Tag Archives: low-fat

The End of the Low-Fat Era? | The Paleo Diet

The year was 1977. The US Senate Select Committee on Nutrition and Human Needs, led by Senator George McGovern, issued the first Dietary Goals for Americans, thereby marking the beginning of the low-fat era of dietary nutrition, arguably the most misguided period of government-led nutrition ever. After 38 years, however, the low-fat era might officially end later this year.

The Dietary Goals evolved into the Department of Health and Human Services’ (HHS) and Department of Agriculture’s (USDA) Dietary Guidelines for Americans, later represented as the Food Pyramid and, currently, as MyPlate. The Guidelines’ dominant theme has been that calories consumed should equal calories expended. And since fat has 9 calories per gram, compared to only 4 for both carbohydrates and protein, fat became typecast as the “bad guy” nutrient.

Furthermore, since saturated fat and dietary cholesterol have been thought to promote cardiovascular disease, the Guidelines have recommended restricting fat to less than 30% (revised to 35% in 2005) of total calories. Consequently, carbohydrates, particularly refined carbohydrates and added sugars, came to replace healthy fats in Americans’ diets.

USDA and HHS update the Guidelines once every five years and the next revision is forthcoming later this year. Historically, the Guidelines echo the Dietary Guidelines Advisory Committee (DGAC) report, written by appointed scientists who systematically review the scientific literature on nutrition. The current DGAC report, published earlier this year, features two monumental deviations from the current Guidelines.

First, as we previously reported, the DGAC no longer considers dietary cholesterol to be a “nutrient of concern.”1 Previously, they recommended limiting cholesterol to 300 mg/day, but now acknowledge, “available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol.”

Second, the DGAC recommends removing upper limits on total fat consumption with respect to total calories. “In low fat diets,” they write, “fats are often replaced with refined carbohydrates and this is of particular concern because such diets are generally associated with dyslipidemia.”2 Reducing total fat (replacing total fat with overall carbohydrates), they conclude, “does not lower cardiovascular disease risk.”

So what does all this mean? If USDA and HHS follow the DGAC’s recommendations, the low-fat era will finally end and, going forward, Americans will have more scientifically accurate information about fat and will likely embrace healthful, fatty foods more readily.

CALLING ALL NUTRITION ADVOCATES

The DGAC recommendations are clear, but in making their final decision, the USDA and HHS also consider comments from the public, academics, advocacy groups, and industry. As such, two prominent scientists, Dr. David Ludwig and Dr. Dariush Mozaffarian, recently penned an article for the Journal of the American Medical Association in which they strongly endorsed lifting the total fat limits.3

Their article follows-up on a similar article they co-authored in 2010 about the previous Dietary Guidelines update. In their 2010 article, they recommended moving away from a nutrient-metrics approach, whereby specific nutrient targets are defined, and toward an approach emphasizing specific, healthy foods. They noted that the proportion of total energy from fat “appears largely unrelated to risk of cardiovascular disease, cancer, diabetes, or obesity” and that saturated fat “has little relation to heart disease within most prevailing dietary patterns.”4

We recently caught up with Dr. Mozaffarian to ask him about this extremely important story.

Q: What are your impressions about the progress made since your 2010 article with Dr. Ludwig? Are we moving in the right direction?

A: The 2015 DGAC report has made great strides in the right direction, with its major new focus on healthful, food-based, diet patterns. Now we must wait to see what the USDA and HHS do with this information in the final Guidelines—boldly move toward this modern evidence, or sit back and return to old conventions.

Assuming the USDA drops its limits on total fat consumption, how impactful do you think this could be?

This could have tremendous positive impact, especially if mirrored in other national policies e.g. food labeling, school lunch, feeding programs, and so on. Consumers and companies would be unshackled to allow focus on increasing healthy foods, including those higher in fat, and on reducing refined grains and sugars.

Would you care to comment on the Paleo diet from a nutritional perspective?

The main benefits of Paleo are recognizing the harms of refined grains, starches, and sugars, which dominate the food supply; and the (potential) focus on fruits, vegetables, nuts, and fish. But, if ‘Paleo’ leads one to high-meat diets, few benefits will be gained.

Dr. Mozaffarian makes a valid point. One of the largest misconceptions surrounding Paleo diets and lifestyles is that it promotes high-meat consumption without balance from other food groups. Dr. Cordain among the many other thought leaders in the scientific and lay communities continue to debunk this misconception. A real Paleo diet is a high-vegetable diet with moderate amounts of animal protein, including lean meat and fish high in omega-3, plus animal and vegetable sources of fat.

In our interview with Dr. Mozaffarian, he also noted that some vegetable oils “are extremely healthy, but are shunned by many Paleo aficionados.” While we respectfully disagree about the health impact of high-omega-6 vegetable oils, we strongly agree that proportional upper limits on total fat must be removed from the US Dietary Guidelines.

For nearly four decades, the US government has promoted high-carbohydrate, low-fat diets. Incidentally, a recent systematic review of the randomized controlled trials available to McGovern’s Committee back in 1977 determined there was no scientific basis for their restrictions on fat.[5] In other words, the low-fat era never should have happened. And with the 2015 Dietary Guidelines update, it should finally end.

 

REFERENCES

[1] Dietary Guidelines Advisory Committee. (February 2015). Scientific Report of the 2015 Dietary Guidelines Advisory Committee.

[2] Ibid, Dietary Guidelines Advisory Committee.

[3] Dariush Mozaffarian and David S. Ludwig. (June 2015). The 2015 US Dietary Guidelines: Lifting the Ban on Total Dietary Fat. Journal of the American Medical Association, 313(24).

[4] Dariush Mozaffarian and David S. Ludwig. (August 2010). Dietary Guidelines in the 21st Century—a Time for Food. Journal of the American Medical Association, 304(6).

[5] Z Harcombe, JS Baker, SM Cooper, B Davies, N Sculthorpe, JJ DiNicolantonio and F Grace. (February 2015). Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open Heart, 2.

Nutrition Divided: Low-Fat vs. High-Fat Diet | The Paleo Diet

The amount of debate in the nutrition field has never been greater.1, 2, 3 As Americans (and everyone in the world) gets progressively more obese, we seem to be digging into our respective trenches, saying ‘this diet or that diet will cure all ills’.4, 5 This is a sad waste of resources, and a little bit irresponsible, especially in a field where the endgame should be helping people – not furthering one’s own agenda. Sure, you may say I’m biased as well, writing this piece for The Paleo Diet. But the bottom line is, I care about people’s health more than I care about making money.

If you don’t believe me, go ahead and take a look at my website Eat Clean Train Clean. See if I have anything for sale, or any agenda to be pushed. You will find that I have a nutrition lecture, with slides and scientific references for sale, for a whopping $2 – and that’s it. And it isn’t a ‘pro-Paleo, bash everything else’ lecture. It highlights the science behind good nutritional choices. The long-winded opening here is simply to make a point: everyone who has a ‘big voice’ in nutrition – also has an agenda.6, 7, 8 And they’re not going to stray from their agenda, because it might mean less book sales, less money and less of a voice.

Possibly the single best example of this is Dean Ornish.9 While at first glance Ornish seems like a great nutrition icon (after all, he pushes low fat diets, lots of vegetables, etc.) if you dig a little below the surface, you will find some rot.10 Okay – lots of rot.11 Did you know that Ornish is paid by McDonald’s?12 Yes – that McDonald’s. ConAgra and Pepsi Co. also have Ornish on the payroll.13, 14 Since we all clearly know that McDonald’s, ConAgra and Pepsi are making us all healthier, we really should applaud Dr. Ornish for his work – right? My tongue is planted firmly in cheek on that one.

Nonetheless, because I firmly believe in unbiased science, if Ornish’s approach had some scientific merit, I would actually applaud him for some of his work (the Big Food work is never going to get my approval, but to each their own). But the simple fact is – Ornish’s approach has little-to-no scientific merit.15, 16 While he is indeed correct in stating that we all likely need to eat more vegetables, he goes far away from good science by virtually ignoring the huge problem of sugar – which is undoubtedly one of our biggest dietary downfall in the last 50 years.17, 18, 19 Is it a mere coincidence that if Ornish bashed sugar, he might lose his McDonald’s, ConAgra and Pepsi deals? I think any astute reader will clearly be able to draw the obvious conclusion here.

If you haven’t caught on to the fact that your favorite dietary “guru” may just be cashing in on things, it may be a good idea to take a look around and do some internet searching – just to see what really goes on behind the scenes. If one wants to see some clear bias in action, go ahead and read Dr. Ornish’s piece for The New York Times.20 But this isn’t to simply bash Ornish – like any headline-grabbing nutrition guru, he does offer some good advice. Because when it comes to nutrition, there are always some broad agreements that can be made.21, 22

No one will ever debate that organic vegetables should be included in every diet.23, 24 That is because they have clearly been found to support many different neuronal and physiologic processes.25 26, 27 Though Ornish himself ignores this next point (another nail in the coffin for his bias) almost everyone else agrees that good amounts of healthy fats are very beneficial (elements such as extra virgin olive oil, avocados, almonds, etc.).28, 29, 30 Another common point that nearly everyone agrees on? Eating organic, lean protein.31, 32, 33 This means wild caught salmon, organic chicken and other muscle-building sources of essential amino acids.

Another point that – again, everyone but seemingly Ornish – can agree on? Keep sugar to a minimum – especially added sugar.34, 35 Even the World Health Organization agrees on this point.36 If Ornish’s bias isn’t crystal clear by now, then I’d be shocked. You can also clearly see that I have yet to mention a Paleo Diet. Again, I am not biased. Does it happen that all of these points fall squarely under the Paleo Diet umbrella? Sure. But all of these elements also fall under the Mediterranean Diet umbrella – which nearly everyone in the nutrition world agrees – is extremely healthy.37 And guess what? The science backs up that diet, too.38

Even Dr. David Perlmutter’s often controversial ketogenic diet approach, is substantiated by sound scientific research.39 While one could argue the science doesn’t quite back up all of Dr. Perlmutter’s conclusions yet, the point is he has salient scientific data to support his claims. And I do think one day he will end up being right about nearly everything he states in his book. Only time – and more scientific research – will tell.

So, when you look to indulge in a healthy diet, they may be confused by all of the noise in the media. At that point, I think it is important readers look to the science. And what does the science say? Avoid lots of sugar, eat lots of vegetables, eat lots of healthy fats, and consume quality sources of protein.40 That is all you really need, to put together a healthy diet.

Another huge issue here, which seemingly is only hinted at, is that people have trouble sticking to any diet.41 That is another discussion for another day, but the human factor must be weighed into the scientific debate, as well. The bottom line is, take care of yourself, worry only about your health, and not the back-and-forth bantering that goes on in the media.

There is very little new in the world of nutrition, and the same foods which have been helping humans thrive for centuries, will also be the ones we should keep consuming, since our physiology will not change enough by the time I’m dead, or you are dead, to warrant brand new food choices. If you are overweight, think of all the food choices that led you to this state. Too much sugar? Too many processed foods? Not enough vegetables? That’s what I thought. You don’t need to read biased, industry-backed propaganda to know what to eat. Intrinsically, you’ve known all along.
 

REFERENCES

[1] Willett WC. Diet and health: what should we eat?. Science. 1994;264(5158):532-7.

[2] Kornhuber J. [What should we eat?]. Fortschr Neurol Psychiatr. 2014;82(6):309-10.

[3] Adams SM, Standridge JB. What should we eat? Evidence from observational studies. South Med J. 2006;99(7):744-8.

[4] Roth J, Qiang X, Marbán SL, Redelt H, Lowell BC. The obesity pandemic: where have we been and where are we going?. Obes Res. 2004;12 Suppl 2:88S-101S.

[5] Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.

[6] Available at: //www.npr.org/templates/story/story.php?storyId=6759000. Accessed May 5, 2015.

[7] Available at: //www.nytimes.com/2007/01/09/health/09research.html. Accessed May 5, 2015.

[8] Available at: //www.latimes.com/entertainment/tv/showtracker/la-et-st-dr-oz-hits-back-with-investigation-of-mysterious-critics-20150423-story.html. Accessed May 5, 2015.

[9] Available at: //www.yourdoctorsorders.com/2011/12/the-ornish-myth/. Accessed May 5, 2015.

[10] Available at: //www.menshealth.com/nutrition/high-protein-diets. Accessed May 5, 2015.

[11] Available at: //articles.chicagotribune.com/1990-11-15/entertainment/9004040864_1_fat-diet-nathan-pritikin-diseased-arteries. Accessed May 5, 2015.

[12] Available at: //www.weightymatters.ca/2007/02/dr-dean-ornish-shills-for-mcdonalds.html. Accessed May 5, 2015.

[13] Available at: //www.foodonline.com/doc/dr-dean-ornish-endorses-conagras-natural-food-0001. Accessed May 5, 2015.

[14] Available at: //www.hsc.wvu.edu/Wellness/Dr-Dean-Ornish-Program/Bio-Dean-Ornish.aspx. Accessed May 5, 2015.

[15] Available at: //www.scientificamerican.com/article/why-almost-everything-dean-ornish-says-about-nutrition-is-wrong/. Accessed May 5, 2015.

[16] Gardner CD, Kiazand A, Alhassan S, et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA. 2007;297(9):969-77.

[17] Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014;174(4):516-24.

[18] Ahmed SH, Guillem K, Vandaele Y. Sugar addiction: pushing the drug-sugar analogy to the limit. Curr Opin Clin Nutr Metab Care. 2013;16(4):434-9.

[19] Avena NM, Rada P, Hoebel BG. Sugar and fat bingeing have notable differences in addictive-like behavior. J Nutr. 2009;139(3):623-8.

[20] Available at: //www.nytimes.com/2015/03/23/opinion/the-myth-of-high-protein-diets.html. Accessed May 5, 2015.

[21] Liu RH. Health-promoting components of fruits and vegetables in the diet. Adv Nutr. 2013;4(3):384S-92S.

[22] Steinmetz KA, Potter JD. Vegetables, fruit, and cancer prevention: a review. J Am Diet Assoc. 1996;96(10):1027-39.

[23] Magkos F, Arvaniti F, Zampelas A. Organic food: buying more safety or just peace of mind? A critical review of the literature. Crit Rev Food Sci Nutr. 2006;46(1):23-56.

[24] Liu RH. Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals. Am J Clin Nutr. 2003;78(3 Suppl):517S-520S.

[25] Martin A, Cherubini A, Andres-lacueva C, Paniagua M, Joseph J. Effects of fruits and vegetables on levels of vitamins E and C in the brain and their association with cognitive performance. J Nutr Health Aging. 2002;6(6):392-404.

[26] Polidori MC, Praticó D, Mangialasche F, et al. High fruit and vegetable intake is positively correlated with antioxidant status and cognitive performance in healthy subjects. J Alzheimers Dis. 2009;17(4):921-7.

[27] Pandey KB, Rizvi SI. Plant polyphenols as dietary antioxidants in human health and disease. Oxid Med Cell Longev. 2009;2(5):270-8.

[28] Lawrence GD. Dietary fats and health: dietary recommendations in the context of scientific evidence. Adv Nutr. 2013;4(3):294-302.

[29] De roos N, Schouten E, Katan M. Consumption of a solid fat rich in lauric acid results in a more favorable serum lipid profile in healthy men and women than consumption of a solid fat rich in trans-fatty acids. J Nutr. 2001;131(2):242-5.

[30] Willett WC. Dietary fat plays a major role in obesity: no. Obes Rev. 2002;3(2):59-68.

[31] Brehm BJ, D’alessio DA. Benefits of high-protein weight loss diets: enough evidence for practice?. Curr Opin Endocrinol Diabetes Obes. 2008;15(5):416-21.

[32] Paddon-jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-plantenga M. Protein, weight management, and satiety. Am J Clin Nutr. 2008;87(5):1558S-1561S.

[33] Halton TL, Hu FB. The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. J Am Coll Nutr. 2004;23(5):373-85.

[34] Clabaugh K, Neuberger GB. Research evidence for reducing sugar sweetened beverages in children. Issues Compr Pediatr Nurs. 2011;34(3):119-30.

[35] Basu S, Lewis K. Reducing added sugars in the food supply through a cap-and-trade approach. Am J Public Health. 2014;104(12):2432-8.

[36] Available at: //www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/. Accessed May 5, 2015.

[37] Willett WC. The Mediterranean diet: science and practice. Public Health Nutr. 2006;9(1A):105-10.

[38] Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol. 2006;59(6):912-21.

[39] Available at: //www.drperlmutter.com/learn/studies/. Accessed May 5, 2015.

[40] Babio N, Bulló M, Salas-salvadó J. Mediterranean diet and metabolic syndrome: the evidence. Public Health Nutr. 2009;12(9A):1607-17.

[41] Thomas SL, Hyde J, Karunaratne A, Kausman R, Komesaroff PA. “They all work.when you stick to them”: a qualitative investigation of dieting, weight loss, and physical exercise, in obese individuals. Nutr J. 2008;7:34.

Affiliates and Credentials