Chewing the fat

by Ari LeVaux

Nina Teicholz, author of the acclaimed and controversial book Big Fat Surprise: Why Butter, Meat & Cheese Belong in a Healthy Diet has caused another stir. Her recent feature in the British Medical Journal chastises the U.S. Dietary Guidelines Advisory Committee (DGAC) for not being responsive to recent evidence that would cast serious doubt upon numerous recommendations that appear destined for inclusion in the nation’s latest, best guess at what we should be eating.

The dietary guidelines are revised every five years and control virtually every context in which the government has a hand in growing food and feeding people, including meals in schools, prisons, hospitals, military bases, summer camps and research stations, as well as programs like food stamps, the curricula of registered dieticians and agricultural subsidies.

In an Oct. 7 congressional hearing about the proposed guidelines, lawmakers on both sides of the aisle repeatedly used Teicholz’s BMJ story as ammo with which to grill USDA chief Tom Vilsack and Dept. of Health and Human Services Secretary Sylvia Burwell about the draft dietary guidelines. The congressmen wondered things like why, with so much recent evidence exonerating saturated fat and implicating low-fat diets in various health problems, do the guidelines continue to stay a fat-fearing course where skim milk is preferred, butter is shunned, and the meat, if any, must be lean, and preferably white. Echoing, and citing, her BMJ letter, the lawmakers had wanted to know why the dietary guidelines are not following the mandate to use the best science available?

Teicholz has been attacked for alleged conflicts of interest, for being a mere journalist among scientists, and a profiteering, sensationalist fear mongerer. But never, she told me recently in a phone interview, have her claims been legitimately challenged. While often cast as being a pro-fat crusader, Teicholz purports to be undogmatic in pursuit of evidence-based dietary guidance. This claim was supported by her recent tweeting of a link to the blog post “In Defense of Low Fat.”

“Here’s an intelligent researcher arguing the benefits of a very low-fat diet,” she tweeted.

And, here are some excerpts from my conversation with Teicholz.

Me: In your article you describe several studies that the dietary guidelines ignore. If you could wave a magic wand and force the committee to face any one study and consider its repercussions, what would it be?

Teicholz: They left out the Women’s Health Initiative, which is the biggest ever trial of a diet low in fat, and showed the low-fat diet was not effective in fighting any kind of chronic disease of any kind, cancer, diabetes, heart disease, obesity. In several really important reviews on fat and saturated fats, they just left this study out. There is debate about many aspects of the study, but nevertheless it’s still the biggest ever test of the low-fat diet, and you can’t just ignore it. It was an NIH-Funded study, and cost like $700 million. You can’t leave it out. You have to reckon with it somehow, even if you feel like it didn’t accomplish what it was supposed to do, or whatever, it still has to be considered.

Me: The USDA recently announced that the guidelines would not be taking environmental sustainability concerns into consideration when making dietary recommendations. Do you agree with that decision? And do you consider it cause for concern that there might not be enough land on earth to raise enough animals to put everyone on the Paleo diet?

Teicholz: I think it was the right decision (for USDA to not include sustainability in the dietary guidelines). Those are not environmental scientists, and that is not their mandate. I do think that sustainability is enormously important and food policy needs to be examined in the context of sustainability, it’s just that you need environmental scientists doing that.”

Me: You’re obviously a big supporter of dietary fat. Do you believe some sources of fat are better or worse than others? Is there such a thing as too much fat?

Teicholz: The evidence on different kinds of saturated fats, like the kinds in cheese vs. meat vs. palm oil, tropical oils, it’s still very preliminary. We just don’t have a lot of great data on the various different kinds of saturated fat. Any food is a mixture of many different kinds of fats. A large portion of the fat in beef – I’d have to look up the exact proportion but about a third to a half of the fats in beef – are the same kind of fats that you’d have in olive oil. Most foods contain a mixture of different kinds of saturated and unsaturated fatty acids, and also different chain lengths of different fatty acids.

I would say that the only evidence that seems to be worrisome about saturated fat is that there are some small clinical trials that show that saturated fats lead to inflammation in the context of a high carbohydrate diet. But those are small clinical trials, and there have been large clinical trials lasting long periods of time on close to 50,000 people and none of those showed that reducing saturated fat, replacing it with polyunsaturated fat, or anything, reduced cardiovascular mortality. So even if there is this short-term possibly of inflammatory effects, it doesn’t seem to translate into shortening one’s life by having a heart attack and dying.

Me: How, in your opinion, has the USDA’s misunderstanding of fat convoluted the guidelines?

Teicholz: The U.S. government is advising we get three to five servings of refined grains, like breakfast cereals, per day, because those grains are fortified with nutrients like iron and folate, and they need those nutrients because otherwise the recommended diet is going to be nutritionally deficient.

Red meat and dairy have those things, but they are so restricted in the amount of animal foods that they will recommend, because they have these longstanding caps on cholesterol and saturated fats. You can get those nutrients if you eat liver, but they can’t recommend liver.

See Teicholz’s full critique of the proposed dietary guidelines at forbetterdietaryguidelines.com/