relationship between these three categories of food and replace it with a real, working knowledge that you can use in a practical way to help you reach your goals. The Smart Fat Solution will work for you—for life—and you’ll appreciate why once you have all the smart facts.
graph only six. In response to the lack of enthusiasm for his hypothesis, he designed a real study, one of the biggest and most famous studies in all of nutritional epidemiology. Known as the Seven Countries Study, it began in 1958 and lasted nearly twenty years. And—no surprise to anyone—Keys got exactly the results he wanted. The Seven Countries Study, which is cited more often than any other study in nutrition history, did indeed claim to prove that saturated fat is the root cause of heart disease.
Except that it isn’t.
Dozens of problems in the Seven Countries Study have emerged since it was first published. For one thing, findings that contradicted Keys’s hypothesis were simply ignored. (For example, saturated fat intake was equal on two Greek islands, Crete and Corfu. But the death rate from heart disease was a whopping seventeen times higher on Corfu than on Crete. That difference certainly couldn’t be explained by saturated fat intake.) For another, alternate hypotheses were not considered; could something other than saturated fat have accounted for the differences in heart disease rates? Keys dismissed alternatives to the “fat causes heart disease” theory (see, for example, the case of John Yudkin below) because he was convinced that his theory was right.
And that’s the kiss of death for real objective science.
At about the same time that Keys was promoting his theory, British physician and researcher John Yudkin was also wondering about the increase in heart disease in First World countries. But Yudkin suggested a different culprit. He pointed out in a series of papers that sugar consumption had a stronger relationship to heart disease mortality than fat did. Keys, however, ignored these inconvenient facts and instead slammed Yudkin in the press at every opportunity. Eventually, as an influential member of the nutrition advisory committee to the American Heart Association, Keys managed to get his theories officially incorporated into the 1961 American Heart Association dietary guidelines. For decades, the American Heart Association has exerted a powerful influence on government health recommendations regarding heart disease, cholesterol, and fat consumption.
The message that eating fat makes you fat—and leads you on an irreversible path to heart disease
—was not lost on the American people, and the notion that fat is “bad” has become nothing less than a cultural meme.
What’s interesting is that the conventional wisdom on fat in the diet was very different before Keys and the Seven Countries Study. Before Keys’s theories became entrenched, most doctors knew that the cause of obesity was sugar and starch, not dietary fat. William Osler, known as the father of modern medicine in North America, suggested that people should “reduce sugar and starches” to avoid obesity as early as 1892 in his classic textbook The Principles and Practice of Medicine. Dr.
Richard Mackarness, who ran Britain’s first obesity and food allergy clinic, wrote in 1958 that carbohydrates were the culprit in weight gain in his book Eat Fat and Grow Slim.
But what got everyone’s attention was when President Dwight D. Eisenhower suffered a heart attack in 1955. This created a huge interest in what was coming to be understood as the No. 1 killer of men and women—heart disease. Eisenhower’s attack made the danger real for a lot of people, and Americans wanted answers about this new threat to their health. And they wanted them now. The government was pressured to take action and make some dietary recommendations. Waiting for more conclusive science was just not an option.
In the face of such pressure, the government and numerous health organizations and healthcare providers fell in line behind the American Heart Association recommendations, which included
Keys’s theories. Americans, who wanted to know what they could do to beat this killer, got their official answer: Avoid fat and eat lots of “complex carbohydrates.”
Unfortunately, this was the wrong answer.
We know now that Keys’s conclusion was incorrect. But his overall message caught on; the anti-fat revolution was born; and the high-carb, low-anti-fat diet and lifestyle took hold—ultimately resulting in an epidemic of obesity, disease, and accelerated aging that still has us in its grip.
You may notice that we’re suddenly talking a lot about fat, though we started out focusing on carbs. That’s because you can’t discuss the damage that refined carbohydrates can do without talking about the role of dietary fat. After all, there are only three macronutrients—protein, fat, and carbohydrates. If you eat less of one of them, you wind up eating more of the others. In our case, we stripped beneficial smart fat from our diets and replaced it with the worst type of carbs—mostly the kind that come in a box. And we’ve been doing that for about four decades, all in the name of good health.
It hasn’t worked out so well.
Removing smart fat from our diets was hardly the only thing we collectively did to raise the risk of heart disease and obesity. Smoking, for instance, used to be widely accepted behavior. In fact, the emerging epidemic of heart disease was occurring at a time when even physicians routinely endorsed cigarettes. (“More doctors smoke Camels than any other cigarette!”) And while we puffed away, food manufacturers were beginning to add something quite deadly to our diets: trans fats.
In midcentury America, the “Crisco Creep” was in full-swing, with home cooks, food manufacturers, and even the American Heart Association embracing the use of highly engineered dumb fats like margarine and hydrogenated (and partially hydrogenated) “vegetable” oils. For home cooks and dieters trying to do the right thing, these artificial fats seemed like the answer because they were increasingly presented as heart-healthy alternatives to saturated animal fats like butter and lard.
For big food companies, hydrogenated fats allowed for the mass production of shelf-stable baked goods, snack foods, convenience foods, and fast food—profitable, booming business sectors that were rapidly growing in postwar America. Trans fats were in the right place at the right time.
So was high-fructose corn syrup. Though arguably no worse than regular sugar, it was spectacularly cheaper. Food manufacturers began adding it to everything, partially to compensate for how bad foods taste when you take out the fat. The wide availability and ubiquity of high-fructose corn syrup partially accounts for the fact that between the 1950s and 2000, per capita consumption of caloric sweeteners increased 39 percent to an average of a whopping 152 pounds per person per year.
And let’s not forget another critical factor. While all this was happening—the banishment of fat from our diets, our increased intake of processed carbohydrates, and our reliance on dumb fats like margarine—we were becoming less physically active. After World War II, we rapidly became a car culture and no longer went everywhere (some might say anywhere) on foot. We went from working the land to working the phone. Kids didn’t get to school on two wheels or two feet; they got a ride.
Sidewalks were sacrificed for wider roads to accommodate more cars. We had lots of new reasons to be sedentary. (The postwar Golden Age of Television was only the beginning of our love affair with the screen.) We no longer experienced exercise as something built in to our days. Instead, we had to schedule a “workout,” and who could possibly make time for that?
So there you have it. We began reducing naturally occurring dietary fat to avoid heart disease,
even though recent evidence shows no connection between fat in the diet—even saturated fat—and heart disease; simultaneously, we increased our consumption of toxic trans fats and refined carbohydrates, all the while decreasing our level of physical activity. Our food supply became more industrialized (and toxic) as factory-farmed meat from huge agricultural feedlot operations replaced grass-fed cattle, free-range chickens, and pasture-raised pigs. Before factory farms became the norm, it was easy to follow our prescription to eat clean, not mean.
Within one generation, out went the farm-fresh eggs and bacon and in came the breakfast of sugary cereal, white-bread toast slathered with margarine, and, of course, a glass of sweet orange juice—the ultimate “low-fat” (and therefore “healthy”) breakfast. Gone was the home-cooked dinner of roasted chicken and garden-fresh vegetables, replaced by chemically laden mystery meat, a few scoops of starch, and a tiny mound of overcooked mixed vegetables. And in between that breakfast and dinner was a lunch break that increasingly involved another dining trend, one that was rapidly becoming an everyday habit for millions: fast food. (But even dinner quickly became fast food. That wholesome, homemade roasted chicken dinner eventually became a bucket of chicken pieces from the drive-through, a side of creamed corn, biscuits, and a liter of soda.)
Our new diet—low in fat, high in refined carbs, and meant to rescue us from heart disease—was actually killing us. Here’s why.