The Big Fat Surprise



The Australian, 30 December 2014


“NEVER greet your husband with that ‘you’re late — your dinner’s spoiled’ expression,” advised The Australian Women’s Weekly in 1962. “A man should be given a chance to get into a relaxed frame of mind over a drink in his own favourite chair before dinner.”

The Weekly’s October 31, 1962, edition provides abundant material for those who like to sneer at the customs of their forebears. On the subject of nutrition, however, The Weekly is dispiritingly up to date. “How Not to Kill Your Husband,” written by an unnamed family doctor, delivers a diatribe against fat.

“Even if your husband’s blood cholesterol is not raised it will do him no harm to substitute safe vegetable oils for animal fats,” the doctor advises. A long string of advice follows: cream is only for holidays; meat should be browned with corn oil, sunflower oil or soy oil after cutting off the fat. Hubby should eat no more than one egg a day and, if he must have chips, they should be cooked in vegetable oil.

The anti-fat message, novel for its time, drew on a hypothesis popularised by American biologist and pathologist Ancel Keys. In a 1961 cover story, Time magazine had dubbed Keys “Mr Cholesterol” on the basis of his advice to drastically reduce the consumption of saturated fat.

Keys, however, had jumped the gun. There was no conclusive evidence linking saturated fat consumption to the incidence of heart disease in 1962, just as there is no conclusive evidence today.

There were epidemiological studies, like one conducted by Norman Jolliffe, who in 1957 signed up 1100 men to his Anti-Coronary Club, instructed them to eat less meat, eggs, milk and cheese, and to drink at least two ­tablespoons of polyunsaturated vegetable oil a day. In May 1962, The New York Times reported Jolliffe’s early findings under the headline “Diet Linked to Cut in Heart Attacks”. A decade into the trial, however, investigators discovered that 26 members of Jolliffe’s diet club had died, compared with only six men from the control group. Eight members of the club had died of heart attacks.

A challenging new book by Nina Teicholz, The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet, recounts the sorry history of a hypothesis that refuses to stand up. The demonisation of fat has altered Western diets conspicuously in the past 50 years without any solid evidence that eating less animal fats actually makes you healthier.

There is little doubt that lowering consumption of saturated fat will reduce cholesterol levels in the bloodstream, but scientists have yet to demonstrate that you are less likely to die as a result. Unlike the link between cigarettes, cancer and coronaries, the case against saturated fat is unproven.

Worse still, claims Teicholz, the increased consumption of processed, carbohydrate-laden food that came with jumping aboard the cholesterol bandwagon has made us fatter, increased the likelihood of diabetes and raised our blood pressure. In 1962 the average Australian ate 1.6kg of beef, mutton and lamb, four eggs and 220g of butter a week. By the turn of the century they were eating less than a 1kg a week of red meat (excluding pork), 2.6 eggs and just 55g of butter. Yet the rate of obesity had doubled and the incidence of type 2 diabetes had gone through the roof.

Correlation is not causation, and the relationship between nutrition and health is complex. If nutritionists have made a mistake, however, Teicholz says it will have been a monumental one. “Measured just by death and disease, and not including the millions of lives derailed by excess weight and obesity, it’s very possible that the course of nutrition advice over the past 60 years has taken an unparalleled toll on human history,” Teicholz writes.

“It now appears that since 1961, the entire American population has, indeed, been subjected to a mass experiment, and the results have clearly been a failure. Every reliable indicator of good health isworsened by a low-fat diet.”

Teicholz provides considerable evidence to back her extraordinary claim. It is disconcerting, to put it mildly, to learn that the story put forward by the nutritional establishment, reinforced by the low-fat labels in supermarket fridges and reported as fact in the mainstream media for decades, could be fiction. Science was supposed to provide more certainty than this.

Yet Teicholz’s account of an unproven hypothesis that became enshrined as dogma before it had been properly tested is wearingly familiar: the casual confusion of correlation with causality; the cherry-picking of data; the hardening of biases and the crossing of the line between empiricism and campaigning.

The theory, once adopted by official institutions, is nearly impossible to challenge. Organic chemist David Kritchevsky tells
Teicholz of his experience on a National Academy of Sciences panel 30 years ago when he suggested relaxing the guidelines on dietary fat. “We were jumped on!” he said. “It’s hard to imagine now, the heat of the passion. It was just like we had desecrated the American flag.”

Researchers questioning the prevailing view were cut off from grants and struggled to find scientific journals that would publish their papers. The outward impression that nutritionists were united was made possible only by pushing aside opposing views.

In its most recent advice on the subject, the National Health and Medical Research Council still advises Australians to limit their
consumption of saturated fat and to replace saturated fats such as butter, cream, cooking margarine, coconut and palm oil with
polyunsaturated and mono-unsaturated fats. 

It hedges its bets, however, noting the difficulty in designing studies to address the effect of dietary fat on disease, the complexity of understanding the different effects of various fatty acids in the context of the whole diet. The NHMRC plays it safe, concluding: “As a general message to the public, limiting total dietary saturated fat remains the best guide.” 

Perhaps. But if Teicholz is correct and the conventional wisdom is based on nothing more than 60 years of misconceived nutrition research, then nutritionists may have disregarded the principle of the Hippocratic oath: “First, do no harm.”

The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet by Nina Teicholz (Simon & Schuster).