The Longest Fad Diet in American History

The Fad Pyramid

In 1955, President Dwight Eisenhower suffered a heart attack and survived. At the time, he was at a healthy weight and had normal serum cholesterol levels. The president’s medical advisors then instructed him to decrease his fat intake and increase his carbohydrate intake. In response to the intense dietary intervention, his blood cholesterol levels increased as well as his weight. Naturally, he decreased his fat intake even more to try to counteract this unexpected result. He soon became obsessed with these numbers. So, you can guess that he followed the medical advice to a tee.

How do you think this story ends? Well, President Eisenhower had 6 more heart attacks in the next 13 years along with other diet related issues (persistent digestive issues for example). The last of the 7 total heart attacks killed him in 1969.

Now let’s take a step back and look at the bigger picture. This is just one person. The same advice that was given to Eisenhower is being given to us every single day. Whether it be via advertisements on TV telling you to “go ahead. cheat on butter” or news headlines telling you red meat will kill you (based on faux science).

History of the Low Fat Diet

Prior to the 1960′s, it was “common knowledge” that foods rich in carbohydrates were fattening. And even back then, it was known that insulin (along with other enzymes and growth factors) was the regulator of fat tissue. However, a man named Ancel Keys played a huge role in masking that truth and shifting the focus of obesity problems to something else entirely. The name might sound familiar to you. Ancel Keys was the person that came up with the K-rations for soldiers in WWII (the K of course stood for Keys).

Ancel Keys’ 6 country graph

In 1953, Ancel Keys used data from 6 countries to come up with a graph that shows a clear correlation (note that word for later, correlation) between eating dietary fat and increase in rate of degenerative heart disease. He was met with some skepticism but still had many supporters. The skepticism was justified. Ancel Key’s didn’t mention that he had data from 22 different countries, but cherry picked the 6 that supported his theory.

Now, take a look at Keys’s graph vs the actual data available. As you can see, there is still an upward trend in the 22 data points, but the correlation between fat intake and heart disease becomes incredibly weak and statistically insignificant.

Ancel Keys’ 22 datapoints

For example, if you simply compare points 12, 15 and 22, you can see that there isn’t a direct link between dietary fat intake and heart disease. 15 had more fat intake than 12 (close to double) and actually had less heart disease. 15 and 22 had close to the same fat intake but had completely different rates of heart disease. The correlation that Keys made was very weak as you can see. Much of the scientific community wasn’t please. This included an organization called the American Heart Association. But from this graph came what is known as “the lipid hypothesis”. Keys also did another study with the same bad scientific integrity that produced the “diet-heart hypothesis”. Both are related and together state the eating dietary fat will increase your cholesterol levels, which in turn will increase your chance of heart disease.

The American Heart Association (AHA) at the time opposed Keys’s research. In case you were wondering, the AHA gives that stamp of approval you see on so many food labels these days that says the food is “heart healthy”. It is that famous heart shape symbol that is probably on your cereal box right now. In 1957, the AHA said further study is needed to prove that fats (and specifically saturated fats as well) and cholesterol were the causes of heart disease. Nothing happened with that and in 1961, the AHA had a sudden change of heart (pun intended). Coincidentally, in that time, the AHA dropped some members and of course picked up new members including Ancel Keys himself. That same year, Keys was on the cover of time magazine for his amazing [insert eye roll here] find on his 6 country graph. So, what did they do in 1961? They told the general public that they should reduce fat intake in their diets and replace it with carbohydrates. This recommendation was made without any scientific research backing the idea. They totally jumped the gun. I read in a couple places that the AHA funded a study around that time to try and prove the lipid hypothesis and the results started coming in implying that they were dead wrong. So the AHA cut the funding and buried the project. Self preservation. But take that with a grain of salt for now because I can’t find the article (but will post it once I find it again). But what I do know for a fact is that a study was initiated by the AHA and was cut due to “lack of funding“. I am not sure if these two studies referenced are the same ones. Regardless, there was no science behind their recommendations. And thus started a huge race to produce as many low fat products as possible.

And then in 1984, Time magazine reported on a trial that “proved” the diet-heart hypothesis. High cholesterol kills you. What they left out is a study released that same year that showed that high levels of OXIDIZED cholesterols was what actually was harmful, and that it wasn’t cholesterol in general. But the Time magazine had already done it’s damage and the low fat craze went even further. Before we knew it, everyone was terrified of fat. Low fat/high sugar foods saturated the super markets and convenience foods became widespread (TV dinners?). Just for kicks, let’s look at the obesity rates starting from 1985 to 2010, shall we?

Obesity rates in 1985

Obesity rates in 2010

Now, just based off of that, I can’t definitively say it was the low fat scare that caused this. But there is so much more evidence that I’ll bring to light in future posts that shows that this, in fact, is the most likely case of what is going on here.

You might be asking at this point, if there is so much science behind the idea that eating fat WON’T kill you, why am I not hearing about this until now? Well, after the AHA supported the lipid hypothesis, the USDA got involved. And in the world of science, researchers live off of their grants. If they don’t have grants, they can’t do research. And once the USDA got on board with the lipid hypothesis as well, there was incentive to support the lipid hypothesis. And if you didn’t you probably wouldn’t get a good enough grant to continue your work. That isn’t to say large studies still weren’t taking place between then and now. They were. Just not as many as there could have been. And not as many people would listen to the results back then. On top of that, there was plenty of intentional oversight going on at the time. Establishments are hard to beat once they are… well… established. Luckily, it seems like people are finally realizing that all of this low fat diet advice might actually be making this obesity epidemic worse, and is actually the cause of it. So now people are listening to the scientists that have been saying this all along.

Cholesterol: Misunderstood by the Masses

Let’s take a step back for a moment and look at what cholesterol is. Well first, LDL and HDL which you always hear about aren’t actually cholesterol. They are lipoproteins. LDL’s job in the body is to carry cholesterol from the liver to the cells in your body. This is a good thing. Your body needs this process to repair cells damaged by inflammation. HDL’s job is to pick up the old/used cholesterol and recycle it back in the liver. When cholesterol is damaged by oxidation, it can penetrate the inflamed arterial cell walls and thus begins plaquing. This narrows that pathways and leads to heart disease.

The generally accepted idea which you’ve probably heard before is that cholesterol/LDL is what causes heart disease, and not the inflammation in your body and the oxidation of cholesterols. The comedy style documentary, named Fat Head, aptly described this idea using the following analogy:

In high crime areas, there are a lot of phone calls to the police.
We can conclude that calling the police produces an increase in crime.
To decrease the crime rate, we need to stop calling the police.

As you can see, this is very elementary level thinking. I think these so called “health experts” need to take a step back and look at the full picture. It also helps my case that there are several new and reputable studies that completely disprove the lipid hypothesis. And there are exactly ZERO studies that prove that the lipid hypothesis is even remotely true. In fact, here is an analysis done on 21 different studies that involved about 350,000 people over an average of 14 years. It of course concluded that saturated fat has nothing to do with heart disease and/or strokes:

http://www.ajcn.org/content/early/2010/01/13/ajcn.2009.27725.abstract

I will talk about this more in another blog post, but it is proven that a high level of HDL is more of a protective factor than low LDL levels is. And lower triglycerides is also a better indicator of heart health than low LDL. So, why is everyone (Statin companies I’m sure have put out enough propaganda) so focused on lowering their LDL specifically? Studies show that eating more saturated fats is healthy for you in that it increases your HDL levels! Also, more and more studies are showing that eating carbohydrate actually increases your triglycerides and due to something known as glycation, a lot of inflammation and oxidation is happening in our bodies. High carbohydrate intake is killing us. Not fat.

Correlation Does Not Imply Causation

Correlation does not imply causation. Otherwise, most of us are going to the moon.

I asked you to note when I used the word “correlation” earlier when talking about Ancel Keys’ graph making a correlation between eating fat and getting heart disease. Although we already discussed that Keys’ graph was not very statistically relevant, we should still explore this correlation thing. The reason is that most (if not all) studies that promote a low FAT diet seem to be based on correlation and not the entire scientific method. Basically, it is bad science to make a correlation between two things and then draw definitive conclusions from the results. One of my next few articles will touch base upon this a bit more, but in order for something to be really relevant enough to draw conclusions from, real tests must be done. You can’t simply look at something, you actually have to experiment. Ancel Keys’ would have had a better case if based on his graph, he came up with the lipid hypothesis, and then did trials with a control group and with a separate experimental group just changed the amount of fat intake (nothing else). The results from that would have been a much better source to pull conclusions from. And I’m sure he would have found that his original hypothesis was wrong (just like many researchers are finding now). Observational studies have a place in science, but only as a starting point.

For example, a recent study said that red meat will increase your likelihood of dying early by 13%. This hit news headlines hard a couple of months ago. It was groundbreaking science [insert more eye rolling]! Well, the “study” was conducted by doing a series of questionnaires asking the participants a bunch of lifestyle questions. What they found was that people who ate the most red meat did in fact die earlier. But what the news headlines didn’t say was that the study also found that red meat eaters tended to take care of themselves less in general. They tended to smoke more, take less vitamins, exercise less, etc. It kind of makes sense. People who are vegans and vegetarians tend to be more health conscious in general right? You better be kidding me if you tell me eating red meat makes you want to smoke more. In this case, the correlation they decided to make was that read meat eaters died earlier. Then they foolishly concluded that the red meat was what was actually causing them to die earlier. This is a classic example of people using correlation alone as real science. Science that is good enough to report to the news outlets and make people terrified of eating meat. And there is plenty of this “science” going around to support the suggested Standard American Diet.

Low Fat: The Largest Experiment and Fad Diet in American History

President Eisenhower wasn’t the only victim of this big fat scare. This obesity epidemic is real. The experts blame it on the fast food restaurants, but where is the science in just making a correlation between the fact that fast food is more prevalent now and that obesity/diabetes/heart disease is at an all time high. Again, correlation does not imply causation. Look around you and you will see that people are suffering from heart attacks left and right. And what are they being told to do? Exactly the same thing Eisenhower was. Eat less fat. Eat more carbohydrates. As you can see now, the foundation for the argument that a low fat life style is the healthiest choice is not based off of any science. And to this day, there is still no scientific support.

I argue that the low fat diet promoted in the last 50 years is the fad diet to rule them all.

Bonus Note

Extra data points

I found a graph of Ancel Keys’ original 22 data points along with 5 extra points added in just to further illustrate the point that Keys’ argument was weak and still is. The extra points include the Masai, Inuit, and Tokelau people. They eat plenty of fat and have almost no heart disease.

[UPDATE: March 21, 2013] 

As one of the commenters pointed out, the additional points here in red have their caveats. The most important thing to call out is that Inuit, Masai, etc people have pretty low life expectancies today. Note that the majority of their causes of death are external (infectious disease, accidents, etc). Most sources that I could find seem to put Inuit at a 30 year average disadvantage in life expectancy.

However, I looked into the Ancel Key’s data a little bit more and it looks like his surveying was done on over 12,000 men between 40-59 years. [I can’t say the same about the age group of the surveyed extra data points, as those point’s weren’t added by me. I’m on a crazy hunt to find the original data that was used for these extra points.] Still, this doesn’t necessarily prove anything for the added points, as the majority of Inuit who survived infancy, where a large number of deaths occurred, probably only lived to about 50 (the median age of the study) if not slightly less back in 1948-1949. The addition of 10+ year span in Ancel Key’s study could pretty significantly decrease the number of CVD incidences in all the countries. But even still, it seems unlikely that you’d be able to draw a straight line through the graph.

And one last thing, the red dots are really just to illustrate the point a bit more just so you can see the discordance with the lipid hypothesis, although slightly flawed.

 

 

[Hit the comments below and let me know you are still here with me :) Let's get some conversations going!]

Yes, I am indeed the asian with the cheese bowl. I am also a huge nerd and love science. My real job as the co-founder and technical director for Inphantry keeps my nerdiness factor at a record high. In my spare time, I am obsessive about diet and nutrition. Maybe even too obsessive... Keep reading and I'm sure you will pick up little bits of who I am along the way!

17 Comments on "The Longest Fad Diet in American History"

  1. Cindy Theng says:

    Derek, damn you make me question my education sometimes -_-

    • Derek Tran says:

      Good! I was listening to this podcast recently and a researcher surveyed a bunch of physicians. He gathered the info and found that on average, physicians were trained on nutrition for 2 weeks. We all have a lot to learn and many questions to ask. Including MDs.

    • 'Dan' Tran says:

      I’m sorry, but some doctors ARE not properly educated… I went to 3 optometrists, and the first two could not explain to me what 20/20 meant, only the last one could. Not to mention astigmatism; the first two said the shape of my eye is wrong, but the last told me that the cornea is not a perfect sphere, which in turn causes the light and reflection to not pinpoint at the back of my eye perfectly…

      I know that my examples were just about Optometrists, but they specialize in eyes. Physicians have a lot more that they need to learn…

      • Derek Tran says:

        Exactly. I don’t think the general public knows that physicians/optometrists are really only comfortable treating within what they’ve been taught. And what they’ve been taught is very general stuff. Physicians are in no way shape or form specialists in nutrition 99 times out of 100. So they go with generally accepted methods. IE if you are overweight and are prediabetic, eat less fat. Diabetes will be another one of my upcoming posts as well.

  2. Ryan Chan says:

    This article is pretty sweet. And for the record, doctors know more about medication and drugs rather than diet, nutrition and the biochemical breakdown of foods. http://www.sott.net/articles/show/242516-Heart-Surgeon-Speaks-Out-On-What-Really-Causes-Heart-Disease

    • Derek Tran says:

      Isn’t it a shame that doctors are looked upon for just about everything including how to manage weight/prevent heart disease and diabetes? Not many people know doctors are not nutritionists so they take their advice with absolute confidence. But now we have the Internet. Hopefully we can spread the truth and cause some change sooner rather than later. In my eyes, paleo is our generations new “fad diet” but since we have the power of the internet maybe we can defend against the media fat mongers like the Atkins diet couldn’t in it’s time. And soon it won’t be seen as a fad anymore but rather the accepted way to eat healthily. And low fat can finally be labeled as unsafe.

  3. James says:

    Derek I love your blog, I think it is a great site about healthy eating. In my personal taste it is taken too far but the campaign against highly refined, low fat/sugar added foods is a good one. I have an issue about your 6 vs. 22 vs. 22+5 graph. I did some googling and found, 12 years less than average Canadians (Inuit), less than 50 (Masai) and 69 (Tokelau). Those are current life expectancies and not from the 60′s when perhaps they could have been much less. If I decapitated every American or Australian at 65 I assume the degenerative heart disease rate would plummet. The data was cherry picked for Keys but to call him out on it and then do the very same yourself in my opinion unnecessarily weakens your point.

    • Derek Tran says:

      Glad you enjoy reading my blog! Just so I have a better reference, can you post your reference? I’d love to see the data and give you my take on it, for whatever that is worth. I’m intrigued by what you found. My goal is to stay objective, so I’ll look at it with an open mind.

      Thanks James!

      • James says:

        My reference was literally googling “life expectancy of xxx” and using the number from the first link that had one. Hardly scientific but its a comment section of a blog. That said there is a definite correlation between age and degenerative heart disease. Including populations which may have drastically truncated life expectancies (I haven’t gotten hard numbers on it but for me it doesn’t pass the sniff test) has the potential to introduce the very distortion you speak out against. Have you seen this article: http://www.nytimes.com/2012/10/28/magazine/the-island-where-people-forget-to-die.html?pagewanted=all&_r=0 ? A great read.

        • Derek Tran says:

          Awesome read.

          I’d have to agree completely with the writers analysis on how the entire environment affected pretty much the majority of their day to day actions. Sounds like overall happy people, low hormonal issues and stress, eating lots of omega 3′s, low processed foods and sugar, etc. Sadly not in America :(

          Also just realize NuSi was mentioned in there too :)

      • Derek Tran says:

        Alright, I added a bit more info at the bottom. More of a disclaimer about the added data if anything. But one thing to point out is that Key’s original survey was on men between 40-59 (with the upper half of that age bracket still being slightly out of the Inuit, the one of the lower expectancy groups, life expectancy range). But I agree, the data should be taken with a pretty big hunk of salt. The main point was trying to point out the level of discordance if you were to simplify it as saturated fat -> heart disease.

        I have not read that one yet, but thanks for the link! I’ll give it a read now.

        • James says:

          Nice job! I definitely agree with the oversimplification you mention. The issue is much more complex than what is it made out to be. Keep up the good work!

      • Derek Tran says:

        PS, I love this kind of conversation. Keeps me on my toes, engaged, and encourages me to make sure my research/logic/data is sound. So keep them coming. It’ll be a pretty devastating day if I find out everything I’ve written about is a load of bull, but at the end of the day I’d be happy being enlightened, as I’m sure any good scientist (by no means calling myself one) and truth seeker would as well.

        So everyone else out there reading this, feel free to call me out on anything. Keeps me honest.

      • Derek Tran says:

        If you are interested, take a look into http://nusi.org

        It was started up by Peter Attia and Gary Taubes and basically is attempting to gather up some of the top researchers from different schools of thought, and design very strong experiments to solve the biggest questions having to do with health and nutrition. Traditionally, those studies that would attempt to definitively give answers to some of these questions (saturated fat = CVD? among many other health relative things) are nearly impossible to study due to lack of funding (due to lack of incentive), sample size, participant coherence (who wants to be in a metabolic ward for months!), etc. So this very diverse board is attempting to:
        A) Raise money via donation more than anything (a lot less money than pharma spends in a day)
        B) Design unbiased studies to answer these questions
        C) Come up with (near) definitive well designed research

        What I love about them is it isn’t just a board of paleo and low carb researchers, but there are vegans, standard american diet, etc scientists on the board as well. It will be a while before we really see much research, and strong studies are done over a long period of time…

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