You can also check out the video version of this post!
Ancel Keys’ hard work to make us healthy
Let me tell you the story of how one man accidentally gave us the obesity epidemic, soaring rates of cardiovascular disease, made billions for the pharmaceutical industry and programmed us to be afraid of fat and cholesterol. All the benefits from Skim milk, low fat Snackwells, and cholesterol lowering Cheerios that were sold to you are based on hypotheses made by a man named Ancel Keys.
The idea that we should avoid fat and cholesterol at all costs comes from Keys’ “Diet-Heart Hypothesis” and “Lipid Hypothesis”. These ideas come from him analyzing the data from 7 countries which showed that when you plotted incidence of heart attacks against fat consumption you see that the countries that ate more fat had more heart attacks. It was simple, you could draw a straight line through the data points which showed more fat equaled more heart attacks. Pretty straight forward, you eat more fat, you get fat, your cholesterol rises, arteries get clogged, and you have a heart attack. Ancel Keys got this accepted by the USDA, the American Medical Association, the American Diabetes Association and the American Heart Association and off went the anti-fat anti-cholesterol movement.
A serious lack of evidence
The only catch here is that there weren’t only 7 countries for which data was available, there were 22 countries. When you factor in the remaining countries there is no straight line to be drawn. You could select 7 different countries and make the claim that more fat meant less heart disease. Maybe Keys had access to the remaining data, maybe he didn’t, but he sure worked fast to have his recommendations put in place. The lack of good evidence didn’t go unnoticed: Dr. George Mann, one of the researchers on the Framingham study which was actually supposed to bolster this cholesterol theory, said, “Dietary fat is not the determinant of either high cholesterol or coronary heart disease” and ‘”the diet heart hypothesis is the greatest scam ever perpetrated on the American public.“ By the way, it’s still called “hypothesis” because it’s never been proven.
You might be up to date with recent health information and even on board with a low carb diet, but chances are you’re still a little cautious of fat. After all, we’ve been programmed to associate saturated fats with “Artery Clogging” and we’ve seen the commercials where they do something like clog a drain with bacon fat. Also Butter, Lard and Coconut Oil solidify at room temperature so it’s pretty easy logic that those solid fats clog your arteries; which makes vegetable oil the better choice because it stays liquid.
The only problem with that is those saturated fats will melt easily in your hand, not to mention inside your body; and the thing that clogs your arteries resulting in a heart attack is not an accumulation of fat. Fat doesn’t even stay intact in the body- it is broken up into small droplets by the bile in your stomach and then wrapped inside carrier molecules called lipoproteins. Fat is never technically even in the bloodstream, it’s always transported inside a lipoprotein shell.
Why fat is important to us
I mentioned before how if humans needed to be so selective with their diet, we would not have gotten this far. Our choices were to eat whatever was in the environment that had calories or be dead. When you look at health from an evolutionary standpoint, the concept of engineering fat out of our foods for our health is completely ludicrous. Our brains, which is what got us so far, are the most metabolically expensive organs we have: consuming 25% of the adult and 75% of the infant metabolic budget. To adjust for the high metabolic cost of a large brain “…shrinkage in gut size (another metabolically energy expensive organ) was a necessary accompaniment. … A shorter human gut, had evolved to be more dependent on nutrient and energy-dense foods than other primates. [A smaller gut] is less efficient at extracting sufficient energy and nutrition from fibrous foods and considerably more dependent on higher-density, higher bio-available foods that require less energy for their digestion per unit of energy/nutrition released.” (from “Man the Fat Hunter” – Public Library of Science)
And which macronutrient is the most calorie dense? Fat comes in at first place at 9 calories per gram. For around 190,000 years of our existence we did not have agriculture and thus we couldn’t expect to eat every day. So fat would be a very valuable macronutrient that we would get as much of as our environment allowed. There is even evidence that suggests homo sapiens would eat all the fat on an animal before eating any of the meat- most of the time leaving a good portion of the meat behind if they already had their fill. Protein, while important, only provides 4 calories per gram and requires a lot of energy to digest making it a less efficient macronutrient.
Sure we have plenty of fruits and vegetables that have been cultivated to be more nutrient and calorie dense and we spend much less time moving around, so ravenously eating fat is hardly necessary. However it’s not very plausible that a macronutrient that used to be so important to us is now killing us in hordes.
Timothy Olsen showcases the efficiency of fat in spectacular fashion. He holds the record for the Western 100 Endurance run, a 100 mile ultra distance race in California that includes an 18,000 feet climb and 23,000 feet descent. He said he used to consume dozens of sports gels throughout his races to keep him going, but switched to a low carb high fat diet for more stable energy; he preferred not having to empty his stomach out in the woods multiple times during the race.
You might have stopped and thought “How can fat not be the problem? I ate a plant based diet and reversed my atherosclerosis!” I live in Japan and am well aware of how healthy a high carbohydrate diet can be, especially a primarily plant based one like the Okinawan people’s who frequently live to be 100 while less than 8% of their calories come from fat. Don’t worry, we’ll get to this.
Despite our bodies preferring the energy dense fat, this idea that saturated fat and cholesterol needs to be reduced at all costs became medical dogma. However, not only does our body want fat, it doesn’t want to reduce cholesterol. Cholesterol is incredibly important: we need it for the membranes of our cells, we need it to make brain cells, we need it to make several important hormones like estrogen, progesterone and testosterone.
Enter inflammation
Cholesterol is actually the thing that comes in and helps with arterial damage. The process leading up to a heart attack starts with an inflamed, damaged arterial wall. The body sends cholesterol to mend that damage, as well as other substances like calcium, and a substance similar to collagen called fibrin. Blaming cholesterol instead of the inflammation is like blaming the fireman instead of the fire.
Back to the Okinawan people: they have such a low incidence of heart disease because they’re not eating foods that cause inflammation so atherosclerosis never develops. Of course they live long: they eat locally grown, organic, fiber rich vegetables designed to nourish them, not optimized for profit and laden with pesticides. Keep in mind that the saturated fat our homo sapien ancestors were getting was from wild (cage free,organic) animals, not from highly processed ham slices in Kraft Food’s “Lunchables” , and certainly not from the butter of cows pumped with hormones while living in cow jail and eating processed corn scrap. Also they were getting their unsaturated fat in the form of omega-3’s from fish and omega-6’s from nuts, not mostly from Canola seeds that had to be washed in hexane solvent & sodium hydroxide, bleached and then steam injected.
In the book “The Great Cholesterol Myth”, Dr. Stephen Sinatra and Dr. Johnny Bowden cover this topic very extensively. Here’s an excerpt regarding the effects of a lack of cholesterol:
“The emphasis on lowering cholesterol as much as possible is not only misguided, but also dangerous. Studies show that those at the lowest end of the cholesterol spectrum have a significantly increased risk of death from myriad conditions and situations unrelated to heart disease. Including but not limited to cancer, suicide and accidents. … You need cholesterol to make brain cells. A cholesterol level too low around 160mg/dl has in fact been linked to depression, aggression and cerebral haemorrhages.”
Total cholesterol’s irrelevance and the real “bad cholesterol
But what happens if you consume too much cholesterol? Nothing. “The Framingham Heart study found that there was virtually no difference in the amount of cholesterol consumed on a daily basis by those who went on to develop cardiovascular disease and those who did not.”
What if you have too much cholesterol? It doesn’t matter. Dr. Johnny Bowden explained in this video that in the Lyon Diet Heart Study they had a group of 605 people with high cholesterol and a very high risk of heart disease. In one group they put them on the Mediterranean diet and in another they recommended they cut saturated fat, reduce cholesterol intake to 300mg per day and follow the “healthy” western diet. The results? Cardiac death and all cause mortality on the Mediterranean diet was significantly lower than on the low saturated fat diet. After explaining this, Dr. Bowden says “So here’s the question, what do you think happened to the cholesterol of the people on the Mediterranean diet? Their cholesterol didn’t budge. They just stopped dying. Cholesterol had nothing to do with it. Whatever their cholesterol was at the beginning, it was pretty much the same at the end.”
OK so knowing total cholesterol is not helpful. What about the HDL “good” cholesterol and the LDL “bad” cholesterol? This concept is also outdated. You can have bad “good” cholesterol and you can have good “bad” cholesterol. What you would want to know is particle size. You don’t want to have a high concentration of the small LDL particles. One of the key things that increases these smaller particles is refined carbohydrates and sugar. The science around cholesterol is much too complicated to explain here, but the point is that the standard metrics for understanding your heart disease risk and judging whether something is healthy or not are seriously outdated and have surprisingly little to do with fat consumption. You can learn more on Dr. Peter Attia’s blog.
When I got to this point in my research I was dumbfounded and outraged. Cardiovascular disease kills 610,000 people in America every year, yet the guidelines we have to avoid it are utterly worthless? I immediately threw away my 1992 collector’s edition Snackwell cookies.
The mess confirmation bias put us in
Possibly the worst part is that it wasn’t like nobody knew that low fat diets had virtually zero science to back them up. British physiologist John Yudkin wrote a book in 1972 “Pure, White and Deadly: The Problem of Sugar” which correctly warned that the consumption of sugar is dangerous to health, an argument he had made since at least 1957. The final chapter of the book lists several examples of attempts to interfere with the funding of his research and to prevent its publication. It also refers to the personal smears that Ancel Keys employed to dismiss the evidence that sugar was the true culprit of heart disease.
This excerpt of ABC TV Australia’s broadcast “Heart of the matter” explains: “In 1977, the U.S. Government stepped in. Senator George McGovern, an advocate of Ancel Key’s theory headed a committee hearing to end the debate … Eminent scientists at the time disagreed with the [Keys] report.” In the clip, you can hear Dr. Robert Olsen saying: “That’s why I have pleaded in my report and will plead again orally here for more research on the problem before we make announcements to the American public.” George McGovern’s rebuttal was simply: “Well I would only argue that senators don’t have that luxury that a research scientist does of waiting until every last shred of evidence is in.” It didn’t matter how illogical or misguided McGovern’s response was, he came out on top.
What’s happened since then? Hospitalizations for Heart Failure went straight up and heart disease is still the leading cause of death in the world.
In fact, when it comes to weight gain, the data suggests people started gaining weight immediately after the guidelines came out.
We now understand that:
1) Knowing total cholesterol is irrelevant to your health
2) Knowing your so called “good” and “bad” cholesterol is irrelevant because you can have bad HDL particles and good LDL particles; and the bad version of these particles are caused by more complex issues than just fat.
3) Heart disease is primarily due to damage to the arterial wall caused by inflammation, high blood pressure, high blood sugar and insulin levels and stress.
4) The more key things to limit to avoid heart disease are sugar and processed carbohydrates.
Despite all this, the “Heart Healthy” guidelines encourage over-consumption of inflammation promoting vegetable oils and processed carbs that keep our blood sugar high. Maybe even worse than that is we’re still being prescribed Statin drugs, whose harmful effects are a constant testament to how important cholesterol is for the body.
The billion dollar toxin
You might be thinking “Hey but my doctor said I should be on a statin…” if so, go ahead and ask your doctor what the number needed to treat for statin drugs is. In this video, Neuroscientist Daniel Levitin explains that the NNT is the number of people that have to take the drug before one person benefits from the drug. He says: “… you’re thinking, what kind of crazy statistic is that? The number should be one. My doctor wouldn’t prescribe something to me if it’s not going to help. The number needed to treat for the most widely prescribed statin, what do you suppose it is? How many people have to take it before one person is helped? Three hundred. 300 people have to take the drug for a year before one heart attack, stroke or other adverse event is prevented. So for this particular drug, the side effects occur in 5 percent of the patients and they include terrible things – debilitating muscle and joint pain, gastrointestinal distress. 300 people take the drug, right? One person’s helped, five percent of those 300 have side effects, that’s 15 people. You are 15 times more likely to be harmed by the drug than helped.“
Duane Graveline MD wrote a book called “Lipitor, thief of memory” after experiencing “Transient Global Amnesia”- a type of memory loss where your wife is in the same room as you and you don’t know who she is. By the way, remember how I said cholesterol is important for producing sex hormones like testosterone and estrogen? What do you think the second highest revenue prescription drug is for Pfizer after Lipitor, which is the #1 prescribed statin? Viagra comes in right after Lipitor. Also, it’s not like Viagra just happens to be the next biggest revenue stream there’s only an 8% difference between the two.
Surely you’re thinking “this is a terrible situation, how come the diet guidelines haven’t been changed?” Well it’s almost as unlikely for the medical industry to come out and say “Looks like we were wrong. Sorry.” as it is for a pastor to say “Hey, y’know this religion we’ve been following all our lives? I think it might be the wrong one, sorry about that.” Australia’s leading lipid expert David Sullivan demonstrated (maybe on accident) pretty well that admitting the recommendations are useless might put some people out of a job. When asked whether they should be giving people dietary advice when they don’t have enough evidence to back up their advice he said “We are particularly keen to give some dietary advice because otherwise what do we offer people?”
What we should really be paying attention to
I would like to lay out the complete details of how to really avoid heart disease, but I recommend you start by reading “The Great Cholesterol Myth” or at least Dr. Bowden’s article on “The Four Horsemen of Aging“. For now, let me leave you with one rule of thumb you can use to pick out your food:
Just think about how much something has been screwed with before you make the decision to eat that.
For example: coca Leaves in their natural state are quite harmless, the farmers in the Andes have chewed on them for hundreds of years for a small boost in energy. However, when you process the hell out of them, you get cocaine. Eating a lot of sugar beets probably isn’t so bad for you, but if you boil them in water to make a crude syrup, then wash that solution with calcium hydroxide and proceed to refine it with 6 different boilers… maybe the resulting white powder isn’t the best thing for you. You can apply this idea to anything from processed cheese and meats to packages of “whole wheat bread”.
This goes for fats too. If Jack the cow just had to walk around and eat grass, his butter is going to be better than Byron the cow’s butter if Byron had to be given growth hormone and a specifically designed rapid growth promoting feed. Canola oil requires a lengthy industrial process to wrench the oil out of the canola seed, but you can get a decent amount of fat from nuts just eating them as they are.
I’m not here to sell you any one diet or macronutrient ratio for now. However, I can tell you for certain that this granulated sugar and processed crap that’s been marketed to us in place of what we had been eating for centuries is not what we should be eating. Sometimes we have to dig way past spiffy marketing, guidelines from big establishments, and our own doctor’s advice before choosing what to eat.