quality of nutrition instruction and the current polarization of opinion regarding what constitutes proper nutrition.

Regarding the food supply, it's unfortunate that government agencies, charged with protecting and improving the public health, have consistently caved in to pressure from corporate interests. The consequence is Dietary Guidelines that seem to be doing just the opposite of what was intended. Of particular concern to me is the fat-phobic orthodoxy that permeates every government (health) agency and every school of public health in the land.

I monitored the situation for fifteen years without attempting to do anything about it because I fully expected sound science to prevail. More recently I have been doing what I can to encourage others to inform themselves about biochemical individuality, fat metabolism, and carbohydrate sensitivity.

The biochemical knowledge required to determine the adequacy and appropriateness of individualized diets may be maturing with the emergence of genomics, protenomics, and metabolomics. Meanwhile, it's important that the mainstream health establishment stop demonizing saturated fat and focus on sugars and omega-6 vegetable oils as the actual culprits causing the current epidemics of obesity, diabetes, and cancers in younger and younger age groups.

The remainder of this post is a letter recently published in The Daily Inter Lake here in Kalispell.

Dear Editor:

In late February I learned that the Montana Department of Public Health and Human Services (DPHHS) has a strategy for improving the health of Montanans. It's called the 2006-2010 Montana Nutrition and Physical Activity State Plan to Prevent Obesity and Other Chronic Diseases. The Plan was formulated by a 77 member Cardiovascular Disease/ Obesity Prevention Task Force and became public policy in June 2006.

Many aspects of the Plan are indeed helpful. Unfortunately, the major dietary advice for weight control is reduced fat intake. In addition, the cornerstone of heart disease prevention involves severely limiting saturated fat consumption. Neither recommendation has sound science behind it.

What these ideas do have behind them is the backing of vegetarian activists, food manufacturers, the edible oils industry, and sugar producers. For decades these corporate interests have controlled advertising, funded research, and exerted influence on government agencies that supply educational materials (Dietary Guidelines) to state and county health departments. Fortunately, there's growing suspicion that current fat-phobic orthodoxy may actually be damaging the public health. For example, on January 21, 2008 researchers at Albert Einstein College of Medicine released a statement that generated a number of articles headlined "Do national dietary guidelines do more harm than good?" A press release reads, "Mid-way to the drafting of the 2010 guidelines, researchers at Albert Einstein College of Medicine of Yeshiva University raise questions about the benefits of federal dietary guidelines, and urge that guideline writers be guided by explicit standards of evidence to ensure the public good."

This is exactly what has not been done where dietary fat is concerned. Further along in the article one reads, "Dr. Marantz and colleagues argue that if guidelines can alter behavior, such alteration could have positive or negative effects. They cite how, in 2000, the Dietary Guideline Advisory Committee suggested that the recommendation to lower fat, advised in the 1995 guidelines, had perhaps been ill-advised and might actually have some potential harm. The committee noted concern that the previous priority given to a low-fat intake may lead people to believe that, as long as fat intake is low, the diet will be entirely healthful. This belief could engender an overconsumption of total calories in the form of carbohydrates, resulting in the adverse metabolic consequences of high-carbohydrate diets, the committee wrote, while also noting that an increasing prevalence of obesity in the United States has corresponded roughly with an absolute increase in carbohydrate consumption.

Another indication that the focus is shifting from fat to carbohydrate is this observation in a February 6 article by Dr. J. Rand Baggesen entitled "The latest news about cholesterol medicine." His concluding remark: "There is no substitute for an active physical lifestyle in combination with a diet that avoids high levels of simple carbohydrates when it comes to health. In 2008, we do not have a medicine as powerful as these simple measures when it comes to avoidance of heart disease and stroke.

Other researchers are finding that lower cholesterol levels may have a serious downside not previously noticed because of the prejudice against high cholesterol. For example,
in a January 9, 2008 press release "Researchers at Texas A&M University have discovered that lower cholesterol levels can actually reduce muscle gain with exercising." Lead investigator Steven Riechman reported that subjects who were taking cholesterol-lowering drugs while participating in the study showed lower muscle gain totals than those who were not. “Needless to say," he said, "these findings caught us totally off guard.”

While the prejudice against saturated fat and cholesterol runs deep, it's possible that obesity experts will soon begin telling carb-sensitive individuals to consume more butter, eggs, coconut oil, and red meat to reduce insulin levels to allow stored fat to be burned so that weight loss can occur.

In conjunction with the 2008 Western Regional Obesity Course sponsored by the American Society of Bariatric Physicians, the Nutrition and Metabolism Society held a Symposium in Phoenix on April 12-13. The event featured, among others, Gary Taubes, Jeff S. Volek, Stephen D. Phinney, and J. Bruce German. The topic was "Saturated Fat and Heart Disease: What's the Evidence?"

The evidence, of course, is the research that the mainstream nutrition establishment has been ignoring for more than 30 years and will probably continue to ignore for a while yet. That evidence indicates that excessive fructose consumption, not saturated fat, is largely to blame for the continued high incidence of heart disease and the recent increase in the incidence of diabetes and obesity.

David Brown
1925 Belmar Dr
Kalispell, MT 59901


Friday, February 1, 2008

Nutrition Against Disease

My thanks to Dr. Donald R. Davis, Ph.D. University of Texas at Austin, for permission to use this material in my Nutrition Education Project.

The following paragraphs are from pages 81-83 of Nutrition Against Disease (1971) by Roger J. Williams, PhD. More information about Dr. Williams and his work is available at I encourage you to read the references and notes. They are every bit as interesting as the associated text.

No discussion of heart disease would be complete without mention of the question of saturated fats. It has come to be almost an orthodox position that if one wishes to protect oneself against heart disease, one should avoid eating saturated (animal) fats. While this idea may not be entirely in error, it is misleading in its emphasis. The evidence shows that high fat consumption, when accompanied by plenty of the essential nutrients which all the cells need, does not cause atherosclerosis or heart disease.

Rats have been used extensively to study the effects of diet on atherosclerosis. Under ordinary dietary conditions the inclusion of saturated fats in their diet will consistently promote the deposition of cholesterol in their arteries.(50) For 285 days rats were fed a diet containing 61.6 percent animal fat, but highly superior with respect to protein, mineral, and vitamin content, without producing any pathological changes in the aorta or in the heart.(51) The animals did, to be sure, become obese, as much as three to four times their normal weight. Animals fed vegetable fats at the same level fared essentially no better and no worse. These findings were based upon extensive long-term experiments at Yale, using a total of 600 rats, which were observed for as long as two years. There were no findings suggestive that either high animal fat diets or high vegetable fat diets were conducive under these conditions to atherosclerosis.

That cardiovascular disease is not associated with high fat diets is also shown by comparison study of matched groups of twenty-eight railwaymen from North India and twenty-eight from Southern India.(53) The consumption of fats, mostly of animal origin, was ten times higher among the North Indians than the South Indians, but there were no significant differences between their lipid and cholesterol levels. Among the South Indian population, the incidence of heart disease is said to be fifteen times as high as among the North Indians where the fat content of the diet is ten times higher. Dietary factors are doubtless very important in connection with the incidence of heart disease, but fat is only one factor, and other dietary factors are considerably more important.

This is also corroborated by a study of 400 Masai men in Tanganyika.(54) In spite of the fact that the diet of these men is almost exclusively milk and meat (consumption of whole blood is relatively rare), both of which contain much fat and plenty of cholesterol, the cholesterol levels in the blood of the Masai are extraordinarily low, and there was "no evidence of arteriosclerotic heart disease." It should be noted that a diet containing large quantities of meat is free from "naked calories," and is certain to supply an assortment of amino acids, minerals, and vitamins in liberal amounts. Though the Masai have other health disorders - many of infective origin - they probably escape heart disease because their body cells are furnished with an environment that is adequate enough to protect their hearts and blood vessels.

A corollary of the notion that saturated fats are arch villains is the idea that one should eat substantial amounts of polyunsaturated fats. (The phrase "polyunsaturated fatty acids" has become virtually synonymous with "heart protection" in both popular and orthodox medical thinking.) While everyone should have unsaturated fats in his diet, their presence does not by any means afford adequate protection against atherosclerosis and heart disease. The current consumption of polyunsaturated fatty acids in the USA is higher than it has ever been, yet this does not curb heart disease.(55) There are many reasons on which to base our conclusion that other factors are far more important.(56) When other deficiencies are eliminated, the amount of unsaturated fat is of secondary importance. If there is plenty of vitamin B6 in the diet, fat metabolism tends to take care of itself.

I have said a good deal about vitamin B6, but I do not mean to imply that it is, by itself, the answer to heart disease. All the nutrients contribute to the prevention of heart trouble.

References and notes:

50. Thomas, W.A., and Hartroft, W.S. "Myocardial infarction in rats fed diets containing high fat, cholesterol, thiouracil, and sodium cholate." Circulation, 19:65, 1959; Taylor, C. B., et al. "Fatal myocardial infarction in rhesus monkeys with diet-induced hyper-cholesterolemia." Circulation, 20;975, 1959.

In the above experiments, the investigators found that prolonged feeding of butter or lard to rats resulted in hyperlipemia and finally coronary thrombosis and myocardial infarction with lesions similar to those found in human beings. The diets of these animals were regarded as otherwise "normal" in respect to their intake of supplementary vitamins, minerals, and amino acids. Other data, however (see reference note 52 below) demonstrate that when fat and cholesterol (or animal protein) are increased in the diet, certain nutrients (particularly pyridoxine) must be increased above "average" or "normal" requirements.

51. Barboriak, J.J., et al. "Influence of high-fat diets on growth and development of obesity in the albino rat." J. Nutr., 64: 241, 1958.

52. Naimi, S., et al. "Cardiovascular lesions, blood lipids, coagulation and fibrinolysis in butter-induced obesity in the rat." J. Nutr., 86:325, 1965.

In this more recent study, Naimi and his colleagues were directly interested in the effects of a high fat butter-induced obesity on the cardiovascular system of seventeen male Wistar albino rats. Butter constituted 65 percent of the total calories, with 20 percent protein (casin) and generous vitamin and mineral supplements equal to if not superior to those used in the above-mentioned Yale study.

Under the conditions of their experiment, these investigators found that a high fat butter diet causing obesity in rats did not produce changes in blood cholesterol nor result in cardiovascular lesions, as other data had led them to expect. The authors note, "The absence of such adverse changes, despite, the development of gross obesity in these animals may be significant, since both obesity and animal fats have been considered to be associated with lipemia and vascular lesions. It may be suggested that other dietary factors might have protected the experimental group against such changes. Yet, even if this happens to be the case, it should not detract from the significance of the fact that large amounts of saturated fat and obesity are not necessarily associated with lipemia and vascular lesions."

We are confident that other dietary factors did protect these rats, and that only in the absence of sufficient supportive nutrients are obesity and high fat and high cholesterol diets associated with atherosclerosis and heart disease in the human population.

53. Malhotra, S.L., "Serum Lipids, dietary factors and ischemic heart disease," Am. J. Clin. Nutr., 20:462, 1967.

See also Malhotra, S.L., "Geographical aspects of acute myocardial infarction in India , with special reference to the pattern of diet and eating." Brit. Heart J., 29:777, 1967.

54. Mann, G.V., et al. "Cardiovascular disease in the Masai." J. Atheroscler. Res., 4:289, 1964.

In an extensive review of the various peoples of the earth who have little or no atherosclerosis and are virtually free of heart disease, Lowenstein found that the fat intake ranged from 21 grams per day to as much as 355 grams per day (Lowenstein, F.W. Am. J. Clin. Nutr., 15:175, 1964). In both the Somalis and the Samburus of East Africa, the diet is from 60 to 65 percent fat (animal), and yet they are nearly free from atherosclerosis and heart attacks. While it might be argued that ethnic differences are involved here, population groups of wide ethnic variation have been reported who subsist on high fat, high cholesterol, high caloric diets while remaining virtually free of coronary heart disease.

In the text we have mentioned the report of Mann and his colleagues of the Masai tribe who subsist on a diet excessively high in butter fat (and cholesterol), the fat constituting as much as 60 percent of the total calories consumed, yet are virtually free of cardiovascular disease. Gsell and Mayer report that the semi isolated peoples of the Loetschental valley in the Valaisian Alps of Switzerland habitually eat a diet high in saturated fat and cholesterol, high in calories, but evidence low serum cholesterol values and little cardiovascular disorders (Gsell, D., and Mayer, J. "Low blood cholesterol associated with high calorie, high saturated fat intake in a Swiss Alpine village population." Am. J. Clin. Nutr., 10:471, 1962).

Stout and his coworkers report that an Italian immigrant colony in Roseta , Pennsylvania , consumes diets much richer than other Americans, yet have less than half the incidence of coronary heart disease (J. A. M. A., 188:845, 1964).

In a survey study of 27,000 Kenya East Indians, A. D. Charters and B. P. Arya report (Lancet, 1:288, 1960) that the animal fat consumption was relatively high among the Punjabi nonvegetarians and relatively low among the vegetarian Gujeratis, but the percentage of heart disease morbidity "is closely proportional to that of the population." The statistics of their survey, conclude these investigators, suggest that in the case of the East Indian population in Kenya , "the ingestion of animal fats is not an important etiological factor" in heart disease morbidity. Interestingly, besides their low animal fat diet, the Gujerati vegetarians consume foods rich in polyunsaturated oils, as groundnut, cottonseed, and simsim oils, yet were not "protected from coronary occlusion by a high intake of unsaturated fatty acids."

In an epidemiological study of coronary heart disease in a general population of 106,000 Americans conducted over a one year period, W.J. Zukel and his coworkers found the highly provocative fact that farmers showed a much lower incidence of coronary heart disease than males of other groups, in spite of the fact that there were no substantial differences in their mean caloric intake or fat and cholesterol consumption (Zukel, W. J., et al. Am. J. Pub. Health, 49:1630. 1959).

In an epidemiological study of two Polynesian island groups, Hunter compared the diet, body build, blood pressure, and serum cholesterol levels of the tradition-following Atiu and Mitiaro with the more Europeanized Raroyongan Neighbors (Hunter, J.D. Fed. Proc., 21, Supp. 11:36, 1962). The Atiu-Mitiaro people live on a diet low in calories and protein but rich in highly saturated coconut fat. Hunter found that 25 percent of Rarotongans (males) suffered from hypertension as compared to only 10 percent of the Atiu-Mitiaro males. While the serum cholesterol levels of the saturated coconut fat-eating Atiu-Mitiaro males were higher (as high as European males), Hunter was unable to discover by electrocardiographic readings any tendency to coronary heart disease.

Finally we turn to the early primitive Eskimo who subsisted almost totally on an excessively high animal fat diet. In an early 1927 issue of the Journal of the American Medical Association (May), in an article titled "Health of a Carnivorous Race," Dr. William Thomas reports that of 142 adults between the ages of forty and sixty who were completely examined, he found no unusual signs of vascular or renal morbidity, and all indications were that diseases of the cardiovascular system were not prevalent among these people. This is in agreement with other reports of scientists of the primitive Eskimo (e.g. C. Lieb. J. A. M. A., July, 1926; V. Stefannsson, in his book Cancer: Disease of Civilization, p. 76; I. M. Rabinowitch, Canad. Med. Assoc. J., 31:487, 1936; W. Price, Nutrition and Physical Degeneration. New York : Hoeber, 1939).

It is clear, therefore, that adult males of a widely differing ethnic stock can subsist on a high fat, high cholesterol, high caloric diet, and yet remain relatively free of cardiovascular disorders. Even if prevailing views are to the contrary, I think that the evidence points strongly toward the conclusion that the nutritional environment of the body cells - involving minerals, amino acids, and vitamins - is crucial, and that the amount of fat or cholesterol consumed is relatively inconsequential.

55. Antar, M.A., et al. "Changes in retail market food supplies in the United States . . . ." Am. J. Clin. Nutr., 14:169, 1964.

Saturday, January 19, 2008

The heart-healthy diet: does it protect your health?

At least where nutrition is concerned, comments that follow articles published on the internet indicate how schooling, advertising, consensus of opinion, authority, experience, and even personal preference can instill prejudice. Consider, for example, the following response to this ABC News segment by a student majoring in nutrition:

"You all should be sued for every penny you are worth for airing and promoting the Gary Taubes section. I guess the fact that he has NO research of his own to prove his theories and the fact that what he says HAS been proven incorrect by scientific studies holds no merit with your network. For the average person, with no nutrition education background, this could easily be believed (Taubes info) and if his methods are practiced, America's obesity, high cholesterol and heart disease epidemic will continue to increase. As a nutrition major in college, I am appalled that anyone would publicize such nonsense. I have always enjoyed watching your morning show, however, after seeing what kind of harmful information you advocate, I will never again watch GMA OR any other program aired by ABC, and I will be sure to inform my colleagues of the information you are advocating (I am sure they will follow suit and boycott your network). As I mentioned in beginning, I hope that every health organization and medical association responds as appropriate. As a respected (or formerly respected, in my case) news network, you really should evaluate what you choose to air more carefully, as many people accept what you air as fact. You should really be ashamed for advocating information that is so blatantly wrong and potentially harmful for the health of America. At least I know now where to go if I ever get any random ideas that I want all of America to hear."

As an interesting comparison, here is comment about the same ABC News segment by a more experienced person, also with health science schooling.

" I am a RN. I had all the typical nutrition and biology classes while achieving my degree. The nutrition advice was the same low fat dogma that is preached today. Over the course of time, looking for answers to my own health problems; morbid obesity, hypertension, insulin dependent diabetes, PCOS, Bipolar Disorder, yeast over growth, etc. I found the carb restricted approach, higher fat and moderate protein consumption. I have since lost 200+ lbs. I no longer require medications for all but one of my diagnoses, Bipolar Disorder. Those have been decreased to the minimum doses.The brain functions better on a higher fat diet, as does the heart, saturated fat at that."

Here's more comment by another health professional with some sage advice at the end.

"I'm a hospice nurse, and I am amazed at the amount of surprising cancer cases I see. I'm talking people in their 40's, 50's, 60's, with active lives, just totally struck down and they have no idea why. I heard some oncologists I've worked with talk about sugar and carbohydrate, and how it feeds cancer cells. Those of you who are a bit older, and following standard very, very careful with your diets. Don't assume that what the media tells you isn't paid for by big business. Do your research."

Finally, with permission from Fred Ottoboni, PhD and Alice Ottoboni, PhD, authors of The Modern Nutritional Diseases, here are some insights as to how science works shared by two retired public health scientists who became suspicious of conventional wisdom rather late in their careers:

It is not unusual nowadays to see family members and friends taking costly prescription drugs or being hospitalized for such illnesses as heart attack, stroke, or cancer. At the same time, a day seldom passes without some message in the public media from nutrition and government agencies advising that these same health problems can be prevented - or even cured - by a heart-healthy diet. This recommended diet severely restricts red meat, eggs, butter, and saturated fat and promotes low-fat, low-cholesterol foods plus an abundance of grain-based breads, cereals, and polyunsaturated vegetable oils.

The national education program touting the diet for heart disease prevention began about a half century ago. The great increases in sales of low-fat, low-cholesterol, and high-carbohydrate foods and polyunsaturated vegetable oils that have resulted since then is good evidence that this public education program has been very effective. Today, millions of Americans are following the recommended low-fat, low-cholesterol, high-carbohydrate dietary regime.

Despite this major dietary change, national health statistics show that attack rates (new cases) of cardiovascular diseases and a number of other chronic conditions, including high blood cholesterol, high blood pressure, stroke, and type-2 diabetes, have been steadily increasing. It is becoming evident that we are now in the midst of an epidemic of what we call the modern nutritional diseases.

When we were growing up, there was little public awareness that cardiovascular diseases might be related to diet. Obesity and adult-onset diabetes 9 type-2 diabetes) were uncommon and few people had ever heard of cholesterol. People had an intuitive feeling that nutrition was important to health, but what knowledge they had did not extend much beyond a few vitamins, primarily vitamin C and B vitamins. There was a general consensus that a hearty meal of meat and potatoes was a healthful one.

We learned about the heart-healthy diet when we entered the field of public health over 40 years ago. By that time the statistical association between cardiovascular diseases and saturated fats and cholesterol in the diet was accepted by the medical and nutrition communities as being more than a chance relationship. It formed the basis for official government policy and dietary recommendations. People were advised to reduce their consumption of animal fats and replace them with vegetable fats, which contain little saturated fat and no cholesterol.

People were further urged to restrict or eliminate the use of animal foods (because of their saturated fat and cholesterol content) and replace them with grains, breads, and pasta to make up for the loss of calories. At the time we had no reason to doubt that these changes were healthful ones. we reduced our intake of saturated fats by substituting vegetable oils and margarine for butter and switched from whole milk to skim milk. We reduced our consumption of red meats, ate cereal instead of eggs, and added more whole grain products to our daily fare.

By the mid-1970s, in the course of our work, we were becoming aware of some reports in the scientific literature that hinted of a conflict with the prevailing nutritional philosophy. The wisdom of the low-fat, high-carbohydrate diet was beginning to be challenged more frequently and more openly. We were starting to hear about the observations and theories of scientists who found the official heart-healthy nutritional recommendations potentially dangerous. At the same time, we were also aware that the rates of cardiovascular diseases, obesity, and type-2 diabetes had increased dramatically over the past several decades and were reaching epidemic proportions. However, at the time, we did not make an association between the increasing incidence of these diseases, which normally are associated with the aging process, and the dietary changes that had occurred over the past several decades.

We followed the controversy with only academic interest until a few years later when a routine physical examination showed that one of us had slightly elevated blood levels of cholesterol and triglycerides - not life threatening, but something to follow. These findings disturbed us. We were only in our mid-fifties at the time. We had been following the low-fat, high-carbohydrate diet that traditional nutritional science recommended as a healthful one. The controversy now assumed a personal interest. Was there merit in the reports we had been hearing that the heart-healthy diet might not be what it was labeled? What should we do? These thoughts prompted us to do what our professional training had taught us to do - go to the library, delve into the scientific literature, and try to find the answers to our questions.

We were both scientists who had worked for many years in the field of disease investigation and prevention. This work had taught us that disease, even in older adults, does not just happen but is caused by something. And, time and again, this work taught us that the answers to most questions involving the causation and prevention of disease were already known - they were just buried in the scientific literature that resides in the libraries of all major universities.

We decided to examine the heart-healthy diet and why it had become the national panacea for cardiovascular diseases. We also decided to investigate the overall relationship between diet and the chronic diseases that were thought to occur only in older people but were now beginning to afflict young adults and even children. Why had the dietary changes that had been imposed on the public many years before not been effective? Why were the numbers of new cases of cardiovascular disease, obesity, type-2 diabetes, and perhaps even some forms of cancer increasing instead of decreasing?

With these thoughts in mind we began our long search of the literature, both scientific and popular. In general we learned that lifestyle and nutrition, not genetics and not luck, were the most powerful factors affecting health and well being. Further, it became apparent that unhealthful lifestyles and faulty nutrition were affecting the health not only of older adults but also of people in all age groups. We learned that popular notions concerning the adverse effects of dietary fats and cholesterol, which were the foundation of the heart-healthy diet, were not based on scientific facts. What we read in the popular press was not what we read in the scientific literature.

Reports in the popular press, which are the major source of information on nutrition for the average person, are not always reliable. Many reporters are not experts in the fields they write about. The do not check the accuracy of information in press releases, and usually do not include references to the scientific literature to document the statements and recommendations made. This lack of documentation by health reporters has long been a concern to us. It is a circumstance that makes it difficult for readers to check the accuracy of reporting.

Finding trustworthy information in bookstores also is not easy. Popular books on health and nutrition, like media reports, health newsletters, and direct mail advertising, run the gamut from total quackery to solid science. How can the average person distinguish between the two? The answer is, "he can't - at least not without a lot of work." Despite the difficulty, the question of whom and what to believe is a very important one to anyone interested in good health and long life. Perhaps the best advice is: approach all recommendations for health and well being with a large quantity of skepticism; study all sides of an issue before coming to a conclusion; investigate the source or sources of the recommendations; and learn the clues to pseudo science (Chapter 9).

Our primary sources of information were scientific journals and textbooks. We reviewed the epidemiological studies that examined the association between diet and various diseases. We returned to our human biochemistry texts that outlined the pathways followed by nutrients in the body. We looked more closely at leading causes of disability and death among adults. The hard facts were startling. They clearly pointed to a strong association between the major causes of death, particularly among older people, and the highly touted low-fat, low-cholesterol, high-polyunsaturated vegetable oil diets that had been promoted for the last 40 or more years. But even more disconcerting, we discovered in our research that modern nutritional dogma, as epitomized by the famous Food Pyramid (1), is based, at best, on bad epidemiology or, at worst, fiction.

Our investigations confirmed our suspicion that the scientists that were challenging the validity of the heart-healthy diet were correct; the long-standing national dietary policy probably was causing disease rather than preventing it. Published epidemiological, biochemical, and dietary studies did not support the idea that the heart-healthy diet prevented heart disease, stroke, high blood pressure, or hypercholesterolemia. Other studies made clear that these atherosclerotic diseases plus adult-onset diabetes, obesity, and cancer probably all shared the same underlying cause, namely the modern American heart-healthy diet.

Especially reassuring were the number of well-documented, popular books on health and nutrition that also supported such a conclusion (2,3,4,5,6,7,8,9). Further, it is an accepted truth that once the cause of a disease is known, good preventive programs can usually be formulated. Such programs have been developed and published by these authors. We not only refer to them frequently throughout this book but also recommend them highly. They are easy to read and understand and, what is more important, they can also stand the test of scientific scrutiny.

During the years of our study of the relationship between diet and the modern nutritional diseases, we often discussed the subject with our family and friends. They expressed interest during our conversations and asked many questions, so we finally decided to write a few pages that we thought would be helpful to them. The volume of information we gathered kept growing until it was many pages, and then finally it became a book.

This book would have been shorter if it included only our personal views and opinions accompanied by recommendations of what and what not to do. However, to merely tell people that the diet recommended for the past 50 years by nutrition and medical associations and government agencies was wrong was not acceptable. Such a publication would be no more worthy of belief than the nutritional nonscience that appears every day on television, in the newspapers, and in direct mail advertising. We could not expect our family and friends, much less strangers, based on our words alone, to reject the dietary advice of organizations that presumably had been created to protect and preserve their health.

With recognition that a credible book would require clear documentation of the information it contained, we began assembling the data, including figures and references to the published scientific literature required to support the conclusions and advice we offered. Thus, at the expense of brevity, we have included explanations of the reasons for our conclusions accompanied by numerous references to the scientific literature and texts that we used as our authorities.

Two chapters in this book, "The New Epidemics and the New Diet" and "The Connection," describe the current American diet and its impact on health, particularly in older adults. These two chapters were especially difficult to write, because they obviously conflict with long-standing and widely followed American dietary policy. In order to leave little doubt about their veracity, these two chapters are purposely detailed and amply referenced with citations to the scientific literature. Details of biochemical pathways and mechanisms are also included, because they are required not only to explain and document important nutritional concepts but also to illustrate the beauty and logic involved in the construction of the human body.

We expect that much of what we have written in the following chapters will be challenged by advocates of traditional nutrition, because the proposition that the heart-healthy diet is an underlying cause of many of today's chronic diseases is contrary to longstanding nutritional teachings and governmental policies. In view of this, it is important to stress that the biochemistry presented in this book is established scientific fact. The references we cite are from recognized scientific journals and textbooks, not cryptic writings hidden in obscure or ancient papers. A question that has baffled us through the years, given that all this information is freely available, why is it largely ignored by nutrition academia and government agencies?

What follows here is what we have learned over a period of years and what we have practiced in our daily lives. It is not a panacea. It will not stop the march of time. It will not stop the onset of gray hair and the progression of years. But we know our study and research has improved the status of our own health and the quality of our lives, and we believe that the information contained herein can have a positive impact on the lives and health of all people, not just the elderly. In this book we describe what we consider of value for improved health at any age and the reasons for our conclusions.

The information in this book should help you feel better, live longer, avoid the modern nutritional diseases, and be happier and more active as you grow older. The ideal is to keep all systems functioning well until that point where everything wears out and fails all at once, like the fabled one-hoss shay (10). How tragic it is, for example, to have a sound body and mind capable of functioning efficiently for twenty or more years stilled by a heart attack or stroke.


1.) USDA Center for Nutrition Policy and Promotion, The Food Guide Pyramid.
2.) Atkins, Robert C. Dr. Atkins New Diet Revolution. New York, NY: Avon Books, Inc. 1999.
3.) Eades, Michael R., and Mary Dan Eades, Protein Power, Paperback Edition. New York, NY: Bantam Books, 1999.
4.) Enig, Mary G. Know Your Fats: The Complete Primer for Understanding Fats, Oils, and Cholesterol. Silver Springs MD: Bethesda Press, 2000.
5.) Pauling, Linus. How to Live Longer and Feel Better. New York, NY: W.H. Freeman and Co., 1986.
6.) Sears, Barry. Enter the Zone. New York, NY: Harper Collins Publishers, 1995.
7.) Simopoulos, Artemis P. The Omega Plan. New York, NY: Harper Collins Publishers, 1998.
8.) McCully, K. and McCully, M. The Heart Revolution: The Vitamin Breakthrough that Lowers Homocysteine, Cuts your Risk of Heart Disease, and Protects your Health. New York, NY: Harper Collins Publishers, 1999.
9.) Ravnskov, Uffe. The Cholesterol Myth: Exposing the Myth that Saturated Fat and Cholesterol Cause Heart Disease. Washington, DC: New Trends Publishing Inc., 2000.
10.) Oliver Wendel Holmes. The One Hoss Shay, Copyright 1891 by Houghton, Mifflin & Co.

Here's a review (15 New And Essential Diet & Health Books I've Been Reading Lately) of The Modern Nutritional Diseases by low-carb enthusiast Jimmy Moore.

So much of the research into the most destructive health ailments we now face is focusing on the role of the diet. This is something Dr. Fred Ottoboni and his wife Dr. Alice Ottoboni know a thing or two about. Before retirement, they had spent many years of their career investigating, studying, and researching disease occurrence among various people groups around the world and they discovered something quite revealing in light of our current crisis with obesity, diabetes and worse: much of it is preventable by simply ignoring the high-carb, low-fat, low-cholesterol advice that has sadly become accepted as the "healthy" diet.

In Modern Nutritional Diseases, Drs. Ottoboni explain in meticulous detail why those diets are useless against most modern diseases and shares the research showing the elimination of sugars and starches will put us back on the road to health faster than removing saturated fat and cholesterol from our diet. There's even an invaluable chapter on how to distinguish good science from bad science among the many voices telling us what the facts are.

The references and charts contained in this book make it well worth having in your low-carb library. I'll warn you now that it does get a bit technical in some areas, but this stuff isn't simple either. There are many things to evaluate and analyze in the process of coming to the conclusions about nutrition and metabolism that Drs. Ottoboni do. This is every bit as good a book to read as Gary Taubes' Good Calories, Bad Calories was because it complements much of the same concepts and ideas.

My favorite part is at the end in a chapter called "What do you do now?" the authors give you practical instructions about making the changes you need in order to ward off the modern nutritional diseases in your own life. Specifics about diet, supplements, exercise, and suggested resources for further education are provided. This is an invaluable tool for anyone following a controlled-carbohydrate nutritional approach or who wants to learn more about why this way of eating works so well.

Saturday, January 5, 2008

Is saturated fat a health hazard?

If there's a doctrine that has achieved universal acceptance in the political arena, in public health, in medicine, and in the commercial sector, it's the idea that saturated fat is an artery-clogging health hazard.

Over the past five decades this idea has spread about the globe. Here in the USA it has both undermined the health of Americans and caused politicians to squander unimaginable sums of taxpayer dollars. Arguably, it is the major reason why vascular diseases remain the number 1 cause of death in many developed countries.

This doctrine is also largely responsible for the current epidemic of type 2 diabetes among young and old alike. As for obesity, fear of developing clogged arteries prevents many from consuming the amount and kinds of fats that would promote weight loss.

Who adheres to this doctrine? Just about everybody; all the major health organizations including the American Medical Association, the American Heart Association, the National Heart Lung and Blood Institute, the American Dietetic Association, and the American Diabetes Association, federal government agencies such as the FDA, CDC, USDA, NIH, and HHS, the food manufacturing, sweeteners, and edible oils industries, vegetarian activists, and the CSPI. In addition, most schools of public health teach that saturated fat is a health hazard. Here is documentation from various websites:

Health Organizations

American Medical Association

"The Council is deeply concerned about any diet that advocates an 'unlimited' intake of saturated fats and cholesterol-rich foods."

American Heart Association

"Limit foods high in saturated fat, trans fat and/or cholesterol, such as whole-milk dairy products, fatty meats, tropical oils, partially hydrogenated vegetable oils and egg yolks. Instead choose foods low in saturated fat, trans fat and cholesterol."

National Heart Lung and Blood Institute

Be Heart Smart!
Eat Foods Lower in Saturated Fat and Cholesterol.

Why should you be concerned about saturated fat?

Saturated fat raises blood cholesterol the most. Over time, this extra cholesterol can clog your arteries. You are then at risk for having a heart attack or stroke.

Why should you be concerned about cholesterol?

Your body makes all the cholesterol you need. Eating foods high in saturated fat can raise your blood cholesterol levels. The higher your blood cholesterol, the greater your risk for heart disease. Too much cholesterol can lead to clogged arteries. You are then at risk for having a heart attack, a stroke, or poor circulation.

American Dietetic Association: Nutrition standards ...

"Although intake of fat and saturated fat has declined, it still is consumed in amounts that exceed recommendations."

"Healthy, growing children need a balanced diet that includes fruits, vegetables, whole grains, lean meats and/or legumes, and low-fat dairy products to achieve a dietary pattern that maintains appropriate blood cholesterol levels and optimal energy."

American Diabetes Association

"Everyone (emphasis mine) should eat less saturated fat. Saturated fat can raise your cholesterol level which increases your chances of having heart disease."

Government Agencies:

Food and Drug Administration

"Diets high in saturated fat and cholesterol increase total and low-density (bad) blood cholesterol levels and, thus, the risk of coronary heart disease."

U.S. Department of Agriculture

"Saturated fat raises blood cholesterol more than other forms of fat. Reducing saturated fat to less than 10 percent of calories will help you lower your blood cholesterol level."

Health and Human Services: New Dietary Guidelines

"Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol..."

Center for Disease Control

"Although the findings in this report indicate a decline in the mean percentage of total fat energy intake derived from total dietary fat and from saturated fat, these intake levels remain higher than the year 2000 objective."

"The findings in this report can assist in tracking progress toward achieving the goals of public health initiatives aimed at reducing and modifying total dietary fat and saturated fat intakes."

National Institutes of Health

"These are the biggest dietary cause of high LDL levels ("bad cholesterol"). When looking at a food label, pay very close attention to the percentage of saturated fat and avoid or limit any foods that are high. Saturated fat should be limited to 10% of calories. Saturated fats are found in animal products such as butter, cheese, whole milk, ice cream, cream, and fatty meats."

(Note: the above statement is blatantly false. Excessive refined carbohydrate consumption is the major cause of high LDL levels.)

Vegetarian Activists:

Physicians for Responsible Medicine

1. A Vegan Diet: Avoiding Animal Products
"Animal products contain fat, especially saturated fat, which is linked to heart disease, insulin resistance, and certain forms of cancer. These products also contain cholesterol, something never found in foods from plants."

"Well-planned vegetarian diets provide us with all the nutrients that we need, minus all the saturated fat, cholesterol, and contaminants found in animal flesh, eggs, and dairy products."

Center for Science in the Public Interest

"Senators Harkin and Murkowski plan to offer their school nutrition bill as an amendment to the Farm bill."

"Notably, the soft drink industry and many major food manufacturers are supporting, not opposing, the Harkin-Murkowski amendment. The amendment also is supported by 100 organizations, including the American Medical Association, American Public Health Association, American Dental Association, National PTA, American Association of School Administrators, and the American Federation of Teachers."

"The amendment also would set limits for calories, sodium, saturated fat and trans fat in school snacks."

Public Health:

Harvard School of Public Health

"Saturated fats raise total blood cholesterol levels more than dietary cholesterol because they tend to boost both good HDL and bad LDL cholesterol. The net effect is negative, meaning it's important to limit saturated fats."

Public Health | Monroe County, NY

Trans fat is made when an otherwise healthful liquid (vegetable) oil is chemically changed to make a semi-solid product called "partially hydrogenated" vegetable oil. Food manufacturers began using these altered products a number of years ago because it was shown to increase shelf life, texture, and flavor and at the time it was thought to be a healthful alternative to saturated fat. Trans fat is commonly found in deep fried foods, baked goods, snack foods, and many processed foods.

All fats are not the same. There are "good" fats and "bad" fats. When we eat foods high in saturated fat or trans fat, it raises the bad (LDL) cholesterol in our blood. Having high LDL cholesterol increases the risk for heart disease, the leading cause of death in the US, in New York, and in Monroe County. Trans fat is even worse than saturated fat because it actually lowers the good (HDL) cholesterol in the blood. Eating foods high in poly and monounsaturated fat have a good effect on cholesterol levels and are encouraged.

Federal guidelines recommend that total fat intake be 20-35% of total calories. Saturated fat intake should be less than 10%, and trans fat consumption should be kept as close to zero as possible.

Journals and mainstream press:

The Journal of Nutrition

"Saturated fat (SF) intake contributes to the risk of coronary heart disease (CHD) mortality."

Science Daily

"Dr. Carter emphasized he does not advocate strict low-carbohydrates for long-term weight management. Such diets may adversely overload the kidneys with protein and lead dieters to consume more artery-clogging saturated fats and cholesterol, he said."

Back to my comment:

Public health at the state level marches in lockstep with the federal government. For example, the Montana Department of Health and Human Services is still using the Cardiovascular Disease State Plan adopted and implemented during the Racicot administration. The main focus is toward reducing cholesterol levels. Here are some excerpts from the report:

On page 13 one reads, "In 1999, Montanans who participated in a CVD telephone survey and who had high cholesterol were asked how they planned to decrease their cholesterol levels.The most common responses were to reduce their fat intake and increase their exercise levels."

On page 22 one reads, "Educate patients who have high cholesterol or who have had a myocardial infarction about the AHA and National Cholesterol Education Program guidelines for managing high cholesterol."

Page 27 "HP2010 Objective - Fat intake: Increase to at least 75% the proportion of persons aged 2 and older who consume no more than 30% if calories from fat."

Page 28 "Promote 1% (milk) as the standard to be served in Montana Schools."

Since government agencies at the federal level are either controlled or heavily influenced by special interests such as the food manufacturing, edible oils, sweeteners, and beverage industries, it makes sense for public health at the state level to develop dietary guidelines and strategies for prevention of chronic diseases based on the best science available, not federal recommendations. In my state, current recommendations aimed at persuading Montanans to eat fewer calories (by restricting fat calories) and exercise more (MTNAPA) reflect an inadequate understanding of factors such as biochemical variability and fat and carbohydrate metabolism.

While the best science available regarding fat metabolism is not to be found in textbooks and government publications, the internet increasingly provides ready access to the truth about saturated fats. For example, view this webcast (The Quality of Calories: What Makes Us Fat and Why Nobody Seems to Care) of a recent lecture by science writer Gary Taubes delivered at the University of California Berkeley. I also encourage you to read the book (Good Calories, Bad Calories) which will take considerably more time as it consists of 550 pages of text and 100 pages of notes.