Meanwhile, the American Heart Association continued to fi nd new ways to prosper from lipophobia. In 1988 it deleted the provision in its char-ter prohibiting product endorsements and began off ering, for a fee, to endorse any food products that met its guidelines for fat, cholesterol, and sodium. This allowed foods to carry a special AHA “Heart Guide”
seal on their labels, with the logo “American Heart Association Tested and Approved.” (Some eyebrows were raised when Rax restaurants began using the seal on its Big Rax roast beef sandwiches, whose thirty grams of fat were half of the AHA’s entire daily allowance for a woman.) How-ever, aft er the FDA objected that this implied that these foods were health foods, the AHA dropped the program until the FDA came out with new rules for food labels.
Once the new rules came out, the AHA remounted the campaign.
This time it sold the right to use a “Heart Check” symbol and say “Meets American Heart Association food criteria for saturated fat, cholesterol and whole grains for healthy people over age 2.” For this, it charged fees ranging from the $2,500 it cost Kellogg’s for each of the more than fi ft y of its products which qualifi ed (including such nutritional dazzlers as Fruity Marshmallow Krispies) to the $200,000 that Florida citrus fruit producers paid for exclusive rights to the symbol, cutt ing out their com-petitors in California. The Florida producers now ran ads saying, “Fight Heart Disease. Drink Florida Grapefruit Juice.” These pictured a jug of
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juice, the AHA Heart Check, the words “Certifi ed Heart Healthy,” and a heart enclosing the phrases “Cholesterol Free” and “Fat Free.” The AHA’s old bête noire, the Catt lemen’s Association, not only bought the right to put the Heart Check seal on beef; it was also received a special “Champi-ons of Heart” award for unspecifi ed “contributi“Champi-ons that . . . allowed AHA to further its fi ght against heart disease and stroke.” In 1992–93 ConAgra, the hydra-headed giant involved in practically every stage of food pro-duction, gave $3.5 million to the AHA, ostensibly to make a television program on nutrition.⁷³
Yet by the end of the century, the AHA’s calls to reduce heart disease through diet were sounding rather threadbare. It seemed that only in extreme cases, such as those terrifi ed men who were able to stick with the incredibly restrictive Dean Ornish diet, could people stay on a diet low enough in saturated fat long enough for it to have much of an eff ect on their LDL/HDL levels. For everyone else, there was still no evidence that low-fat diets prevented heart disease. In 1996 the American College of Physicians came out against the AHA program of screening all people over twenty for high cholesterol. It said that it resulted in young people being put on low-fat diets that rarely reduced cholesterol. They were then told to take medications, whose long-term eff ects were unknown, for the rest of their lives. Others began pointing out that the AHA campaign to have people adopt low-fat, high-carbohydrate diets led to increased consumption of calorie-dense foods that contributed to obesity and dia-betes, both of which were risk factors for cardiovascular disease.⁷⁴
However, in 2000 another panic gave lipophobia yet another boost.
This time it was about trans fats, which were in the hydrogenated oils used in making everything from French fries to Doritos to granola bars.
Not only did they raise levels of “bad” LDL in the blood; they also low-ered “good” HDL ones. New York City banned trans fats from restau-rants, school boards across the nation banished them from cafeterias, and processors began furiously trying to replace them.⁷⁵
One would think that the trans fat scare might prompt lipophobes to eat a bit of humble pie. Aft er all, years before, when they were fi rst raised, Keys had dismissed these fears as groundless. Then, in the 1970s, the AHA, the Center for Science in the Public Interest, and other agen-cies had urged processors to use trans fats to replace supposedly deadly saturated fats.⁷⁶ Moreover, the most common conveyor of trans fats to the bloodstream turned out to be margarine, which they all had recom-mended as a heart-healthy alternative to deadly butt er.⁷⁷ Yet nary a mea culpa was heard.
Florida citrus growers were among the many food producers who tried to profi t from lipophobia—
fear of dietary fat—by paying the American Heart Association to use its “Heart Check” symbol to support questionable claims that their fat-free or low-fat products helped prevent heart disease.
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However, at least all the talk about “good” and “bad” fats fi nally forced lipophobes to abandon their calls for reducing total consumption of di-etary fat. Instead, the AHA began recommending that people substitute unsaturated fats, such as olive oil, for the saturated and trans fat ones in their diets. Similarly, in 2000 the government’s revised Dietary Guide-lines replaced the previous advice to choose a diet that was “low in fat, saturated fat and cholesterol” with a diet that was “low in saturated fat and cholesterol and moderate in total fat.” However, the baleful eff ects of lipophobia could not be eradicated so easily. In 2001 a number of re-pentant lipophobes expressed regret that the long campaign they had waged against total fat had “made the belief that fat is bad so strong and widespread” that it would take a herculean eff ort to undo it.⁷⁸