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Tuesday, 28 May 2013

The Truth Was Still Putting on its Shoes - How Pseudoscience Came to Dominate the Concept of Healthy Eating

Imagine you could restore health and lose weight by eating fats and protein and consuming fewer carbohydrates, i.e. sugar and grains. This was standard medical advice up until the late 1970s. Then the advice changed to “eat more grains and limit saturated fats”. The new “healthy eating” advice was never subjected to rigorous testing before the old advice, which had served society well, was ignominiously dumped. Are we, as a nation, now fitter, better nourished, and less disease prone as a result?

The Kiwi ANZACs, widely considered to be the fittest troops in the Allied armies in two world wars, were raised in a nation where per capita weekly butter consumption was 415 grams. It is now 112 grams, which is half of the reduced 1940s wartime ration. The consumption of fat from red meat has also decreased as drastically. We eat fewer eggs and drink less full-fat milk. 

There is a fallacy that stems initially from the Western intellectual's sense of cultural inadequacy and guilt, and the assumption that Eastern cultures must somehow be purer and wiser. One of the features of Eastern religious culture identified early on by aficionados like Schopenhauer – because the things that are unusual in a culture attract attention first - was vegetarianism. The reality of Buddhist and Hindu society, like all successful human society, didn't involve denial of animal foods (the Dalai Lama eats meat, observant Hindus cook with butter fat), but the ideal, already present in Western ascetic tradition and not associated there with robust physical or mental health, had a persistent appeal, which found expression in the early temperance, vegetarian and vegan movements.

We then come to a point in history - the 60's - 70's counterculture - where the idea took hold more widely, through music and other popular media, that vegetarianism (and other aspects of Eastern religious thought) represented the higher path, while the habits of the older generation were anathematized; including church-going, smoking, drinking, meat eating. 

Various influential people exposed to this assumption in their formative years unconsciously accepted it as factual.  The same bias can be seen to persist today when veganism, despite its risks, is accepted as normal by government dieticians as somehow being worth nurturing as the expression of a noble and virtuous impulse; whereas the Atkins type of high fat, low carb diet is not to be encouraged, despite the scientific evidence in its favour and common-sense assessments of its nutritive value, because it is seen as self-indulgent. Deep psychological forces decide the values different foods are given, and mystical, revolutionary, and puritanical impulses as well as economic and social pressures distort the collection, interpretation and publication of data.

Scientific research has been misinterpreted to reflect an existing prejudice, and this has suited the food manufacturing industry, with novel oil, grain, and soy products to find markets for. A perfect storm of error has formed around the question of fat, because of the earlier invention of the cholesterol test, which seemed to support the new belief, and which lent it a spurious validity. The animal fat in our diets has been the ultimate casualty.

Most people cannot stay vegetarian for good reasons, and many backslide, but not all the way, only to the "vegan meat" chicken, to lean meats, low fat dairy and so on. It's as if by avoiding what one thinks is "saturated" fat one can avoid the sinful aspects of consuming flesh. The very word “saturated”, a technical description of chemical bonds, conveys unintended connotations of excess.

Yet highly saturated fats like beef dripping and coconut oil have a remarkable ability to protect the liver from the toxicity of alcohol or other drugs. Polyunsaturated fats have the opposite effect. That seems like something that should be more widely known, instead of confined to those medical journals that specialize in alcoholism. It should also be more widely known that people who eat the most dairy fat have half the diabetes incidence of the people who eat the least, or that, all over the world, those who attempt suicide tend to have significantly lower cholesterol levels than those who do not. And so on.

It was studying the life cycle of the hepatitis C virus (HCV) that eventually forced me to question my received beliefs about fat, carbohydrate, and cholesterol:
-  HCV depresses and monopolises cholesterol production; cholesterol in the diet counteracts  this.
 - HCV uses VLDL to exit infected cells; starches and sugars increase VLDL production. 
- Saturated fats in a low-carbohydrate diet (and omega 3 oils from fatty fish) decrease it.
 - HCV infects new cells through the LDL receptor; polyunsaturated vegetable oils increase the number of LDL receptors. 
- If you have Hepatitis C, your prospects improve with higher LDL levels (a sign of fewer LDL   receptors).
 - HCV depresses immunity by sequestering zinc and selenium; these minerals are most easily
 absorbed from fatty foods like meat, seafood and Brazil nuts; their absorption is inhibited by most grains and legumes. 
- The antioxidants from leafy vegetables, fruits and berries are valuable, but they are no substitute for animal fats and carbohydrate restriction when it comes to clearing a fatty liver,  reducing viral replication, or preventing disease progression. 

In the case of at least two diseases, the not uncommon ones of hepatitis C and alcoholism, the two main causes of cirrhosis and primary liver cancer in this country,  current “healthy eating” advice can only be increasing harms. Fast food is not so different; fries are vegetable starch cooked in polyunsaturated vegetable seed oil, supposed to be a healthy alternative to animal fat because it “lowers cholesterol”.

Nutritional epidemiologists write papers about the French paradox, whereby the French, who have largely preserved their traditional diets, diets which happen to be rich in animal fats, have relatively low levels of heart disease, and also low rates of liver cirrhosis relative to the amount of alcohol consumed in France. In the case of the Israeli paradox, this health-conscious population has adopted modern ideas about healthy eating, especially that of reducing saturated fat by substituting polyunsaturated vegetable oils for animal fats, and now has relatively high rates of cardiovascular disease, diabetes, obesity and cancer. That these results are considered paradoxical because they contradict unproven assertions should be an embarrassment to science. 
(paradox, n. Statement contrary to received opinion; statement that, whether true or not, seems absurd at first hearing; person or thing conflicting with preconceived notions of the reasonable or possible.)

Knowing all this, and also considering what our hardier ancestors might once have eaten, and what they could not have eaten, takes us back to the days before the cholesterol craze, before the food processing industry cashed in on vegetarian values, before dieticians became anserine media hacks. Sugars, grains and legumes, and seed oils, as well as the vast array of novel foods made with them, are worth limiting or avoiding. To avoid obesity, to treat diabetes and degenerative diseases, restrict carbohydrates. Fat is your friend, cholesterol is an essential part of your body, and animal foods are the most nutritious foods, with vegetable foods as valuable supplements. 

Inquiry into diet has always been part of the philosophical tradition, for example in the writings of Lucretius, Montaigne, Lichtenberg, Schopenhauer and Nietzsche, because nutrition science is, or should be, concerned with the same questions as philosophy; how do we know what we know?, and, how should we live our lives? The well-designed experiment that can settle a question will always be a commodity that is valuable precisely because it is rare. Since the existence of the deficiency diseases and the harmful effects of smoking and excessive alcohol consumption were proven many years ago it has become unusual for diet and lifestyle studies to generate results that justify sweeping statements or universal recommendations. Nothing in biology makes sense except in the light of evolution, and it is only in the light of human evolution that we can hope to make sense of the human diet and its link to disease.

Originally published in the Café Reader, a fine literary magazine produced by the New Zealand-based company Phantom Billstickers. 


archandevo said...

This is fantastic, George!!!

tess said...

YEP! :-)

Bill said...

Wow, the ANCACs ate 10x more butter than modern Americans +1!

Given our constant exposure to a wide variety of oxidative and inflammatory insults, the protective effects of SFAs really need to be acknowledged and embraced. I’m doing my best to get the word out!

And lastly we have the “American Paradox” (Mozaffarian 2004) – higher SFA and lower CHO intakes associated with less atherosclerotic progression (from a study that got buried and virtually no media attention)

Puddleg said...

What a great paper Bill! Mozaffarian was lead author on the trans-palmitoleic acid papers, which showed careful attention to methodology and confounders. Those were based on the idea that dietary palmitoleate could account for the results seen here, (serum trans-palmitoleate being the marker for that). Which concept may have involved some perhaps unreasonable expectation of finding a non-SaFA protective factor.

Puddleg said...

Here is the editorial that accompanied that 2004 paper:

Saturated fat prevents coronary artery disease? An American paradox
Robert H Knopp and Barbara M Retzlaff

Galina L. said...

It is really hard to convince people to try to eat more animal fats and less grains. My former mother-in-law has rheumatoid arthritis(she is a professional chemist), my sister-in-law(veterinarian) has Hep C. They suffer, especially former MIL, but LCHF sounds too extreme and unhealthy for them.
George, you are my hero. My mom asked me if there any doctor exists who approves and eats LC, and I had a pleasure to present your story among others (I didn't forget Dr. Eades, for example, and Peter, Wooo, Sid).

Puddleg said...

I am not a doctor!
But I do have Hep C and I used to have sme sort of arthritis or rheumatism, so I can definitely say that this way of eating doesn't make those conditions worse, and may well make them better.
There are a few people on the Hep C Nomads forum who are LC-HF too, and are doing better as a result.
But not everyone finds it easy to switch, for sure. NOLA Hepper (see the link at the right) had a rough time. I think it is easier if you have the support of the various LC blogs. I don't think we should underestimate how much this network makes successful LC or paleo dieting work, where without that community fewer people would find the right path.

Galina L. said...

Indeed, the support we give to each other and reading about people with similar experiences apparently make a big difference. All that offisial propahanda in Russia of healthy grains and a wide-spread public acceptance of religious fasting makes my mother feel like LCarbers are engaged in some dangerous experiment. However, she takes a notice herself now when a neighbour complaines that her husband gained too much weight after 40 days of fast, and she remembers well how my father couldn't stop eating when a doctor put him on a no meat diet to help him with pollen allergies. We are social creatures.

ThisisBetty said...

Hi George.. I always really like all your comments I see around various places ... especially the ones I can comprehend. ; >

Congrats on this article. It's awesome. The part about western intellectuals and Eastern cultural interest/influence is very interesting, What a killer use for that Mark Twain quote too . Love that!

Anonymous said...

Excellent piece, George - concise and clear.

The Lama is heading through my little town in a couple of weeks. I must say I'm a little bemused about his rock star status, but that's probably me just being ignorant.

If the internet is to be believed, he gave up vegetarianism because of his Hepatitis?

Puddleg said...

That's interesting.
"The Fourteenth Dalai Lama was raised in a meat-eating family but converted to vegetarianism after arriving in India, where vegetables are much more easily available. He spent many years as a vegetarian, but after contracting Hepatitis in India and suffering from weakness, his doctors ordered him to eat meat on alternating days, which he did for several years. He tried switching back to a vegetarian diet, but once again returned to limited consumption of meat. This attracted public attention when, during a visit to the White House, he was offered a vegetarian menu but declined by replying, as he is known to do on occasion when dining in the company of non-vegetarians, "I'm a Tibetan monk, not a vegetarian".[57] His own home kitchen, however, is completely vegetarian.[58]"
- wikipedia
" When H.H. Dalai Lama is in the company of non-vegetarians, he sometimes says "I am a Tibetan monk, not a vegetarian" and occasionally takes meat. As an observation one could say that especially for (Western) vegetarian Buddhists it is not easy to understand why amongst the many ideals and practises H.H. Dalai Lama lives up to, abstaining from eating meat under all circumstances is not one of them. However within Buddhist Dharma it is not done to proudly judge a man like His Holiness because of statements and outer actions we might not understand."

One of the features of Tibetan village life that struck the invading British Indian Army in 1904 was the piles of bones thrown out of houses into the streets.
(Bayonets to Lhasa, Fleming)

Puddleg said...

There is a brilliant exposition of the fallacy of western inadequacy here, in chapter 49 of Aldous Huxley's "Eyeless in Gaza".
Huxley was always interested in the connection between diet, health, and thought. His works often mention the early probiotic theories of Elie Metchnikoff, and he was a grandson of T. H. Huxley and brother to Julian Huxley, both important figures in the history of the theory of evolution.

'Speaking as a doctor, I'd suggest a course of colonic irrigation to start with.'
'And speaking for God,' said Anthony, allowing his pleasure to overflow in good-humoured mockery, 'a course of prayer and fasting.'
'No, not fasting,' the doctor protested very seriously, 'not fasting. Only a proper diet. No butcher's meat; it's poison, so far as you're concerned. And no milk; it'll only blow you up with wind. Take it in the form of cheese and butter; never liquid. And a minimum of eggs. And, of course, only one heavy meal a day. You don't need half the stuff you're eating...

...if you're not careful, prayer just confirms you in the bad habit of being personal. I tell you, I've observed it clinically, and it seems to have much the same effect on people as butcher's meat. Prayer makes you more yourself, more separate. Just as a rump-steak does. Look at the correlation between religion and diet. Christians eat meat, drink alcohol, smoke tobacco; and Christianity exalts personality, insists on the value of petitionary prayer, teaches that God feels anger and approves the persecution of heretics. It's the same with the Jews and the Moslems. Kosher and an indignant Jehovah. Mutton and beef – and personal survival among the houris, avenging Allah and holy wars. Now look at the Buddhists. Vegetables and water. And what's their philosophy? They don't exalt personality; they try to transcend it. They don't imagine that God can be angry; when they're unenlightened, they think he's compassionate, and when they're enlightened, they think he doesn't exist, except as an impersonal mind of the universal. Hence they don't offer petitionary prayer; they meditate – or, in other words, try to merge their own minds in the universal mind. Finally, they don't believe in special providences for individuals; they believe in a moral order, where every event has its cause and produces its effect – where the card's forced upon you by the conjuror, but only because your previous actions have forced the conjuror to force it upon you. What worlds away from Jehovah and God the Father and everlasting, individual souls! The fact is, of course, that we think as we eat. I eat like a Buddhist, because I find it keeps me well and happy; and the result is that I think like a Buddhist – and, thinking like a Buddhist, I'm confirmed in my determination to eat like one.'

Puddleg said...

So, one wonders, what was the root cause of all this? I suspect, the Christian sense of "we are not worthy". The Romans never had this problem, never looked outside themselves for answers. But, if we and our civilisation are not worthy, it is easy to believe, after a while, that there exist people who are more worthy than us, civilisations or cultures free from the handicap self-imposed on our own.
Hence the lure of the mystic East - and also, of the noble paleo savage.

ThisisBetty said...

Sins of the flesh indeed. Makes me wonder about origin/ubiquity of the Eucharist.

When I was vegetarian I got mainly two reactions. One was people praising me for being good. The other was people acting kind of mildly defensive ... kind of like how some people get a little threatened if you're not drinking/smoking with them etc. Now I'm more likely to be told I should educate myself about nutrition due to the fact I eat gunless burgers etc.

ThisisBetty said...

bunless* : >

Puddleg said...

And these days people feel threatened if you don't eat gluten...
my vegan friend loves to attribute ill health to "wrong food" - or rather it is pronounced WRONG FOOD.
We need to get beyond good and evil, but food is wrapped up in those concepts - kosher, halal, fish on friday, etc.

Gabriella Kadar said...

George, food has gotten way too political. It's almost worse than talking about sex these days. Must be the aging demographic or something.

Puddleg said...

Eating has replaced sex as a sin.

I am looking at a paper now, in which the lowest quartile reports consuming 1227 calories per day (average). The BMI of this group is 28.4.
That's not possible, I'm no fan of CICO but seriously.

Compared to the other quartiles, this group includes way more females.

Someone here is trying to hide their sin.

brighteye said...

Great post as usual, and your pictures are awesome, where do you always find them?
Being a vegan or vegetarian is considered as morally superior, but dare say you eat gluten-free or LCHF and MAN, YOU ARE THE FREAK. But as Dr. Kurt Harris said, I fly my freak-flag high :-)