Fat-tastic news: What if fat doesn’t make you pile on the pounds?

From The Sunday Times
London, UK
17 August, 2014

Tuck into that steak and — go on — have a pudding as well. Nina Teicholz’s new bestseller claims the central dogma of healthy eating is a lie. Josh Glancy really hopes she’s right 

Imagine a delicious dinner tonight. Chicken liver parfait to start, soft and smooth. Then a marbled ribeye steak juicily cooked in a slab of butter. And a crunchy pavlova to finish smothered in strawberries and whipped double cream. The food sounds appealing, if a little rich, but a meal like this would surely come with a health warning. Three courses of artery-clogging, heart attack- inducing fatty acids that will slowly constrict your blood flow and consign you to an early grave. 

Not true, says Nina Teicholz, whose mammoth new book The Big Fat Surprise has hit the bestseller lists in America and is published here this week. She claims the opposite is true: we need saturated fat in our diets and the orthodox view that they are bad for us has had tragic consequences for our health and weight. 

Obesity is a modern epidemic. Only last week it was revealed that being overweight puts people at greater risk of developing 10 of the most common cancers. It also causes heart disease, which is the world’s biggest killer. But fat, it is argued, is not the culprit. 

Just over 10 years ago, when she was working as a journalist and food writer, Teicholz reviewed restaurants for a New York paper. She didn’t have much of a budget so she was restricted to asking chefs to cook whatever they felt like showing off. 

“I was practically a vegetarian at the time, I hadn’t eaten red meat or fatty food for decades,” she says. 

“But it turned out that what chefs wanted to send out to display their prowess was red meat, creamy sauces, pâté, cheeses. 

“They were rich flavours, delicious. But the weird thing was that I lost weight. I quickly shed 10lb that I hadn’t been able to get rid of for years. Then I had my cholesterol levels checked and they’d actually improved.” 

Teicholz began her research. She read the work of the nutrition writer Gary Taubes, whom she calls the “godfather” of the pro-fat revolution. Years later she has produced her magnum opus in defence of fat. 

At the centre of the problem is what she calls a “tragic” homonym: that we describe the fat in our bodies and the fat in our food using the same word. In fact, they are two very different things. 

In her book Teicholz spends densely footnoted page after page dismantling the standard argument that saturated fat is bad for you. Her case hinges on new research into cholesterol, which shows it is far more complex than initially thought. 

“Saturated fat was condemned based on a very early, now antiquated notion of cholesterol. It’s been in jail based on false evidence for decades. You can eat it and not feel guilty about that,” says Teicholz. 

“The original hypothesis was that saturated fats raise your total cholesterol and cause heart attacks. This is not true. Saturated fats do cause total cholesterol to go up. But your total cholesterol is not a good predictor of your heart attack risk.” 

The science of Teicholz’s argument goes like this. We know that cholesterol — or strictly speaking the lipoproteins that carry it — comes in two types: low-density lipoproteins (LDLs) and high-density lipoproteins (HDLs). LDLs are the dangerous or “bad” type because they can cause fatty deposits or “plaque” to be left on artery walls and raise the possibility of a heart attack. HDLs or “good” cholesterol helps to guard against arterial plaque. 

Because saturated fats cause LDL levels to rise, it seemed logical to blame them for high levels of bad cholesterol. But it turns out that there are also two types of LDL: big fluffy particles and small dense ones. Importantly, eating saturated fats boosts the big fluffy particles. But it is the small dense ones that cause the real damage. 

Based on her research, Teicholz makes a number of counterintuitive recommendations. Butter is better than margarine. Don’t trim the fat off meat. Keep the yolks in eggs and cook with delicious lard, not vegetable oils. 

If you’ve been putting anaemic skimmed milk on cereal instead of creamy whole milk, you’ve been getting it wrong. “Whole milk is better for you,” says Teicholz. 

“If you don’t have the fat in there, then it’s hard to absorb fat-soluble vitamins such as A and D which are present in milk. The skimmed version means you can’t absorb those vitamins. Whole milk is also lower in sugar. When they take the fat out of food, which provides creaminess and texture, companies use fat replacers and those are almost always carbohydrate-based.” 

Carbohydrates are the enemy. In the absence of saturated fats, which are filling and nutritious, Teicholz says our diets have suffered because we have substituted carbs. The food industry has been quick to supply us with carbohydrate alternatives that make us pile on weight. Cutting fat out of our diets has made us fatter. 

“The idea that fat makes you fat is based on the fact that it has nine calories per gram, as opposed to four or five in carbohydrates,” she says. 

“But it turns out that our bodies are not like mathematical counters. We do not process all calories in the same way. We respond differently to a fat calorie as opposed to a carb calorie. 

“The main difference is that carbs alone stimulate your pancreas to release insulin. This is the king of all hormones for making you fat as it stores all the fatty acids coming into your body. 

“When you eat carbs they become glucose in your body. This is a good short-term source of energy, so the body decides to put its long-term calorie storage into your fat cells because it has an alternative, immediate source of energy.” 

When we have insulin in our bodies we operate on glucose and don’t bother using up our long-term fat deposits. If we restricted carbs, our insulin levels would drop and we would switch to burning fat cells. 

The Big Fat Surprise is part of a growing movement in the world of nutrition in favour of the high-fat low-carb diet. Books such as Wheat Belly by Dr William Davis and Grain Brain by Dr David Perlmutter lay many of our nutritional ills at the door of the carbohydrate. 

However, it’s fair to say there are many doctors who don’t agree. “Putting saturated fats back at the centre of our diet would be a tragic mistake,” says Dr David Katz, a nutritionist and academic at Yale University. 

“There is no diet that is mostly meat, butter and cheese anywhere in the world that is associated with good health outcomes. There is no evidence that a diet high in saturated fats would be good for health. A healthy diet still features all the usual suspects: vegetables, fruits, beans, lentils, nuts, seeds, wholegrains. Optional is fish, seafood, dairy and lean meats. But it reliably excludes saturated fats.” 

Pretty much the only thing Katz and Teicholz agree on is that sugar is bad. As for the rest, there’s a fat chance of them coming to an agreement any time soon. 


Carbs on the table: this is the worst diet 

Results from a two-year trial in Israel were published in 2008. It was rigorous, with an international group of professors on board. 

The researchers selected 322 moderately obese middle-aged people, mostly men, and fed them one of three diets: one low in carbohydrates, one low in fat and the third a Mediterranean diet (rich in vegetables and low in red meat, with lots of poultry and fish). 

Meals were served at a work cafeteria, allowing for a high degree of control over what foods were eaten — and how much. 

During the study, those on the Mediterranean diet were found to have a lower risk for heart disease than those on the low-fat diet. 

Compared with the low-fat group, the Mediterranean dieters maintained lower triglycerides, higher “good” HDL-cholesterol, lower “bad” LDL-cholesterol, lower C-reactive protein (an indicator of chronic inflammation) and lower insulin (a marker for diabetes); they also lost more weight, averaging about 10lb over two years, compared with 7lb for the low-fat set. 

The Mediterranean diet therefore looked better than the low-fat diet in every way. “So my conservative conclusion is, don’t start with a low-fat diet,” said the epidemiologist Meir Stampfer, a pronouncement that would have been unthinkable a decade earlier. 

These are certainly positive results for the much-beloved Mediterranean diet. But do they suggest that the diet is best? Stampfer stresses that the people on this diet had the easiest time adhering to it, which is important. But that might be due to the fact that since they were Israeli, it was their local cuisine. 

Indeed, what Stampfer doesn’t like to advertise, and what the study report itself doesn’t emphasise, was the notable success of the third arm of the study. This was the group eating a low-carbohydrate diet, relatively high in fat. The participants on this diet, it turned out, looked the healthiest of all. They lost more weight (12lb) and their heart disease biomarkers looked even better: their triglycerides were lower and their HDL-cholesterol much higher than the other two groups. 

Only LDL-cholesterol looked better for Mediterranean dieters, yet this biomarker has proven to be less reliable than previously thought. Therefore, although the finding has received no attention, there’s really no doubt that the low-carb/high-fat diet performed better than both the low-fat and the Mediterranean diets.

http://www.thesundaytimes.co.uk/

Graham