Here is the full transcript of investigative journalist Nina Teicholz’s TEDx Talk: The Big Fat Surprise at TEDxEast conference.
Nina Teicholz – Investigative journalist
Well, hello everybody. That’s so nice of you.
So, like probably many of you, and probably most of the Western the world, a decade ago, I was just totally confused about what to eat. And that’s kind of no surprise because there’s a lot of conflicting advice out there. You’ve got Mark Bittman, the New York Times, telling you, you should eat vegan, at least before six; there’s the Paleo dieters, why are they still around? That’s still very popular.
But it seems like the one thing that everybody can pretty much agree upon is that saturated fat is bad for you. Meat is bad for you. Saturated fats, the kind that’s found in animal foods, in milk, cream, cheese, eggs, red meat, is bad for you, and everybody agrees upon that. And you know, that’s what we’re told.
Everybody knows these images – one is the USDA Food Pyramid, and the other one is the Mediterranean Diet Food Pyramid. But you can see that grains, vegetables, fruit, that’s all the big slices at the bottom, and animal foods is up there at the top, and you’re not supposed to eat a lot of those, and so we’re just doing like we’re supposed to.
And so in 2003, I was assigned a story by my editor at Gourmet magazine to write about trans fats, and that was a story before they became known, and they were put on the food label by the FDA in 2006, and I got a book contract out of that, and I started researching it. And I realized there was just an incredible story about fats in general, and I became kind of obsessed with this subject, and it’s because fat is, of course- fat’s the macronutrient that our dietary recommendations have been most obsessed about.
There are basically three macronutrients out there: there’s protein, carbohydrates and fat. And our recommendations have been obsessed about fat – non-fat, good fat, bad fat, low fat, you know, what kind of fats should we eat, and that’s been, for most people our age, the story of our lifetime in eating.
And then I spent the next eight years reading every single bit of science out there, and learning about this field, learning about the politics, or the people involved in this field, and who are the people who are doing the science, and where does it all come from? And it was kind of an amazing journey.
And one of the things that you’re – When you have an idea about what you’re supposed to eat, when you have any idea in science, it’s supposed to explain all the observations out there. That’s kind of a scientific term, like it’s supposed to explain what’s going on in the world, like, you know, do we know who’s getting – Why are they getting fat? It’s supposed to explain everything we’re seeing, and one of the amazing things about this journey that I went on was that our idea about this USDA Food Pyramid, how to eat, really did not explain the observations.
So, this is kind of I think you probably already guessed, but I’m going to ask you a question, like, who’s on the USDA-recommended low-fat, high-grain diet here? So, this woman, Fat Louisa, was a Pima Indian in the 1930s and ’40s, and she’s obese, and she was – We typically think, the idea is that we get obese because we live in a toxic food environment. She’s nowhere near a supermarket or any kind of, like, Doritos or Cheese Curls or anything, but she’s on a high-grain, low-fat diet and she’s obese.
This guy over here is a Masai warrior. This picture was taken by a physician and researcher named George Mann, who went there in the mid-’70s to Uganda and studied the Masai warriors. This guy, and all of the Masai warriors that he studied, had very low cholesterol, very low blood pressure that did not rise with age, which was amazing. They also didn’t gain weight with age. And they weren’t particularly active.
The older people would sit around, basically swatting flies and doing nothing, and he’s on a diet of three to five pounds of meat a day, and what else he ate was milk and blood, that’s it. No fruits and vegetables – failing grade by any nutrition today.
And George Mann, he took 600 of these Masai warriors, and he took EKGs of them, and he found only two incidents of possible heart attack – possible, out of 600 men, and that was a finding that was also confirmed by somebody else who’s studying another African tribe nearby. And then he looked at some of the Masai warriors who’d gone to Nairobi, because he thought maybe they were a genetic freak and had some genetic protection. He found the ones who moved to Nairobi looked just like the people in Nairobi – high cholesterol, high blood pressure, and they were getting fat.
This guy’s not working out at the gym and he looks amazing. So, when you have a scientific hypothesis that doesn’t explain your observations, you can’t just ignore your observations, you have to explain them, you have to say, okay, what’s wrong with our hypothesis? Is there something wrong with it? Do we have to change it? What’s wrong with what we’re thinking about the way that we eat and what makes us healthy?
So the next question that really came to mind was, like, okay, where does their hypothesis come from that saturated fat, and fat at all, is unhealthy for you? And like any idea, it was born in a moment in time. There was, basically- The first time it became an official policy, an official dietary recommendation, was 1961, the American Heart Association came out with the very first dietary guidelines, that’s like the gold standard in the world of nutrition guidelines. Everything flows from the American Heart Association.
In 1961, the first guidelines: diet low in fat, low in saturated fat to protect against heart disease, that’s what people should eat. That’s the first time that was ever recommended to the American people, and this guy, Ancel Benjamin Keys, who was a pathologist at the University of Minnesota, was kind of the powerhouse behind that idea.
You know there are various ideas about, like, what steers history, if it’s economic forces, or what it is, but in the history of nutrition, it really is like a “great man” theory of history. This guy steered a tremendous amount of nutrition history. And his idea was this: It’s called the Diet-Heart Hypothesis, it was developed in the ’50s, and the idea is if you eat saturated fat, you raise your blood cholesterol, in your blood – that had been shown in some scientific lab experiments and experiments on people in mental hospitals, and that would lead to a heart attack. Just a whole chain of events here, none of which has ever been proven, even today, but that was the idea that really took hold. It’s called the Diet-Heart Hypothesis, and he prevailed with that idea, and one of the reasons why is that the nation- it was like a moment in time in the 1940s when there was a kind of panic going on in the country.
There was a tremendous need for some kind of solution. I mean, heart disease, heart attacks felling men in their prime, and particularly all the men who ran the country – in this case Eisenhower had his first heart attack in 1955 – but the men who ran the country, who did the research, who were interested in nutrition, everybody – heart disease had risen out of nowhere – there were almost no cases of heart disease before the 19-teens, and all of the sudden it became this enormous public health issue, and everybody was focused on it, and they wanted a solution.
And so they were willing to kind of cut corners on the science before any idea was ever proven because they were so afraid. So the most important nutrition study ever done was done by Ancel Benjamin Keys, and he went to- It’s called the Seven Country Study, and it’s like the Rosetta Stone of nutrition studies – everything telescopes back to this study.
And he is the first-ever study, epidemiological study, it’s a study where you go out and look at people, you ask them, you know, “Who’s got high cholesterol? What do you eat?” And it observes them, and it sees if there’s some sort of correlation they can draw. He went to the island- He chose seven countries, six in Europe and in Japan, and he looked at what they ate, and he looked at he took their EKGs and stuff, and I showed you those two men because the place where his- He had already pretty much decided that saturated fat caused heart attacks, but the place that really fit his theory the best was the island of Crete.
There were long-lived people there, a high number of centenarians, there was hardly any heart disease, and they didn’t eat much saturated fat, and that fit his theory perfectly. Because other places he went didn’t fit his theory very well, and there was a lot of problematic data points in his theory, but he loved this particular data set, they were like his star data set on the island of Crete. And this is literally the study, I mean, it’s been cited tens of thousands of times, because in its day, it was the only really big study that had been done.
And so I went back — and one of the things I did was I went back and I really dug into that study because it’s been so influential, and I found some amazing stuff, like, I mean, first of all, it was post-World War II Europe, people were still, like, devastation and poverty. People were basically eating a poverty diet back then, but Keys did a lot of, you know, there’s hardly a better word for it than kind of saying ‘fudging the data’.
And he published it in obscure, German-only journals, I had to go back to obscure places – he really didn’t want this data to get out. And what I found, amongst many things, but I’ll just mention one here, is that these people that he had found- He went to the island of Crete three times for three weeks, each one week, three times. One of his data collection periods was during Lent, it turns out. So, I don’t know if you know about Lent, but it’s a highly Greek Orthodox country, and in Lent, you don’t eat any animal foods – you don’t eat any meat, you don’t eat any dairy, you don’t eat – So, this totally skewed his data. Of course it’s a low-saturated-fat diet – and he stuffed that, you know, he was like, “Oh, well, it was during Lent, but we don’t think that had any influence on the outcome,” but of course it did.
And scientists have gone back and analyzed this, too late for it to make a difference, but they went back and analyzed, “How many people observe Lent, and exactly what is the difference that makes on the saturated fat content of the food?” And it turns out to be enormous. So, this study that was so influential – I mean, that is just one of a great many number of problems, but. So the data was kind of biased from the beginning, and this is, like, a catch-all slide to try to encapsulate the next 25 years of nutrition history, but basically, that original American Heart Association recommendation, 1961.
Then there was just, like, this gigantic snowball effect. Well, the USDA adopted it in 1978, that was the first-ever dietary guidelines. And it was kind of like the same group. That’s Keys on the left in the front, and his colleague, Jerry Stamler, and there was kind of this same group of people who were on all the expert panels, and they all reviewed each other’s papers, and these groups controlled all of the funding, so if you didn’t get on this ‘cholesterol bandwagon,’ it was called, you couldn’t get funding, you couldn’t do research, you couldn’t be a scientist.
And over the course of 25 years, this Diet-Heart Hypothesis, it became ingrained in institutions, there was an institutional bias; the media, there was a kind of bias that fell into the media; and everybody kind of lined up behind this hypothesis. You really couldn’t be a scientist if you did not get on board.
And by 1986, the critics had basically been silenced. There were a lot of critics along the way but you don’t hear about them anymore because they were gone by 1986. So I want to make it clear, I’m not- There’s two parts to this diet – there’s the low-fat diet, which is to reduce fat, so the original idea had been that you should reduce saturated fat. And then, because there was kind of a bias all along about just fat in general, because that had been Keys’ original idea, that all fats raised cholesterol, so he just was kind of biased against fat. And the idea was fat had more calories per gram than carbohydrates or proteins, so it was just probably better to lower fat overall, it was just sort of thought that was a good idea.
And for any of you who kind of keep on top of nutrition news, that diet was kind of on its way out, the low-fat part of it, but we still really believe that saturated fat is bad for us. But all the early studies were really done on saturated fat, they were really done based on the original hypothesis that it was saturated fat that was bad for you.
So there were a lot of studies that were done looking at- not a lot, there were five or six really important studies that were done looking at people on a saturated fat diet and comparing them to people on an unsaturated fat diet. And they were generally done on prison populations or people in hospitals because you can control them. You can’t do those kinds of studies any more.
So these studies were all extremely influential, and I’m just going to mention one of them, a very influential study, cited a million times, it’s called the LA Veterans Association Study, and it was done in the LA Veterans Hospital, and they followed people for a couple of years.
They had- They put- The experimental group was on a high unsaturated-fat diet, and they had soybean oil, they tried to replace the milk with what was called ‘filled milk,’ a soybean-based milk. It’s not really unlike the soy infant formula that people give their kids today, that kind of replacement of animal fats with soy fats. And they found- and this is why- This is what kind of helped propel along the Diet-Heart Hypothesis, they found that heart attacks- they did see a reduction in heart attacks, but they saw something else, which is that you can see the experimental group is on the top – those people had much higher rates of cancer, and in the end, there was no difference in overall death rates.
So you could be- And all these early studies had the same results, which is that heart attacks may have gone down but your overall risk of dying didn’t go down, and in the end, that’s what you want to know, like, what’s my risk of dying?
So, sure, you can spare me a heart attack, but if I die of cancer, what good is that to me? And it was a really serious issue in the time. The National Institute of Health had a series of expert panels in the late ’80s, where people got together and said, “What are we going to do about these findings? They’re very worrisome.” They couldn’t figure it out, they basically couldn’t figure it out.
Years later, I talked to the rapporteur of those NIH meetings, and I said, you know, “What went on? Like, why you never figured it out?” And he said to me, this is, like, 19- this is maybe 2008, and he said, “Gee, have we still not figured that out? That’s really worrisome.” And it’s just been forgotten. They don’t know if it was the more vegetable oil, or it was the fact that in these trials they all did successfully lower their cholesterol, and maybe the lower cholesterol- I mean, one of the populations that nutrition researchers have obsessed about are the Japanese, because they have that, you know, lots of fruits and vegetables, or at least vegetables and rice diet, and they have lower rates of cholesterol, at least in kind of rural areas of Japan, and they do have lower rates of heart disease, but they have astronomically much higher rates of stroke and other kinds of cardiovascular problems. So it’s just not clear what we’re trading off here.
And all those studies – the caveats with those studies, it’s like a game of telephone over the years, where you’re like, “Oh, well, we had this success, but we have all these caveats that go along with that study.” But down the line, it’s just like, “Oh, we have this success.” And all the other kind of information attached to it gets lost.
So What’s next? Oh, I just want to say briefly that one of the things that was kind of propelling this hypothesis along with Benjamin Keys and the American Heart Association in the beginning was, if you’re not eating saturated fats, what are you eating? You’re eating unsaturated fats. And one of the things that I uncovered was just the tremendous force that the vegetable oil companies played in helping along this hypothesis.
They basically launched the American Heart Association. The American Heart Association was a tiny society of cardiologists. In 1948, Proctor and Gamble, makers of Crisco, decided to make them the beneficiary of this radio program. It completely launched them into a national organization. They made millions of dollars, and that was the beginning of the AHA as we know it.
And, you know, they market their products as ‘Doctor recommended’ healthy products to lower your cholesterol. So, at the end of all this – that’s Robert Atkins eating like a Masai warrior. So Robert Atkins was not beloved in his day by the nutrition establishment. This is a field really governed by politics, and he was not even remotely a good politician, and he used to just really rub people the wrong way, and that’s kind of one reason he never really made it in the nutrition establishment.
But it was also that he didn’t have any scientific data. He was just going on his experience of treating tens of thousands of patients, and there was really nothing behind him to- He couldn’t sort of ‘play’ in the nutrition community because he didn’t have scientific studies.
In the last ten years, unbeknownst to all of you because these studies go up against the current prevailing dogma and therefore are not really discussed, but there’s been a tremendous amount of research done by researchers who are not popular but they have done a tremendous amount of clinical trials, like, very rigorous clinical trials to basically provide the kind of scientific evidence that Robert Atkins lacked in his day.
And I think we are possibly at the beginning of a kind of paradigm shift. There have been a number of meetings of top nutritionists for the very first time, the very first time in 2011 and 2010, coming out with consensus papers saying maybe saturated fats are not as bad as we thought they were; they’re certainly not as bad as carbohydrates.
So, in the end, I think the message is, like, whole fats, those original whole fats, like whole foods, I think we will see possibly a return to those kinds of foods. Look, I’m right on time.