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In March 2014, an article appeared in the Annals of Internal Medicine that sent the food-obsessed public into gastronomic raptures. We currently have 441,287 full downloads including categories such as: software, movies, games, tv, adult movies, music, ebooks, apps and much more. Our members download database is updated on a daily basis.
The fact is, not all fats are bad, and concentrating too much on eliminating “fat” from our diets has, in many cases, led us to replace even healthy fats with sugars and other simple carbohydrate foods that may actually be worse for our health.We asked four nutrition experts to describe an ideal meal. The debate exists even among professional colleagues—and friends—within Harvard School of Public Health’s Department of Nutrition.But there are also broad areas of continuing agreement around what constitutes a “ healthy diet.” The consensus: We all need to shift our collective nutritional thinking toward an emphasis on food-based, rather than nutrient-based, recommendations. Indeed, there is debate within the scientific community itself over how important it is to focus on certain types of dietary fat—and that debate existed long before the Annals article appeared. Julia Child, goddess of fat, is beaming somewhere.”The Annals article, and the subsequent news coverage, set off a national conversation about dietary fat. As Mark Bittman’s column in The New York Times rhapsodized: “Butter is Back.
And, of course, water is always good.Dessert: Fruits. We eat fish at least three or four times a week, and some poultry.Drink: I used to drink tea, but now I drink three or four cups of coffee per day, because we have found more and more evidence that coffee is good for you. And I put nuts in everything, basically. I have a generous amount of vegetables.
He actually spent several years after World War II at HSPH examining this thorny problem. On that day, a University of Minnesota physiologist named Ancel Keys appeared on the cover of Time magazine, glowering at the gluttonous American public through horn-rimmed glasses.Keys had made a name for himself during World War II by developing the K ration, and after the war turned his attention to the relationship between diet and health, particularly heart disease. FAT WARS: A SHORT HISTORYIt’s hard to pinpoint exactly when fat started to become the enemy on our plate, but a good guess may be January 13, 1961. I eat dark chocolate every day.
Keys suggested that it was the type of fat, as well as the Mediterranean diet in general, that spelled the difference in heart disease risk.Keys delivered his opinions with the force of fact. Indeed, total fat intake in Crete was just as high as in Finland, which had the highest rates of heart disease at that time. He found that saturated fat consumption was strongly associated with regional rates of heart disease, but that total fat intake was not. It’s hard to pinpoint exactly when fat started to become the enemy on our plate, but a good guess may be January 13, 1961.Keys’ work provided some hints about the culprit behind this yawning gap. The study, which began in the 1950s, continues even today. Keys led the seminal Seven Countries Study, which for the first time documented that the incidence and mortality rates of coronary heart disease varied as much as tenfold among countries, with the lowest rates in Crete.
Researchers in Finland fed butter to patients in one mental hospital, while those in another got soybean oil—and the patients eating the vegetable oil had a lower risk of heart attack. Scientists fed monkeys diets high in saturated fat and watched them develop atherosclerosis. Indeed, many better-designed studies have since proven that total dietary fat has no effect on heart disease.Numerous other investigations building on Keys’ work focused on specific types of fat. Keys’ work also suggested that diets high in saturated fat and cholesterol increased total cholesterol levels.Yet based on the well-recognized limitations of cross-country studies, Keys was smart enough to conclude that this early evidence did not prove cause and effect, but rather suggested a need for further research, especially in cohort studies examining individuals within populations. “Maybe if the idea got around again that obesity was immoral, the fat man would start to think.”) He found that nations where people ate lots of saturated fat—think of the Finns smearing butter on their cheese—suffered higher rates of heart disease.
Decades passed data accumulated.Keys also conducted controlled feeding studies, in parallel with the HSPH Department of Nutrition’s Mark Hegsted, which showed that polyunsaturated fats (the kind found just in plants) reduced blood cholesterol levels. Epidemiologists established large investigations like the Framingham Heart Study, monitoring people’s health for years. In a recent study conducted in Spain, scientists gave subjects a free supply of either olive oil or mixed nuts for five years and watched both groups’ risk of heart disease drop.
Scientists around the world simultaneously showed that saturated fat—the kind in butter and lard—increases both “bad” LDL cholesterol and “good” HDL cholesterol, making it similar to carbohydrates overall but not as beneficial to health as polyunsaturated fats from nuts and vegetables. In the early 1990s, Walter Willett, now chair of the HSPH Department of Nutrition, and others determined that trans fats—liquid vegetable oils transformed into shelf-stable solids (think Crisco)—were associated with greater risk of heart disease and are a double metabolic whammy, raising “bad” LDL and decreasing “good” HDL. Unsaturated fats, especially polyunsaturated fatty acids like those in walnuts, decrease the “bad” LDL cholesterol and raise the “good” HDL cholesterol. VERDICT: NOT ALL FATS ARE BADBy the 1970s, Keys and Hegsted, among other scientists, concluded that different types of dietary fat had varying effects on blood cholesterol levels, and that different types of cholesterol had varying effects on heart disease.
The public ate it up, so to speak. Kaiser Family Foundation launched a social marketing campaign called Project LEAN (Low-Fat Eating for America Now), encouraging Americans to reduce total fat intake to 30 percent of their diet, and spreading the message through advertising and supermarket promotions. “They thought of a shortcut: Just cut down fat.”In 1987, the Henry J. Instead, doctors and scientists running the National Heart, Lung and Blood Institute’s National Cholesterol Education Program in the mid-1980s decided to simplify it, explains Lilian Cheung, director of health promotion and communication in the HSPH Department of Nutrition. Shifted the spotlight to reducing total fat—period—despite little or no evidence that this simplistic advice would prevent disease.The complicated message—that some fats are good for you and others are bad—didn’t reach the general public.
Our bodies digest these refined carbohydrates and starches very quickly, causing an insulin spike.” Insulin tells the body to store fat and causes our blood sugar to drop, which makes us feel hungry. “For example, low-fat yogurt is loaded with sugar. “FAT-FREE” MESSAGE A PUBLIC HEALTH DISASTERIt was one big, happy, fat-free feeding frenzy—and a public health disaster.“We didn’t know as much then about the bad effects of refined carbohydrates,” says Cheung. The food industry jumped on board, removing fat from food and replacing it with sugar and carbohydrates, filling supermarket shelves with fat-free salad dressing, fat-free ice cream, and low-fat SnackWell’s cookies.
Instead of emphasizing one nutrient, we need to move to food-based recommendations.
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