Story time!

Long, long ago (1958), a researcher from the University of Minnesota named Ancel Keyes began a study to determine what health, diet, and lifestyle factors might possibly correlate to the rising epidemic of heart attacks among middle-aged American men. This was a major concern at the time to politicians and government officials; given the United States had emerged from WWII a superpower, and our entire way of life was at odds with the the world’s only other superpower, and obviously everything American was superior to everything else in every other country, especially whatever those poor, miserable, fur-swaddled commies managed to get their hands on after standing in line all day, stomping their feet and rubbing their hands together—why, given our unheard of and ever-growing prosperity, were more and more of our men dying of heart attacks?

Keyes’s study was dubbed “The Seven Countries Study,” and included the United States, Finland, the Netherlands, Italy, Yugoslavia, Greece, and Japan. This study became the basis for everything we now consider common knowledge about heart disease, cholesterol, blood pressure, smoking, diet, obesity, and exercise. In a nutshell, the escalation of heart disease correlates with blood cholesterol level, elevated blood pressure, obesity, and smoking, and these factors can be positively influenced through a healthy diet and exercise. As far as diet is concerned, a diet high in fat correlates with elevated blood cholesterol, which correlates with high blood pressure, which indicates an increased risk of heart disease. If you eat fat, you die.

Finally, we have an answer for the rising rate of heart attacks! And it’s such an elegant solution! We just get Americans to stop eating butter, and bacon, and lard, and maybe cut back a little on smoking, and our middle-aged men will be in tip-top shape to kick some serious commie ass!

Actually, Keyes’s contemporaries were skeptical of the findings, especially the board members at the American Heart Association, and additional clinical studies were scheduled. But funding for more research was not forthcoming. A few years later, Ancel Keyes and his colleges who supported his research became AHA board themselves, and The Seven Countries Study became gospel.

The Seven Countries Study continued for more than fifty years, and is still called by the original name despite one of the original countries dissolving into five separate countries. And while its scale and ambition was groundbreaking at the time, its implications fall apart under closer scrutiny. For instance, women were not included in the study. There were actually data from twenty-two countries, and the seven countries chosen for the final report “just happened” to present the best evidence for Keyes’s argument. The countries and populations included in the study were not chosen at random. And most importantly, as any high school science class should teach us, correlation does not prove causation.

Since the 1950’s there have been dozens of studies and clinical trials conducted that have attempted to show directly and indirectly that dietary fat, especially saturated fat, is responsible for heart disease. None of them have been successful.

A few examples:

In 1984 the National Heart, Lung, and Blood Institute spent ten years and $115 million on a clinical trial to prove that eating less saturated fat would reduce the incidence of heart disease. The study was called the Multiple Risk Factor Intervention Trial. It failed to identify saturated fat as a risk factor.

In 2001 the Cochrane Collaboration, a widely respected international organization that performs peer reviews of medical literature, reviewed all of the clinical trials relating to dietary fat and mortality that the organization considered professionally reliable. Their conclusion, “Despite decades of effort and many thousands of people randomized, there is still only limited and inconclusive evidence of the effects of modification of total saturated, monounsaturated, or polyunsaturated fats on cardiovascular morbidity and mortality.”

Published in 2006, The Women’s Health Initiative, the largest  and most expensive health study ever conducted (over one hundred thousand participants and eight hundred million dollars), chose twenty thousand middle-aged women at random to eat a low-fat, low-saturated fat diet for eight years. Compared with the thirty thousand women of the study who stuck to their regular eating habits, the low-fat diet had no significant effect on heart disease, stroke, breast cancer, colon cancer, or accumulation of body fat.

So what does all this prove? Not a goddamned thing. We haven’t proved that fat is good for us, but billions of dollars and fifty years of research have failed to prove that dietary fat is bad for us, so there is no reason to think that it is. It’s alright if you’re skeptical; I still get a twinge of guilt when I cook eggs in butter. We’ve been told our whole lives fat is bad for us, by people we trust who meant well.

It’s also alright if you flat out don’t believe me; I believe we’re better off getting the majority of our calories from fat, but a low-fat diet won’t kill you. As long as you understand that fat doesn’t make you fat, that a diet high in sugar and refined starches does, and so as long as you’re not replacing fat calories with sugar and white flour I’ll be happy.

In my next post I’ll tackle the different types of dietary fat, how each of them affects our cholesterol, and what our various cholesterol numbers mean when we get them back from the doctor.

Also, nothing I said above applies to artificial fats.  Trans fat and hydrogenated oils are created in a laboratory and absolutely can ruin your health.  Trans fat is banned in the U.S. now, but margarine and most vegetable oils are poison, so look at the ingredients of whatever oils you have in the kitchen and if they say hydrogenated or partially-hydrogenated throw them the hell away.