In Nina Teicholz’s book, The Big Fat Surprise, the surprise is that fat is actually good for us and carbohydrates are the culprits of many of our health issues. She explores this revelation by reviewing over 50 years of scientific and sometimes not-so-scientific studies on nutrition.
The idea that fat, particularly saturated fat, was unhealthy came primarily from the diet-heart hypothesis of Ancel Benjamin Keys, a biologist and pathologist from the University of Minnesota. As Nina Teicholz said while discussing her book, The Big Fat Surprise, on the MSNBC program Weekends with Alex, Keys proposed that the heart disease crisis that America was experiencing in the 1950s was largely due to the consumption of saturated fat. He convinced others to adopt the same stance with his Seven Countries Study, an epidemiological study of middle aged men in rural areas of Europe, Asia, and the United States.
Epidemiological studies are very useful in some circumstances, especially when scientists are seeking through observation to know the root of a chronic disease. The greatest example of such a success, Nina Teicholz says in The Big Fat Secret, is the observation that cigarette smoking causes lung disease. This is a rare success, however. In order to pin down a cause of a phenomenon like heart disease, clinical trials are better suited. The Seven Countries Study simply observed eating habits and certain health measures. Keys used his gathered data to claim that saturated fat caused poor health, especially poor heart health.
Several problems can be seen in Keys’ methodology for the study, as Nina Teicholz points out in her Wall Street Journal essay. He handpicked countries where he had already noticed a seeming correlation between fat and poor health and discounted countries that did not readily fit that pattern. Also, he even surveyed one group of subjects during Lent when animal fats and proteins are avoided anyway.
As Nina Teicholz explains in her CNN.com commentary, despite all of these weaknesses, Keys claimed that the Seven Countries Study proved his diet-heart hypothesis and convinced the health and nutrition establishment to follow his low-fat advice. The Big Fat Surprise says that we have been living with their acquiescence to his ideas ever since. Soon, his prescribed low-fat diet was the official dietary recommendation of the U.S. government.
If we have to trim the fat in our diets, what do we increase to keep our food filling and tasty? We increase the number of carbohydrates. Nina Teicholz told the hosts of ABC’s Good Morning America, if you look at the present My Plate diet recommendation by the USDA, fruits and grains, both high in carbohydrates, make up about one half of the recommended daily diet. According to her book, The Big Fat Surprise, this is not at all healthy.
As early as 1921, some scientists began to explore this. Elmer V. McCollum, a Johns Hopkins University biochemist, published his results of studying rats in his book The Newer Knowledge of Nutrition. Nina Teicholz discusses his research in The Big Fat Surprise. He chose rats because, like humans, they are omnivores. Therefore, they make good subjects for nutrition studies about human nutrition. The rats he fed with a high carbohydrate, nearly vegetarian diet were much more difficult to keep healthy than the ones he fed milk, eggs, butter, and organ meats. He labeled these higher fat foods “protective” because they better sustained healthy growth and reproduction.
Despite this and other sporadic research that showed fat’s nutritional benefits and the less healthy alternative of a diet high in carbohydrates, the standard for over 50 years has been the same one seen on the My Plate illustration. Not everyone agreed, however. One of the most visible and vocal dissenters has been Robert C. Atkins, a New York City cardiologist who observed in his own patients that this low-fat diet was not working. As The Big Fat Surprise explains, he publicly changed nutrition history when his book, The New Diet Revolution, came out in 1972. Despite the ridicule of nutrition “experts,” who said that his point of view was a fad, his book and products have been highly successful.
Atkins told readers what he had been telling his patients, that a diet hearty with meat, cheese, eggs, and cream were not only allowed but were good for you. As Nina Teicholz says in The Big Fat Surprise, his diet “was more or less the USDA pyramid turned on its head, high in fat and low in carbohydrates.” He believed that this revolutionary way of eating would not only make people lose weight but would also prolong their lives by reducing the possibility of heart disease and diabetes.
Just commercial success is not enough to prove a nutrition idea has merit, however. Clinical trials must do that. These tests of the Atkins diet began in the late 1990s. Duke University’s Eric Westman was among the first to do this research. A doctor as well as a researcher, Westman had a patient who insisted that his good cholesterol numbers were due to his steak and eggs diet. This led Westman to look into the files of Atkins to see if the diet’s claims were true. After seeing positive anecdotal evidence, he began scientific study.
Nina Teicholz explains in The Big Fat Surprise that Westman concentrated his studies on the effects of the Atkins Diet on type II diabetes. He found that putting patients on a low carbohydrate, high fat diet was highly effective at managing the disease. Some patients even saw their diabetes go completely into remission, allowing them to discontinue diabetes medications completely. Although convincing to the scientists and doctors who have witnessed the results, the American Diabetes Association only in the last few years has emphasized the role of carbohydrates in controlling the disease.
The Big Fat Surprise explores these and other topics that conclude what we read in the subtitle, Why Butter, Meat & Cheese Belong in a Healthy Diet.