Big Fat Nutrition Policy | Nina Teicholz

Estimated read time: 1:20

Summary

Nina Teicholz criticizes long-standing dietary guidelines which advocate for low fat and high carbohydrate intake, linking them to rising obesity and diabetes. As an investigative journalist, she challenges the scientific community's adherence to flawed studies, primarily the influence of Ancel Keys' diet-heart hypothesis. She advocates for dietary policies based on robust clinical trials rather than weak epidemiological studies, suggesting a move towards low carbohydrate diets that show promise in treating conditions like diabetes. Teicholz emphasizes the necessity for diverse dietary guidelines that cater to different health needs and challenges the political and institutional barriers to changing dietary recommendations.

Highlights

Nina Teicholz critiques decades-long dietary recommendations, which have potentially exacerbated obesity and diabetes 🍩🚫.
Ancel Keys' hypotheses influenced public dietary policies, despite minimal supporting clinical evidence 🍴🤔.
The need for diverse, scientifically-backed dietary guidelines is paramount, says Teicholz, to meet varied health needs 🌍🔄.
She challenges the prioritization of weak epidemiological evidence in creating dietary guidelines over robust clinical trials 🔬📒.
Teicholz lauds low-carb diets for promising results in diabetes management, with evidence from numerous clinical trials 🍳💪.

Key Takeaways

Nina Teicholz exposes flaws in 60-year-old dietary guidelines pushing low fat and high carb intake, linking them to obesity and diabetes 🍔📉.
Ancel Keys' influential diet-heart hypothesis contributed to public health advice, despite weak scientific backing 📊❌.
Teicholz highlights the need for clinical trials over unreliable epidemiological studies for dietary recommendations ⚗️🔍.
Low carbohydrate diets have shown promise in treating conditions like diabetes, challenging current dietary guidelines 🍽️🩺.
Diverse, evidence-based dietary guidelines are needed to cater to individual health needs, breaking the one-size-fits-all model 👩‍🔬🎯.

Overview

In her insightful talk, Nina Teicholz dismantles traditional dietary guidelines which have long championed low-fat and high-carb diets as the key to maintaining public health. She underscores that these recommendations lack robust scientific evidence and have coincided with a rise in chronic diseases like obesity and diabetes.

Teicholz highlights the undue influence of Ancel Keys—a prominent figure whose diet-heart hypothesis advocated for reducing saturated fat and cholesterol—arguing that such guidelines were based more on flawed scientific studies and institutional biases rather than sound clinical trials.

She advocates for a profound reevaluation of dietary guidelines to reflect diverse needs, prioritizing evidence-based clinical research over unreliable epidemiological data. Teicholz points to low-carb diets as a promising alternative for managing health, especially in conditions like diabetes, urging for a political and scientific shift in dietary policy-making.

Chapters

00:00 - 09:00: Introduction and Background The authorities have been advising people for 60 years to consume less fat, more carbohydrates, and to replace saturated fats with unsaturated fats, including trans fats. This advice is criticized as it coincides with rising diabetes and obesity rates.
09:00 - 18:00: Nina Teicholz's Investigation The chapter delves into the significant impact of Nina Teicholz's work, which challenges a longstanding public misconception concerning health and its implications. Despite not being a scientist, doctor, or nutritionist, Nina's investigative skills have been pivotal in revealing the truth. Her outsider perspective perhaps plays a crucial role in the success of her investigation, allowing her to approach the topic without preconceived notions common in scientific fields.
18:00 - 27:00: Criticism of Dietary Guidelines The chapter titled 'Criticism of Dietary Guidelines' introduces a journalist, Nina, who is appreciated for her work in recognizing potential flaws within the field of dietary guidelines. The introduction given to Nina is warm, reflecting admiration for her outsider perspective that brought new insights to the field. This sets the stage for a critical discussion on the existing dietary guidelines.
27:00 - 36:00: New Dietary Hypotheses and Evidence The chapter titled 'New Dietary Hypotheses and Evidence' explores the author's journey into the field of nutrition and dietary science driven by their research for a book called 'The Big Fat Surprise'. The central theme of the book challenges the established views of government and health authorities on dietary fats, particularly saturated fats. The author argues that these views, which have been widely promoted, may be incorrect, prompting a re-evaluation of dietary guidelines and health advice related to fat consumption.
36:00 - 43:00: Wrap-up and Audience Q&A This chapter discusses the author's motivations for writing the book, mentioning their adherence to current dietary recommendations based on the well-known food pyramid. The focus is on challenging traditional dietary guidelines, particularly in relation to the consumption of meat, cheese, and whole milk. The author aims to shed light on potential misconceptions within these recommendations and advocate for a more informed approach to diet. Additionally, the segment suggests an interactive component with audience questions and wrap-up discussion.

Big Fat Nutrition Policy | Nina Teicholz Transcription

00:00 - 00:30 aren't you okay thank you all for coming um for 60 years now the authorities have told us we should eat less fat more carbohydrate and if we're eating less saturated fat more unsaturated fat like trans fats and this has been terrible advice which is at the very best coincided with this epidemic of diabetes and obesity
00:30 - 01:00 and that worse has been causative rather than associative the extraordinary thing about this huge Collective public error is that the person who has done more than anybody else to explode it Nina is neither a scientist nor a doctor nor nutritionist and in fact perhaps it's necessary that she is in fact an investigative
01:00 - 01:30 journalist and perhaps it did take someone from completely outside the field to recognize that the entire field was flawed we're incredibly lucky that she's come to talk to us today and I welcome her on your behalf Nina thank you very much [Applause] it is lovely introduction and thank you for having me Cato hello to the audience um and all the people who are watching online or maybe just one of you
01:30 - 02:00 um but um so great uh so I got into this field because I wrote this book called The Big Fat Surprise and it has the central thesis of the book is is what Taryn so elegantly described which is that it seems that the government had and our health authorities had really gotten it completely wrong on fat and especially saturated fat uh you know the kind of
02:00 - 02:30 fat the reason we avoid meat and cheese and whole whole milk so I wrote this book um when I started I like everybody else was pretty much everybody else was following our current dietary recommendations these are them depending on your age you probably most of you probably grew up on the the food pyramid you know this is the food pyramid that we've all lived off of and you can see that it recommends that big bottom slab there is recommending that we the bulk
02:30 - 03:00 of our calories really come from grains um uh so you know bread pasta rice those are all grains mainly carbohydrates um and um and you know this has been this has sort of been our like our Bible in terms of every Everybody every school child gets this everybody learns it every doctor teaches this uh every nurse but every
03:00 - 03:30 nutritionist every dietitian um so and I followed this religiously I used to bake my own seven grain bread every day and make my own pasta salads every day for lunch and I would jogged or biked or swam at least an hour every day and I got fat I got fatter than this but I'm not showing you that photo it's bad enough to show you this photo with that terrible haircut but I was you know I really tried very hard I was a vegetarian for over 25 years not a
03:30 - 04:00 strict vegetarian but I had no red meat no butter barely any cheese I'm from Berkeley California so of course I was a vegetarian and then from there I moved from to New York City other capital of vegetarianism so you know I really came to this with zero preconceptions as a journalist I really never thought I would end up putting a piece of red meat on the cover of a book
04:00 - 04:30 much less eat any myself but what happened was is that I got assigned an article by a magazine I was a freelance journalist and was assigned an article to write about trans fats in the early 2000s well what was trans fats I didn't know what they were I hadn't really studied anything about it but I um I that took me into the world of dietary fat um and you know fat is what we have obsessed about most in terms of our diet for Americans low-fat non-fat good fat
04:30 - 05:00 bad fat high fat I mean we have just it has been a central preoccupation of our dietary guidelines and therefore of all of us and I discovered all sorts of things that really as a journalist made my ears perk up like talking calling up scientists and saying uh I can't talk to you about fat and hanging up on me or um people I mean scientists real scientists at reputable universities or scientists telling me they had been visited by officials from
05:00 - 05:30 the margarine industry and told to yank papers from journals editors told to get rid of you know to pre-publication to take that paper out of a journal and I thought um you know sometimes I would hang up the phone after these phone calls and sort of be shaking like am I investigating the mob or am I investigating nutrition science what is going on and I just you know as a journalist you realize there's just a very big story out there um and this took me I read thousands and
05:30 - 06:00 thousands of scientific papers I interviewed hundreds of the top experts around the world and it took me a very long time took me almost a decade of my life to try to get to the bottom of this story um I should say that I do not receive any industry funding and never have um and so that's the only disclosure that I have one of the things that really interested me when I started my research is how do you explain this what happened in 1980 that American obesity just shoots upwards
06:00 - 06:30 um that's very strange obesity is fairly low in the 1970s or not too aggressive and then something happens to get ticked sharply upwards in fact if you go back and look at pictures in the 1970s you know go look at the line of kids waiting to watch the latest Star Wars movie come that's come out like they are all thin not one fat kid among them and then you know now we live in a much different world what happened in 1980 well I want to tell you a story uh the
06:30 - 07:00 story I tell in my book in a very abbreviated way of just how do we come to believe what we believe about fat and saturated fat and cholesterol so it all starts in the 1950s you can see that chart that's uh on your uh right that is the rising tide the sharply Rising tide of heart disease in America which was terrifying uh President Eisenhower himself has a heart attack in 1955 is out of the Oval Office for 10 days that is a huge uh and terrifying event for
07:00 - 07:30 everybody and just imagine you know men are dying in the prime of their life right and left and this had not happened to their fathers this was something entirely new and it was really important that people try to understand why is this happening well there were a number of uh ideas about it maybe it was vitamin deficiency maybe it was Auto exhaust maybe is that famous type A personality you know you yell all the time and then you just Keel over with a heart attack um these were all viable hypotheses but
07:30 - 08:00 there was one hypothesis proposed by this man Ansel Keyes a pathologist at the University of Minnesota and what he came up with with what was called his diet heart hypothesis and his idea was that you would eat saturated fat and cholesterol in your diet says meat cheese Dairy and you would this would lead to your having elevated cholesterol in your blood serum cholesterol this would clog your arteries like cold oil hot oil down a
08:00 - 08:30 cold stove pipe and would give you a heart attack that was his hypothesis um and it turns out that he was just a very kind of outsized personality he was very aggressive I mean he was called arrogant and a bully even by his friends and he could was said that he could argue anyone to the death he was fiercely a believer in his hypothesis and he was able to get himself into the to the nutrition Committee of the American
08:30 - 09:00 Heart Association which you see here that was at the time the really the only public health group that was dealing with heart disease uh and and and everybody was following your advice in 1960 they came up with a paper saying we really would like to tell the American public what to do to avoid heart disease but there's no data Ansley Keys gets on the nutrition committee and one year later with no greater data in hand he's able to get this recommendation published which says you need to restrict your saturated fat and
09:00 - 09:30 cholesterol in order to prevent heart disease and this is the first advice anywhere in the world telling people to cut back unsaturated fat and cholesterol this is what I sort of think of like the Little Acorn That Grew into the giant oak tree of advice that we have today this is where this idea first became institutionalized um so this meant in practice that you cut out animal Foods um and I mean sort of the easiest thing
09:30 - 10:00 to imagine here is replacing butter with margarine you replace it with you replace your saturated fats with unsaturated fats right so instead of butter which is saturated you have margarine which comes from polyunsaturated vegetable oils and I think it's harder to imagine what you how you have vegetable oils instead of meat for dinner but that was the idea um and we just have to go back in history for a second to remember what were the original fats that people cooked with I mean vegetable oils came
10:00 - 10:30 later before cooked with Tallow it comes from beef and suet which comes from sheep and they mainly the two main fats that that European populations used in Americans used before 1900s was lard and butter lard is from pigs obviously and butter and oils did not come on to the scene they were they were actually the first oil that was sort of used was um whale oil that was used to it was used to fuel the Industrial Revolution who I was going to keep all those
10:30 - 11:00 machines lubricated they used whale oil when they killed off all the whales they started to use cotton seed oil and then in the early 1900s somebody looked at cotton seed oil and figured out a way to harden it and said hmm that looks a lot like lard why don't we try to sell that to Americans to eat and that was Crisco and that came into the American food supply in 1911 and sure and after that came regular vegetable oils but these are new
11:00 - 11:30 foods that used to be used to lubricate machinery and still are um but in any case Ansel Keys really won the day I mean the way to understand him is that it was a moment of complete panic in the United States there was a demand for some kind of answer he walked into this vacuum with a very strong idea and uh his idea became adopted by the American Heart Association and he was
11:30 - 12:00 easily the most influent he still is the most influential nutrition scientist in the history of nutrition science so and here he is on the cover of Time magazine in 1961 the same year of that American Heart Association recommendation but what was the evidence at the time well it really amounted to one study that he uh himself had did called the seven country study um and it was funded by NIH in part um I'm just going to so this is what it was it was a a survey of nearly 13 000
12:00 - 12:30 men and women in seven countries around the world mainly in Europe but also in the US and Japan and he looked at answer keys and his team went around and they looked at serum cholesterol levels and they looked at diet and you know Ansel Keys had gone into this study thinking I want to prove my hypothesis and he did in the end uh show a very weak correlation between saturated animal fats and your risk of having a heart attack
12:30 - 13:00 um and if you read if you are unfortunate enough to read uh 10 000 nutrition studies as I have done I would say 90 of them telescope back to Ansel Keyes seven country study it is the one of the most cited Works ever and it was and it's because it was really the only study of its day and because it launched a thousand ships and he so I took I spent enormous inordinate amount of time looking into the details of this study I'm just going
13:00 - 13:30 to give you a couple highlights of its methodological weaknesses for one it only measured the diets of fewer than three percent of its participants which is nowhere near as statistically representative sample so it really didn't know what these people were eating um number two it was um it was a a kind of the kind of study that only shows Association and not causation so it really can't ever prove that reducing animal fats was what
13:30 - 14:00 caused the reduction in heart attacks number three it didn't actually show that that there was a reduced total mortality so people weren't dying of heart attacks but maybe they were dying of something else anyway I want to share with you one particular other methodological flaw which I think is really more emblematic than anything else which is that it had to do with the Islanders of Crete so these are the people on whom the whole Mediterranean diet came to be
14:00 - 14:30 based Ansel Keys looked at the dietary records of about 32 or 33 of them that's the total population he looked at he went to this island he fell in love with them because they were just these seem to him ideal they were they had they lived this life of a peasant it was a beautiful unruined Crete not the hyper Hotel decrete of today and um but it turns out if you read the fine print of his study that he went to Crete
14:30 - 15:00 three times for a week each and one of those weeks he showed up turns out he turned he turned up during Lent uh when everybody is avoiding eating animal Foods so he no doubt under counted the amount of saturated fats that was being consumed by that population but as I said ultimately the ultimate problem was it was an epidemiological study it showed Association it could not prove cause and effect and for those of you who don't really understand what that means I'm going to give you one quick
15:00 - 15:30 example about epidemiology epidemiology looks at things that are correlated many things are correlated so here we find that the divorce rate in Maine is correlated with their consumption of margarine so does that mean you should reduce your consumption of margarine to prevent getting divorced no that's what's called a false Association there are many things that are associated with each other but they do not cause each other here's another example people with yellow fingers tend
15:30 - 16:00 to die more of lung cancer we shouldn't avoid yellow fingers at all costs what causes yellow fingers smoking so you may be missing the thing all together and I want to say that nutrition scientists in the 1960s they knew that that the seven country study was a weak study and that they needed to do random what's the a more rigorous form of science called randomized controlled clinical trials and they did them governments around the world undertook
16:00 - 16:30 for billions of dollars in randomized controlled clinical trials and these took place many I'm saying Australia and England and most were in the U.S but in Finland in Denmark uh sorry Norway um and many of them took place in uh mental institutions or hospitals where people were confined and these are the kind of experiments you cannot do now because they're considered unethical but
16:30 - 17:00 the reason that they're such good trials is that you control all the food of everybody in that setting people are not allowed to go out down to the local Bodega they you know you can see what people are eating and this is different than the many of the clinical trials that you read about today when somebody they're really just given a diet book and maybe they're given an hour of counseling you know once a week and they're given a support group but you really don't know what they're eating so these were well-controlled trials there were on tens of thousands of people I mean this is a very
17:00 - 17:30 conservative number I've put up there uh the 25 000 it's just but but if you if you depending on how you count you can get up to 50 60 000 people who were tested and experiments lasting one to twelve years and what were the results there has no effect of saturated fats on cardiovascular mortality or total mortality and this is uh my summary of it but I can um there's you know a crane review on this with the same results just no effect
17:30 - 18:00 um so Ansel Keys's hypothesis is actually the most tested hypothesis in the history of nutrition and heart disease and we can fairly say that the results were null which is they did not show him to be correct a recent uh the largest ever epidemiological study that was ever that's been done globally um you know I don't normally quote epidemiological studies but I do and they have contrary results and this is one that is a truly
18:00 - 18:30 Global study they found that the more saturated fat people ate they're the lower their risk of stroke um so that's a contrary result and here this is Salim Youssef who is the immediate past president of the World Heart Federation saying I think we got it wrong unsaturated fats the other worrisome thing about these studies that I have just listed is that in a number of them nearly a dozen of them they had this side effect this is the results in one of them where you can see that the people who lower their
18:30 - 19:00 saturated fat they they uh they died at much higher rates of cancer and this was a consistent finding across all these studies the people who had gone on the diets higher in vegetable oils and eating the margarine and the soy filled milk and the soy-filled burgers were all dying at higher rates of cancer and the NIH was so concerned about this in the early 1980s they had four meetings they held four high-level meetings Ansel Keys wins his colleagues all went and they discussed this side effect of cancer
19:00 - 19:30 that could not be explained and they could not find a an answer but they decided that the reduction of saturated fat and cholesterol was just so important for fighting heart disease that they were basically going to ignore the cancer side effects um there were also huge government trials on the low-fat diet so just remember Ansel Keys was particularly obsessed with saturated fats right he wasn't saying lower your total fat
19:30 - 20:00 content overall he was saying switch saturated fats for unsaturated fats but in 1970 the American Heart Association really said you know what let's just look let's lower all fats because fats are more grams per calorie than either protein or carbohydrate so if we just lower now let me just lower the fat content of our diet we'll save calories that was it was sort of a an untested Theory but they um they started recommending it to the American population and
20:00 - 20:30 um and subsequently that's not how policy is supposed to work you know you're supposed to do the clinical trials first and then do the policy but it happened in the reverse fashion when they finally did clinical trials including the women's health initiative and two Boeing trials these are just two of quite a large number they didn't start taking place until the late 1990s by the way they could not find that the low-fat diet had any ability to fight
20:30 - 21:00 obesity type 2 diabetes heart disease or any kind of cancer and in fact if people lowered their fat too much they found that it actually made their HDL which is their good cholesterol go down and that meant they were actually increasing their risk of heart disease and that is why we no longer how many people here know that we no longer have a low-fat diet recommendation oh that's pretty good so you know the American Heart Association in 2013 and the U.S dietary
21:00 - 21:30 guidelines in 2015 those are our two major sources of nutrition guidelines they have dropped any low-fat language so we don't actually have a low-fat diet anymore and they recognized that uh the reason was it doesn't lower your risk of heart disease and in fact May worsen it um oh so why is this not more widely known um you know people say to me oh you don't have any Science degrees and that
21:30 - 22:00 is true I did do pre-med and thought I would become a doctor but um I studied politics and I often say to people to understand the history of this story you must it is really at least half a story of politics um and this is sort of my general politics of nutrition slide because I can't get into it in great detail but it shows you it's Ansel Keys who's seated uh on the left there and you know that
22:00 - 22:30 nutrition science really was run by a very small group of men and all these uh these um the National Institutes of Health the American Heart Association and then the US government was on board they really controlled the nutrition agenda and if you didn't agree with them you couldn't get grant funding it's very hard to get your papers published it's very hard to get you weren't invited to conferences and so they really controlled the agenda I mean I have many stories and interviews from scientists
22:30 - 23:00 saying to me uh you know I tried to challenge keys but you know then my my I was told by NIH um secretary that if I continue to do that I would lose my grant funding and then his grant funding disappeared so I mean it was a very real threat to uh to scientists to be critics of this um and also that people who believed in this um you know
23:00 - 23:30 this is the people who believed in this hypothesis answer keys obviously believed in it there was a whole kind of group who around him who strongly strongly really believed their hypothesis and so there was this kind of selection of data going on where they really I think genuinely just did not see dated to the contrary this is called in science it's called selection bias where you select things that agree with your advice your opinion and you disregard things that don't I mean we all do this where this is normal
23:30 - 24:00 human uh kind of instinct which is you see the things you want to see and you just don't see those other things but scientists are taught to think differently and be different they're taught to distrust themselves and they are taught to try to prove themselves wrong so this clearly did not happen in nutrition I this slide that I have up is I think the most incredible example of selection bias that I ever found which was this was the largest the Minnesota coronary survey was the largest ever test on Ansel Keys's hypothesis it took
24:00 - 24:30 place in five Minnesota Mental Hospitals so well controlled they controlled the diet it was on more than 9 000 men and women one of the few studies to include women half the people were put on a diet that was considered average in saturated fats at the time which was 18 which would seem like our ages to us now but you know regular milk regular meat cheese the other half were put on nine percent saturated fat which is about what we're recommended to eat now so soy filled milk soy filled cheese at the end
24:30 - 25:00 of four and a half years of that experiment this was their conclusion there was no difference in the treatment and the control groups um and and subsequently actually some researchers from NIH went back and looked at the original tapes that were in the basement from this study the original magnetic tapes and and re-analyzed them and found out that actually the more the men lowered their cholesterol the greater their risk of dying from heart disease and that had never been published in this original
25:00 - 25:30 paper so those findings were not published these original findings were not published for 16 years this is an NIH funded study findings are not published for 16 years and then they're putting this out of the way paper that they know nutritionists will not read and this is pictured here as Ivan France who is one of the project investigators and when he was asked much later by a journalist well how come you didn't publish the results he said well there was nothing wrong with the study
25:30 - 26:00 we were just so disappointed in the way it came out which in science I have to tell you is a kind of lying all right so how does this become our official dietary guidelines and our official government policy in the late 1970s Senator George McGovern had a select senate committee on uh on nutrition and they were mainly looking at under nutrition but they decided to look at these new killer diseases coming up heart disease and now cancer was on the rise and he uh published this that
26:00 - 26:30 committee published this report there's quite an amazing story about how this report came to be published it was written by one Senate staffer with no background in nutrition who is sort of on his way to becoming a vegetarian and um and you know didn't know about the subtleties of epidemiology versus randomized controlled clinical trials very much influenced by the American Heart Association so they published this report and that is what becomes our dietary guidelines That's the basis of our dietary
26:30 - 27:00 guidelines and that my friends is what happened in 1980. um now this is just a correlation it's not causation it's a suggestive correlation there is you cannot say from this chart alone that the dietary guidelines caused obesity I think there are a number of other scientific studies that give weight to that case um but it is it is a very inconvenient correlation for the people who crafted
27:00 - 27:30 our guidelines um I I want to talk to you about what is the evidence behind our guidelines um and so I wrote this story for the bmj um and it it actually went to them back to the most recent dietary guidelines the guidelines come out every five years the last set came out in 2015 and it came out right as my book was coming out um and I went to read the expert report and I was like well where is all the
27:30 - 28:00 science that I've been studying it just wasn't there like it was nothing there was no science in the in the report that I that I knew about so I I went and I looked at um I went and I looked at every single study that was cited to resp to support the dietary recommendations that we are all currently following today okay so these are these are the usda's three dietary patterns there's the U.S style which is really dash if you know what
28:00 - 28:30 Dash the dietary two uh stop hypertension the Mediterranean diet and the vegetarian diet you can see in terms of their macronutrient makeup they're all pretty much the same and you would basically call this a low-fat diet low-fat diets have been described as being anywhere between 30 30 25 to 35 percent fat so it's still a low-fat diet even though they're not calling it a low-fat diet and that means that you're eating over 50 of your calories is carbohydrates this is just another chart showing in a
28:30 - 29:00 slightly different way that you can see that in terms of the daily recommendations of food groups that the diets are all very very similar um so I went and looked at you know what are what where where's the evidence for these dietary patterns that we're all following okay so um so the first one is and I only looked at the major diseases that they're looking at what is the relationship between dietary patterns or risk of cardiovascular disease so um what was their source of data for
29:00 - 29:30 that well they studied the pretty Med trial which is this huge trial on the Mediterranean diet that has been retracted uh and reissued but with so many problems that it's really the basic evidence has been called seriously undercut into question and then the dash trials all the dash trials let me tell you something that most people don't know about the dash trials they have only DASH diet has only been tested on 1200 people total
29:30 - 30:00 in experiments lasting no longer than five months long they have never been shown to be able to help people lose weight they do reduce your blood pressure if you have high blood pressure and they will reduce your LDL cholesterol which is your bad cholesterol but at the same time they also reduce your good cholesterol your HDL so at best they're kind of a wash for heart disease and the evidence is very thin and that is the entire clinical trial base for
30:00 - 30:30 this dietary powder this this recommending our dietary patterns okay oh this is just the dash I didn't realize I had to slide on this oh I can tell you this mostly middle-aged men they tested most trials lasting no longer than eight weeks so um next question what about body weight meaning can the dietary patterns help you lose weight here they've cited only one trial on 180 subjects that's the total
30:30 - 31:00 evidence base for the uh for this recommendation that any of those dietary patterns will help you lose weight and now I'm saying when you go to the doctor and the doctor says you need to follow a Mediterranean diet this is the only to lose weight this is the only trial that that doctor will be able to cite um and they didn't lose much more weight right uh they had about well what is that in pounds five six pounds um okay so let's go on to diabetes can the dietary patterns help you reverse
31:00 - 31:30 your diabetes fight type 2 diabetes or type 1. zero there are zero clinical trials to support this um so that's pretty bad evidence what about the vegetarian diet that is the new diet that they came up with in 2015 to recommend to all Americans they could find no randomized controlled clinical trial to support the health benefits of that diet I know it's very popular and probably everybody in the room knows somebody on this diet right
31:30 - 32:00 now but um there are no clinical trials to support its health benefits and they overall when they looked at all the data they had to give it the lowest rank that they could possibly give for available data so this is quite a surprise because one of the things that that I did recently was look at the publication history of every of the 14 people in this expert committee who wrote this report and um and before they were chosen for the committee 11 out of 14 of them which I
32:00 - 32:30 think is around almost 80 percent but um 11 out of 14 of them had published histories saying they believed the vegetarian diet was the best diet or another called a plant dip based diet so they came into the committee with a bias for the vegetarian diet they couldn't find any evidence for it but they recommended it anyway um so what is the evidence for dietary patterns why do we why are we why are we
32:30 - 33:00 all following them and the answer is it's all epidemiological it's all this weak epidemiological data um uh so this was something that um that was sort of confirmed in a report by the National Academy of Sciences engineering and Medicine who took uh they did really the first ever outside peer review of the dietary guidelines the report came out in 2017 and they came to the conclusion that
33:00 - 33:30 really they um they were not prioritizing the science correctly and they lacked scientific rigor and they lack transparency and they suffered from bias um so that just tells a story that uh you know our dietary guidelines were born out of weak science and remain weak science um and this is not what we're told though I mean what this is this is what we're told this is what the you know I think the mainstream uh journalists and experts will tell you this story which
33:30 - 34:00 is that it is your fault America that you're fat and sick because you failed to follow the guidelines and you don't exercise enough well I'm a journalist and I thought okay maybe that is true I you know I should go and look at that data and see what that data says and here's what the data says actually this is the best available government data that you can find on this subject and it shows you what the trends are in food consumption I don't know if you can see this but um so Americans eat 20 more fresh vegetables 35 more fresh fruits 28 more
34:00 - 34:30 grains than today than and the it's the years are from 1970 to 2014. we eat 87 more vegetable oils so they're all those are all the blue lines going up so everything we've been told to eat more of we eat more of uh and then the red lines going down are everything we've been told to eat less of we eat less of uh we eat I can't even see that number um but I think it's um about 25 less red meat I know that we eat 34 less beef now
34:30 - 35:00 whole milk is down by 79 eggs are down animal fats are down by 27 butter is down and this is not a Cherry Picked set of food groups here I can tell you that in every category you check for for you know fish we eat more fish we eat more nuts we in everything that we are supposed to eat more of wheat more of you know and the vegetable category is not ketchup that is the biggest increase in in vegetable consumption has been in
35:00 - 35:30 leafy greens so we've done a pretty good job of following the guidelines I'd say and this also turns comes out in terms of macronutrients we were told to increase our carb consumption uh and we did carbs are up by 30 we were told to decrease fat we did that down by 25 percent um and um I would say the more reliable numbers are from 1971 but um but still you can see the trends we did and we did follow in big macronutrient patterns we
35:30 - 36:00 we follow the guidelines what about on exercise is it the fact that we don't exercise as much as we used to well according to the latest one of the latest reports by the uscdc ex Americans are exercising more than we used to so we are now we 50 more than half of us are meeting the government's physical activity guidelines and that's up from 41 in 2005. and so people are increasingly saying there's another report that says that
36:00 - 36:30 you know that looked at sedentary Behavior they could not find any evidence that seven sedentary Behavior leads to obesity which doesn't mean it's not true but they just couldn't find any evidence for it which is good news in the meantime for us couch potatoes uh but as people experts are increasingly saying you really cannot exercise your way out of a bad diet it's really that that that obesity and other diseases are really driven by nutrition
36:30 - 37:00 so what are the nutritional options you know look the Ansel Keys's diet was tested results came up null low-fat diet tested results did not show any benefit well there is now a new idea about diet a new hypothesis about what causes obesity and other diseases and it's called the carbohydrate insulin hypothesis and it holds that carbohydrates really of any kind even those health healthy
37:00 - 37:30 whole grains in your body they become glucose your body understands all of that is glucose which is sugar that triggers the release of pain of insulin from the pancreas and insulin is like the king of all hormones for making you fat so you take insulin plus glucose and that is stuck away in your fat cells and if you have carbohydrates all day long if you're having cereal for breakfast and then your blood spikes your sugar spikes and then your hungry mid-morning and you
37:30 - 38:00 have uh maybe you have a piece of fruit and then your sugar spikes and then lunch you have a sandwich and then mid-afternoon snack is some crackers or gummy bears and then for dinner you're having pasta that is carbohydrates all day long and over time your ability to produce insulin and respond to insulin and your body's ability to deal with insulin is just exhausted you become what's called hyperinsulinemic or you you just you can no longer process the insulin and that is when you become type 2 diabetic
38:00 - 38:30 you have to shoot yourself up with insulin because your body can no longer deal with it no longer responds to the amount of insulin that itself can produce so what is the evidence supporting this new Theory uh well quite a lot more than 100 randomized controlled clinical trials on more than seven thousand people some of them are what we consider you know quite six of them are two years long that's considered long enough to flush out any side effects
38:30 - 39:00 some of you probably knew this originally as the Atkins diet it used to be thought it would lead to renal failure and bone loss and other kinds of side effects none of that that would have been seen in the two-year trials and none of those side effects turned out to be true um low carb nearly always results in more weight loss maybe not dramatically but always more and it's accomplished without any hunger or calorie counting which is always one
39:00 - 39:30 of these kind of unrecognized aspects about a low carbohydrate diet because like what if your doctor said and said I'm going to give you you have two pills to choose from this pill is going to make you hungry irritable tired cranky and constantly think about food all the time and this pill has no side effects which one would you choose you choose the you choose the pillow you choose the diet that doesn't make you hungry it doesn't make you tired doesn't lead to you know lowered metabolism so
39:30 - 40:00 um and there are there's more than one experiment now that shows that um that the diet can reverse type 2 diabetes quite quickly uh the the largest trial on this showed 60 reversal of diabetes in one year and by that I mean that it it the average blood glucose of these people fell below the diabetic diagnosis so they were no longer diagnosed as diabetes that does not mean it's a cure if they start eating carbohydrates again they'll
40:00 - 40:30 get their diabetes back um a study just came out showing it could reverse fatty liver disease and it improves most cardiovascular risk factors I hear you cry yes but we eat more calories it's about the calories it must be that we eat more calories and it's true we eat more calories now than we did uh 30 years ago but all those calories practically are carbohydrates so we cannot from this information alone say it's just the calories it could be
40:30 - 41:00 the carbohydrates um so looking at all that uh I founded a group called The Nutrition Coalition uh which is based here in DC and our work is simply to try to get the guidelines to be evidence-based our it's very simple we just want them to be based on randomized controlled clinical trials on humans and not on this weak epidemiological evidence because we believe that this would allow people to
41:00 - 41:30 get healthy again and the reason that we're focused on the guidelines is they are incredibly powerful I know probably throughout this whole you know talk you're thinking I don't go to a.gov website to find out my dietary advice I go to the Internet or I ask my doctor but look how powerful the guidelines are they control all the uh your school lunch programs feeding programs for the elderly they controlled women and infant children what's fed to them those are the biggest budget line
41:30 - 42:00 in USDA budget they control all the K-12 education they are downloaded virtually by all the medical all the associations The Diabetes Association the medical association nutritionist and on the nurse Association and then there so at every point of contact with patients in every office in every setting you're being told the guideline you're being taught the guidelines they direct food for the military we now have a obesity problem in the military and they change the whole food supply so
42:00 - 42:30 all of cattle were bred to be leaner that's why we have lean on pretty much only lean meat in the supermarkets and and led to the creation of thousands and thousands of low-fat products they are really powerful and it's a problem uh you know and and they haven't been helpful that's to say the least we could say is they have not been helpful um and I want to uh you know I also want to say about them that they are really they remain this one-size-fits-all diet and you know one of our goals is is
42:30 - 43:00 simply to say you know beyond there being evidence-based we really need a diversity of diets and everybody in this room ha is different and and has unique and different kinds of nutritional needs responds to diet very differently children have different nutritional needs the elderly have different nutritional needs people who are obese or have diabetes or heart disease have a metabolic issue that requires a different diet So currently our dietary
43:00 - 43:30 guidelines are only for healthy Americans did you know that so that applies to about less than 20 percent of America is still considered metabolically healthy so that is something else that really needs to change um and and the final thing that needs to change is the dietary guidelines are currently they do not meet nutritional adequacy goals for potassium magnesium choline and something I'm forgetting but I mean it they should meet nutritional adequacy goals because people need nutrients in order to avoid disease and
43:30 - 44:00 to grow and healthfully reproduce so that's the goal of the nutrition Coalition it should be all of our goal um and um and so I thank you for having me here today I think I've landed on time Terence uh so um we wanted to have plenty of time for your questions and so I'd like to welcome any questions that you have especially the hard ones foreign
44:00 - 44:30 so the question is that the dietary guideline committee has been formed for the 2020 guidelines it was just announced last week and am I happy with it that is a complicated question it's a 20-person committee it is definitely more diverse than any committee has been in the past there is an expert there who is an expert in animal proteins that's never been the case there is
44:30 - 45:00 um there's somebody who is I wouldn't say a true expert in low carbohydrate diets but is somebody who's knowledgeable about them and has done low carbohydrate diet experiments and is open to them um that said there is a there is a Seventh Day Adventist Who as a matter of religious belief whole believes in a vegetarian diet and I don't believe we should be mixing religion with uh good science or policy
45:00 - 45:30 um and find me somebody who does and their air you know there are quite a few people in the committee who are really strong Old Guard people who have you know who have served on the committee before instrumental in creating the committee long long time people who have been um employed by the USDA employed by FDA so very very close to the government and those will be the Heavy Hitters on a committee so I just don't know the question is how much can these sort of
45:30 - 46:00 Outsider or up-and-comers have their voices be heard uh yes in the back I've been involved in a number of non-profits I'm looking for a new Mission oh great sign us up how are things coming at the coalition I don't know if your magazine but the question is uh he's a gentleman in the back is looking for a new non-profit and
46:00 - 46:30 how are we doing at the nutrition Coalition well we're solvent um we were responsible for that National Academy of Sciences report that was the first ever outside peer review of the of the guidelines that was pretty much that was our work I mean nobody can say anything for sure but um but we proposed it um and so that I think was quite an accomplishment we uh actively um educated people at USDA about the need to include in their topics for this
46:30 - 47:00 year the low carbohydrate diet and saturated fat as topics that needed to be reviewed and they did so again you never are sure if you've done something but I know that we're we're really the only group in the world right now that is advocating for evidence-based guidelines I mean we're it um the the there's a tremendous kind of bottom-up movement of people who have gotten healthy By ignoring the
47:00 - 47:30 guidelines uh and so but they're you know then there there are hundreds and we have we have uh maybe 500 doctors signed up with us who and many many phds signed up with us who believe in our mission but um it really hasn't translated into an advocacy effort until our group was formed so we could use your support yes woman in purple
47:30 - 48:00 I did cut out carbohydrates and my blood sugar did go down however I've had high cholesterol for a long time should I take cholesterol medication or do you suggest anything else uh so I want to say that um one of the one of the chapters that is one of the sections of my book that is worth reading is how women and the data on
48:00 - 48:30 women and children have been has been ignored uh and how the data for women and children is very different than it is from middle-aged men and one of the findings that came out of the very earliest uh uh studies that looked at risk factors found that women especially women over 50 the higher their cholesterol the longer they lived but that finding in an effort to just sort of simplify the message that finding for women was just ignored
48:30 - 49:00 so if you have I mean unless you have you know there are people with something called familial hypercholesterolemia which is super high cholesterol and they are that's a genetic defect and uh treatment for that might be different but if you are regular Garden variety high cholesterol that is a good sign if you are a woman yes that's good all right I think there's somebody in the back there who's had their hand raised for a while in the green cap
49:00 - 49:30 or we might as well do those two in the back thanks so much a question about high fructose corn syrup which is generally entering to almost every processed food uh and I hear that it's used to fatten cattle but that is going throughout the food supply so would you like to comment on that is that something you yeah I mean high fructose corn syrup uh you know high fructose corn syrup is really not that much different from sugar
49:30 - 50:00 um it's just one is in a in the evidence to show that it's really so much worse for health is is is is not that strong I mean sugar is Ted correct me if I'm wrong here but sugar is like 50 glucose 50 fructose high fructose corn syrup is 55 fructose and 45 glucose is that a difference that really has a huge Metabolic Effect on the body it's
50:00 - 50:30 not really clear um so in general I mean I want to say something about sugar versus grains what fattens cattle is whether they've had a fat in cattle anybody know they feed them grains that's what happens and that's why they go into feedlots because just eating grass is not fat and cattle that efficiently so they stick them on a feedlot and they give them grains so remember the big bottom slab of the food pyramid what fattens humans
50:30 - 51:00 could very well be all those grains or grains plus sugar but I'm not convinced truly by the evidence to show that high fructose corn syrup is so much worse than just regular sugar uh I think he's had his hand up for a while and then maybe down here you've had your hand up for a while yeah I actually had a little different comment but to build on what you just said about fattening the animals uh in a feedlot the the way you get them fat is
51:00 - 51:30 to feed them more grain the way you get them to eat more grain is to actually put less salt density in the grain because there is an inherent appetite for salt and so that's how they get them to eat more grain which gets me to the other question that I wanted to get to which is uh first of all congratulations I think you nailed the the political machinations and I'm more familiar with the salt questions than the fat ones but it's the
51:30 - 52:00 same story and only the actor's names changes uh but the the question I had was are you familiar with the latest research on the neural control of appetites uh there's a study that came out on and uh a New England Journal uh just two to three weeks ago where it pointed out that for water for what was the third one I've got here
52:00 - 52:30 water salt and uh for food generally quantities of calories are driven by appetites modulated by the brain activity so if you're not familiar with it I'll share this story with you it's a it's a fascinating story because there as I said uh a a cow or a steer will have a inherent appetite for salt and that's
52:30 - 53:00 how you deliver antibiotics too because you can meter it but it's uh it's there because the brain tells the body keep eating that's why when you go to a low sodium diet as opposed maybe a low fat diet too but a low sodium diet people will keep eating the same amount of sodium and that you showed the chart about how we follow the guidelines salt
53:00 - 53:30 is unchanged in the entire time of uh of that guideline except for in the school lunch program where it's been required now to go down I'm sorry well no sorry finish your point and then I'll okay well the point I was making I think was that uh it's controlled by the brain and the Brain will uh tell people keep eating whatever amount and it varies by individual their body needs and therefore if they try to
53:30 - 54:00 choose low sodium foods they'll just end up eating more Foods uh so yes that is right I mean the the the brain regulates appetite and it's the way I think about it is the body you know your body requires certain nutrients to survive and if your body is not getting those nutrients it sends a message up to the brain eat more so if you what I was saying is that you know that under the guidelines because
54:00 - 54:30 they have they've reduced salt say in the school lunch programs that that mean there will be reduced uh salt in any of the USDA feeding Assistance programs and that means that kids are likely well then if they can get it you know eat more food because they need the salt it's true of other Foods too and and that's one of the reasons why people when they reduce carbohydrates and they increase fat and protein in mainly in animal Foods say
54:30 - 55:00 they uh they won't eat as much or they won't what you know is a sort of a tautological term but they won't over eat um and that's because their body is getting those foods contain the nutrients that they need and the fat that they need to be healthy so they find that that the way to talk about is they say fat and protein are more satiating and they fill you up and they've done experiments on subjects where they put a stack of pork chops in front of people and say you know eat you must eat these people cannot overeat in
55:00 - 55:30 pork chops or steak they're just like I'm full I'm really full and I can't eat anymore but you know what it's like to open a bag of cookies or crackers or popcorn or crisps or you know whatever you can you can eat that stuff forever and I know because I used to live on rice cakes and I could just never get to the bottom of the number of rice cakes that I could eat because I wasn't getting the nutrients that my body needed so your body is setting up that continual message just keep eating until you get what you need to feel satiated
55:30 - 56:00 and what is satiating is the right amount of nutrients and and and and fat and protein so that your body can survive healthfully so uh so anyway so that's it's it's a complex subject about appetite but I think it's basically driven by our basic biological needs our bodies are not idiots you know these ideas like oh go fill yourself up with water before a meal or fill yourself up with celery or your body is not that dumb it's not going to be filled up with celery you're
56:00 - 56:30 just going to get hungry later on and eat something else until you give it what it needs to live okay you've been waiting for a while and then yes yes okay um when I looked at some of the write-ups on that study the only marker that got just a little bit worse was ldlc correct and that's debatable
56:30 - 57:00 okay whether you should include it at all the diet that made everyone sicker was the Ada diet right and I keep seeing this stuff over and over again and you pointed out the history of the American Heart Association why can't the Ada be sued into extinction because the amount of human misery that they're responsible for is just unbelievable I mean this tops
57:00 - 57:30 anything you could talk about in the 19th century with with respect to Medicine okay and why can't why can't there be something stronger than they get away with it every time the yeah yeah I mean why is it so rigged um so first I want to tell everybody about this a little bit more about this study it's called the virta study because it was funded by a company called virta that made the the mobile
57:30 - 58:00 app that that was used to communicate with patients and that was a really good way of staying in touch with patients it's uh it's over 300 people who when they entered the study it's a university-based study at the University of Indiana when they started the study they had on average been suffering from diabetes for eight years that is very unlike other studies where people are pre-diabetic or or an early stage of diabetes these people who had serious diabetes they were on multiple medications and after one year of going
58:00 - 58:30 on a very low carbohydrate diet which by the way they tested with adherence by by measuring their Ketone levels which showed absolutely you cannot you cannot get ketones in your blood if you're not on a very low carbohydrate diet so they had excellent adherence 60 had reversed their diagnosis of diabetes and compared to the control group which followed the American Diabetes Association diet they have 0.1 percent reversal and that's because the American Diabetes Association tells you eat carbohydrates
58:30 - 59:00 but just match it with insulin so you know you're just trying to chase your carbs all day long matching it with insulin and then you need ever more insulin and you know insulin is not a benign drug it makes you gain weight weight also so you're in this like negative Loop of gaining weight getting more diabetic the American Diabetes Association is almost 100 percent supported by pharmaceutical companies that make insulin so um it's just uh I mean I I think it has
59:00 - 59:30 just has to be said it's just a wholly captured organization that is not serving the public and um why can it not be sued I don't know that it can't be sued I was told by one expert that if you have uh scientists legitimate scientist who will stand up on both sides of the debate that they can make the defense that this is scientifically justifiable there's legitimate scientific debate and therefore they have their protection against uh they have a lawsuit but you
59:30 - 60:00 know I would love to see somebody test that if there are any lawyers in the room here oh your second last slide yes that one one more sorry one more I'm looking for the one where the dietary guideline goes in uh the the 1980s
60:00 - 60:30 the one that has one of your first slides of the one year later obesity obesity right there no okay there we go okay dietary guidelines go in in 1980. uh and in 1981 we have seen a four percent increase in obesity I don't think people get obese that fast uh so there so there something was going on prior to the initiation of the
60:30 - 61:00 guidelines that was going to predispose people which were the American Heart Association recommendations was that was that what it was yes so the official policy people started to change their eating habits starting with the American Heart Association in in 1961 they told everybody they told men to cut back on saturated fat and cholesterol and then they said then they expanded that to all people because they
61:00 - 61:30 were basically their logic was it's just easier for a housewife to cook one meal for everyone so that's all let's all take care of the dad and and maybe we're preventing heart disease for everybody else in the family too in 1970 they start recommending the low fat diet and everybody starts learning through newspapers and magazines and echoing that message to to start lowering their fat and they did I think it is true that is a very sharp incline that you see there but you have to remember that the U.S guidelines the
61:30 - 62:00 whole food industry is swiveling around to respond to them literally I mean the USDA puts out a notice saying we need in the next two years we need 3 500 more low-fat products on the shelves is they what it probably the federal registered it says to the you know to the whole food industry and all of cattle start to be you know they change all the cattle to be bred to be leaner and they change everything that's sold in this in the stores but but there had
62:00 - 62:30 been this whole you're right there have been 20 years prior where the American Heart Association was getting out these messages and they're going out through magazines and and so people are already changing the way they eat over here the so yeah 1997 was the the report by the Senate select committee on nutrition so and that came out and there was a lot
62:30 - 63:00 of well actually in the years that right after that came out there was a lot of controversy around it um and there was I would say there were a couple of years where there was just a tremendous amount of debate um but yes so that was definitely sort of brought it all to the fore for the public and made it more um all these issues all more known good point all right you've been waiting for quite a while over here in the corner
63:00 - 63:30 I want to be clear are you calling for a rejection um the question is am I calling for a rejection of epidemiological evidence or a more skeptical eye of it um so epidemiology is really a science that is meant to generate hypotheses to be tested so it really is meant to say like hey we found an association between you know meat and cancer
63:30 - 64:00 so uh let's go out and test that in a clinical trial that's what it's meant to do you're not supposed to take the epidemiological finding as a basis for Public Policy I mean the level of certainty that you need to have for Public Policy of an entire population it ought to be very high a very high standard for telling people you know you were telling a healthy in 1980 we were still a fairly healthy population so you're telling a healthy population to change their diet and need a very high
64:00 - 64:30 level of evidence so in general when you're looking at data there's these data pyramids that they have at the top are usually rent you know randomized controlled clinical trials or meta-analyzes of those trials at the bottom our epidemiological studies and the critique of the dietary guidelines is that it's ignored these trials and elevated the epidemiology a different issue than you know ignoring evidence that's on the table is different than
64:30 - 65:00 uh saying that there are creations well as you suggested you know one of the limitations of you know the the clinical trials you know is that adherence is difficult to monitor especially over long term uh the the populations that are involved are often not representative of the general population so uh again you know it sounds like you're
65:00 - 65:30 saying take you know epidemi Epi evidence off the table rather than considering all of the available evidence given its strengths and its weaknesses and and I'm just trying to clarify you know you know is the position that you're putting forward that Deputy should not play a role in this uh development of this policy I think for public wide population-wide
65:30 - 66:00 policy recommendations you need to have more than epidemiology epidemiology to make them you need to have replicated randomized controlled clinical trials on humans because the epidemiology has been shown demonstrated time and time again to be unreliable let me give you an example let me tell you what I mean by that just so everybody understands in two separate studies where they looked at nutritional epidemiological findings which include in the past uh uh
66:00 - 66:30 you know take vitamin E supplements hormone replacement therapy take beta-carotene um uh you know there's a there's a long list of them when they test those epidemiological findings in rigorous clinical trials they have been shown to be correct zero to twenty percent of the time that means that 80 to 100 of the time they're wrong so we can't I don't think it's fair to bet the public health on those kinds of odds like I just think that's irresponsible
66:30 - 67:00 and we can see how we have gone wrong because the advice you know all that the advice not to eat cholesterol in your eggs in your shellfish and the reason we avoided all those really nutrient-dense Foods was based on epidemiology that turned out to be wrong uh same thing with low-fat diet turned out to be wrong so I think we cannot and and not just wrong but harmed people hormone replacement therapy killed women so I think that we cannot afford to be
67:00 - 67:30 that wrong like and we should not we should not risk our public in these kinds of experiments it would be better I mean according to the medical dictum it is better to do no harm so better to remain silent a man in the back in the corner it's a great presentation thank you very much thank you so a couple questions um first one is do you follow the Cleveland Clinic and Dr esselstein's
67:30 - 68:00 perspective on heart disease do you feel like that somewhat conflicts with what you're advocating for us number two is yes you probably have followed The China Study which yes you know those people have very high life expectancies and they're mostly vegan um the third thing is you know the the meat and and dairy that are our forefathers ate is different from the kind of food that we get these days right I mean these cows are laced with hormones and antibiotics
68:00 - 68:30 um and then also if we bring in sort of where we are with our climate I know this is Cato and they're not exactly advocates for for climate change but you know it's reality and you know um so do we think about those things and um yes in our diet so I appreciate it commentary so uh so there's a number of uh arguments about you know for the vegan diet so at the Cleveland Clinic there's somebody named Caldwell esselton who recommends a vegan diet um he's done one uncontrolled experiment
68:30 - 69:00 so no control group on a very small number of people and was not well not not controlled in terms of how he followed up on them so I think his data is not strong and it's why the dietary guideline committee didn't cite it um they also did not sign right The China Study because that was never published in a peer-reviewed journal and has been there's been a number of problems found with that study which is in the end uh an epidemiological study never peer-reviewed never published in a peer-reviewed paper so there are
69:00 - 69:30 problems with that literature um the um the question about meat and dairy being different today than they were previously uh you know I think that um people always have the choice if they have the income to go and get um you know higher quality meat and and higher quality Dairy if they if they feel like that's where that I looked personally into with a question of whether there are actually hormones in our milk and they're not um that turns out to be a sort of a myth that's been
69:30 - 70:00 perpetrated by I don't know who but um so you know if you can afford it but I mean I think given the choice of buying conventional meat which a lot of uh you know still contains folate selenium B2 all the B vitamins zinc iron compared to having pasta for dinner which contains uh none of those things in their natural form and it's full of carbohydrates I still think the better choice for a family on a budget is uh is
70:00 - 70:30 the meat because it's nutrient dense and it allows children to grow healthfully um this the question of climate change and whether or not meat animal agriculture drives climate change is I think one I can just say it's one of unsettled science right now there are many things that we uh you know it's it's been promoted by people flying on private jets around the world but no I mean I take it as a serious issue it's just that I think that you know we need
70:30 - 71:00 I mean my basic point is we need to we have a tremendous obesity and diabetes crisis in this country you know diabetes alone without even the side effects cost 322 billion dollars a year we are unhealthy we are suffering it is a huge economic cost so I think the the question that I ask myself is what is the diet that will make us healthy for which we have the evidence that makes us healthy and how do we make that diet sustainable
71:00 - 71:30 we cannot enshrine this diet or the diet you know the diet that is making us unhealthy and make that the sustainable diet that that create that puts in place ever Rising rates of obesity and diabetes which I think is unacceptable or should be unacceptable to us mm-hmm I don't know who's next you here thanks for the presentation you know as you said your book is a lot about
71:30 - 72:00 politics and there's a lot in your book that in a way isn't really limited to nutrition it's about Academia and it's about rivalries and jealousies and studies and people saying I can't talk to you about that and that sort of thing as a result of your research do you think we should all have a more skeptical attitude just in general about what is or is not settled science I mean does does it give you a perspective on questions like I know this is
72:00 - 72:30 controversial you know the vaccine controversy and whether or not it's such a slam dunk or we shouldn't at least have a grain of of skepticism about whether or not that's settled science um if you're asking me if I have any trust left in the world answer is not very much like I really distrust most claims now that I've seen how science can be distorted and how um I think the process of doing science is so uh it there's so
72:30 - 73:00 it's so deeply flawed not by the scientists themselves necessarily but by the way it becomes institutionalized hypotheses are adopted by institutions and then they become the favorite hypotheses and then it is almost impossible to be a dissenter or a Critic and so the voices of the critics become marginalized and this is happening at a shockingly fast rate now that we have you know the the way that scientists and academic institutions have learned how to play into the media and and and do PR
73:00 - 73:30 for their science and they because they know that's also how they'll get more research grants so it does make one me very skeptical about the ability to trust science um so unfortunately yes I need to be one of those people that like goes off and lives off the off the grid um yes over here I was wondering how does fast food uh fit into all of this because in 1980
73:30 - 74:00 besides Reagan becoming president I think uh it's kind of fast food industry really started to take off so how does fast food fit into all of this so yeah the question about fast food I think is an excellent one which is we we have seen over the you know we've seen the great rise in manufactured foods but it really started in in the 20s and 30s where you know the rise of standard Biscuit Company and Heinz and they're all that's really when those companies
74:00 - 74:30 started coming into being and then they really I um you know went into overdrive I think in the last 30 years so we're surrounded by what people call a toxic food environment and it is really hard um for people to resist that that's definitely a factor in what's driving obesity but it's also true that there are many overweight and sick people who are are trying really I'm saying junk food is not the only explanation and there are a couple data points that
74:30 - 75:00 I want to give you on that consumption of sugar has actually been dropping since 1999. so has the consumption of refined grains consumption of whole grains has been rising since 1999. those are Trends in the right direction yet we see no difference in obesity maybe there's a lag time response I don't know and it's also true that there are many many people who have had non-junk food Laden diets in other words those nearly
75:00 - 75:30 50 000 women who all went on the Women's Health Initiative they were not told to eat junk food they were told to eat fruits vegetables whole grains and they did not get any healthier this of course dovetails with my own experience making my own bread and having lots of fruits and vegetables and not eating sweets and being extremely good and and I only got fatter and sicker so I think there is I think that junk food is one component uh but it is not the only story here about why we are
75:30 - 76:00 so unhealthy any other questions uh okay lady in purple in the back do you want to add anything yeah I keep reading about how vegetarian and vegan diets are good for the planet you know because they don't use up as much land and water I mean do you have any comments on this
76:00 - 76:30 so you know I'm not an environmental scientist so the you know the question about vegetarian diets being better for the planet I think that you can look at you know the argument has always been there's you know it takes more inputs to create a pound of meat than it does a pound of plants right and that's always so why should we be eating meat because this is much cheaper but if you calculate in a pound of plants comes with obesity diabetes heart disease maybe cancer that all of a sudden looks like a very expensive pound of plants
76:30 - 77:00 maybe they you know a pound of meat without all the disease would be a better investment of our resources how about back there in the green hat oh sorry I miss you out here just wanted to kind of piggyback on a question comment from earlier is that one of the things that I'm a Health Fitness Viper in that right profession
77:00 - 77:30 and one of the things I find incredibly disturbing and really frustrating is how like you're saying these methodologies methodologies and opinions become institutionalized and particularly in um in the lack of nutrition education in medical professions um like my dad has diabetes recovered from prostate cancer is kind of borderline dementia and I have to argue with him against his own doctor's advice
77:30 - 78:00 on what he should be eating like he's being told I advocate uh low-carb higher fat and it's going against his doctor's advice his primary care physician he's different doctors and you know um even several friends are are doctors and they have a primary care doctor and an anesthesiologist have the same amount of nutrition education and it's really it's it's we're up against something like that is so heavily ingrained in and
78:00 - 78:30 and how how to go without changing that yeah taught in medical schools well this is why our strategy for change is to change the guidelines because you know the doctors are are taught the guidelines I just and they and they must fight if you're in a large Medical Practice you must follow the guidelines
78:30 - 79:00 or you risk you know being sued you ask medical a lot we have a doctor in the audience who told me stories we're not allowed to not teach the guidelines another friend of mine who's in medical school and wrote and said I just sat through you know they get like one or two days of nutrition training in medical school and they are taught the guidelines and he says our teacher is telling me teaching the guidelines and I just I just you know I'm on a low carb diet and I and I just can't I can't believe what he's teaching us and he went to him after the lecture and said
79:00 - 79:30 how come you don't mention anything about you know other kinds of dietary patterns and the professor himself said well I myself am on a ketogenic diet but I'm I'm not allowed to teach you anything else and that's because of the medical associations which goes back to the guideline the guidelines are considered the gold standard they're considered the gold standard worldwide and until that changes it imposes such rigidities on our whole medical system and I you know actually feel sorry for doctors because you know it's not their fault they're really like they're just
79:30 - 80:00 doing what they've been told um and and so you know but but there there is a rigidity imposed upon them that they that you know most people can't can't break out of so I agree it's a somewhat tragic State of Affairs yes thank you very much we've just had 40 to 60 years of collective error destroyed in just 45
80:00 - 80:30 minutes of excellent and elegant destruction it was absolutely brilliant and the questions could tell how engaged the audience were thank you very much for a wonderful wonderful talk and then upstairs there are drinks and I'm glad to say lots and lots of cheese thank you very much foreign