Today, I am thrilled to reconnect with my friend and colleague, Dr. Nina Teicholz, an investigative science journalist, author, nutritional thought leader, and a science writer I love to follow.
In our conversation today, Dr. Teicholz highlights the challenges of distinguishing real news from propaganda, and we examine how nutritional dogma shapes the identity of many individuals. We explore the history and consequences of our food guidelines, including the Diet-Heart Hypothesis and the Seven Countries Study, looking at the impact of cancel culture in science, the role of seed oils and processed carbohydrates, and the misconceptions about red and processed meats. She also shares her vision for the future, which includes much-needed shifts in nutritional guidelines to improve metabolic health.
This discussion with Nina Teicholz is eye-opening, so you may want to listen to it more than once.
IN THIS EPISODE YOU WILL LEARN:
Difficulties with finding real information and reliable advice on nutrition and health
Why we need to be open-minded about dietary changes
Biological truths that apply to all humans
How toxins and chronic stress impact our health
Historical context of our dietary guidelines
How the Seven Countries Study impacted the Diet-Heart hypothesis
Long-term influence of the Diet-Heart hypothesis on our dietary guidelines
Nina outlines the unintended consequences of the Diet-Heart hypothesis
Challenges of changing the current diet guidelines
How the notion that red and processed meats cause cancer came about
Bio: Nina Teicholz
Nina Teicholz, a science journalist, is 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 in fact 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 working to ensure that government nutrition policy is transparent and evidence-based-work for which she’s been asked to testify before the U.S. Department of Agriculture and the Canadian Senate. Teicholz 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. Dr. Teicholz lives in New York City with her husband and two sons.
“The problem with trying to find reliable information now is that there are no truly trusted nutrition sources with authority.”
-Dr. Nina Teicholz
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The Big Fat Surprise: Why Butter, Meat, and Cheese Belong in a Healthy Diet
Nutrition Coalition Dietary Guidelines Primer
Transcript:
Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
[00:00:29] Today, I had the honor of reconnecting with friend and colleague, Nina Teicholz. She's an investigative science journalist, author and thought leader in nutrition and just about one of my favorite science writers to follow.
[00:00:42] Today, we spoke about how we can attempt to differentiate from real news versus propaganda, dogmatism in nutrition and how for many it becomes their identity, vitamin and mineral deficiencies in our food environment, the history of the food guidelines which includes the diet-heart hypothesis and Seven Countries Study, the impact of cancel culture in nutritional science, how to advocate for yourself and your family, the consequences of the diet-heart hypothesis specific to seed oil consumption and processed carbohydrates, why red meats and processed meats do not cause colorectal cancer? and lastly, Nina's wish lists of things she hopes will be accomplished in the next few years including eliminating the saturated fat cap for nutritional guidelines, increases in protein, and adjustments in guidelines specific to those with poor metabolic health. It is always an invaluable conversation with Nina and one that I know you will listen to at least once, if not twice.
[00:01:45] What's interesting is in this segues into the first question I was going to ask you is helping people differentiate between real information, real news, versus propaganda because--
Nina Teicholz: [00:01:57] No, I can’t. That's an impossible question to answer right now. [Cynthia laughs] No, I think it is impossible. I could say I can tell you people that I trust in their information, but that doesn't mean anything. And I think the problem with trying to find reliable information now is that there are no truly trusted nutrition sources with authority. We basically have a situation where our elite institutions, Harvard, Stanford, our government institutions, the CDC, the FDA, the USDA are not providing reliable advice on nutrition and health, and so what do you do? I think it's very difficult.
[00:02:39] I'm happy to tell you who I think provides reliable and good information, but that's just my assertion and I don't see how that is necessarily better than somebody else who is asserting other websites. I think it's incredibly hard for the average consumer to try to make sense of the information landscape out there, which is incredibly unfortunate. Hopefully really the long-term solution is to try to reform our trusted institutions so that they are giving better, more science-based, more evidence-based advice. I think that's the longer-term solution, but that will be a battle and will take a while. And hopefully, under this new administration, I think there is a chance that may happen, although, it's anybody's guess at this point.
[00:03:23] But yeah, I guess the one note of hope I would say is that-- and we see this amongst people out there on the Internet, but the one note of hope is that unlike science, say on air pollution, science on nutrition and health is something that everybody can experiment with on their own body. So, they can try a vegan diet and see how that feels, then they can try another diet and see how that feels. And they have their own experience with their own body to, they're doing their own science really to understand what works for them. And so, they can do their own N = 1 experiment, and people are different so they may have different kinds of results.
[00:04:03] But you know, I was on a vegetarian diet for 25 years and was much heavier and got infections much more often and my skin was terrible. And eventually after thinking for decades that I just wasn't trying hard enough or I wasn't good enough or whatever it was basically I wasn't trying hard enough, I tried something else which was a lower carbohydrate diet, ketogenic diet, and that worked for me. So, now I know that works and all my blood markers are fine and so that's my experiment. That's the kind of information that I think people can trust.
Cynthia Thurlow: [00:04:37] And I think it's so important to back up and to identify that there is so much confusion whether it's the influence of social media, whether it's the influence of well-meaning influencers on social media. I think that the conversations around nutrition can be highly polarizing, highly dogmatic, but yet you speak to something that I think we both really embrace, the power of bio individuality and figuring out what works for us. Because I know even as a now middle-aged woman, I've cycled through what I would think is fairly rigid paleo to now being a little bit more experimentally open minded about carbohydrate intake. For me personally, more protein, a little bit more carbohydrate, I tend to do better with those principles for me personally.
[00:05:30] But I find for hundreds if not thousands of people I interact with that for most people when they're eating more protein, they generally feel better. Like that is something that seems to be conventionally, for me as a clinician, seems to be fairly consistent. Beyond that it is so unique as each one of us is unique as an individual. And so, I think from many different perspectives, inviting people to the possibility that they not remain rigidly dogmatic and be open minded, that things may change for them. I look at fasting as one of many strategies that we can use. And I certainly used to do a lot more fasting, now I do a lot less. But having said that, I think that being open minded is a really important prevailing mindset philosophy around this whole entire journey. And I think for sometimes people get stuck like wherever they've identified themselves, whether it's carnivore or vegan or vegetarianism, etc., they get uncomfortable identifying themselves in a different way. And I think that both of you and I are speaking to the fact that if something isn't working, it's okay to change it. Like you can course correct. You don't have to stay feeling stuck in one identity, if you will.
Nina Teicholz: [00:06:42] Yeah, I think people are very identified with their diets and it's almost a closer relationship than people have with religion. With religion, you go to church once a week with your food, you eat three times a day, that is affirming your choices, and for many people that becomes a sense of identity. Plus, you fed that food, if you have kids, to your family, so you're invested in having made decisions to try to nourish your children that may or may not be right. I've experienced that being dramatically wrong. And it's very hard to change your view when you're so invested in something, especially when you think that you may have harmed your children.
[00:07:23] But I don't want to be overly deferential to the idea that everybody is in fact different, because we do. It's just an inalienable truth that-- we do all have mitochondria in the cells. We do have certain biological mechanisms all in common, more than we have that are different. And so, it is true that if you eat carbohydrates and those become digested as glucose and fructose, that the glucose will trigger a release of insulin from the pancreas for everybody. And that insulin is the king of all hormones for making you fat, but that people's reactions to insulin and the amount of insulin that is secreted is different, those are different. But then fructose goes to the liver and is metabolized in the liver and how the liver does that is, does also involve individual variation. But those biological processes are the same for everybody. Nobody escapes them.
[00:08:19] And it's also biologically true that a vegan diet does not provide all the essential vitamins and minerals that are essential. They're not, maybe, would be, could be good for you, they're just essential for growth of children, optimal health, healthy aging, so we can't get away from that, which isn't to say that people can't follow a vegan diet with if it's very carefully supplemented. So, I wanted to also just nod to like the basic biological truths that we all do share. And as popular as precision nutrition maybe, and as real as variations of our biologies might be, there are ways in which that we can say that there are basic truths that we all share.
Cynthia Thurlow: [00:09:04] Well, and it's so interesting because as I've been writing my second book, things that have stood out to me is we're only as good as what we can absorb from our food. So, when we're talking about nutrients, like being able to actually absorb the nutrients is a key thing. And this is where maybe the functional integrative medicine space, I've learned so much speaking to experts where they'll say “You could have five women or men eating the same diet and they're all metabolically healthy,” let's just say for argument's sake. But if you look at blood markers, if you're looking at let's say minerals and vitamins, they may be absorbing things very, very differently. And so, I think from the construct of saying nutrition is so critically important, if not foundational to our health, I think we all agree on that. But it's also like, how well do we absorb the nutrients? And I think some of the conversation around health is really speaking to what are we doing outside of the nutrition piece? What toxins are we exposed to? Are we dealing with chronic stress? And certainly, the pandemic, I think gave everyone a mini stress test, if you will. It's just amplified since then. And so really looking at what else is going on with this individual that can impact their ability to be able to break down and absorb the high-quality food that they're aiming to and we're endeavoring to consume.
Nina Teicholz: [00:10:24] Yeah and that is a complex issue. For instance, there's a pretty scary study showing that if a mother who is pregnant doesn't have enough B12 in her system, B12 comes exclusively from animal foods. That her baby will not only be B12 deficient, but will be unable to effectively absorb B12 for the rest of their life, that they don't develop the proper absorption mechanisms so that they are not only start off at a deficit, but then they are impaired for life. There's a huge variety in the way that people can absorb nutrients and also whether they can absorb synthetic nutrients in our food. So, absolutely that is true and we need to give more attention to that.
[00:11:12] And in general, I agree with functional medicine doctors that measuring and assessing nutrient status and other kinds of toxins. There're just many things that go into health can be very, very complex. And if you're somebody who is having trouble and you're having stubborn health problems, that is a route I think that can be, well, very expensive, but also can yield a lot of interesting information.
Cynthia Thurlow: [00:11:36] Yeah. I share this probably for the first time publicly our youngest son was having what I would describe as trouble focusing and sleeping. He has a great pediatrician and we actually got him in with a local functional medicine doc who I know personally. And when he did blood work, he was so deficient in omega-3 fatty acids, which we know are so critically important for brain health and so much neuroinflammation. It has been-- And he hates fish that was like the first thing. But supplementation for him has been life altering. And this is where I think testing these nutrients is so helpful/beneficial.
[00:12:19] I hadn't even planned on talking about this, but when I look at the data and I'm very quantitative focused within my practice. When I started looking at his lab work and I look at where he is now with no issues sleeping, much less anxiety, feels so much better, doing really well in school. It just reminds me that the inflammatory nature of the standard American diet as one example, and certainly that's not what we eat at our home, but I'm just giving some context. The inflammatory nature of the bulk of what most Americans are eating is not just inflaming their bodies, but also inflames their brains and can lead to a lot of these mood disorders, trouble focusing, brain fog that we take for granted, like we just assume it's normal.
[00:13:08] Now we've normalized a lot of health issues that are not normal and should not be construed as normal. And so, I just interject that as a personal observation, like, personally, the lack of omega-3s in his body were contributing to some of these symptoms that we were seeing in him, which had been alleviated with alterations in his diet, sometimes against his will. He's like, “I hate eating fish.” And I'm like, “You're going to have to learn to eat some fish.” And being stealthily aware of the benefits of supplementation, I'm obviously not someone that says, “Don't get it from your food first.” But even if he had gotten it from his food, I'm not sure per se, he would have been able to buffer the lower levels of omega-3s.
Nina Teicholz: [00:13:50] Yeah. I'm curious how he got low omega-3 in your household. I assume that he's eating healthy food and you don't necessarily need to eat fish in order to get adequate levels of omega-3. So, do you understand why he's low?
Cynthia Thurlow: [00:14:02] Well, I think that-- Well, so here's the thing, and I know you have teenagers as well. What they eat outside the home, you don’t have control over. And so now that he is driving, he and his friends will have some fast food and do things like that. But trying to get chia seeds, flaxseeds in this kid, he's never been that kid. And admittedly will eat sushi, but doesn't like eating fish, which makes no sense to me. I'm like, you'll eat raw fish but not cooked fish, which is a whole separate conversation. So, I think some of it's-- It's so much easier when they're younger and you are making all of their food and you know exactly what's in it. And then, they go off to high school and what they eat in school and what they eat when they're outside the home, you don't have 100% control over. So, whether or not he started off low to begin with and it just got exacerbated, we're not sure, but I do know for him, the supplementation piece has been huge. He won't fight me on that, but I'm like, “You're taking 3-4 g a day of fish oil right now.”
Nina Teicholz: [00:15:01] Interesting. Well, yes, I live in New York City where my kids were off on their own getting around town, 10 or younger, so that was it. Hit the convenience store, go to the Starbucks, get one of those terrible drinks that are 500 g of sugar. We had absolutely no control. Then, it took a while to teach them good, healthy eating habits. But now they're set up. I have two sons, 18 and 21, and now I really feel like they're pretty much set up for life. They know what a healthy diet is. They don't necessarily follow it all the time, but they're pretty conscientious. And how much better to get that young at that-- rather than wait till you're middle aged and everything is falling apart and then you have some emergency diet change or lifestyle change.
[00:15:51] So, yeah, the food environment that we're in is incredibly challenging and is a huge problem because you really need concrete strategies to confront how you're going to navigate that environment and not be felled by it. As I said, I'm in New York City, okay, so there are three vegan restaurants within two blocks of me. That's not the issue. There's also like five ice cream shops and every corner has cookie shops blowing out their fantastically aromatic smells that are so delicious. And my strategy is I try not to walk around hungry. I'm not going to walk around past a cookie shop. I think now I don't feel so tempted, but I just try, especially when shopping, I just don't go hungry. I make sure to eat beforehand and then I not likely to grab a bag of chips off the shelf or something. I mean, everybody has that weakness.
Cynthia Thurlow: [00:16:47] Oh, absolutely. And I think bringing up the point of don't go to the grocery store, don't go by a restaurant if you're starving, because then you're likely not to make the best choices. Now, I'd love to pivot. I know in our previous conversation we talked a little bit about the advent of a lot of these dietary changes that happened in the United States. And really looking at, President Eisenhower, and he had this myocardial infarction and heart attack and then this curious character, Ancel Keys, who really has probably set the set into motion a series of events that led to the development of a lot of the prevailing nutritional philosophies that certainly I was raised within and certainly initially as an early, younger clinician was indoctrinated into. But let's touch on that to give people some context around the current dietary guidelines, how that evolved, because I think it's important when we start to talk about how can we change things is to figure out where have we been the last 60 plus years?
Nina Teicholz: [00:17:56] Okay, well, this is really was at the heart of my book, which I guess I'm going to show for people because it's the most rigorous treatment of that history. And I spent at least a year just studying Ancel Keys, who is a key pivotal figure in this story. The story really starts in the 1950s, when the nation was in a panic over the rising tide of heart disease. Heart disease had been known, identified in textbooks, but quite rare, was not observed in hospitals in the early 1900s. By the 1950s, it was the number one killer of men, middle-aged men. So just imagine their grandfathers, their fathers had not had heart attacks, but they were in the prime of life.
[00:18:39] President Eisenhower in 1955 had a heart attack, was out of the Oval Office for 10 days. That was a crucial moment in American history when all eyes were on this question, “What causes heart disease?” People really didn't know. And there were a number of competing theories. One was that it was vitamin deficiency. And these theories were all seriously considered by top scientists of the day. Another theory was that it was the rising tide of auto exhaust. Cars were becoming more plentiful. Another theory was that it was the type A personality. You go around screaming at everybody, then have a heart attack. But the theory that really stepped into this vacuum and won the day was called the diet-heart hypothesis. That was an idea proposed by Ancel Keys from the University of Minnesota.
[00:19:27] His idea was that it was saturated fats that we find most commonly in meat and dairy and dietary cholesterol, egg yolks, shellfish, that would cause your blood cholesterol to rise and then cause a heart attack. So, it was like hot oil poured down a cold stove pipe. Your arteries would gradually shrink until they closed and that was a heart attack. Okay, so now we know that particular model of heart disease is not even true. What causes heart attacks is the unstable breakaway plaque in your arteries that dislodges and will cause-- Is the most common cause of heart attacks. So, it's not just the simple buildup of plaque, although that is also important and relevant.
[00:20:12] But this diet-heart hypothesis was able to carry the day because Ancel Keys was a very self-assured, self-promoting, argumentative, and scientist and he was called a bully even by his colleagues. He was able to get his idea implanted into the American Heart Association, which was the only and leading public health organization on heart disease, such that in 1961, the American Heart Association comes out with the first ever recommendations anywhere in the world telling people to avoid saturated fats and cholesterol as the best way to protect themselves against heart disease. That's like the tiny acorn that grew into the giant oak tree of advice we now have all over the world.
[00:21:04] And one of the things that I investigated in my book was just the paucity of evidence for that recommendation at the time, there was tiny human studies, some animal studies cobbled together. There was a huge study that was underway called the Seven Countries Study. Also, I spent six months just diving into that and getting foreign publications on that stuff. But that is an incredibly important study. But it had not been completed before this American Heart Association recommendation came out. It wasn't actually published until 1970. And that study is like the tabula rasa or it's a foundational study in the history of nutrition science, which is like thousands and thousands of studies have cite telescope back to the Seven Countries Study. And that's why I spent so much time analyzing it.
[00:21:58] And it was basically, Ancel Keys was the leader of that study. It was funded by the U.S. Public Health Service. He went to seven different countries, mostly in Europe, but also the U.S. and Japan. He looked at nearly 13,000 men, only men. He measured their cholesterol. He tried to understand what they were eating through dietary surveys and also by taking samples of their food. That was extremely unreliable data, which is-- the stories are almost hilarious of they would put the food in baskets and then the fat would get absorbed into the basket. And so, they were really-- So, it was primitive. In some ways, you could see him as a courageous pioneer traveling on dirt roads all over the world to obscure locations to try to get this data. And it was a pioneering study, but it was weak. And the basic problem with this study is that it can only show association. It cannot prove cause and effect. That's the fundamental problem of this study and all observational or also called epidemiological studies.
[00:23:01] It was also problematic that Ancel Keys went into this study with his own already settled belief that saturated fat and cholesterol cause heart disease. So that is what he wanted to find, and that is indeed what he said he found, which is that the more people ate saturated fat and cholesterol, the more likely they were to die from heart disease.
[00:23:22] So later on, much later on, in a reanalysis of his data by his colleagues, they came out with a paper saying, actually, what most closely associates with heart disease is the amount of desserts that you eat, implying that sugar was the issue, but I interviewed those colleagues of Dr. Keys and they said, “Well, sugar was just never something that Dr. Keys wants to talk about. And so, we knew it was an issue, but it was just he would not want to have those conversations. So, we just never brought it up.” It turns out that sugar as a competing hypothesis was quite powerful and Ancel Keys took steps to really quash this alternative hypothesis.
[00:24:05] So, some of the stories that I recount are about, for instance, John Yudkin at Imperial College in England was the, I would say, most well-known proponent of the sugar hypothesis as causing heart disease and other chronic diseases. Ancel Keys went after him in using tactics that we might recognize today, calling ad hominem attacks, accusing him of being funded by industry picking holes in his work that didn't really exist. He effectively ruined his career and drummed him out of the business of nutrition science and thereby eliminated his competition.
[00:24:47] Ancel Keys did that to-- or three other scientists in stories that I recount where he really goes after people in an extremely aggressive way. I would call this like very early cancel culture. This is something we think has started recently, but I would argue potentially that nutrition science was one of the pioneers of cancel culture. You see it all over with the slandering, the ad hominem attacks, the calling people's names, the poking holes, endless niggling with their work, huge long attacks against people. It's shocking. I now recognize it in retrospect as what we understand as cancel culture.
[00:25:30] We're talking about-- this was going on in the 1960s and the 1970s. So really the larger picture of the story of nutrition science is that there came to the fore this dominant hypothesis, the diet-heart hypothesis about saturated fat and cholesterol. This dominant hypothesis took hold through all our expert institutions, the National Institutes of Health, the American Heart Association, eventually the U.S. Department of Agriculture got on board with the dietary guidelines that became such an entrenched narrative that any information to the contrary was suppressed, buried, left unpublished in a NIH basement. Not published by the authors. I have stories of them like getting out of the field because they're so harassed they find they're unable to--
[00:26:24] I have a story of a prominent scientist from the University of Vanderbilt who's called into the hall by the secretary at NIH saying, “If you continue to oppose Ancel Keys, you're going to lose your research grant.” And indeed, he then did. He ended up writing a book what he called a cabal of nutrition scientists led by Ancel Keys and his colleagues, which he called the Diet-Heart Mafia. But indeed, they did act like a mafia in certain ways and that they really suppressed any ideas to the contrary, which is of course the antithesis of good science.
[00:27:00] But I would also argue that this continues very much today. I'm now in the opposition and I have suffered the exact same playbook that was unleashed against John Yudkin, same playbook on me. It just continues with the same dominant narrative about saturated fat, cholesterol. And now I would add, like a mostly plant-based diet. And the same tactics are being employed to try to silence the opposition. I know I've been talking a while, but just one more point on this. Like for instance, I was part of an author team that included former expert committee members who wrote that our government's dietary guidelines, so let's say a very high-level team of people, we did a paper criticizing the dietary guidelines and everything that we think is non-science based about them that was published in a journal of the National Academy of Sciences, all right, no small. That's not an outlier journal.
[00:27:56] The officials at Department of Agriculture and Department of Health and Human Services, which together run the guidelines, came out with a paper, the headline is “Addressing misinformation about the dietary guidelines.” That's the headline of the paper and it's about our work. So, this continues, it is echoed, I think, in other public health issues that we're facing now where we're having so much trouble trying to get information out that counters prevailing narratives. And I think it's obviously a real problem, not just for good science, but it's a real problem because we can't get information out to people about how they can put into remission or reverse their chronic health diseases, which exists. We have no really powerful vehicle for getting that out to people.
Cynthia Thurlow: [00:28:49] Well, I think it's-- On so many levels, I'm so grateful for your work. And for listeners, I don't give out my email easily and I follow you on Substack, and so I get information every week. And to me, I was trained at an institution that encouraged us to disagree and encouraged us to not accept things and to not be someone that does not challenge authority and to not have a degree of cognitive dissonance, which I feel like it may be worse now than it was 10 years ago. I don't know if you agree with that. And so, I think it's very, very important for us to consider that maybe we didn't-- Well, we definitely didn't get it right with the diet-heart hypothesis, and how can we do better?
[00:29:35] And so moving forward, when I look at the unintended consequences that have happened vis-a-vis this diet-heart hypothesis, they are catastrophic. It is not benign. And I know that you really speak much more eloquently to this than I can. The unintended consequences of this cognitive dissonance around dietary guidelines. What are some of the big picture things that listeners can really understand? Because we're seeing it right now. As a clinician 25 years ago, I was not at that time seeing some of the things that we're seeing clinically as clinicians right now. And so much of it has to do with these dietary guidelines that have changed the way and types of foods that we are consuming, frequency with which we are eating, etc.
Nina Teicholz: [00:30:31] Yeah, so to carry this history story forward, what happened was that in 1980, the US government basically adopted the position of the American Heart Association, with which it had a very, very close relationship. Everything the American Heart Association said now became US government policy in the form of the US Dietary Guidelines, which started in 1980. So that meant only lean meat, low-fat dairy, only fruits, vegetables, whole grains. Don't eat eggs because of the cholesterol or minimize them. Don't eat animal fats like butter and instead replace them with seed oils or plant oils, I think is maybe a more accurate term. That was the advice.
[00:31:16] And well actually, the first guidelines did include a warning about sugar, but that sort of fell away over the years and didn't come back until 2015. And now there's a 10% of calories limit on sugar, which is still, I think, very high. But it is hard to overstate how incredibly powerful these guidelines are. And I know people think, “Well, I have never been to a government website to find out about how to eat,” but they are downloaded as the gold standard through all the professional health associations. They come at you through your doctor, your nutritionist, your dietitian, your nurse, they're all instructed to teach the guidelines. And doctors have encountered penalties in their practices for teaching anything other than the guidelines. There's a liability there because those are not evidence based, approved by the government. The guidelines also affected our entire food supply. So, all of a sudden, all pork is bred to be lean, that's why we have dry, tasteless pork. [Cynthia laughs]
[00:32:19] Or all packaged food products, the label on the back of it that you see, all of that is designed to comply with the guidelines, to get it into the right range. So, I have actually sat down with an employee of a major giant food company employee and he said, “We start with what we want to see on the food label. How many grams of fat, how many grams of carbohydrates, and then we back engineer into the food product.” So, it's like, “Well, this is what we want on the label,” so this is going to be yogurt drink. That's how important the food label is to food companies.
[00:32:57] So, it affects the whole food supply. It is by law, all federal programs are required to follow the guidelines, so that means your school lunches, your women and infant children food baskets, the SNAP education program, the military is required to follow the guidelines. People in the military are allowed to eat what they want in mess hall, but there's a lot of encouragement. Like there's a green light over the pasta and a red light over the red meat. And so, you are definitely guiding people's behavior. And the military has an obesity problem equal to the general population despite many of them having a physical exercise requirement, we haven't been able to recruit people and we've missed recruiting targets because our population is so obese.
[00:33:41] So, these guidelines are required to be followed by all federal programs. So, they're just very pervasive in terms of their influence. We cannot underestimate it. And that's why when I started a 501 (c) (3) about a decade ago, it was called the Nutrition Coalition. It was really focused on trying to change the guidelines because I realized just how powerful they are, the top-down effect that they have, and how hard it would be to change if the guidelines did not change and reflect the better science. And what the guidelines did is it put us on an unproven experimental diet, low in saturated fat, high in seed oils. And without consent, at that time we were a healthy population put on a diet without consent or really even knowledge and we have just seen ever since obesity, diabetes, non-alcoholic fatty liver disease, you name it, every chronic disease has since skyrocketed.
[00:34:39] So, obesity in America is about 12%, 13%. In 1980, year of the first dietary guidelines, it notches sharply upwards and has barely stopped since. Only recently have we seen better obesity numbers, probably due to Ozempic, Wegovy and those drugs. But we are an incredibly sick nation. I think there's plenty of evidence to show, because we have put on a high-grain, low-fat diet. The diet that you use to fatten pigs is a high-grain, low-fat diet, and it turns out it works for humans too.
[00:35:15] And in the inception of the guidelines, there was debate among scientists and there were people. Actually, it was preceded by a whole senate committee hearing where they talked about the pros and cons of implementing this nationwide policy. And there were senators who said, “What about the unintended consequences? We don't know what we're doing. This is a radical change for the American people.” And Mark Hegstad of Harvard, who was later found to be taking money from the sugar industry, but also just like a real believer and very close to the American Heart Association, he said, “Whatever the unintended consequences are, we can't anticipate them and we just need to move ahead because this is an urgent rising problem, the problem of heart disease.” And that's the key blindness that we still see today, which is people saying, “This is urgent, we must do something. Okay, all the data isn't in, but we just have to move forward and move ahead,” and we can't see what the unintended consequences are. So that's a crucial kind of blindness that is human.
[00:36:23] This feeling like a sense of urgency, I need to do something. The data's not there yet, but we feel like we pretty much know. And that's what set off this terrible, terrible grievous experiment on the American public, which has resulted in-- Now we have $4.5 trillion in healthcare costs, 85%, 90% of them are spent on chronic diseases. You go to any city around the country, what's the spanking new building that's just up is a cancer center or a kidney dialysis center. It just could not be more depressing. And people's lives are being just destroyed and ruined. And our country's financial health also has been destroyed by this.
[00:37:08] And so, it's just a terrible tragedy what has happened. And reversing course also involves bureaucracies and people admitting that they were wrong. And that is understandably very, very hard to do. Not to mention all the food companies and even the pharmaceutical companies who are dependent upon this model that we have, model of making people sick and then selling them drugs and medications to manage their diseases.
[00:37:34] I want to say, because I know there's always a question in people's minds when they, like, “Did we actually follow the guidelines?” Because one of the major counterpoints when I talk about this is, well, Americans don't follow the guidelines anyway, so that's not true. But in fact, and I have this data on my homepage of my website, nutritioncoalition.us and it shows the best available government data on food availability and estimated consumption. And it shows that in every single category measured, we eat more of what wer’e told to eat more of, 20% to 35% more fruits and vegetables, something like 35% more grains, 90% more seed oils. We did a good job on that. And then everything we were told to eat less of, we eat less of. We eat 28% less red meat, 35% less beef, 79% less whole milk. This is since 1970, all these numbers, 1970 to 2014. Butter is down. Eggs are down. There's not a single category where we have not complied.
[00:38:40] So, the idea that we haven't followed the guidelines is untrue. This is the best longitudinal data that's been adjusted and analyzed and the numbers have been adjusted. And we also, in terms of macronutrients, we increased carbohydrates by maybe 35%, and fat is down by something around 20%. Saturated fat dropped by about 20%. So, we really did a good job of following the guidelines. And the prevailing narrative that we just need to push people to comply harder with the guidelines to see better results is truly not supported by any data.
Cynthia Thurlow: [00:39:19] Well, I can remember when I was a new nurse practitioner, so we're talking 2000, 2001, so a long time ago. And I was handed nutritional information that I was to cover with my patients. And it was everything that you just reported. And we would encourage patients to use Brummel & Brown, those vegetable spread oils instead of butter. We would tell patients, “You want to eat the leanest meats possible. Really stay away from beef, because that's bad. Don't eat the eggs. If you do eat eggs, don't eat the yolks. And if you have dairy products, you want non-fat dairy.” And it's interesting to me, the things that patients would say to me was, I don't-- They didn't perhaps use this terminology. They weren't satiated. They found that when they stopped eating fat, their appetites were not kept in check. They felt like they needed to continue eating even though they felt physically full.
[00:40:17] And these are the kinds of things when I would have conversations around these recommendations, they said, “Well, can I just have half and half? I would be so much happier if I had half and half in my coffee as opposed to non-fat milk or can I just have the ribeye steak once in a while?” “Oh no, fat is bad.” And so, I think that on so many levels all the communication opportunities that we have had with clinicians at least 20 plus years ago were misguided, but we didn't even realize it, but now we know better.
[00:40:47] And I think for a lot of individuals it's helping consumers understand that these dietary patterns, these dietary guidelines have so impacted not just the trajectory of their health, but the trajectory of their children's lives as well. As consumers, how do we take back our power? What would be the things that when you're speaking to consumers or to audiences, what are the high-level things that you encourage them to do for themselves so that they are armed with better information?
Nina Teicholz: [00:41:23] Well, and there are several levels at which people can act. I think most importantly they need to fix their own health and the health of their own family. And they can do that through. There's a lot of resources and books and I'm actually in the process of working on a new website that will be a free non-corporate supported website for people who are just curious about how they can reverse their chronic diseases using nutrition and that will I hope be a great resource for people because that doesn't exist out there yet. And that's going to be-- That's sponsored by the Nutrition Coalition.
[00:41:56] I think for people who want to understand the whole history, which for some people is necessary, they need to understand the story. Like they're just cannot get their heads around this science versus that science and they really need to understand the story. And so, I still just have to say, I think you know, my book is even it's not really out of date. Even though it's been out for a while, it is still the best place to go and read that story and was called A Nutrition Thriller by the Economist, which I think that was an oxymoron. But you know, I didn't think a nutrition book could be a thriller.
[00:42:29] But I think that you know, after you really take care of your own family, there are things you can do. If you can get involved in your schools, your ability to change schools is pretty limited because of again of these top-down government guidelines, but you can try to educate. There are resources for that we will be posting on the Nutrition Coalition to try to change your school lunches to have more healthy fats, more proteins, more whole proteins for kids. What kids are being fed in schools like pancakes-- pre-made pancakes heated up with maple syrup and orange juice, like that's just a sugar rush to start the day and terrible for kids.
[00:43:09] And people are getting involved in their communities just doing things like trying to hand out healthy snacks. I know Diana Rogers had a whole-- She had fundraisers where she was just getting meat snacks to kids. And you can go to the Nutrition Coalition and support us because we're doing policy work like we are actually working. We have done a tremendous amount of work to-- We got the first ever outside peer review of the dietary guidelines had never happened. We got that done by the National Academy of Sciences. Top level, like a brick of a report documenting all the problems with the science. We have many, many papers that we've gotten out with top academics to document the issues and problems with the guidelines. So now, we have really a body of literature to challenge the dietary guidelines.
[00:43:53] And now we have an administration, I think that could be open to radical change, but you could support our work. We're the only group in the United States doing this work, so. Yeah, because I don't know where else to send you if you're interested in, there's a group called the Society for Metabolic Health Practitioners, they're doing excellent work. They're trying to educate more health practitioners around these issues and they are trying to develop more patient resources. I think that's a superb group.
[00:44:20] Yeah, if you're a billionaire, there are a lot of research studies that need to be funded and efforts like we need a lot more research. We need more data on certain topics. I think the data is pretty good, but we could use more studies on I would say all these kinds of gut biome, irritable bowel disease problems. We really need more good randomized controlled trials on that issue. We could use more studies on the liver. Just there's so many chronic diseases where the initial studies are incredibly promising, like actually reverse non-alcoholic fatty liver disease. And there's a case series now showing how effective very low carb or I think it's carnivore could be for these irritable bowel disease issues, but that needs more research. So, if any of your listeners are in a position to fund those kinds of studies, please get in touch because I think supporting research is incredibly important. I'm hopeful that the new NIH director, if he gets confirmed that he will also be willing to invest resources in those kinds of trials because right now the NIH is funding completely meaningless nutrition research, and that's a shame.
Cynthia Thurlow: [00:45:32] I just wanted to touch on some of the things that I did when my kids were younger. Number one, I actually was in the classroom and my plate was what the teachers wanted me to talk about. And they actually were open minded and allowed me to focus more on talking about protein and talking about fruits and vegetables and de-emphasizing so much processed carbohydrate, emphasizing that carbohydrates are definitely helpful. There was also an organization called Real Food for Kids and in our county, we were able to get local farmers that would donate beef and vegetables to a lot of the schools. And so, depending on where you're located, there are other resources like that. I found that to be very valuable. I felt like I was at least doing something to be helpful, at least on a local level. But thank you for including your website because I think that is another invaluable opportunity.
[00:46:21] Now, before we end our conversation today, a lot of questions came in and this made me chuckle. So, as I've been writing my book, Nina, my editor will give me feedback. And there was pushback about red meat and cholesterol-laden foods. And so, I had to dig a little bit deeper to explain to her that these are not things that need to be vilified.
[00:46:43] Now, in terms of red meat and processed foods and concerns around cancer and colorectal cancer, what are your standard-- kind of retorts to people that express concerns around consuming more red meat, as if it is something that is going to lead to untoward consequences in terms of health.
Nina Teicholz: [00:47:05] Yeah, the idea that red and processed meat caused cancer and when this became official doctrine was a decision by a group called the IARC, I-A-R-C, which is part of the World Health Organization, goes back to 2000, I believe in 2015. I wrote recently a very long article which I think is the only in-depth article I've seen where I talked to the people on that IARC committee. I researched everybody's backgrounds. I think it's the only investigative piece that's been done on that. Process which is hugely influential, they just determined that red and processed meats was as cancerous as cigarettes. So I go through all the data, the animal data was very weak. There was data that was more rigorous, that was excluded from consideration. There was an attempt to include it, and the chair of the committee screamed at this person and told him to sit down and not mention it anymore. I think maybe most importantly, I forget the exact percentage, but maybe about 80% of the committee members had spent their entire lives trying to show that red and processed meat causes cancer. So, this was a hugely biased committee. The IARC staff was also biased. And this was discovered by people who sat down and had meals with them and discovered that maybe 30% of them were vegetarian. They are so sick they put a film crew on a member of the beef industry who just harassed her and followed her around everywhere she went.
[00:48:37] I think it's fair to say that's a biased committee. And the IARC exists in order to show that things cause cancer. And they have a laughably long list of things that cause cancer, including hot beverages. So, coffee causes cancer, but tea doesn't cause cancer, but hot beverages cause cancer. It's a completely ridiculous list of things that cause cancer. But if they don't find that things cause cancer, they go out of business. So, they are in the business of showing things cause cancer. They used to have a category of things they found didn't cause cancer, but they eliminated that. They no longer have that on their website. Now everything is a potential cause of cancer, so there's nothing that's ever ruled out as a cause of cancer.
[00:49:21] So the whole structural system of IARC is problematic in the way that its goal and incentive is to find cancerous food and other causes. And I think this committee on red and processed meat itself was hugely problematic because it was stacked and it had a predictable outcome. And I have people whom I interviewed who were on that panel talking about the problems of the evidence themselves. A lot of problems with the evidence and that they themselves acknowledge. So, I would recommend that's on my Substack, which is called Unsettled Science. And again, not here to plug things, but that's where you can find it.
Cynthia Thurlow: [00:50:01] And if you were to think of three things that you think would help move the needle forward for our prevailing nutritional dogma and guidelines, what are three things that you would love to see change?
Nina Teicholz: [00:50:13] Well, I think the cap on saturated fats has never been evidence based and needs to be eliminated. Just to go back to the history with Ancel Keys after that American Heart Association recommendation in 1961, there were large clinical trials undertaken all over the world by various different governments to test his diet-heart hypothesis. They understood that there was no evidence, even though there was this official recommendation. So, they set out to test it. Those are called the core trials. And they were on a huge number of people, like 76,000 is a fair estimate. That's extraordinary.
[00:50:55] A study that makes the front page of the New York times is like 200 people, this is 76,000 people tested on the idea that saturated fats cause heart disease. So, these are clinical trials, interventions where half the people get what was then considered a normal amount of saturated fat, which was 18% of calories, which is high by our standards. The current cap is at 10%, the official cap. The other group would get roughly 9% of our calories is saturated fat, pretty much what we're told to eat now. And so, they would get the soy-filled milk and the soy burgers and whatever their version of the impossible burger was back then, at the end of all of those experiments, every single one of them could not find that the people with higher saturated fat diets that it had resulted in any increase in your total mortality, that is death from any cause, or your cardiovascular mortality, which is death from heart disease.
[00:51:52] And there's little to no evidence in those clinical trials that these people eating more saturated fat had any evidence of heart disease, which is a more wobbly term to measure. It's heart attacks that can be hard-- There are different diagnoses of that, angina, chest pain, also varying diagnoses. So, the really hard evidence is the mortality evidence, and it shows that a higher saturated fat diet does not have any negative effect on that.
[00:52:21] And worse, I would say in six of those trials where they analyzed them, they found that the people eating more seed oils, less saturated fat, had higher death rates, significantly higher death rates from cancer. One trial also showed that the more people lowered their cholesterol, the more likely they were to die from heart attacks. So, you don't know about this evidence because literally some of it went unpublished. It was ignored. Really, these trials were all buried until Gary Taubes book came along in 2007, and then my book in 2014, which really focused on the saturated fat issue. That was the first book to really focus on saturated fat.
[00:53:05] Since then-- Those books really informed a lot of scientists. So now we have about two dozen systematic reviews and meta-analyses, high-level reviews of all those core trials, and almost like every single one of those review papers concludes that saturated fats have no effect on mortality or cardiovascular mortality. So those 24 review papers have never been considered in any systematic way by our Dietary Guidelines expert committees. So, there's this humongous body of science that just sits right there, but is not recognized by our officials. So, we have to recognize that science and we have to-- I think the outcome of that would be the elimination of the cap on saturated fats, which is not justified by the evidence.
[00:53:57] That's probably longer of answer than you wanted, but I think also we really need to look at the protein category, which has eroded over time. We advise lower quantities of protein, and we have also eroded the quality of the protein. So, in a category that mainly used to include animal foods when it came out in 1980, now includes, well, it always included peas and beans, but now it's got lentils, nuts, seeds, soy.
[00:54:24] And those are not as complete proteins. They also come along with a huge load of starch, which is bad for people with metabolic diseases. So, we need to restore the protein category in terms of quantity and quality so that it can help Americans achieve optimal health. And actually, the current amount of protein that is recommended is only the amount to prevent deficiency. Like, to prevent the worst possible deficiency, we should get that up to the level that is known to promote optimal health. Why not? Why should we be just preventing starvation? We need to have proper muscle growth, muscles, tissues, and tissues all over your body need protein, so that's another thing I would do.
[00:55:13] And then I think it's really important-- The Dietary Guidelines currently have no option for people with metabolic diseases, but their goal is to prevent disease, which they do not do, but they do not have an option to treat disease. So, I think there needs to be-- they have three dietary patterns. I think there needs to be an additional dietary pattern that is suitable for people with metabolic diseases to help them put their disease in remission or reverse the diagnosis or however you want to call it. And I think the evidence clearly shows that would be a fairly low-carbohydrate diet. That needs to be one option. Not for everybody, but it needs to be an option so that doctors can prescribe it without getting in trouble, so that people can be made aware of it without being told it's a fad, dangerous diet. I think that would go long ways. It is the single most powerful lever to creating change of people's diets in America, so that would be phenomenal if we could get that done.
Cynthia Thurlow: [00:56:16] No, I would love that. And I will do everything I can to help support you sharing that message. Please let listeners know how to connect with you outside of this podcast. How to get access to your book, which is a book I recommend with frequency and actually sits in my office on my-- I have one bookcase in my office that are the books that I recommend and suggest to patients most frequently.
Nina Teicholz: [00:56:39] Well, I'm honored. Thank you. My book is on Amazon, The Big Fat Surprise. It's a little weirdly hidden on Amazon, so you have to look for it to get a paperback copy. You can find my writing on Substack at unsettled-- My column is called Unsettled Science. I'm doing so much right now to try to promote this agenda in Washington that I'm not writing as often. But there's just, I think, great articles in there about corruption at Stanford, corruption at Harvard, corruption-- I do a lot of work to try to unearth the conflicts of interest. And this article, if anybody's interested on the meat and cancer decision. And thenutritioncoalition.us, again, .us not dot anything else.
[00:57:23] Just our homepage is a great primer on the dietary guidelines. And if you want to do a deep dive into the dietary guidelines that's I think really the best place to go for all that information. And then don't go to my home website because I haven't updated it in several years. But you're welcome to see whatever I was doing some years ago. And I guess, I'm on active on social media, so on Twitter @bigfatsurprise and on Instagram, I think @ninateicholz. Yeah, so those are places that I try to care and feed when I can.
Cynthia Thurlow: [00:57:58] Well, thank you for all the work that you do. You're one of my favorite writers to follow. And like I mentioned, I don't give out my email address all that readily, but I do get your Substack. When I'm not in the app, I can read it on my email.
Nina Teicholz: [00:58:10] That's great. Well, we'll be certain not to dox you, Cynthia. [laughter] All right. Thank you so much for having me on your show.
Cynthia Thurlow: [00:58:19] Thank you. Thanks again.
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