We've been led to believe fat is bad, and carbohydrates are good. Turns out our food pyramid is upside down and it's doing way more harm than good. How did this happen, and what does it mean for us as insurers, and the population as a whole – both now, and in the future?
A number of high profile articles have recently come to bear on the creaking foundation that has been our dietary conviction for the last half century. We were (and still are) told to limit fats, particularly saturated fat, and that means getting energy from carbohydrates. This most unfortunate instruction has led to an obesity and diabetes epidemic of unimagined proportions. Indeed one of the biggest failed experiments of humankind.
A recent headline analysis has shown that when the US Government published its 1977 dietary guidelines, there was no scientific evidence that showed saturated fat intake leads to increased mortality, and follows on a major 2010 study that showed there is currently still no evidence that links saturated fat to heart disease.
Zoë Harcombe(1) published a systematic review last year looking at what evidence was, in fact, available when the US Government created its recommended food pyramid that puts carbohydrates as the mainstay and foundation of our nutritional intake, while fats and oils languished as demonized foods to be strictly limited. The article concludes that the best evidence available at that time showed "There were no differences in all-cause mortality resulting from the dietary interventions [i.e. reducing saturated fat]."
Another significant analysis by Siri-Tarino(2) studied the effect of saturated fat on cardiovascular disease based on more than 20 studies involving 347,747 people. Their conclusion? "There is no significant evidence that … saturated fat is associated with an increased risk of (heart disease)".
So, if we know saturated fat is okay, a key question that remains is how good are carbs for us? Particularly the "good" carbs? Here I think we should focus on diabetic (T2), pre-diabetic, and obese populations because all these populations are carbohydrate intolerant.
Last year Sackner-Bernstein(3) looked at overweight and obese subjects on a low carb or low fat diet. They found a low carb diet achieved significantly greater improvements in weight loss and predicted heart disease risk compared to a low fat (and hence higher carb) diet. A low carb program run by Diabetes.co.uk has signed up 120,000 diabetics. Just by switching to a low carb/higher fat diet, 70% of these people improved their blood sugar, 80% lost weight, and 1 in 5 said that they no longer needed drugs to control their blood sugar.
Limiting carbs for people who are carbohydrate intolerant. That seems so obvious, so how did we get here?? Because we were so terrified of fat!
An explosive new article(4), sheds some light on one of the factors that led to this and points a finger at the sugar industry. The article is based on a number of documents from the 1950s and 60s that show correspondence between the sugar industry, and various researchers including a professor of nutrition at Harvard. The sugar industry and its paid researchers pulled apart studies that implicated sugar and their review, published in the NEJM concluded that changing fat and cholesterol intake was the (only) dietary intervention that could prevent heart disease.
Here is an excerpt of the misdirected and self-serving assertion written by John Hickson, the Sugar Research Foundation's director of research to a Harvard researcher : “Our particular interest had to do with that part of nutrition in which there are claims that carbohydrates in the form of sucrose make an inordinate contribution to the metabolic condition....I will be disappointed if this aspect is drowned out in a cascade of review and general interpretation”.
We have been conned into thinking fat is bad, and consequently this drove us to get our energy needs from carbohydrates, including sugar. Sugar is now a key ingredient in just about any processed food we eat. Average ketchup is 25% sugar. Typical peanut butter 10-11% sugar.
Having read extensively on this, and seeing evidence first hand, I have no doubt that putting people who are insulin resistant, overweight and diabetic on a lower carb and higher fat diet will significantly reverse much of the metabolic disease process, and change the trajectory of the obesity and diabetic epidemic. A number of clinicians around the world are already putting this into practice and encouraging patients to get more energy from fat rather than carbohydrates. The results are astonishing – blood glucose levels (hence insulin sensitivity) improve dramatically, weight reduction is significant, blood pressure reduces. As time progresses and we get more data we may find more wide reaching benefits to this upside down food pyramid.
The first question or concern though that many have regarding this new evidence, is what about the cholesterol? Well, if we know that consuming more saturated fats doesn't lead to greater chance of dying or getting heart disease (for which we now have good evidence), then we need to question the link between saturated fat and serum cholesterol levels. Or, as many experts are now doing, question the strength of the link between serum cholesterol levels and heart disease and mortality, particularly in healthy people. Could it be that there is a "sugar industry" conspiracy behind the cholesterol hypothesis as well? Only time will tell.
1. Harcombe et al; Open Heart 2015;2:e000196
2. Siri-Tarino et al; Am J Clin Nutr 2010;91:535–46
3. Sackner-Bernstein et al; PLOS ONE, DOI:10.1371
4. Kearns et al; JAMA Intern Med. September 12, 2016. doi:10.1001
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Location: Zürich, Switzerland