reconsideration of saturated fat and cholesterol: separating fact … · 2016. 4. 5. · title:...
TRANSCRIPT
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Reconsideration of Saturated Fat and Cholesterol: Separating Fact from Fiction
by Nina Teicholz
“This book should be read by every nutrition professional…
All scientists should read it.”
–American journal of Clinical Nutrition
“A Best Book of 2014”
–The Economist
“Top 10 Nonfiction of 2014”—The Wall Street Journal
“Most Memorable Healthcare Book of 2014”
–Forbes
“A Best Book of 2014”
–Mother Jones, Times of London, BBC Food, Kirkus
Reviews, Library Journal
“Impressive . . This book shook me. . . Teicholz
has done a remarkable job”
British Medical Journal
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What I’ll talk about today:
1.
What I discovered about America’s nutrition policy gone wrong
2. Why this is (sadly) relevant to dairy
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How it All Started RATE OF HEART DISEASE PER 100,000 PEOPLE
19001955
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Ancel Keys’ Diet-Heart Hypothesis
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1961:
First advice world-wide to limit saturated fats and cholesterol
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Animal fats vs. Vegetable fats 20th
century
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What is natural? Which is a “whole food?”
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Ancel
Keys was “Mr. Cholesterol”
The most influential nutrition scientist of the
20th
century
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The Seven Countries Study
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Six Countries Study
Keys A. Journal of Mount Sinai Hospital 1953; 20:118-139
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Trying to prove Ancel Keys’ hypothesis
• Randomized, Controlled Clinical Trials (gold standard of evidence)
•75,655
men and women, in experiments lasting 1 to 12 years.
•Conclusion: None
of these showed that saturated fats had an effect
on cardiovascular mortality.
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L.A. Veterans Trial—risk of cancer
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Politics of Science
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Conclusion: “For the entire study
population, no differences between the
treatment and control groups were
observed for cardiovascular events,
cardiovascular deaths, or total
mortality."
Selection bias, continued: Minnesota Coronary Heart Study
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Government got involved: 1977 US Dietary Goals
Senator George McGovern
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Rate of Obesity in US
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Is it all our fault?
• Americans eat too much junk
• Americans exercise too little
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On Exercise…
• “…physical activity is generally insufficient by itself
to bring about
clinically significant weight loss…a dietary intervention is usually
needed”• Physical Activity Guidelines Advisory Committee Report, 2008
• “sedentary behavior cannot be shown to lead to obesity.”• Report by the 2015 Dietary Guidelines Advisory Committee
• Conclusion: You can’t exercise your way out of a bad diet
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Maybe it’s not our fault after all…
Maybe its’
the fault of the Food Guide itself…
What does the science now say?
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#1: Saturated Fats Do Not Cause Heart Attacks
Now 14 meta‐analyses and systematic reviews looking at:link between saturated fats and heart disease.
Taken together, these conclude that:
• Saturated fats are NOT ASSOCIATED WITH
heart disease
• Saturated fats have NO EFFECT ON cardiovascular mortality
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#2: Eating Cholesterol does not Worsen Blood Cholesterol
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Ancel Keys’ Diet-Heart Hypothesis
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Low‐fat diet doesn’t work
• Tested in NIH‐funded, randomized controlled clinical trials
(gold standard)
• On
>65,000 men and women
• Conclusions: Low‐fat diet cannot be shown to fight obesity, diabetes,
heart disease, or cancer of any kind.
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#3: Fat Does Not Cause Cancer
• World Cancer Report 2007: • No association between fat of any kind
and cancer.
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#4 Fat Does Not Make you Fat
Swedish Government Report 2014
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Major macronutrient shift in US 1965‐2011
Source: Cohen et. al., Nutrition, 2015 (Article in press)
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How Carbohydrates Make you FAT
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Path to Diabetes (consistent exposure to insulin over time)
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So let’s back out of the low‐fat diet…
• Reducing carbohydrates down to 40% or less is a good
recommendation for the healthy population (This is what we ate in
1965)
• For people with metabolic conditions (obesity, diabetes, heart
disease), further carbohydrate restriction is a good idea
• >50
clinical trials (gold standard) showing benefits of low‐carbohydrate
diet for weight loss, controlling blood glucose (diabetes) and improving most
heart disease risk factors.
• Including 3 trials of 2 years duration (considered adequate to reveal any
adverse effects)
• Key thing is that it works without calorie reduction. Without HUNGER
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• “LCHF”
low‐carb, high‐fat• Ketogenic• Paleo (low‐carb but no dairy)• “Banting”
in South Africa
Used to be called Atkins…
Now goes by other names…
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Also hitting the mainstream…
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“I Ate Butter and my Pants Fell Off”
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What About Dairy?
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Nutrition science rallying behind dairy fats…
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And Keys hypothesis on dietary cholesterol and
saturated fat collapsing…
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However, in the Dietary Guidelines…
Dairy Healthy intake: Healthy eating patterns include fat-free and low-fat (1%) dairy, including milk, yogurt, cheese, or fortified soy beverages (commonly known as “soymilk”). Soy beverages fortified with calcium, vitamin A, and vitamin D, are included as part of the dairy group because they are similar to milk based on nutrient composition and in their use in meals. Other products sold as “milks” but made from plants (e.g., almond, rice, coconut, and hemp “milks”) may contain calcium and be consumed as a source of calcium, but they are not included as part of the dairy group because their overall nutritional content is not similar to dairy milk and fortified soy beverages (soymilk). The recommended amounts of dairy in the Healthy U.S.-Style Pattern are based on age rather than calorie level and are 2 cup-equivalents per day for children ages 2 to 3 years, 2½ cup-equivalents per day for children ages 4 to 8 years, and 3 cup-equivalents per day for adolescents ages 9 to 18 years and for adults.!
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@bigfatsuprise
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