Weekend Watching: Another Look at Dietary Guidelines

Conventional dietary wisdom tells us that we should limit intake of fat, and that saturated fat is the worst!

Right at the top of the Nutrition Facts panel on any of the processed food we buy is a declaration of its fat content: Total Fat, Saturated Fat, Trans Fat, Polyunsaturated Fat and Monounsaturated Fat.

Total Carbohydrate doesn’t even get second billing: it’s below both Cholesterol and Sodium.

There was a time when I was extremely grateful for the product at right, when I had recently been diagnosed with celiac disease.

Other cereals I had tried were gluten free, but that was the most you could say for them. They were not at all tasty. Chex cereals were the first ones made for the mass market that also were gluten-free, and Corn Chex was my favorite variety.

I ate it for breakfast almost every day, and as you can see on the label I definitely wasn’t getting too much fat, even with 2% milk. But each serving did have 33g of carbohydrates, even when I didn’t add any extra sugar.

Over just a few years it played a significant role in me gaining 40 lbs. and getting to Peak Lee.

Knowing that I had been on a diet that was rich in so-called “healthy whole grains” and yet was anything but healthy, when I started to run across messages challenging this dietary consensus I was open to at least trying a different approach.

Of course it was not without a bit of concern: after all, if I lost a bunch of weight but was setting myself up for heart disease, that wouldn’t be a net benefit.

That’s why I found it really helpful to have serious scientists like Dr. Peter Attia review the literature and outline what the research on diet and heart disease really says.

I think you’ll find this video fascinating, as I did. Watch it for yourself and let me know what you think in the comments.

If you doubt that it’s worth the 79 minutes to watch, I’ll provide a few bullet point highlights below.

  • Studies of Benedictine and Trappist monks, Navajo Indians, Irish immigrants to Boston, Swiss Alpine farmers and Maasai and other African pastoralists report no association of saturated fat to heart disease.
  • A 1957 study of 5,400 male employees of Western Electric Company compared the 15 percent who ate the most fat to the 15 percent who ate the least. “Worthy of comment, is the fact that of the 88 coronary cases, 14 have appeared in the high-fat intake group and 16 in the low-fat group.”
  • A follow-up study of the Western Electric cohort in 1981 found “The amount of saturated fatty acids in the diet was not significantly associated with the risk of death from CHD.”
  • The Minnesota Coronary Study, which involved 9,000 men and women whose diets could be strictly controlled because they were in mental institutions, found 269 deaths in the intervention group (with low saturated fat and cholesterol) and 206 deaths in the control group. The results, available in 1973, went unpublished for 16 years. Why? “We were disappointed in the way they turned out.”
  • 2001 Cochrane Collaboration meta-analysis involving 27 well-controlled randomized trials with 10,000 subjects followed for an average of three years each found No effect on longevity and No “significant effect on cardiovascular events.”
  • A second Cochrane Collaboration meta-analysis in 2006 “Multiple risk factor interventions for primary prevention for coronary heart disease” with 900,000 patient years of observation concluded: “The pooled effects suggest multiple risk factor intervention has no effect on mortality.”

OK, now go back and watch the video. It’s a pretty compelling story.

What do you think?

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A Calorie is NOT a Calorie

Just as not all studies are created equal, neither are all calories.

This isn’t new news in the scientific literature. In fact, a study from the 1950s showed that carbohydrates, protein and fat in the diet have significantly different impacts on metabolism.

And yet today we still hear the refrain: “A calorie is a calorie is a calorie. Weight is simply a matter of calories in vs. calories out. If you want to lose weight, the solution is simple: Eat less. Move more.”

A paper published in The Lancet in 1956 by Kekwick and Pawan (embedded at the bottom of this post so you can read for yourself) tells a much different story.

The paper reported on three diet studies involving obese patients.

In the first, when the proportion of protein (20%), fat (33%) and carbohydrate (47%) calories were held constant (20%), lower daily calorie intake led to greater weight loss.

No surprise there.

But the results of two other series of diets seriously undermined the theory that “a calorie is a calorie is a calorie.”

In the second series, 14 subjects were put on three different semi-starvation diets, each of which fed them 1,000 calories per day with 90% of calories coming from either carbohydrates, protein or fat. On the 90% protein and 90% fat diets, the subjects lost 0.6-0.9 lbs. per day, while on the 90% carbohydrate diet they actually gained weight.

Let that sink in: obese subjects gained weight on 1,000 calories per day.

On a semi-starvation diet.

When the calories came from carbohydrates.

In the third diet series, patients were put on a balanced diet of carbs, protein and fat at 2,000 calories per day, which caused them to maintain or gain weight.

When they were placed on a 2,600 calorie diet that was mostly fat and protein, four out of five lost weight.

With 600 more calories each day, as long as they came from fat and protein, the patients lost weight.

This study involved a small group of subjects, and the authors noted that “many of these patients had inadequate personalities. At worst they would cheat and lie, obtaining food from visitors, from trolleys touring the wards, and from neighbouring patients…. At best they cooperated fully but a few found the diet so trying that they could not eat the whole of their meals.”

That last point is important: if patients were on a 2,600-calorie protein/fat diet and found they couldn’t eat their whole meals, that’s kind of the goal, isn’t it?

It’s reverse cheating. They can eat as much as they want…but they just don’t want.

As the authors noted, high-carb diets tend to promote water retention, while protein/fat diets lead to loss of water weight. And even though those water weight losses aren’t permanent, it still demonstrates the underlying point: your body is not a bomb calorimeter. It doesn’t “burn” calories.

While the laws of thermodynamics are true, they aren’t the major driver of body weight issues.

Different types of calories are metabolized differently.

A calorie is NOT a calorie.

This was shown more than 60 years ago. And yet well into this century the U.S. government was officially recommending 6-11 servings per day of bread, cereal, rice and pasta.

I first learned about the Kekwick-Pawan paper in The 4-Hour Body by Tim Ferriss, which led to me adopting the Slow-Carb Diet and eating eggs for breakfast every day.

Tim’s podcast also introduced me to some interesting researchers, thinkers, authors and podcasters, whose programs and publications led to others from whom I’ve learned.

I’ll introduce you to the first of these next time.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.