Ancel Keys – Big Fat Confusion ?

Leave a comment

An early picture of Ancel Keys, This image is ...

An early picture of Ancel Keys, (Photo credit: Wikipedia)

Time Magazine 1961. Ancel Keys appears on the cover to claim that saturated fat in the diet clogged arteries and caused heart disease.

Time Magazine, 2014. Eat Butter. Scientists were wrong about saturated fat. They don’t cause heart disease.

How did the low saturated fat message begin?  How, when and why did this confusion begin?

Ancel Benjamin Keys was born in 1904 in Colorado Springs, Colorado to teenage parents. In his younger years he had various jobs including a clerk in a Woolworth store. He finished college in 3 years with Honors at Berkeley and earned a MS in Biology followed by a PhD from the Scripps Institute of Oceanography. In 1930 he traveled to Copenhagen to work with Nobel laureate, August Krogh where he studied the ability of eels to survive in both fresh and salt-water environments. He then went to Cambridge and obtained a second PhD in animal physiology from King’s College.

What made Keys famous was his Seven Countries Study, a study that remains controversial to this day. He initially observed that heart disease rates dropped in countries forced to alter their high fat diets because of the war rationing and reversed to higher rates when these diets returned.

He suspected dietary factors, particularly saturated fat, that might play a key role in atherosclerosis. After conducting some well-designed studies to support his theory, “he formulated an equation that simply showed a 2.7% mg/dl rise in cholesterol for every 1% of calories derived from saturated fat. The equation also suggested that polyunsaturated fat lowered serum cholesterol and dietary cholesterol raised serum cholesterol but to a lesser extent than saturated fat. “ Journal of Clinical Lipidology, page 435

Keys had based his theory on when he had previously visited Italy and Spain. He observed in Naples, Italy that only heart disease patients in hospitals were wealthy men. In Madrid, Spain he took blood samples from some men in one of the poorer districts where heart disease was rare and compared them to samples of more well-off patients with heart disease. What he found were differences in their serum cholesterol values with the higher levels in the wealthy and lower values in the poorer population. The diets of the two groups also differed with the poorer diets lower in fat than those of the wealthy. These observations were central to his theory that saturated fat or animal fat and dietary cholesterol contributed to heart disease.  Levenstein, Harvey, Junk Science Week: Lipophobia and the Bad Science Diet, Financial Post, June 11,2012.

The theory gained some steam when in 1955, President Dwight David Eisenhower had a heart attack at age 64, “ Over the next six weeks, twice-daily press conferences were held on his condition. After his attack, he dieted religiously with a low-fat diet and had his cholesterol measured ten times a year (it had been 165 mg initially)”. Taubes, Gary. Good Calories, Bad Calories, page 1-4.   The low-fat diet had little effect and his cholesterol continued to rise as well as his weight.

Between 1955 and 1958, Keys began to study the male population aged 40 to 59 in rural areas in certain countries. He used electrocardiograph data to detect heart abnormalities and cardiovascular disease. The countries included Yugoslavia, Italy, Greece, Finland, the Netherlands, the U.S. and Japan. The countries he had chosen represented varied intakes of saturated or animal fat; lower levels were found in some populations in Yugoslavia, Italy, Greece, and Japan. Finland, the Netherlands, and the U.S. represented higher levels of animal fat in their diets. Five and ten years later, the researchers returned to identify those who had experienced heart attacks. The lowest rates were found in Crete and Japan with the lowest levels of animal fat; the highest was found in East Finland and the U. S. with the highest levels of animal fat. All in all, Keys studied nearly 13,000 men.  From this study, he concluded that “saturated fats as a percentage of calories was the most powerful lifestyle predictor of heart disease. “Blood cholesterol was the important physiological variable. “ Journal of Clinical Lipidology, page 437.

In 1961 Keys appeared on the cover of Time magaine with the Seven Countries Study’s alleged link between fat, cholesterol and heart disease that fueled the fear of dietary fat in America. Two weeks later the American Heart Association (AHA) endorsed the theory.  With this announcement, the vegetable oil producers could not get their advertisements out fast enough. Wesson Oil said: “polyunsaturated Wesson is unsurpassed by any leading oil in its ability to reduce blood cholesterol.” Nutrition scientists jumped on the bandwagon. For example, Harvard nutritionist, Frederick Stare advised swallowing three tablespoons of polyunsaturated oil each day. Lipophobia had begun in earnest. Levenstein, Harvey, Lipophobia and the bad science.

Consumption of margarine doubled from 1950 to 1972 and that of vegetable oil rose by over 50% in the 10 years from 1966 to 1976. Ironically, based on the thesis of Keys that saturated fat was the culprit, the AHA and other agencies had urged food processors to use trans fats to replace the alleged deadly saturated fat. Ironically, the most common source of trans fats turned out to be the very margarine they had promoted as heart healthy. From 1956 to 1976, per-capita butter consumption fell by over half.

Key’s hypothesis strengthened in 1977 with Senator George McGovern’s publication of the First Dietary Goals for the U.S., which was the first time that any government group had told Americans to eat less fat and cholesterol to improve health. The document became gospel and had a tremendous impact on consumers and the food industry. In 1980, Hegsted and McGinnis produced the USDA Dietary Guidelines for Americans that concurred with “avoiding too much fat and cholesterol and eating more foods with adequate starch and fiber.”

However, three major studies failed in their support for Key’s hypothesis and without going into the details, each one raised doubts about the  hypothesis.

The Key’s Seven Countries Study, so pivotal in lipophobia has been debunked by many, particularly those who favor the idea of eating meat.. On the other hand, vegans favor the thesis. Here is what the critics of the study say: First, Keys did not randomly choose countries but is accused of picking those countries most likely to support his theory. He excluded France whose diet has been notoriously rich in saturated fat along with a low heart disease rate (The French Paradox). He also excluded Switzerland, Sweden, and West Germany with the similar higher saturated fat intakes but with lower rates of heart disease. He originally gathered data from 22 countries.   However, some point out that even when all 22 countries are analyzed, the trend that fat intake is associated with heart disease still weakly exists.

Ancel Keys died in November of 2004 at the age of 100 years old.

Key’s thesis is still hotly debated to this day because of its limitations and lack of  conclusive support from the research community. There are still adherents of the efficacy of the low fat diet, particularly in its effects on atherosclerosis regression or prevention.  The debate has now switched to which diet is heart healthy – a low-fat or a low-carbohydrate diet. However, that is another story.

I truly don’t know if Keys was right or wrong. The purpose of this post is to point out that his legacy remains as one of the leading food crusaders that changed the American plate.  Is the low fat craze finally coming to an end?  Has this national experiment failed?  Will the low carbohydrate diet help curb the obesity epidemic or prevent heart disease?  Sounds like a “soap opera, doesn’t it?  One thing is certain – atherosclerosis is a complicated disorder and until its origin and pathology is conclusively determined, no one will know who was right.

 

The Pros and Cons of the Paleolithic Diet

The Paleolithic diet has been around for a few years and in my opinion is a pretty good diet, but alas as with every restrictive diet, there are caveats.

The following article comprehensively covers the pros and cons of this eating pattern. It is based on the facts (as we know them) that our ancestors only had access to certain foods and that our genetic development is presumed to have evolved from inclusion and exclusion of these foods into our current dietary pattern. Evidence for this is presumed to be accurate – however, we truly do not know what our Paleo ancestors really ate.  Our ancestors lived in diverse environments; therefore, their diets were dependent on the foods found there. There is a great deal of controversy about the possibility that some ate a diverse plant-based diet, e.g. hunting was not so reliable.

Most evidence is based on our contemporary hunter-gatherer societies which exhibit less chronic disease than those populations that follow the current American diet. For example, there are no Hadza adults diagnosed with diabetes in Tanzania, while the Tsimané people in Bolivia have an 80 percent lower rate of atherosclerosis compared to people in the U.S. The Maasai community in Kenya that relies on red meat, blood and milk is also known for little to none cardiovascular diseases.

The Pros and Cons

Our ancestors and modern-day hunter-gatherers ate more animal-based foods, which contain good amounts of high-quality protein, calcium, iron, omega-3 fatty acids and vitamins B12 and K2. Such nutrients are commonly found in seafood, red meat, pastured eggs and liver.

An ancestral diet removes refined sugar, grains and seed oils from one’s daily meals. Avoiding these modern products helps reduce markers of inflammation, leading to improvements in blood pressure, waist circumference and lipid profiles, components of the metabolic syndrome.

One study showed that people who consumed less added sugar, refined grains and processed foods could significantly reduce weight in 12 months. The ancestral diets provide foods that are more satiating, which help people consume fewer calories.

The Paleo diet excludes extremely calorie dense foods (starchy foods) as well as many processed and snack foods.

However the diet eliminates two major food groups (dairy and grains (enriched or whole).  This puts at risk adequate vitamin D and calcium levels as well as the other nutrients found within these foods.

The Paleo diet provides some essential nutrients and may appeal to some people that are not interested in a total plant based eating pattern, i.e., dedicated carnivores.

CLICK HERE.

 

 

 

 

The Rising Rate of Obesity and Its Consequences

“The headlines this week broadcast the following research:  Doctors at NYU Langone Health center conducted the largest study so far of US hospital admissions for COVID-19, focused on New York City. They found obesity, along with age, was the biggest deciding factor in hospital admissions, which may suggest the role of hyper-inflammatory reactions that can happen in those with the disease.”

Just what are the latest facts and implications about our obesity epidemic in the U.S.?

This data is from the U.S. Centers of Disease Control and Prevention in February 2020 and presented in Life Extension Magazine, May 2020.

  • A startling result is that 42.4% of adults are obese. Additionally, 31.8% were overweight.
  • This situation is expected to not improve statistically. A study in the New England Journal of Medicine estimates that by 2030, the percentage of obese American adults will rise to 48.9%. These percentages reflect a total of $446 billion dollars of medical costs annually.
  • Women, African Americans, and those with a low socioeconomic status are affected at a significantly higher rate.

What are the medical implications?

  • Excess body weight increases the risk of developing and dying from a broad spectrum of cardiovascular diseases, cognitive disorders (e.g. Alzheimer’s) and at least 13 different types of cancers.
  • Obesity has been determined to be the underlying cause of approximately 20% of deaths in the United States.
  • An analysis of 57 studies encompassing 900,000 individuals published in Lancet found that for every 5 point increment in Body Mass Index was associated with a 30% increased mortality risk.
  • Additional negative effects of excess weight include fatty liver disease, sleep apnea, chronic pain syndromes like low back pain, IBS, osteoarthtis, depression, negative pregnancy outcomes, and chronic inflammation.

Foods that Kill

There are many factors that contribute to the rise in obesity rates; however, diet and lifestyle have recently been identified and collectively referred to as components of the Standard American Diet (SAD). One of these is processed food.

  • Processed foods tend to be high in added sugar, salt, oil and unhealthy fats are often mentioned as well as ultra-processed foods that are so altered that they hardly resemble their original whole-food state.
  • The food industry refers to them as an “industrial product” loaded with additives that attempt to enhance the food’s characteristics such as food stability, shelf life, textures, colors, and flavors. They are often referred to as emulsifiers, humectants, and sequestrants or others that have barely recognizable names.  Ultra-processed foods are often ready-to-eat, require minimal preparation and are highly marketed. Ultra-processed foods account for more than 60% of dietary energy in the U.S.
  • Populations that have the lowest intake of processed foods exist and have been recently studied and known as the Blue Zones. These are groups of individuals that live an average of 10 years longer than those in cultures who consume the SAD, otherwise known as the Western diet. These areas are found around the globe in Sardinia, Italy, Ikaria, Greece, Okinawa, Loma Linda, California, and Nicoya, Costa Rica.
  • An observational study of Spanish university graduates followed participants for a median of 10.4 years. Consumption of an average of 5.3 servings of ultra-processed food per day, compared to an average of less than 1.5 servings per day, was associated with a 62% increase for all-cause mortality. For each additional serving, this risk increased by 18%.

What Is the Optimal Diet?

There are numerable reports on the health benefits of vegan, vegetarian, or plant-based diets. However, there is one diet that has been studied extensively for its healthy effects called the Mediterranean Diet. There is no one Mediterranean diet; however, it is usually associated with the intake of vegetables, fruits, whole grains, beans, nuts and seeds, extra-virgin olive oil, fish, seafood, moderate amounts of poultry, eggs, and dairy products. Red meat and sweets are limited as well as a low intake of processed foods.  A moderate intake of wine is acceptable. (moderate = 1-2 glasses).

Conclusions:
A possible molecular explanation for why overweight is harmful has been discovered by researchers. They suggest that overeating increases the immune response. This response causes the body to generate excessive inflammation  during the COVID-19 infection and that inflammation is at the core of many other chronic diseases.
University of Oslo. “Being overweight causes hazardous inflammations.” ScienceDaily, 25, August 2014.
If current trends continue and we find that 50% of our population is in the obese weight category, there will be alarming rates of catastrophic health consequences. Our health care costs will become unsustainable. It is a common belief that as long as you are not obese, you can be overweight and still be healthy. This is not always true. Many studies have found that a higher weight was associated with a higher risk of dying; however, this has remained  a major debate issue among obesity experts.

How to Avoid Overeating During the Coronovirus “Break”

Many of you are now working at home for the first time.  It becomes very easy to realize that when that happens,  food is not that far away and I am sure that avoiding snacking and even binge-eating is not that easy.  One sign, is that bag of chips always open and at your desk?  Before you buy that Peleton or tape the doors to the kitchen cabinets shut, try to exercise a little scheduling and practice the art of mindful eating.

Here is HELP:

 

 

Fiber: The Basis of a Plant-based Diet?

 

Such an important nutrient, but never the talk of the town. Actually it gets little attention on the large scale of “most talked about nutrition issues list”.  What is low in calories, prevents constipation, may lower the risk of heart disease, obesity and diabetes, and is generally underconsumed by people on the Standard American Diet (SAD)?  The answer? Fiber!!

Total fiber intake in U.S. children and adults is about 15 grams a day. When teaching nutrition, most students in my classes after diet analyses, were lucky if they went over 9 grams a day. The recommendation is 28 grams a day for women and 35 grams a day for men.

It was thought that fiber contributed little caloric value since it is not broken down by human digestive enzymes. Recent studies suggest that bacteria in the colon are able to break down many types of fibers to some extent (2 calories/gram). They excrete fatty acids as a waste product and then used as an energy source by the colon and the rest of the body. When you think about it, fiber may be responsible to a great extent for the health benefits of a plant-based diet.

There are two major classifications of dietary fiber – soluble and insoluble. Soluble fibers slow down glucose absorption and reduces fat and cholesterol absorption. They are found in oats, barley, fruit pulp, dried beans and psyllium.  They are fibers that are not fibrous.

Insoluble fibers are particularly beneficial for preventing constipation. They are found more in wheat bran,  legumes, seeds, and the skin on fruits and vegetables.

CLICK HERE.

How to Like Vegetables?

 

Americans need all the help they can get in eating more vegetables (nutrient dense, low in calories, loaded with fiber).  If you have children, It’s even more important  My personal advice?

Roast them – they caramelize and take on a whole new flavor and texture. Add a little honey and/or butter for more appeal. And it’s so easy on a foil-lined baking pan. Easy clean-up, too. – yes it can be done.

Enjoy the advice and bon appetit.

CLICK HERE.

Nutrition Myths

It is time to put to rest some nutrition misinformation that has dominated the media for a number of years now. Here is the nonsense and the sense of some of the most prevalent myths – it’s time to move away from them.

Gluten -Free Foods are Healthier. Unless you are truly sensitive to gluten or have been diagnosed with celiac disease,  you may miss out on some healthy whole grains if you choose gluten-free foods.

You only need to limit salt intake if you have high blood pressure. 90% of us will develop high blood pressure and some of us are sodium sensitive. We get plenty of sodium in processed foods and should try to limit our total intake to no more than 2,300 milligrams a day.

Sugar is toxic. There is no evidence that shows that sugar causes disease on its own. However, a high sugar intake can replace the healthier habits of  learning that carbohydrate intake can be healthier if we consume more complex carbs (fruits, whole grains, vegetables) and less highly refined  carbs (sugary drinks and foods with added sugars).

Fresh Produce is healthier than canned or frozen.  Foods which are picked fresh and immediately canned or  frozen may even have more nutrients than fresh produce. In fact, your body more easily absorbs nutrients like lycopene when they’ve gone through the canning process.

The term “natural” means healthier. The term natural on a food label has no FDA defintion, so it has no meaning in terms of health or that it is “organic.”

Farm-raised fish isn’t healthy. Today’s farm-raised fish has just as much and maybe more healthier omega-3 fats than wild-caught. Also farm-raised fish may have less mercury. They are now more sustainable and when from reputable farms can be raised with fewer antibiotics and no added coloration.

Margarine is loaded with unhealthy trans fats. This depends on whether the margarine is in stick form or tub form. A better choice is the softer tub margarine that is less hydrogenated and thus has less trans fat than the more saturated and trans fat content found in the stick form.

Source: Environmental Nutrition.

For more myths:

CLICK HERE.

How Did We Get From There to Here?

 

 

 

 

A DIET HISTORY TIMELINE

1825 A French lawyer named Brillant-Savarin said in a publication entitled The Physiology of Taste: “More or less rigid abstinence from everything that is starchy or floury” is a cure for obesity.

1830 Sugar consumption, mainly as molasses) had increased in the U.S. to 15 pounds per capita.

1863 William Banting lost 65 pounds on a high fat, carbohydrate restricted diet and subsequently published, Letter on Corpulence, Addressed to the Public. He based his success on the advice of his physician, Dr. William Harvey.

1900 Lillian Russell, a stage actress and singer born in 1861. was repeatedly mentioned known as one of the most beautiful women on the American stage.” At the peak of her fame, Russel weighed approximately 200 pounds and was celebrated for her curvaceous figure. She was described ” a particularly robust and healthy creature, who takes good care to remain so.” By today’s standards, her weight would be classified as “obese”.

1911 Proctor and Gamble introduced Crisco – a highly hydrogenated vegetable fat and cheap alternative to lard – the primary cooking fat at the time. The advantage to the manufacturer and the cook was a longer shelf life but provided a multitude of hundreds of pounds of unhealthy trans fatty acids. Now trans fats are banned.

1913 The twenty-seventh President of the United States, William Howard Taft reportedly was stuck in the White House bathtub due to his massive girth.

1918 Lulu Hunt Peters, an American doctor wrote the first known diet book, Diet and Health with a Key to the Calories. It was a best seller with over 2 million copies sold. She was the first to mention that cutting calories was an effective weight-watching tool. Her success was more than likely prompted by the new body image of women as being slender, or “thin was in”.

1920 Sugar consumption reaches 100 pounds per capita in the U.S.1930 Margarine consumption reaches 2.6 pounds per capita.

1934 A blood test for cholesterol was developed.

1937 – The Debate Begins (aka What’s going on here?) Columbia University biochemists David Rittenberg & Rudolph Schoenheimer demonstrated that dietary cholesterol had little or no influence on blood cholesterol. This scientific fact has never been refuted.

“Cholesterol in food has no affect on cholesterol in blood and we’ve known that all along.”  These are the words of Professor Ancel Keys, American Heart Association board member and author of The Seven Countries Study who, in retirement, recanted the idea that dietary cholesterol raises blood levels. His recant has been greeted with silence. Keys studied 22 countries, but chose data from only seven.  He also excluded France with high fat and low rates of heart disease. Due to this, his observational study was considered to be flawed.

1950 – 1955 Dietary emphasis on fats and cholesterol in the diet became a hot topic based on  Ancel Key’s flawed study.

1955 – President  Dwight Eisenhower had a heart attack.  His twice-daily press conferences focused on his cholesterol levels and he was put on a low fat diet by his physician, Dr. Paul Dudley White.  Dietary fat also became the villain for weight gain.

1957 Margarine outsold butter for the first time – more trans fat and an increase in omega-6 fats shown to be inflammatory to the body tissues.

1961 Let the Diet Books Begin. Calories Don’t Count was published by Dr. Herman Taller.  The low-calorie diet is a humbug, he declared. He was also a dieter whose weight ballooned up to 265 lb. on a 5-ft. 10-in. frame. Taller recommended a high-fat diet supplemented by polyunsaturated safflower oil capsules high in omega-6 linoleic acid.  Back in the 1960’s vegetable fats were new and everyone wanted them to be a new health food.  This has not been supported in the last 50 years of research. The American Heart Association adopted the well-known low-fat diet that began an era of fat maligning and the glorification of low fat foods.  Dieters began to count fat grams daily.  However, during our national experiment with a low-fat diet, people continued to pile on the pounds every decade.

1978 High fructose corn syrup enters the sweetener market. By 1985, 50 percent of the this sweetener was consumed in America.

1980 -1990 Obesity levels had remained between 12-14 percent from 1960 to 1980. After 1980 and then again in 1990, obesity grew dramatically until today when every state has obesity rates over 25 percent.  Type 2 diabetes is now reported to have a 1 in 3 lifetime risk.

1992 The Food Guide Pyramid was introduced, recommending 6-11 servings of breads, cereals, rice, or pasta a day without mentioning whole grain options.

2000 Soybean oil has 70 percent of the edible fat market in the U.S.  Lard consumption is less than 1 pound.  Sugar cons0umption in the U.S. 150 pounds per capita. Butter consumption is less than 4 pounds per capita

2004 After 50 years of Egg-beaters, low fat cheese, margarine, skinless chicken breasts, and highly processed soy and canola oils, two Food Guide Pyramids and 11 releases of the USDA Dietary Guidelines,  one third of Americans are obese; 25 percent are diabetic or pre-diabetic.

2008 Sugar consumption is now 160 pounds per capita. Compare that to the 15 pounds per capita in 1830.

2011 No More Pyramids A simplified MyPlate is introduced as the latest attempt at Food Guides. My Plate recommended 30% of the plate as grains, 30% vegetables, 20% fruit and 20% protein. A small circle represents dairy.

2015-16   The 2015 Dietary Guidelines were presented with little changes based on the latest research. Here is what they said and what they should have said.This is a big change  For the first time, our national health authorities are urging Americans to limit sugar to no more than 10% of daily calories. In a 2,000-calorie diet, 10% is 200 calories—the equivalent of about 12½ teaspoons of sugar. Yet we average 20 teaspoons a day. Based on scientific evidence that’s been accumulating for decades, dietary cholesterol (as opposed to blood cholesterol) just isn’t any concern anymore. For the first time, there is no limit on total fat. However, the advice to limit saturated fat is still in there—even though the evidence that saturated fat leads to heart disease has turned out to be pretty weak. An original report associated with the new guidelines called for cutting back on red meat, especially processed meat, but the final official guidelines due to the lobbying of the meat industry wanted its message weakened.

2010-2020 The American Journal of Clinical Nutrition published a landmark report that has turned current fat recommendations upside down. The verdict from the study is that “there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk for heart disease. ’Over the same period, the use of drugs to treat high blood pressure and high cholesterol increased quite a bit. Meat consumption has been declining for the past few decades..

In the last decade the prevalence of Type 2 diabetes has increased by almost a percentage point. Over the same period, obesity has increased by three percentage points. If that trend continues, heart disease rates may again rise. Unless we have been infected by a yet to be discovered obesity virus, we have a national eating disorder that needs to be fixed.

MY OPINION

Big food has made quite a mess of our food supply. Is saturated fat the culprit it was made out to be?  Can excess refined vegetable oils, sugar or fructose be  blamed?

Will our food culture ever be able to return to a diet of whole, real foods to replace the refined, processed, chemical-laden foods forced upon us by the food industry? The debate continues and we will see what trends are coming with the advent of the new Dietary Guidelines due in 2020. We should also hope that these guidelines are not encumbered by the influences of the food industry – but don’t count on it.

 

 

Red Meat: Use Some Common Sense

This debate still continues to capture the headlines – is red meat healthy or not for us or the planet? Food, Facts and Fads will continue to follow the research and attempt to offer some reasonable advice about this issue. Best approach? Be reasonable with your red meat consumption until further notice, but don’t panic. Americans are avid meat eaters and it’s difficult to know who to trust due to the biases of each side. For the latest CLICK HERE.