The Saturated Fat Studies: Buttering Up the Public

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Time magazine's cover exhorting people to eat butter could be viewed as a desperate attempt to revive dwindling print sales, but they claimed to be reporting on real science--a systematic review and meta-analysis published in a prestigious journal that concluded that current evidence does not clearly support cardiovascular guidelines that encourage cutting down on saturated fat, like the kind found in meat and dairy products like butter.

No wonder it got so much press, since reducing saturated fat intake is a major focus of most dietary recommendations worldwide, aiming to prevent chronic diseases including coronary heart disease. So, to quote the Center for Science in the Public Interest, "What gives? Evidently, shaky science...and a mission by the global dairy industry to boost sales."

They interviewed an academic insider, who noted that some researchers are intent on showing saturated fat does not cause heart disease, which can be seen in my video The Saturated Fat Studies: Buttering Up the Public. In 2008, the global dairy industry held a meeting where they decided that one of their main priorities was to "neutralize the negative impact of milk fat by regulators and medical professionals." And when they want to do something, they get it done. So they set up a major, well-funded campaign to come up with proof that saturated fat does not cause heart disease. They assembled scientists who were sympathetic to the dairy industry, provided them with funding, encouraged them to put out statements on milk fat and heart disease, and arranged to have them speak at scientific meetings. And the scientific publications we've seen emerging since the Mexico meeting have done just what they set out to do.

During this meeting, the dairy industry discussed what is the key barrier to increasing worldwide demand for dairy. There's global warming issues and other milks competing out there, but number one on the list is the "Negative messages and intense pressure to reduce saturated fats by governments and non- governmental organizations." In short, the negative messages are outweighing the positive, so indeed, their number one priority is to neutralize the negative image of milk fat among regulators and health professionals as related to heart disease.

So if we are the dairy industry, how are we going to do it? Imagine we work for Big Butter. We've got quite the challenge ahead of us. If we look at recommendations from around the globe, there is a global scientific consensus to limit saturated fat intake with most authoritative bodies recommending getting saturated fat at least under 10% of calories, with the prestigious U.S. Institute of Medicine and the European Food Safety Authority recommending to push saturated fat consumption down as low as possible.

The latest guidelines from the American Heart Association and the American College of Cardiology recommend reducing trans fat intake, giving it their strongest A-grade level of evidence. And they say the same same for reducing saturated fat intake. Since saturated and trans fats are found in the same place, meat and dairy, cutting down on foods with saturated fat will have the additional benefit of lowering trans fat intake. They recommend pushing saturated fat intake down to 5 or 6%. People don't realize how small that is. One KFC chicken breast could take us over the top. Or, two pats of butter and two cubes of cheese and we're done for the day--no more dairy, meat, or eggs. That'd be about 200 calories, so they are in effect saying 90% of our diet should be free of saturated fat-containing foods. That's like the American Heart Association saying, "two meals a week can be packed with meat, dairy, and junk, but the entire rest of the week should be unprocessed plant-foods." That's how stringent the new recommendations are.

So this poses a problem for Big Cheese and Chicken. The top contributors of cholesterol-raising saturated fat is cheese, ice cream, chicken, non-ice cream desserts like cake and pie, and then pork. So what are these industries to do? See The Saturated Fat Studies: Set Up to Fail.

For those unfamiliar with Trans Fat in Meat and Dairy (and refined vegetable oils), that's why I made a video about it.

The U.S. National Academy of Sciences Institute of Medicine "as low as possible" position, echoed by the European Food Safety Authority, is described in my video: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

What happened when a country tried to put the lower saturated fat guidance into practice? See the remarkable results in Dietary Guidelines: From Dairies to Berries.

Don't think the dietary guidelines process could be undermined by underhanded corporate tactics? Sad but true:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: Johnathan Nightingale / Flickr

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How to Design a Misleading Study

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Imagine working for the now defunct Twinkie division of Hostess and wanting to take the tobacco industry tact of not just downplaying the risk of your product, but actually promoting it as healthy. How would we do that?

Our first problem is that each Twinkie has 2.5 grams of saturated fat, which raises cholesterol, the #1 risk factor of our #1 killer, heart disease. How are we going to get around that?

Well, what if we designed a study in which we took a bunch of people eating our arch-rival, Little Debbie cloud cakes. Now they only have one gram each, so what if we took a group eating five cloud cakes a day -- five grams of saturated fat -- and then cut that saturated fat intake in half by switching them to eating one Twinkie a day. What would happen to their cholesterol levels? Their cholesterol would go down due to their decreased saturated fat consumption. So even though they went from eating five cakes down to one, technically, they went from zero Twinkies a day to one Twinkie a day, and their cholesterol went down (we wouldn't mention the five to one thing).

We publish it and crank out a press release, "New research shows that eating a Twinkie a day can be good for heart health by improving cholesterol levels." The media takes our press release and runs with it: "Consumers can eat a Twinkie every day if they choose, and feel confident that science supports Twinkies' healthy benefits, which now include cholesterol-lowering effects!" Twinkies, we just proved with science, have cholesterol-lowering effects. Too outlandish a scenario? Amazingly, that's exactly what the beef industry did (those above quotes are actual quotes-just replace the word beef for Twinkie).

In a study bought and paid for by the beef industry, beef was added to people's diets. At the same time, the subjects removed so much poultry, pork, fish, and cheese from their diet that they halved their saturated fat intake from 12 percent of their diet, down to 6 percent of their diet, causing their cholesterol levels to go down. If our diet goes from 12 percent saturated fat down to 6 percent saturated fat, it doesn't matter if that 6 percent comes from beef, chicken, lard, or Twinkies. If we cut our total saturated fat in half, our cholesterol will follow, especially if we eat more fiber and vegetable protein as they did in the study.

The researchers conclude: "The results of the BOLD study [standing for Beef in an Optimal Lean Diet] provide convincing evidence that lean beef can be included in a heart-healthy diet that meets current dietary recommendations and reduces cardiovascular disease risk." Crisco could be included. Krispy Crème could be included, as long as we cut our total saturated fat intake. What the researchers fail to mention is that our risk would drop even lower if we dropped the beef, as was pointed out by the chair of nutrition at Harvard in a response to the study.

The subjects in this study went from a high risk of dying from heart disease to... a high risk of dying from heart disease. We need to get our LDL (bad) cholesterol down to 50, 60, or 70 to become essentially heart attack proof (see Eliminating the #1 Cause of Death). For most people, that means eliminating saturated animal fat and cholesterol intake completely.

This study is really just showing how bad saturated fat is from any animal source. Yes, based on saturated fat levels, lean beef is often better than chicken (and Twinkies), but that's like touting the health benefits of Coca Cola because it has less sugar than Pepsi. It does--15 spoonfuls of sugar per bottle instead of 16--but that doesn't mean we wouldn't be better not consuming soda at all. Reminds me of this study: "Cheese Intake Lowers LDL-Cholesterol Compared With Butter Intake...." [emphasis added]

In my video, Bold Indeed: Beef Lowers Cholesterol? you can see the beef industry's release. and how they ended up with the "cholesterol-lowering effects of beef." If we cut out enough poultry, pork, fish, and cheese from our diet, we could replace this with almost anything (bacon grease, candy, frosting, deep-fried snickers bars, sewer sludge, etc.), and still reduce cholesterol levels.

How are Americans exposed to saturated fat? Burgers actually fall well below chicken. See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

The beef industry is by no means alone in having a corrupting influence on the scientific method. See, for example:

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image Credit: Seth Tisue / Flickr

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How to Get Kids to Eat Their Vegetables

How to Get Kids to Eat Their Vegetables

What happens if we give one group of kids a plate of cookies and the other group the same number of cookies, but cut in half, and tell both groups they can eat as many as they want? Researchers reported that decreasing cookie size led to 25% fewer cookie calories eaten.

The goal of that study was to help counter obesity-promoting eating behaviors facilitated by the availability of large portions of junk food. The findings "suggest that reducing the size of cookies (without altering the total amount of food) decreases children's short-term caloric intake," a dietary strategy for parents to discreetly decrease unhealthy behaviors. But they were using sugar wafers- what's in those things? Partially hydrogenated oil (trans fats). What's so bad about trans fats? See Trans Fat in Meat and Dairy, Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero, and Breast Cancer Survival and Trans Fat. No one should be eating those cookies. In fact, I can think of another "dietary strategy" to decrease kid's intake--don't give them any!

Admittedly, this is easier said than done. Even in the 'granola crunchy' San Francisco Bay Area, a proposed ban on junk food suggested by parents and school administrators sent a faction of teachers into an apoplectic fit. In Texas, there was so much parental outrage that they got lawmakers to pass a Safe Cupcake Amendment. The amendment, known as Lauren's Law, ensures that parents and grandparents of schoolchildren celebrating a birthday can bring whatever they want to school.

Fine. What if we just offered fruit in addition to the cupcakes at classroom celebrations? In a study outlined in my video, Tricks to Get Kids to Eat Healthier at School, researchers provided bowls of fresh, cut-up fruit in addition to the party food brought by the parents at two of four kindergarten or preschool celebrations to observe student response. No special effort was made to encourage students to choose the fruit: they just put it out there. Would kids actually eat fruit when there was birthday cake, ice cream, and cheese puffs taking up nearly a whopping third of their daily caloric intake? Yes! On average each kid ate a full fruit serving. Take that, cheesy puffs!

There are entire curricula available now for schools, such as "Veggiecation," where for a whole year classrooms feature a new "veggie of the month," sprinkled with nutrition mantras like "Fiber equals a happy tummy." And they work! "The active engagement of students in tasting and rating vegetable dishes seemed to have contributed to higher consumption of featured vegetables."

One school was able in some cases to double vegetable consumption just by giving them attractive names. Elementary students ate twice the number of carrots if they were called "X-ray Vision Carrots," compared to when they were just "carrots" or generically named "Food of the Day."

How about "Power Punch Broccoli, Silly Dilly Green Beans, or Tiny Tasty Tree Tops?" Selection of broccoli increased by 109.4%, and green beans by 177%. Conclusion: "these studies demonstrate that using an attractive name to describe a healthy food in a cafeteria is robustly effective, persistent, and scalable with little or no money or experience. These names were not carefully crafted, discussed in focus groups, and then pre-tested." They just thought them up out of thin air. And kids were suckered into eating healthier for months by putting out silly little signs. In this school, vegetable intake was up nearly 100%, while in the control school without signs, vegetable consumption started low and actually got worse. So why isn't every single school in the country doing this right now?! Bring it up at your next PTA meeting.

And if we want to get really bold, we can join the nutritious school lunch revolution led by pioneering organizations like the New York Coalition for Healthy School Food (check out their website at www.healthyschoolfood.org).

Whenever I find myself frustrated by half measures, I am forced to remind myself just how SAD the Standard American Diet is. See Nation's Diet in Crisis for a reality check. One of the problems is that parents may not even realize there is a problem (Mothers Overestimate Dietary Quality).

For more healthy eating tricks check out: Tricks to Get Kids to Eat Healthier at Home and Tricks to Get Adults to Eat Healthier.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image Credit: U.S. Department of Agriculture / Flickr

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Foods for a Long Life and Love Life

 

 

 

 

 

 

 

 

Foods for a Long Life and Love Life

Motivating patients to change poor lifestyle habits can be extremely difficult. Preventing cardiovascular events such as heart attacks or strokes is a relatively distant benefit, whereas barbecued ribs, cheesecake, or sitting on our butts promises almost instant gratification. Public health experts are now hoping that prevention or improvement of erectile dysfunction could be a more immediate motivator that physicians can use to improve their patients’ lifestyles and in turn their overall cardiovascular health. That’s how doctors can save a life during a clinic visit for erectile dysfunction. (See Survival of the Firmest: Erectile Dysfunction and Death).

We used to think of erectile dysfunction in young men in their 20s and 30s as psychogenic in origin, meaning it’s all in their heads. But now we’re realizing it’s more likely an early sign of vascular disease. But even when the penis heads in the wrong direction, the heart need not follow. Atherosclerosis in both organs can be reversed with lifestyle changes. We know that "a substantial body of knowledge demonstrates that the abundant consumption of vegetables, fruit, and whole grain, and the dietary patterns rich in these foods, convey a markedly lower risk of coronary disease." In a study profiled in my video, 50 Shades of Green, a group of researchers tried putting impotent men on a Mediterranean diet, which includes an abundance of plant-based foods. After two years on the Mediterranean diet, 37% of the men regained normal sexual function. What is it about the diet that appeared to do it? Improvements in erectile function were tied to five things: increased intake of fruits, vegetables, nuts, beans and essentially the ratio of plant fats to animal fats.

Similar benefits were found for women. The same kind of diet significantly improved sexual function, together with a significant reduction of systemic inflammation. As a whole, these findings "suggest that a Mediterranean-style diet may be a safe strategy for amelioration of sexual function" in women with pre-diabetes or diabetes, who found significant improvement in sexual satisfaction on the healthier diet. For more on preventing sexual dysfunction in women in the first place, see Cholesterol and Female Sexual Dysfunction. The improvement in sexual functioning is thought to be because of the anti-inflammatory and antioxidant benefits of plant-based diet.

Check out my related video: Pistachio Nuts for Erectile Dysfunction.

Other benefits of increased fiber intake may include improved bowel function (Bristol Stool Scale) and frequency (Prunes vs. Metamucil vs. Vegan Diet), lower colorectal cancer risk (Stool Size Matters), lower breast cancer risk (Relieving Yourself of Excess Estrogen and Fiber vs. Breast Cancer), lower blood pressure (Whole Grains May Work as Well as Drugs), lower blood cholesterol (How Fiber Lowers Cholesterol), weight loss (Beans and the Second Meal Effect) and a longer lifespan (What Women Should Eat to Live Longer).

A similar Mediterranean diet failed to help fibromyalgia in the short term (see Fibromyalgia vs. Mostly Raw & Mostly Vegetarian Diets), but diets that were even more plant-based were found to be beneficial: Fibromyalgia vs. Vegetarian & Raw Vegan Diets. 

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image Credit: Jon's Pics / Flickr

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Egg Industry Caught Making False Claims

 

 

 

 

 

 

 

 

Egg Industry Caught Making False Claims

On the basis of concerns from the American Heart Association and consumer groups, the Federal Trade Commission carried out successful legal action—upheld by the Supreme Court—to compel the egg industry to cease and desist from false and misleading advertising that eggs had no harmful effects on health.

Over the years, cholesterol concerns resulted in severe economic loss through a reduction in egg consumption, so the egg industry created a “National Commission on Egg Nutrition” to combat the public health warnings with ads that said things like “There is no scientific evidence whatsoever that eating eggs in any way increases the risk of heart attack.” The U.S. Court of Appeals found such outright deception patently false and misleading.

Even the tobacco industry wasn’t that brazen, trying only to introduce the element of doubt, arguing that the relationship between smoking and health remains an open question. In contrast, the egg ads made seven claims, each of which was determined by the courts to be blatantly false. The Court determined the egg industry ads were "false, misleading, and deceptive." Legal scholars note that, like Big Tobacco, the egg industry did more than just espouse one side of a genuine controversy, but flatly denied the existence of scientific evidence.

Over the last 36 years, the American Egg Board has spent hundreds of millions of dollars to convince people eggs are not going to kill them—and it’s working. From one of their internal strategy documents that I was able to get a hold of: “In combination with aggressive nutrition science and public relations efforts, research shows that the advertising has been effective in decreasing consumers concerns over eggs and cholesterol/heart health.”

Currently, they’re targeting moms. Their approach is to “surround moms wherever they are.” They pay integration fees for egg product placement in TV shows. To integrate eggs into The Biggest Loser, for example, could be a million dollars, according to their internal documents. Getting some kids storytime reading program to integrate eggs may only take half a million, though. The American Egg Board keeps track of who is, and is not, a “friend-of-eggs.” They even pay scientists $1500 to sit and answer questions like, “What studies can help disassociate eggs from cardiovascular disease?”

From the beginning, their arch nemesis was the American Heart Association, with whom they fought a major battle over cholesterol. In documents retrieved through the Freedom of Information Act featured in my 6-min video Eggs and Cholesterol: Patently False and Misleading Claims, you can see even the USDA repeatedly chastises the egg industry for misrepresenting the American Heart Association position. In a draft letter to magazine editors, the egg industry tried to say that the “American Heart Association changed its recommendations to approve an egg a day in 2000 and eventually eliminated its number restrictions on eggs in 2002,” to which the head of USDA’s poultry research and promotion programs had to explain that the “change” in 2000 wasn’t a change at all. Nothing in the guidelines or recommendations was changed. What happened was that in response to a question posed by someone planted in the audience, Heart Association reps acknowledged that even though eggs are among the most concentrated source of cholesterol in the diet, an individual egg has under 300mg of cholesterol and could technically fit under the 300 mg daily limit. In 2002, they eliminated the specific mention of eggs for consistency sake, but the American Heart Association insists that they haven’t changed their position and continue to warn consumers about eggs.

The guidelines on the AHA website at the time explained that since one egg has 213 and the limit for people with normal cholesterol is 300 you could fit an egg in if you cut down on all other animal products. If you have an egg for breakfast, for example, and some coffee, some skinless turkey breast for lunch, etc., you could end up at over 500 by the end of the day, nearly twice the recommended limit. So if you are going to eat an egg, the Heart Association instructed, we would need to "substitute vegetables for some of the meat, drink our coffee black, and watch for hidden eggs in baked goods." Furthermore, the limit for folks with high cholesterol is 200mg a day, which may not even allow a single egg a day.

This is how the senior director of nutrition education at the American Egg Board’s Egg Nutrition Center characterized the American Heart Association guidelines: “Maybe I’m being overly sensitive, but this reads like: ‘If you insist on having those deadly high cholesterol eggs your penalty will be to eat vegetables and you can’t even have the yummy steak and creamy coffee you love. Really it’s not worth eating eggs. Oh, and if you think you’ll be able to enjoy some delicious baked goods, forget it, the deadly eggs are there too!’”

I shared some of my other Freedom of Information Act finds in my other egg videos, Eggs vs. Cigarettes in Atherosclerosis, and my personal favorite, Who Says Eggs Aren’t Healthy or Safe?

I’ve also explored the presence of carcinogenic chemicals in eggs (Heterocyclic Amines in Eggs, Cheese, and Creatine?), carcinogenic viruses (Carcinogenic Retrovirus Found in Eggs), industrial pollutants (Food Sources of Perfluorochemicals and Food Sources of PCB Chemical Pollutants), the egg-borne annual epidemic of Salmonella (Total Recall), arachidonic acid (Chicken, Eggs, and Inflammation), misleading claims about eyesight nutrients (Egg Industry Blind Spot), and, of course, cholesterol (Egg Cholesterol in the Diet and What Women Should Eat to Live Longer).

To my surprise, though, eggs are actually not the most concentrated dietary source of cholesterol. See Avoiding Cholesterol Is a No Brainer.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Nick Wheeler/ Flickr

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