Ah, yes. As a 90s kid, I remember the old 'FDA-approved' Food Pyramid plastered all over the walls of the cafeterias of elementary school all the way through high school. Pure carbohydrate foods like bread, pasta, cereal, and rice made up the massive foundation of supposedly healthy eating, whereas fats were, for some odd reason, lumped in with sugar, and should make up the least of your diet. They apparently updated this slightly in 2005, and in 2011, simplified it all even further for our carb-loaded (read: sugar-loaded), nutrient-and-fat deficient brains (our brain is made up of fat) with the dopey MyPlate iteration in 2011.
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| Remember this nonsense? |
The Lancet, a widely known and well-respected medical journal, published a study that has officially and finally blown up the old post-hoc, ergo propter hoc justified narrative of 'consuming fats = bad, therefore, minimize fats (and by implication, replace with carbs)'. Of course, this also ignored the fact that much of our bodies, including our brain, skin, and almost all of our internal organs are made up of fats.
Here's a direct link to the abstract for Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study, with the general summary provided below.
It feels good to be vindicated, doesn't it? Anyone I know, personally, would tell you that I've been touting this side of the argument for over a decade, now -- the idea that many of the problems with heart disease, general health issues such as obesity, and early mortality are not linked to one's fat intake. On the contrary, it's one's lack-of-fat-intake and the subsequent, over-the-top carbohydrate intake, that takes its place.
So why was this ever even 'a thing', anyways, being so ridiculously, dangerously incorrect? Is it just FDA and general government incompetence in a vacuum that brought us here, with moral busy-bodies sticking their nose into everyone's business? As this Salon article rightly points out -- with some snippets below -- the history of the FDA, the USDA, and the lobbies that lobby them encouraged a blatantly unscientific lack of evidence and a stream of logical fallacies that led to these false conclusions. Over time, this was all dogmatically propagated as a kind of inter-generational Holy Faith of Eating, with lobby groups, politicians, and bureaucrats all patting eachother on the back as the dietary saviors of the unwashed masses. Of course, it didn't matter that this narrative continued to crumble for decades to come.
Contra the ideologically motivated documentaries such as 'Super Size Me' (2004), it looks like their antithesis -- documentaries like 'Fat Head' (2009) -- actually had a much better take on the situation.
Self-styled 'moral' government busy-bodies, the power they grant to special interest groups, and the misinformation they spread has done enough damage for far too long. If they had minded their own business in the first place, then we wouldn't be in this mess. It's high time we throw this nonsense into the dustbin of history and start eating healthy again.
Of course, I won't hold my breath in hoping that the moral government busy-bodies on both sides of the political spectrum stop screwing everything up.
Background
The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear.
Methods
The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering.
Findings
During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.
Interpretation
High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.
It feels good to be vindicated, doesn't it? Anyone I know, personally, would tell you that I've been touting this side of the argument for over a decade, now -- the idea that many of the problems with heart disease, general health issues such as obesity, and early mortality are not linked to one's fat intake. On the contrary, it's one's lack-of-fat-intake and the subsequent, over-the-top carbohydrate intake, that takes its place.
So why was this ever even 'a thing', anyways, being so ridiculously, dangerously incorrect? Is it just FDA and general government incompetence in a vacuum that brought us here, with moral busy-bodies sticking their nose into everyone's business? As this Salon article rightly points out -- with some snippets below -- the history of the FDA, the USDA, and the lobbies that lobby them encouraged a blatantly unscientific lack of evidence and a stream of logical fallacies that led to these false conclusions. Over time, this was all dogmatically propagated as a kind of inter-generational Holy Faith of Eating, with lobby groups, politicians, and bureaucrats all patting eachother on the back as the dietary saviors of the unwashed masses. Of course, it didn't matter that this narrative continued to crumble for decades to come.
[...] official government dietary guidelines for healthy eating are dangerously wrong in almost every respect. Like the old food pyramid in its various incarnations, the new food plate is the product of the marriage of politics and Big Agra lobbying—actual nutrition has very little to do with the recommendations. As they stand today, and have for decades, the official recommendations of the USDA are determined by the commercial interests of agribusiness. They’re also the primary reason why two-thirds of all Americans are overweight. They’re why 29 million Americans have type 2 diabetes, another 19 million have it but don’t know it, and 79 million people have prediabetes. They’re also why I never lack for patients suffering from diabetic peripheral neuropathy.
... Specifically, the USDA officially promotes a diet that is far too high in carbohydrates and far too low in healthy fat. In other words, your government is promoting a diet that will make you obese, give you a whole slew of illnesses, and kill your nerves.
... It all started back in the 1950s, when there was an epidemic of middle-aged men dropping dead of heart attacks. The cause, according to the experts, was too much saturated fat in the diet. How did they arrive at this assumption? First, because they knew that a heart attack is caused by a blockage in an artery nourishing the heart. They also knew that atherosclerotic plaques, made up mostly of cholesterol, caused the blockage. And because foods that are high in saturated fat, such as meat, also contain cholesterol, they came to the conclusion, with very little evidence, that a high-fat diet caused heart disease.
... Much as I like to see dots connected, the steps that link saturated fat in the diet to a higher risk of a heart attack were unproved then—and they remain unproved. Even so, the saturated fat–cholesterol–heart hypothesis became an article of faith.
...But was there actually an epidemic of heart attacks among middle-aged men in the 1950s? No. Instead, there was an epidemic of men aged 50 and up. In 1900, the average life expectancy of an American male was 48 years. Most men died of infectious diseases such as tuberculosis, pneumonia, diphtheria, and gastrointestinal illnesses. Accidents of various sorts killed many more men than they do today. In 1900, nutritional deficiencies were fairly common.
... By 1950, however, the average American male was living into his seventies. Death from infectious disease was way down, due to improved living conditions and the discovery of antibiotics. Death from malnutrition was rare and overall, life was safer and healthier. Many more men were now making it into their fifties and beyond, reaching the prime heart attack years. That means more men were dying of heart attacks simply because more were surviving long enough to have one.
... The supposed link between saturated fats and heart disease was a marketing windfall for the food industry... Based on expert testimony from nutritionists who were convinced of the saturated fat–heart hypothesis, in 1977 the committee issued dietary recommendations that pushed for a sharp reduction in fat intake.. The recommendations ignited a firestorm of controversy... The idea that Americans should ever eat less of anything incited every agricultural and food processing lobbyist in the country to protest. In response to the pressure, the guidelines compromised on the dietary fat recommendations... The dietary guidelines recommendations, rather than expiring with the committee, ended up being taken on by the USDA, where they have remained ever since.
Every five years since the late 1970s, the USDA has issued a set of dietary guidelines for Americans. And every five years, predictably, the food industry rises up to make sure that eating less of anything isn’t in those guidelines. Politics and lobbying shape these dietary recommendations far more than actual science.
Not coincidentally, the surge in weight gain among Americans that had begun with the introduction of high-fructose corn syrup gathered steam with the introduction of the food pyramid and its emphasis on carbohydrates...
The really insidious part of the guidelines is that they’re the standard used for school nutrition programs [and] for any food program that involves government money. That’s why your child can be served potato chips in the school lunch program and have them count as a vegetable, or be given a glass of orange juice (another name for concentrated sugar) and have it count as a fruit. It’s also why milk, which is high in sugar in the form of lactose, and flavored yogurt, containing both lactose and added sugar, are pushed in school cafeterias. In other words, official government nutrition recommendations lay the groundwork for later nerve damage.
Contra the ideologically motivated documentaries such as 'Super Size Me' (2004), it looks like their antithesis -- documentaries like 'Fat Head' (2009) -- actually had a much better take on the situation.
Self-styled 'moral' government busy-bodies, the power they grant to special interest groups, and the misinformation they spread has done enough damage for far too long. If they had minded their own business in the first place, then we wouldn't be in this mess. It's high time we throw this nonsense into the dustbin of history and start eating healthy again.
Of course, I won't hold my breath in hoping that the moral government busy-bodies on both sides of the political spectrum stop screwing everything up.
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