New study blasts the ridiculous low-fat dietary guidelines

knockout

I got an email from Pamela Schoenfeld, R.D. the other day. She wanted to make me aware of a paper she and her colleagues (Hite, et al)published on Friday in the journal Nutrition. It’s a critique of the Report of the 2010 Dietary Guidelines Committee (DGAC) that recommended that we all go on eating the same low-fat, high-carb diet that has contributed to the epidemics of obesity, diabetes and heart disease (among others).

The paper is open-access, which means you can read the full text for free (PDF). Here’s the gist: the new dietary guidelines proposed by the DGAC aren’t based on scientific evidence. The authors criticize the DGAC for excluding recent research that contradicts their low-fat propaganda, and for conveniently ignoring the fact that disease rates have skyrocketed over the past 30 years in spite of Americans eating less fat and more carbs.

The DGAC report essentially said, “Hey Americans! You’re fat and sick because you haven’t done a good enough job following our advice. What you need to do is eat even less fat (and by extension more carbs), and then you’ll finally lose weight and maybe not die of a heart attack.

Obviously the DGAC has never heard Einstein’s definition of insanity, which is to do the same thing over and over again and expect a different result.

Hite et al start the paper off with this gem of a quote:

What is required is less advice and more information. – Gerald M. Reaven

Amen to that! There’s no doubt we’re in the midst of a serious nutritional crisis, but the DGAC is dead wrong about what’s causing it. Hite et al continue:

Nutritional health covers a wide range of concerns but first and foremost in the mind of the public are whether the standing recommendations for lowering fat intake and increasing carbohydrate intake were ever appropriate for the prevention of obesity, diabetes, and cardiovascular disease;

You took the words right out of my mouth!

The authors go on to dismantle the DGAC dietary recommendations by reviewing all of the available evidence (imagine that!), rather than just focusing on the studies that support their viewpoint. Real science! What a breath of fresh air.

If you’re interested in learning more about how we’ve been collectively duped into the idea that fat is bad and carbs are good, read the paper. It’s not highly technical and is intended, to some degree I think, for a lay audience. But for those of you who don’t have time to read it, I’m going to list a few of the section headings to give you the idea:

“Strong recommendations, weak evidence”

“Macronutrients: Research questions are formulated in a way that prevents a thorough investigation of the literature” (Translation: we only see what we want to see.)

“Macronutrients and weight loss: Science is inaccurately summarized”

“Low carbohydrate diets: Science is inaccurately represented”

“Low carbohydrate diets: Conclusions do not reflect quantity and/or quality of relevant science”

“Effects of saturated fat: Answers based on an incomplete body of relevant science”

“Diabetes and fat: Science is inaccurately represented or summarized”

“Dietary fiber and whole grains: Conclusions do not reflect the quantity and/or quality of science”

“Animal versus plant protein: Recommendations do not reflect limitations and uncertainties of the science”

This is an important paper. It’s one of the most comprehensive critiques of the mainstream dietary recommendations I’ve seen, and it’s all in one place. So please, share this with as many people as you can. Post it to Facebook. Tweet it. Print it and take it to your doctor. Send it to your Mom & Dad, who might still think butter is bad for them. Tape it on your refrigerator. Get the word out!

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Comments Join the Conversation

  1. Brandon says

    Here is an extremely detailed, 90 minute video on why cutting out the fat is not the only step. This is information gathered and presented by Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology.

    Please watch the entire video and pass to your friends and family.

    This helps to explain why there are obese 6 month old babies and other such obesity epidemics.


  2. says

    It’s probably nit picking, but the attrition table caught my eye since I had done a rather in depth analysis of Foster (http://carbsanity.blogspot.com/2010/08/new-low-carb-v-low-fat-study-much-adieu.html).   The rate reported in this study is in error for Foster.  Attrition/drop-outs and what data was used to generate the “predicted results” is a HUGE issue in that study.   The omission of the infamous Shai study in their analyses is curious.
    Their weight loss section seems to be arguing in favor of a metabolic advantage and that LC is preferred by more people.  I’ve not seen evidence of either.  Indeed if long term maintenance of weight loss (the real goal) is considered, LC doesn’t seem to have any better track record.  Weight loss follows a familiar trajectory of greater initial losses followed by greater regains to get to roughly the same point.
    I have an issue with the strawman constructed for the guidelines.  Much of the increased carb intake is sugar (not recommended), and NHANES demonstrates we’re NOT eating low fat now, and women have increased total fat intake.  A slight reduction in % in the context of a 20+%  increase in total intake is meaningless.   We ARE eating more and getting fatter for it.

  3. Mindy says

    Hi Chris, my husband and I began eating “primal” 4 months ago. he just got his cholesterol tested and I am trying not to panic. :) We got started with primal eating after reading your post about having high cholesterol and not caring. Most of his ratios are ok, but I wanted to get your thoughts…please.
    Total 305
    Trig: 102
    HDL: 55
    LDL:230 (Friedwald equation)
    LDL: 127 (Iranian equation)

    Total/HDL = 5.54
    Trig/HDL = 1.85
    LDL/HDL = 4.18 (Friedwald)
    LDL/HDL = 2.3 (Iranian)

    The one ratio we are concerned about is the Total/HDL. Ideal is 5 for men right? Is 5.5 something to be concerned about?

    What do you think about these numbers? His journey with this began 10 years ago, when before the age of 30 he had high cholesterol and we tried lowering it with diet and exercise. (low fat SAD diet) and it didn’t help. Then he was put and statins and it lowered his cholesterol. Then he went off the statins and changed to the low carb, primal diet and these are the results. I admit that I am having a hard time not caring about the high numbers.

    his blood pressure has always been normal. As far as we know his blood sugar isn’t an issue. Everything else about him seems quite healthy. Both his grandfathers died of heart disease, his dad struggles with high cholesterol and high blood pressure (on the SAD).

    Thanks so much for your thoughts. I really appreciate and value them.

  4. Chris Kresser says

    Mindy:

    The research is clear that total cholesterol and LDL are not strong risk factors for heart disease. The ratio between TG/HDL (<2 ideal, which your husband is) is a much stronger predictor. You can also consider a VAP or NMR test to determine LDL particle size, or a Shiel ox-LDL Triple Marker test.  Both are FAR better indicators of CVD risk than a normal lipid profile. Also remember that a TC of 300 was considered normal not too long ago.

  5. Simon says

    Hey Chris,
     
    Just curious whether you would consider oats to be a safe starch? I eat around 40% carbohydrates because I feel that works for me, mostly yams, brown and white rice, and quinoa, but I’m thinking about cutting out oats because they are part of the Gliadin family. I was wondering what you would recommend to a patient.
     
    Best,
     
    Simon

  6. Chris Kresser says

    Simon,

    I’d recommend cutting oats and eating white rice instead of brown, unless you are preparing the brown rice with traditional methods (i.e. soaking and fermenting).  Make sure you’re also soaking and fermenting the quinoa.

    That said, some people seem to do okay with oats as long as they’re properly prepared (with the methods above), so I’m not too dogmatic about it.

     

  7. Simon says

    Thanks Chris. I’d prefer to just drop both oats and quinoa then go through the trouble. All the best.
     
    -Simon

  8. Mindy says

    Hello again,
    Well, both my husband and I got a VAP test. I had great news. Pattern A. TG/HDL ratio .8. :) I have responded well to the low-carb lifestyle. My husband, not so much.
    His results:

    * means high

    LDL 239 *
    HDL 55
    VLDL 22 *
    Total C 317*
    Triglyceride 99
    LDL+vldl 261*
    Apob100 175*
    LDL-r 226*
    lp(a) 0.0
    Idl 13
    Idl+ vldl3 25
    Hdl-2 12
    Hdl-3 43
    Vldl-3 12*
    LDL density pattern B

    His grandfathers on both sides died of heart attack (at 45yrs old) or heart issues. Uncles on both sides have had heart attacks, his dad is currently battling high cholesterol, high blood pressure.
    We’re trying to figure out what’s going on. His Dr of course wants him on statins, but that will only lower numbers, not necesarily reduce his vldl count.  
    Right now our plan is to add on Coqu10 & maybe niacin? He’s been eating about 50-75g carb. He is already taking fish oil…. He’s 6′ and 180, 19% body fat. He does carry his extra weight in the stomach it seems. He’s only 38. we really want to figure out what’s going on when I responded so well eating very close to the same things. I deeply appreciate your thoughts or advice.

    • Chris Kresser says

      Mindy,

      It’s possible your husband has what Dr. Davis calls “genetic small LDL“. Such a condition is just a theory at this point, but I think it’s plausible.

      What type of fat is your husband eating? Saturated fat increases large, buoyant LDL and decreases small, dense LDL. Coconut oil is an excellent choice because it’s mostly saturated.

      Fructose has a potent effect on the lipid profile and on abdominal fat, so make sure intake of fructose is low (I imagine it is, with only 50-75g of carb).

      Has your husband tried a paleo diet, i.e. removing grains and legumes?

      At this point it’s probably a good idea if he finds someone familiar with these issues to work with. Dr. Davis Track Your Plaque program might be a good option. I am now working with people at a distance, if that’s of interest.

  9. Mindy says

    Chris,
    I was thinking something similar. I have read a bit of Dr. Davis’ site. My husband and I have been following the Primal Blueprint. His typical day starts with a whey protein shake with coconut milk. Lunch is turkey, salami, spinach salad with olive oil/balsamic vinegar. Snacks are pepperoni stick, peach with heavy cream. dinners are usually chicken thigh (with skin), steak, or ground beef, broccoli or some other veggie. We have cut out all grains, legumes. He still gets some sugar from dark chocolate. In the evening we will have some fresh berries with heavy cream. We also eat bacon and eggs cooked in coconut oil or butter. We really embraced the whole primal lifestyle. The one thing we haven’t been able to do is buy grass-fed meats. We are on a very limited budget and have cut cable and other things to enable us to eat as healthy as we can.

    We will be looking into our options. thanks for your offer. thanks again for all your input. I’m glad we are beginning to discover this now in his life. We have 3 young children…he is the love of my life….we want to keep him as long as we can. ;)

  10. says

    Chris – do you have any opinion on eating late at night and its effect on health? I generally eat twice a day – at 11 am and 11 pm. When I lived in Spain in the mid-1980′s I witnessed their late night eating habits. It didn’t seem to do them any harm  – at least in terms of obesity. And I can only imagine that cultural habit was not exactly modern.
    Also – seeing as many animals – particularly carnivores tend to laze around or fall asleep after eating, isn’t it natural for us humans to be doing that late at night rather than at 6 pm when the conventional wisdom dictates you don’t eat much or anything later than in order to avoid weight gain?
    Many thanks for a truly invaluable blog!

  11. Chris Kresser says

    Mart:Some will definitely gain weight eating late at night. Others won’t. It depends on their metabolism, digestive capacity, hormone balance, stress levels and a number of other factors. If it’s not a problem for you, I don’t see a problem with it.

    From an evolutionary perspective, intermittent fasting (12-14 hours between meals on a regular basis) was probably the norm.  That said, we’re pretty far from evolutionary norms now and I believe some people need to eat small, frequent meals to manage their blood sugar imbalance – at least for a period of time.

    I personally don’t like to eat late at night because I don’t feel as clear and energetic when I wake up the next morning.  But YMMV.

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