We are excited today to have Nina Teicholz joining us as our guest. Nina is a science journalist and the author of the New York Times bestseller, The Big Fat Surprise, which upended the conventional wisdom on dietary fat, especially saturated fat, and spurred a new conversation about whether these fats cause heart disease.
Named a “Best Book” of the year by the Economist, the Wall Street Journal, and Mother Jones, among others, it continues to be called a must-read for anyone seeking to understand the amazing story of how we came to believe fat is bad for health and what a better diet might look like. Nina is also the founder of the Nutrition Coalition, a non-profit that works to ensure that government nutrition policy is transparent and evidence-based. It is work for which she has been asked to testify before the U.S. Department of Agriculture and the Canadian Senate.
“I realized that there was a story of persistent suppression of the science on cholesterol and the science on fat that went back decades.”
Nina is a graduate of Stanford and Oxford Universities and previously served as associate director of the Center for Globalization and Sustainable Development at Columbia University. Nina lives in New York City with her husband and two sons.
As a journalist in the early 2000s, while Nina was doing a series of investigative pieces for Gourmet Magazine, they assigned her a magazine story to look into trans-fats. Although she had no idea what trans-fats were at the time, she took the piece on, and interviewed people about trans-fats. What surprised her was that when she started talking to research scientists, she discovered that as early as the 1970s, people had already started talking about the potential dangers of trans-fats. Nina was told about the researcher’s experiences of attempts to get their research suppressed or of people yelling at them and trying to intimidate them off the stage when they spoke about their findings at meetings.
Be sure to stay tuned today to hear Nina’s story and learn about the science and politics of saturated fats, the dangers of vegetable oils, and the history of how we came to believe that fat is bad for health.
IN THIS EPISODE YOU WILL LEARN:
- Nina explains how she became interested in determining how the paradigm shifted in the 1950s regarding the quality of fats recommended to the nation.
- Nina talks about the politics of science.
- The theme that inspired Nina to write her New York Times bestselling book, The Big Fat Surprise.
- The profound and tragic influence that Ancel Keys had on our nation, the food industry, and people’s health.
- The tipping point that occurred when the food giants and the processed food industry started getting involved in some of the private organizations, like the American Heart Association, who before that time, used to be far more objective.
- The conflict of interest that exists with institutions like the American Heart Association and the American Diabetes Association.
- The challenges related to the shifting diet paradigm.
- Why nutrition has become so politicized over time.
- Nina talks about the struggles she has had as a journalist, and with the group that she founded, in trying to have some influence over the dietary guidelines.
- The cognitive dissonance around people not being willing to entertain the possibility that they should question dogma.
- The criticism and hostility leveled at Nina for her alternative viewpoint in the work she does.
- The importance of the US Dietary Guidelines, and what went wrong with them.
- How Nina’s research has impacted what she eats.
Connect with Nina Teicholz
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- Check out Cynthia’s website
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About Everyday Wellness Podcast
Everyday Wellness is not just another health podcast. Your host, Cynthia Thurlow (nurse practitioner and nutrition/IF expert) has over 20 years of experience in clinical medicine and wellness. Her mission is to bring you the best, science-backed yet practical information to improve your physical and mental wellness every day. She is a busy mompreneur and knows how important your time is. She has designed this podcast to be short in time and big on impact. She interviews a variety of guests in the field of health and wellness, and discusses important issues, and provide practical strategies that you can use in your real life.
Presenter: This is Everyday Wellness, a podcast dedicated to helping you achieve your health and wellness goals, and provide practical strategies that you can use in your real life. Now, here’s your host, Nurse Practitioner Cynthia Thurlow.
Cynthia: Today, I’m really excited to have Nina Teicholz. She is a science journalist and author of The New York Times bestseller, The Big Fat Surprise, which up ended the conventional wisdom on dietary fat, especially saturated fat, and spurred a new conversation about whether these fats in fact cause heart disease. She was named a best Book of the Year by The Economist, The Wall Street Journal, and Mother Jones among many others, and it continues to be a must read for anyone seeking to understand the amazing story of how we came to believe fat is bad for health, and what a better diet might look like.
Nina is also the founder of the nutrition coalition, a nonprofit working to ensure that government nutrition policy is transparent and evidence based. Thank you. Work for which has been asked to testify before the US Department of Agriculture, and the Canadian Senate. She’s also a graduate of Stanford and Oxford universities, and previously served as an Associate Director of the Center for Globalization and Sustainable Development at Columbia. She lives in New York with her husband and her two sons. Welcome, it’s so nice to be connected to you.
Nina: Thank you. It’s so nice to be here. Thank you.
Cynthia: What has 2020 been like for you and your family? I’m not sure how old your boys are, but I know with my teenage children, I actually have two boys as well, it has been a heck of a ride.
Nina: Yeah, I think all of us, whatever our struggles, we all put it in the context of, we have not had COVID. We’ve been healthy. We have a home, we have jobs. My husband and I have our jobs. We are relatively lucky, but my children are 14 and 17, and I would say every week is an up and down mental health challenge to keep everybody happy. At a time, especially to have two boys, there’s hardly any sports, it’s hard to get outside to keep them active, but we’re relatively pretty lucky.
Cynthia: I’m grateful to hear that. I know having teenage boys myself, it has been really interesting. There’s been far more electronics than we would normally allow them to do, and we’ve had to get very creative with physical activity. I have a swimmer and a football player. I’m in the Washington DC suburbs. With social distancing, we’ve had one who’s been able to get back in the pool, thankfully, an abbreviated schedule, but the football player, they just do conditioning, which I encourage them to be outside and to do conditioning. But there’s likely no chance they’re going to be back to physical school at this point. It’s just been a year of challenges for everyone. Much to your point, we have our health, we have a roof over our head, we have much to be grateful for, but excited and delighted to have you here with me.
I think it begs the question, how did you initially get so interested, and determining how the whole paradigm shifted in the 1950s with regard to the quality of fats that we were being recommended to us as a nation? How did that initially start? Is it an opportunity that you had that spurned a desire to learn more, I’m curious where that actually started from or stem from?
Nina: Great. I was a journalist. I was assigned a magazine story for Gourmet magazine, where I was doing a series of investigative pieces for them. They said, “You need to look into this story about trans fats.” I had no idea what trans fats were. This is in the early 2000s. I took on this challenge, and I started to research people about trans fats. I thought it was really interesting, and what was most extraordinary to me was that I started talking to scientists, these early researchers, people who in the 70s had started talking about the potential dangers of trans fats, and they told me about their experience of having people trying to suppress their research. I think that’s the most straightforward way to put it, which is that, people would come to meetings, and they would be assigned to try to yell this person down off the stage, or intimidate them with their questions so much, that this person would just not want to ever talk at a conference again.
Or, this woman, Mary Anning, who says that, a margarine manufacturer– margarine, of course, is full of trans fats or used to be. This margarine executive came to her office and tried to get her to stop doing her research. Or, the person who called the medical journal editor in chief to say, “We want you to yank this article from your journal.” There’s all these crazy things going on in science that seemed impossible to me to be true. During my research, I also then started to look at some of the work by other people who had looked at just fats in general. I realized there was just this story of persistent suppression of science, the science on cholesterol, the science on fat that went back decades, and It just fascinated me that this could be true. I thought it couldn’t be true.
Nina: But I was actually given a book proposal to do a book on trans fats. I thought I’ll tell the story of trans fats, but then I got so involved in this larger story about all fats. I wrote a book. Actually, that book, originally, this one at this point, it took me so long. I had a whole chapter on margarine, I had a chapter on fish oils, and then, eventually, my editor said to me, “Nina, your book really is on saturated fats. We need to focus on saturated fats.” My book evolved over time. I didn’t set out to write it, and I also didn’t believe it when I started it. I thought this must be wrong. I’m going to set out to disprove this. It turned out I just couldn’t disprove it. It kept reinforcing that the theme, these ideas that, “Oh, we’d gotten it wrong in cholesterol. We’ve gotten wrong on LDL and HDL cholesterol, and it turned out that saturated fats had not been proven to cause heart disease or mortality.” It was just this long journey of discovery. It was a discovery not only of the science, but also the really of the politics of science. Because I think as anyone understands today, there’s the science, but then there’s the way the science is interpreted, or reported in the media, or what gets chosen for review papers, and what gets ignored, and that is truly the politics of science.
Cynthia: It’s all really fascinating, because I think most of us would assume that there isn’t a trans-fat mafia or a margarine mafia, but it really sounds like there was quite a bit– and I found it really fascinating when I was doing my research for this interview. There were people who would present at conferences or at a summit, and there would be literally hecklers that were trying to derail the focus when conversations were started midway through a presentation, so that it would deflect attention to the evidence they were sharing that was completely contrary to what had become the common narrative that fats are bad, let’s eat more seed oils, let’s eat all these processed trans fats, and it couldn’t be farther from the truth. For the benefit for many people who probably have never heard of a gentleman by the name of Ancel Keys, who is actually a well-known individual in my household, because I talk so much about this in preparation for this talk.
I would love for you to talk about where this stems from. This one individual had such an enormous, and profound, and tragic, frankly, impact on our nation, and the food industry, and our health, and let’s unpack what initially started, as I’m sure in his mind, was a good idea, but cherry picking, study data, and misinterpreting information, and strong arming, major organizations to perpetuate these incorrect and what I consider to be profoundly detrimental ideas.
Nina: Well, Ancel Keys, I think it’s important to understand this larger picture, which is that every idea is born in a moment in time. We just think it is the eternal truth that saturated fat must be bad for health, and therefore, we can’t eat meat, we can eat full fat dairy, and we should always feel guilty if we do so. But that idea does have and it can be pinpointed to a moment in time, and it was born, from Ancel Keys. He was a scientist at the University of Minnesota. He had done some really interesting studies on starvation, starvation experiments during the war, he had a keen interested in physiology. But he was doing research in the 1950s, and that was a time when people were really obsessed about the dramatic rise of heart disease, which had gone from being very rare in the early 1900s to being very quickly rising to be the number one killer in the nation.
In 1955, President Eisenhower has a heart attack. He is out of the Oval Office for 10 days, imagine that. Just as we were obsessed when President Trump was in the hospital for COVID, everybody’s attention is on Eisenhower, who was in the hospital for 10 days, who is trying to recover from this heart attack. All of a sudden, it became extremely urgent to figure out what causes heart disease, or it had been urgent, but now, just an added urgency. There were really a number of theories that were proposed, or that were circulating in medical circles and scientific circles. One of them was that there was too much auto exhaust from the rising number of cars on the road, and that caused heart disease. Other people thought it was a vitamin deficiencies. Other people thought it was a type a personality. You know the person who yells at everybody all the time, then suddenly just drops down dead?
Then, there was Ancel Keys, who proposed this idea that it was saturated fat and cholesterol that would the dietary cholesterol in food that you eat them, it would raise your serum cholesterol, that’s the cholesterol you get from your doctor, that number in your blood, and that would clog your arteries, and lead to a heart attack. That was called the diet-heart hypothesis. That was his idea. He was very strong, and he was an overwhelming, overpowering individual, as described by his colleagues that he was able to argue anybody to the death, and he was this very strong person who had an unshakable faith in his own beliefs. He was able to get his idea adopted by the American Heart Association, which was the premier group, really the only group that was addressing heart disease in the country. They felt that they urgently needed to provide the public with some solution.
In 1960, they said to the public, “We don’t have enough evidence. We would love to tell you what causes heart disease, but we really don’t know.” 1961, Ancel Keys gets on that committee, and there’s no new evidence that makes his case any stronger, but he is able to convince the committee members, they should adopt his idea. So, in 1961, the American Heart Association publishes a paper saying, “You need to avoid saturated fat and cholesterol as your best measure of prevention against heart disease.” That is really the first official recommendation anywhere in the world telling people that advice. It is truly the little tiny net that grew into a huge thicket of advice that we now have that has echoed that basic advice. Saturated fat and cholesterol found mostly in animal foods, as we know, meat, butter dairy cheese, that is what causes heart disease. Instead of eating those foods, you should have, instead of regular meat, lean meats that are regular dairy, lean dairy, and instead of butter, margarine, which is industrialized vegetable oils that have been hardened.
Ancel Keys, at the time, there was really almost no published evidence to support his theory. There were a few tiny feeding studies, really small feeding studies that showed the effect of saturated fat on your cholesterol levels. But it wasn’t until 1970 that he published his paper, his big seminal paper on seven countries study that he had undertaken in the 15 years earlier, and that was a study where they he looked at 13,000 men in seven different countries across the world. It was mainly in Europe, but also in the US and Japan. He had gone into that study, basically, he had his hypothesis set. Actually, first he thought it was fat, total fat that caused heart disease. Then, he switched to saturated fat. But he went into this study thinking fat have some kind cause heart disease. It’s fair to say, well, there’s so many problems the seven countries study, even though it was in its day, a very uniquely ambitious study. Nobody had ever done anything like it to go and sample nearly 13,000 men what they ate, what their cholesterol level was, and to follow them over time.
One of the things I spent, maybe, nine months just analyzing the seven countries study, because it is the Big Bang of nutrition science of the last 100 years. It’s been cited thousands, and thousands, and thousands of times. All nutrition science telescopes back to this original study the seven countries study. Without going into it too much, but one of the basic flaws of that study was, he clearly cherry picked his countries when he went into it. He knew from little pilot studies he had done in Europe, when he traveled around Europe earlier, he knew that in certain countries, they had low rates of heart disease after World War II, and they ate very few animal foods. Countries like Italy, Yugoslavia, and Greece, all of which made it into his study. Why were they eating small amounts of animal foods largely? Because their economies had been decimated due to the war. In surveys that were done at the time, the people said,”What we want is we want to eat more meat.” [laughs]
Nina: But they weren’t able to have access to their regular food supplies. He went in a very unusual moment in time when they were not eating their regular foods. But those countries, he put into his study. What did he leave out? He left out Switzerland, Germany, France, countries that ate a lot of saturated fats. Just think German sausages, French omelets. And also, had very low rates of heart disease post World War II. But Ancel Keys did not include those in his study, and when asked why, when I asked his– not himself, but the researcher who worked most closely with him and who inherited his lab, when I asked him why, he said, “Well, he went to countries just where we had an affinity and some friendship.” Well, that’s nice, and again, this was nobody had done a study like this, and maybe they weren’t so aware of the need for randomization in order to choose your study countries in a randomized way. But that was clearly not a random selection.
When he got results that appeared to confirm his hypothesis– they didn’t all confirm his hypothesis, but he’d gone into it already having skewed the game in his favor. For a long time, there was just no contrary evidence, that was it. When Ancel Keys came out in the cover of Time magazine for having solved the riddle of heart disease in 1961, there was a doctor who said, “I disagree, but what do I say Ancel Keys is his 13,000 cases, and I don’t have anything to counter that with.” Because Ancel Keys have this huge amount of data, because he was so early on the scene, he was really one of the first influential researcher. It was his idea that stuck and that we’ve been living with ever since.
Cynthia: It’s absolutely fascinating, because I wonder with the degree of scrutiny that things go through in our current times, if he could have even been capable of being able to push through such data that really speaks to the fact that manipulating data for the sole purpose of supporting a hypothesis that largely is not consistent with a lot of other information that we now have, I wonder if it had been born in a different time, if that would have ever happened. What I found really interesting as I was preparing for today was, around the time that Ancel Keys and this diet-heart hypothesis came out, this is also when we started to see the food giants, and the processed food industry getting actively involved in some of these private organizations, American Heart Association, that probably prior to that time were much more objective. But you start seeing these supported policies that benefit economically these food giants.
In so many levels, and certainly the physicians or healthcare providers that I’ve had the honor of working with over the past 20 plus years, I know that they very likely would not have been quite so influenced by these private organizations, but I thought that was really interesting. Certainly, to the point of your book, it sounds that was a real tipping point in many ways. It talked about how the American Heart Association seal on products in the grocery store a lot of people assume, it then represents that it’s something that is also then heart healthy. But in many instances, it couldn’t be farther from the truth.
Nina: Yeah, well, this through line of the influence of food, not only food companies, but pharmaceutical companies in some of our most trusted public health institutions, that has been going on since– Well, in my book, I talk about how the very first organization of food companies, Standard Biscuit, and I don’t know if Kellogg’s was around them. But some of the early companies, they started this foundation in 1941. They really figured out that even become incredibly sophisticated. They influence science at every step along the way, the best way to do it is to work with the scientists themselves. You actually are influencing the science at its very root and heart, when you’re forming the opinions of the scientist or influencing their opinions.
They also give a tremendous amount of money to the public health institutions that issue this advice to population wide advice. For instance, there’s a great story that I discovered while doing research for my book about how Crisco, which is the maker of vegetable oils and also– Sorry, Procter & Gamble, the company that made Crisco, what was then replacement lard, but everybody else just knows as Crisco, the vegetable fat. Then, they make Crisco oil. They became a big sponsor of the American Heart Association in 1948, basically, transformed the American Heart Association into a tiny little backwater group, because remember, heart disease was still new. It wasn’t that there were so many cardiologists in that time. They gave millions of dollars to the American Heart Association and transformed into overnight really into a powerhouse. This is according to the company’s own history. Then, some years later, there’s the American Heart Association saying, you should consume vegetable oils instead of natural fats in order to fight heart disease. There was some dispute amongst some of the–
I have a letter referring to dispute between some of the members who have the American Heart Association talking about, “Why is the head of American Heart Association posing with a bottle of Crisco oil that [laughs]–” That doesn’t seem right, but the American Heart Association, American Diabetes Association, they continue to accept. The money that they declare, which is probably much less than what they actually get is about a quarter of all their funds from the food and pharmaceutical businesses. Their interest is not for you to have minimally processed whole foods. They don’t make any money off of that. That’s what I think most people don’t understand that these trusted institutions have huge conflicts of interest. The American Heart Association, they also have a conflict of interest, call it intellectual conflict of interest, and that they have given this advice back in 1961, how can they reverse it? But seems it would greatly affect their trustworthiness and people don’t want their trusted institutions or flip flopping on advice. That’s one reason that I think it’s very hard for them to have to carefully back out of that position, which they have in some ways, for instance, they no longer recommend a low-fat diet, they say, you can have more fat in your diet now, but it can’t be saturated fat. They’re still vehemently against saturated fat.
There’s all kinds of ways in which we see the food interest like they get quite a bit of money from the soybean makers, and what’s the greatest source of vegetable oil of the United States is soybean oil. They’ve published papers why you have to have vegetable oils, but you can’t have saturated fats, and you especially can’t have coconut oil, because coconut oil is especially bad for you. Well, coconut oil competes with soybean oil. It’s just there’s just a lot of food industry interest behind this. Then, you would ask, “Well, what about why pharmaceuticals? Why they take money from pharmaceutical companies?” But again, these are companies that don’t really– They would rather you be taking medications and purchasing their drugs and devices, than they would like for you to get off all your medication and not need any healthcare at all by eating a more healthy diet. I think that sounds really cynical, but I think that is certainly true. There’s some just really blatant examples of that behavior.
Cynthia: Well, and I think, as a clinician, and certainly working in cardiology, by the time a patient came to me, either in clinic or in the hospital, they had documented disease. You don’t do a lot of prevention in cardiology per se, but you’re absolutely correct that a lot of the strategies that many of us are talking about now with our patients, they don’t utilize the pharmaceutical industry. They don’t utilize a lot of these processed foods. But they’re actually getting better results, because you’re getting people off of these highly addictive, highly inflammatory processed foods, and perhaps also, encouraging them to eat less often. I always think about Kellogg’s back in the 1920s that was encouraging people to go from eating bacon and eggs to eating cornflakes. What does cornflakes do? It’s just carbohydrates. Refined carbohydrates, which spike your blood sugar, spike your insulin, and then, you’re hungry an hour or two later. Certainly, not conducive with being able to get through your day.
I think it’s such a good point that, both of these industries would ideally like us to be dependent on them as opposed to independent, because the independency impacts them financially, and that’s really going down that rabbit hole of following the money. A few years ago, I went to a nutrition conference, and if you can imagine this, it’s a nutrition conference that was also co-sponsored by the ADA, American Diabetes Association, and honest to God, one of the sponsors for the ADA was Coca-Cola. There were things that were given out to us, and I kept thinking like, “This is the last thing I want to be looking at it in nutrition conference,” but you’re starting to recognize that there are these relationships that really are at odds with living a healthy lifestyle or being able to live a healthy lifestyle based on what we know now of how these foods impact our health in very negative ways.
Nina: The American Dietitian Association conferences full of little kiosks like McDonald’s and Dunkin Donuts. They have all these fast food and junk food at their conferences. I know to the extent that there’s now some break-off with the American Dietician Association of dietitians who really do not want to be associated with those foods. American Diabetes Association, the majority on their board are makers of insulin. They have a tremendous conflict of interest, and that they didn’t actually have an incentive to get their community, their patients off of insulin. [giggles] They have in their position paper– I would say they allow low carb and keto diets in their position paper alongside a plant-based diet, or Mediterranean diet, or other diets as well. But if you go to their website, I think I went the other day, and I could find one low carb recipe on their website, and they still tweet out things like, “Have pancakes for breakfast, and maple syrup with berries, and then you can cover it with insulin.”
Cynthia: Yeah. [laughs]
Nina: It’s a bad state of affairs in the sense that these public health agencies truly have been captured to some extent by the food and pharmaceutical industries. But I want to say that I don’t think it’s just corporate industry and financial conflicts of interest. I think that we’ve been living for 60, 70 years now with the hypothesis that everyone has truly believed with this idea that fat is bad, saturated fat is bad, egg white omelets are the way to go to avoid cholesterol. I think many people truly still believe this advice. The basic advice being that people will get healthier if they eat more fruits, and vegetables, and whole grains. That’s pretty much the advice if you go to many foundations, Pew Charitable Trust, The Rockefeller Foundation, they believe this advice. This is what has been our surround sound nutritional medical dogma for decades.
I think most doctors believe, this most people will have learned this. It’s changing, but there’s just a lot of genuine, honest, cognitive dissonance that people have when you tell them actually, “There are no studies showing fruits and vegetables will make you healthier.” May be vegetables are not bad for health, we could argue about fruit, because they are very high in sugar, it depends on the fruit. But the advice to become healthy is very different than what you’ve been taught or have thought for many years, and people are so close to the food that they eat, it’s not an easy idea to change. It is a religion almost. It’s something you’ve lived with. You’ve made choices several times a day about the food you eat, you have cooked for your children lovingly, hoping to make them healthy, and it is incredibly hard to think that might be wrong, or that you’ve made a mistake, or that you’ve harmed your family, or– It’s very hard to change people’s ideas about diet.
Cynthia: I think that’s such a good point, because I think sometimes for those of us that are more aware of what a nutrient-dense diet really incorporates that it’s very hard to make those changes. I oftentimes like to remind people just from the perspective of they’re really struggling with the idea that they need more protein and more healthy fats, I just remind them that, in many ways, if you’re eating a lot of whole grains, and a lot of fruit, and a lot of starchy vegetables, you very likely are not particularly satiated. It’s going to stimulate your appetite. I’ve talked about the hormonal response in the body, you get this appetite dysregulation. You just feel, you’re never full, whether that’s an emotional or physiologic feeling. But so many people when you really look at as we shift the diet paradigm, and we’re really talking about focusing on, as one example, animal protein and healthy fats, and people suddenly or satiated for the first time, and they don’t feel like they keep going back to eat every couple of hours and they’re able to lose weight, they’re able to sleep better, they’re managing their stress better.
I agree with you that on many, many levels, when people have to reverse dogma or question dogma that they grew up in, whether it’s breakfast is the most important meal of the day, whether it’s I need to eat three meals a day and mini meals, we just recognize from a hormonal perspective what actually happens in the body. That advice, along with the bastardization of fats has really contributed to the health problems that we’re seeing with increased frequency. I have two teenagers, and I was talking to them about growing up in the 70s and the 80s, and it was very unusual to see obese children. Really unusual. It was unusual to see adults that were particularly obese. Now, that is becoming the norm, largely from the choices that we’re making in terms of diet. I think that’s a profound statement.
You look at photos, my grandmother, who’s now deceased, was born in the 1920s, and she was a nurse. She talked very openly about this nutritional shift that happened. One of the things she talked about was, what she found so troubling was that, as people started eating more processed foods, she was noticing that there was this– and whether or not she was aware of all of the factors that contributed to that, she just kept saying, “My patients are getting sicker.” She practiced as a nurse until she was in her 60s, but she said, “Even then, even as I was watching these things evolve and shift and change, there were a lot of things we didn’t do.” Now, mind you, my grandmother’s smoked. There’s definitely things that people didn’t know as much about that they continue throughout their lifetime, but that paradigm shift for many people is really challenging to do.
Cynthia: Yes, I’m just thinking about this interview with a West Virginia doctor. He actually did a study of his patients. This was maybe 25 years ago, where he followed 75% of his overweight patients to whom he’d been giving advice, “Cut back on fat, eat more fruits, vegetables, whole grains, and get more exercise,” he looked at the data that they looked at all their patients, and not one of them had lost any weight. I think these were children. In fact, they had gained weight, and they had gained weight even at a faster rate than when they first came in. He somehow 25 years ago, when there was really very little discussion or data on this just came to the conclusion that– Oh, I know, a patient of his came in with the Atkins Diet book and said, “Look, all of a sudden, I’m not hungry anymore, and wow, I’ve just lost 10 pounds.” He was open enough to think like, “Well, then maybe there’s another way.” I know many, many cases now where if somebody came in with that information, or had lost weight, and actually I know somebody who just went to the doctor, and she’s lost over 200 pounds, and the doctor said, “Well, be careful. That diet’s going to kill you.”
This again, just goes back to the politics of, and I think I wanted to say, you know what? I trace in my book is the development in this idea that where it becomes institutionalized, why it’s so politicized, why is it that we have so politicized nutrition? It’s food companies, it’s cognitive dissonance, but there are other reasons as well. It’s fascinating to see why and how this has evolved over time. Why should doctors be telling you this diet will kill you, when clearly almost every single major risk factor improves on the diet and people effortlessly lose large amounts of weight, and seem to be able to keep it off to a great degree? It is mostly in the realm of politics trying to understand why the world has become so unnavigable for good science.
I think that’s what I’m having struggling against with this group that I found it in to try to have some influence over the dietary guidelines, but also, just as a journalist, and I think just average people when they walk around, and they try to talk about what they’re eating, they find that people react in ways that are just so extreme, and those extreme views have been cultivated by, I think, a press and PR environment that has created these very negative stereotypes of eating diets that are lower in carbohydrates, and maybe not as high in fruits and whole grains as other people think they should be eating.
Cynthia: I think it’s also really interesting on so many levels that, as you mentioned, this polarizing mindset that there always has to be a conflict. It can’t be easily accepted. I think that one of the big things that– I’ve been following Robb Wolf’s book and his work talking about consumption of meat and how polarizing that can be, I can imagine it’s that much worse on social media for you. But I posted a picture yesterday on Twitter about meat. It was a picture from we actually attended one Thanksgiving and turkey. There were some individuals who were very offended by this photo of meat, and so instead of just ignoring the post or not interacting with it, have my DMs closed, but there were multiple people that were leaving, just argumentative, derogatory, nonproductive, nonobjective comments, and all I can think of is, that’s really the environment in which all of us are working in right now.
Instead of people looking at things more objectively and saying, “Hey, maybe there’s some opportunity for me to learn,” it’s automatically, it’s this knee jerk reaction that you have to be wrong, and I’m only right, and there’s no consensus, there’s no gray, everything is black and white. The one thing I’ve come to realize over 20 some odd years of being in healthcare is that, when you learn better, you do better. Being open minded, being curious, the whole piece of critical thinking that I feel in many ways has been suppressed. I’m sure that’s a whole tangential rabbit hole conversation, but there’s this lack of objectivity, or there’s this denial, you mentioned cognitive dissonance, that people aren’t just not willing to entertain the possibility that there might be a better answer, or that they should question dogma.
Nina: Yeah, well, I think it reflects the moment in US evolution of the nonintellectual life and US history that we are living in, we have an environment where the exchange of different ideas, opposing viewpoints is often not welcome. I know that in the case of low carbohydrate diets and meat, that they’re very organized campaigns designed to make it uncomfortable for people to talk about this subject. They’re even censorship campaigns going on, and people have experience on various social media platforms where their interviews and some of their most popular podcasts or shows on meat have been deleted, and people are punished in various ways for talking about this.
It’s something that goes back in time. It goes back to that conversation we had about the hecklers who’d been hired to try to get people off the stage when they were talking about trans fats at a time when no one was talking about trans fats, especially the vegetable oil manufacturers were organizing that whole heckling effort. I know that today, there’s similar kind of so many interests lined up against meat that has to do with environmental interest, and business interest, and religious ideological interests, and animal rights interests. They want to create a hostile environment in which we find it very uncomfortable to talk about that subject.
There was a series of really extraordinary papers that came out last year on a very rigorous analysis of all the studies on meat that really came to the conclusion that the evidence against meat for heart disease, cancer, diabetes, the evidence against it was extremely weak to the point where the authors conclude, “You should really eat what you want, because evidence is not strong enough to steer you one way or another.” There was a group of scientists or researchers who tried to yank publication of that paper before it even came out, and then proceeded, what I think is a campaign to really destroy the reputation of the lead author on that paper. It was very well orchestrated and funded, and it was devastating all about a conflict of interest that he didn’t have from another paper that wasn’t related to this paper.
That activity has two purposes. It is designed to get that researcher out of the field. You can be sure or that researcher may decide that, “This is not very fun thing to do. Now, I might want to do something else.” I can tell you in researching for my book that I met numerous researchers who had left the field of nutrition, or were sitting in tiny corner offices and said, “I can’t get any money to do any science, because I’ve spoken out against the nutrition dogma.” But that activity has a second purpose, which is to warn other people. “Don’t stick your neck out, because you will get this too.” I’m asked this all the time like, “How do you take all the abuse [laughs] that you get?” Because I do get a lot of criticism. I’ve had various ways in which I’ve been attacked. Part of the reason that I don’t back down is that, I think that sends a message to other people, this is not a rewarding activity for you.
I think there are people in the field who take that to heart. My income does not depend on grants from the NIH, or I don’t need to get invited to nutrition conferences. I can say things more openly than perhaps nutrition, people who feel nutrition can. I think that’s also why you see the people who are really bringing this information to light, or journalists, or academics from outside of the field of nutrition, they’ve come from other fields that are tangential. It is because there is a focused, organized bullying effort that goes on. That takes many different forms, petitions to retract papers, all of that is a way of trying to make people very uncomfortable with their alternative viewpoint. You see that on Twitter. Those people were coming after you. They’re trying to make you feel badly, so, that next time you’ll think twice before you post a picture of meat and say, “I feel happy about eating this.”
Cynthia: Exactly. It’s interesting to me. I think it took me probably becoming a middle-aged woman to feel more comfortable saying– part of the patriarchy was that I was raised a certain way, I was raised to be very deferential, I was supposed to say yes, I was supported to put a smile on my face, whereas, now, I’m in a position where I speak very openly and have no problems having uncomfortable conversations, or challenging people. Quite honestly, I also think there’s beauty in just blocking people. Sometimes, there’s no point in having a discussion with someone that is– the degree of vitriol and nastiness doesn’t justify anything other than blocking them, so that they can no longer pepper my timeline with comments that are completely and woefully inaccurate and inappropriate.
Again, like I mentioned, I’m sure that you are far more savvy with this than even I am. I want to pivot just a little bit and get back to the fat piece, only because I think it’s important for people that are listening to really understand what’s happened over the last 60 years. With the changes in the vilification of fats and this focus on more carbohydrate, grain-focused, starch-focused diet, one of the things I found really interesting was that one of the things I read was, our protein and fat consumption decreased by 25%, but interestingly enough, we increased the grains and starches of over 30%, and what that’s actually led to in terms of obesity, diabesity, cardiovascular disease, and so. It really speaks to the fact that, the assumption is made that if we are consuming less protein and fat, these things should be getting better. They’re actually not. They’re getting worse. People aren’t satiated, there’s more hormonal dysregulation in the body, so it’s much, much easier to gain weight, and put yourself at risk for a lot of these metabolic diseases. Metabolic flexibility is a term that’s used quite a bit now, but we have a largely metabolically inflexible population. That’s a huge concern, seeing that shift in individual’s health and welfare with these dietary recommendations and changes.
Nina: Yeah, the harder question here is, we have this national nutrition policy called the US Dietary Guidelines that started in 1980 in which they pretty much adopted the whole position of the American Heart Association. Low and saturated fat, lean meat, low fat, dairy, emphasize fruits, vegetables, and grains, at that point was just grains, not particularly whole grains, and did that make us fat? Is that policy responsible for disease? That is a big that people have. What has the evidence said? It has. Let me start with, most people believe the dietary guidelines did not impact America, because nobody follows them. That’s the argument that is used to exonerate them, to which I would say, “Well, actually, if you look at the best available government data that’s taken on food availability,” and then, there’s the account for loss, and so they see that’s food consumption. This is data that does come from self-reported dietary questionnaires, which are very unreliable. This more reliable data shows that since 1970, which has been they measure it from that Americans have changed their diets dramatically. We eat 25%, 35% more fruits and vegetables, we eat about 30% more grains, we eat 90% more vegetable oils. This is 2014 this data runs to.
In every category that you look at, we have increased the things that we were told to increase. We even increased leafy greens. If you look at the vegetable, that’s not starchy vegetables, it’s leafy greens we’ve increased. We have simultaneously decreased everything that we’re supposed to decrease. We eat 28% less red meat, and 35% less beef, we eat 90% less butter, about the same amount or less fewer eggs, and fewer animal fats altogether. We’ve done an amazing job of following the guidelines. If you look at food availability data. We’ve also increased our carbohydrates by around 30%, and decreased our fat as a percent of calories by about 25%. Saturated fats, as I said, well, animal fats altogether have gone down around 18% or 19%. These are huge shifts. It follows the guidelines 100%. People who say that we don’t follow the guidelines are instead looking at this index of the USDA, US Department of Agriculture, which issues the guidelines, they came out with an index, and they say, “This is what we’re aiming for, and this is where Americans come in. We’re aiming for this much vegetables. Americans only come in here.”
Well, part of this data is deceiving, because they lifted their targets for vegetables in 2005, I believe. it went from two cups a day to two and a half cups a day. Probably, Americans, they’re moving up, but [laughs] they can’t keep up with the targets. But mainly, it’s just that when they first set these targets of how much fruits, vegetables, whole grains, dairy you should be eating, they were so dramatically different than what Americans were eating at the time. The Americans, if we can trust these statistics were eating 39% of their calories, because carbohydrates in 1965. Then, guidelines came along and said, you need to eat between 51% and 54% of your calories as carbohydrates. Americans had to ramp up their carbs to meet the guidelines, and we had to ramp up our fruits and vegetables, which we were eating less. Yeah, we haven’t made it to the guidelines, but we’re moving in the right direction. We’ve been moving in the right direction. It’s just the original targets were so incredibly ambitious, Americans really did not eat that way. They ate a lot more meat. Then, we’re told, “Oh, you’re not meeting the guidelines. You’re not meeting the guidelines.”
Well, it’s because the guidelines were this draconian program that was given to America. Just adding to my argument is the data that comes from large NIH-funded clinical trials that were on the guidelines where they literally gave people the pyramid or the Dietary Guidelines themselves, and they said, “Please follow this diet,” and they’ve done several of these trials. One of them had 49,000 women in it called the Women’s Health Initiative. Those women stayed on that diet for seven to eight years, and they could find no health benefits. They found that people can comply with that diet, eat less meat, eat less saturated fat, no butter, but they could not find any health benefits. They followed these people to actually be able to measure, cardiovascular mortality. The Women’s Health Initiative was powered to measure cancer outcomes. No prevention of cancer can be seen in prevention of diabetes, no prevention of obesity. Even in experiments where they put people on the diet and have a control group to compare it to, which is the highest quality science you can get, they could not find that the dietary guidelines could prevent any of the chronic diseases that they were meant to prevent.
Now, what is evidence that they may have made us fat? Well, I think that what, we don’t have hardcore evidence that– We couldn’t do in the sense that all of Americas have become fat. We have followed the guidelines. When the guidelines were launched in 1980, 4% of men had obesity, and 7% of women had obesity, adults. Now, 42.4% of American adults have obesity. Well, we have followed the guidelines. Again, we’ve increased our carbohydrates by 25% to 30%. That’s a big experiment we’ve just had there. But I think that the more rigorous evidence comes from the dozens now of randomized controlled clinical trials that show that when people reduce their carbohydrates, when they reverse out of the dietary guideline recommendations, their health improves. They eat more protein and natural fats. As you say, have been saying, they are more satiated. They don’t feel a need to eat as much. They don’t have the hormonal impact of eating so many carbs, or the blood sugar up and down, up and down, up and down that comes with eating sugar, or things that turn to sugar in your blood, which include fruit and whole grains. All that turns to sugar in your blood, and then that creates sugar highs, which then become sugar lows when you want to eat again.
Those experiments show that the vast majority of people are able to within weeks reverse their diabetes, reduce their blood pressure, reduce most major cardiovascular risk factors, including inflammatory markers. I think that evidence shows that reversing out of the high carbohydrate dietary guidelines, it makes people healthier and therefore, you can somewhat make a logical lead that probably increasing those carbohydrates was at least one of the things that led to the obesity and diabetes epidemics.
Cynthia: It’s interesting. I interviewed Dr. Cate Shanahan a few weeks ago on the podcast, and one of the things that she feels strongly has really influenced a lot of the obesity and metabolic diseases is just the use of seed oil. The soybean oil, the canola oil, cottonseed oil, which really proliferate throughout the processed food industry. I’m curious, have your eating habits or frequency of going out for dinner– I know COVID aside, probably not doing a whole lot of that, but has this influenced the way that you choose to eat based on the research that you did for this book, or were you already eating a nonstandard American diet to begin with before you started doing all of your research?
Nina: Well, I was a vegetarian. I guess you’d say I was sort of a pescatarian, or but I didn’t eat red meat, I tried to avoid cheese, I wouldn’t touch butter. I really mostly ate fruits, vegetables, and grains, and I made my own bread. I ate pasta salad for lunch every day. I had a very different diet than I do now. I also wrote a lot about vegetable oils in my book. There’s a particularly scary and fascinating chapter, and at the end of chapter nine, I write about the effects of heating those oils. What happens when things are fried in them in restaurant fryers causing massive oxidation products. That really affected my desire to go out in restaurants, because almost all restaurants use soybean oil. Ironically, now that we’ve taken trans fats out of food supply, those oils are even more dangerous. I won’t get into the whole explanation, but I can go into it in my book, and I don’t eat fried foods in restaurants anymore, because I know those oxidation products will enter into my body, and then pass through the blood brain barrier. I don’t think that’s a healthy thing. Those are highly industrialized products that go through many, many steps to be made, and I would avoid them like the plague. I think that there’s a little bit of evidence or at least there are mechanistic models and some suggestion that they might fuel obesity. May not be the major cause of it, but certainly interact with the cell’s mitochondria.
Anyway, I obviously, I am no longer mainly fruits, vegetables, and whole grains person, and I’ve changed my diet. I remember I would eat meat out, but it took me a while to cook meat on my own, and I’m not very good cook. [laughs] I was a great vegetarian cook. I used to be a great baker. I made all my friends’ wedding cakes, and I loved baking, and now, I have to say I missed that. I really feel, it’s strange when you start to eat protein and fat, and you’re just so happy eating something simple, and then you’re full, and so all of my energy that I spent around food, I used to calorie count and all that, and think about it. I don’t have as much energy around food anymore. I just want to eat something that tastes good, and fills me up, and then I want to get on with my day.
Cynthia: I love that explanation, because as we evolve, shift, and change, sometimes, it also involves our relationship with the food. I, too, was what I would describe as, I just ate poultry and fish for years, and years, and years, and when I got a dog, it completely shifted my perspective about eating mammals. Last year, I got very sick, spent 13 days in the hospital, and on week two, the only thing I thought about was a burger. I wanted beef, and since I left the hospital last March, I have now incorporated some exotic meat into my diet, and I really credit that for being able to heal from being in the hospital, but I think it’s interesting how our relationships with food will change. I too struggle when I go to restaurants, because I either need to remind myself that maybe this is the one time that I’m going to eat a salad dressing, or I’m just not going to have salad dressing, because I know there’s a seed oil in it.
There was a statistic that I saw that suggested that when we ingest seed oils that can actually take up to two years to clear it out of our mitochondria. It causes some cellular inflammation and damage. When I learned that I was like, “It’s one of those things, I sometimes wish I didn’t learn some of the things that I learned,” because then, I’m really the wet blanket when I go out to eat. I was curious how you handle that, and certainly with COVID, you’re probably not doing as much of that as you did before.
Now, I want to be super respectful of your time. I would love for listeners to be able to connect with you, obviously, read your book, we’ll include all your links. But really having the opportunity to impact public policy and the transparency that you’re trying to bring to the government organizations is just so laudable. I’m so grateful for your contributions and the work that you’re doing. But for those that want to connect with you, what’s the easiest way to do so?
Nina: Well, there’s my website, ninateicholz.com, and you can send me a message there. I do respond sometimes on Twitter, which is @bigfatsurprise. If you want to see the work we’re doing on the guidelines, it depends when the show comes out, because the guidelines are going to come out in a matter of weeks. But nutritioncoalition.us is our website there, and if you hit the Take Action button, there’s a really great way to connect very quickly with your elected representatives to let them know what you think about the guidelines, and how they should be limited.
So, you can go there, and I encourage you to do that, because even for people who have their own health and they feel, they’re on their own health journey, and that’s getting better, there are a lot of people out there who literally just have no choice about eating government food, kids who get school lunches, school breakfasts, women and infant children program, hospital food, programs for the elderly, those are really captive populations that don’t get a choice about what they’re served, and they are being served– more than half their calories is carbohydrates and industrial seed oils only. It would be really good to have a policy that serves everybody in our country, even those who are not fortunate enough to make their own choices. So, I encourage people to do that.
Yeah, and then I think I’ve been involved in this group. I’m going to probably start writing another book pretty soon. So, I’ll go back to spending more time over at ninateicholz.com. But really, the place I spend the most time on social media is Twitter. If you’re a troll, I’ll ignore you. [laughs]
Cynthia: It’s probably much safer that way. Are you able to share what your new book is going to be about?
Nina: No, not yet.
Cynthia: Okay. Fair enough. I thought I would ask.
Nina: Good. Yeah.
Cynthia: Awesome. Well, thank you so much for your time, today.
Nina: Thank you for having me. It’s really been fun to talk to you. Thank you.
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