(Mal)Nutrition: Medical Professionals Cried Wolf Too Many Times and Now No One is Listening!

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Many of my patients are frustrated with the seemingly endless stream of conflicting recommendations about the consumption of dietary macro-nutrients. By which I mean - How many carbs, fats, and proteins should a healthy person consume on a daily basis. They have a right to be frustrated! We place so much emphasis on making the right personal choices and blame poor diet and poor health on the "failure" to make these choices based solely on ambiguous and sometimes conflicting recommendations. Think about how many times the "establishment" recommended against the consumption of butter versus margarine! I work in medicine for crying-out-loud and I'm still not clear on the actual establishment recommendations! To add insult to literal injury, when a person's health begins to fail, we blame them for not making better dietary decisions. It's common to talk to a patient about lifestyle modifications and watch them tune out. I can literally see the curtain go over the patient's eyes as their mind drifts elsewhere, far away from the droning of yet another medical professional lecturing on a proper diet.  I DON'T BLAME THEM. Unfortunately, the medical community has cried wolf so many times that no one is paying attention anymore.

 CErtified bad-ass and nazi killer was no match for heart disease 

CErtified bad-ass and nazi killer was no match for heart disease 

We were chugging along quite nicely for around 200,000 years with a few hiccups threatening our existence here and there (I'm looking at you black plague) but then suddenly everything changed. Human's got really smart and we let it get to our heads. We figured that Mother Nature had her time in the spotlight and now we'd like a go at this whole "feeding the world" thing. We began to process the sh!t out of everything under the sun; making it last longer, tastier and addictive. We figured out ways to market "food" as a commodity and over the past 50, business has been booming! Humans messing with nature... this always works out! Except, as the shelf-life increased on cookies and cakes, the shelf-life on humans began to decline. We noticed an increase in the amounts of individuals dropping dead with one hand clutching their chest, the other clutching a pork chop. Even our beloved President Eisenhower fell victim to heart disease in the mid-1950s. This is the PRESIDENT who fought Nazis for God's sake! Things had to change! American physicians were perplexed. What was causing this epidemic? Why were we sick? Why was nature's house of cards crashing down? 

(If you want the full story, check out "Deep Nutrition" by Cate Shanahan)  

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During the 1960s a handsome young fella named Dr. Ancel Keys came along and was very concerned about the health of Americans AND for the state of his scientific legacy (mostly his legacy). He LOVED being in front of the camera and wearing a white lab coat for which it was not easy at all to mistake him for an MD. Oh, you thought he was a doctor? He was... kind of. He was a marine biologist (fish physiology... FISH... not humans) but this wouldn't stop him from harmfully altering human nutrition for a half of century! Through a grant from the government (he had friends), he embarked on an ambitious study of six countries to compare their rates of heart disease against their macro-nutritional intake (Fats, Proteins, Carbohydrates). Guess what? The six countries he studies showed a direct correlation between saturated fat intake and heart disease! Pretty damning right? Great! We have our villain - FAT. Now let's move on and save the world. Enter the low-fat craze of the 1970s-present day. Low-fat meant you could label anything without fat a health food (lollypops, jellybeans, Gummy Bears - all NO fat). 

Once we Identified the culprit as dietary fat, we were free from the adverse effects of heart disease and humans lived long and healthy lives! Well, not quite. In fact, the past 50 years ushered in an all-out epidemic of obesity, diabetes and... you guessed it... HEART DISEASE! Some would argue that it was because Americans are fat and stubborn and didn't heed Dr. Keys' advice but that just isn't true. Americans DID, in fact, cut their fat intake. Butter intake dropped in half since 1960 and gym membership skyrocketed. So what was the deal? What were we missing?

You see, Dr. Keys failed to mention in his landmark study that he researched a total of 22 individual countries, not just six! Why the discrepancy? The 15 countries not included in the final report showed no correlation in heart disease and fat intake. Huh? Really?! Yes, really. When the excluded countries are plugged into the statistical graph (see above), viola... no correlation. Let me repeat that! The study excluded countries that contradicted his hypothesis! He didn't like the data so he through it out! 

So are you saying fats are safe?

Yup! But let me put an asterisk here to avoid confusion: *Natural and unprocessed fats are safe to consume. Clear? I think we need to dive a little deeper here.

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I live by a general rule: Nature doesn't make bad fats. Science is complicated and so too is human physiology. As you may be discovering, science is very gray! First off, trans fats are bad! Very bad! You don't need to know the bio-chemistry properties of WHY it is called a "trans" fat, just knowing they fry your arteries is enough to know that you need to stay away! Eliminating them from the diet should be akin to eliminating smoking cigarettes - there is just no safe amount. However, did you know that the "safe" polyunsaturated fatty acids (PUFAs) contained in vegetable oils such as Canola oil are simply a precursor to trans fats? How might this be? When vegetable oils are in their natural state, that is, contained within the seeds of the plants from which they are derived, they have a beautiful 5-6 sided geometric shape and are loaded with anti-oxidants which neutralize harmful oxidation which tends to occur in nature when the seeds germinate in the hot sun. But when the nuts and seeds are treated high heat and harsh chemicals (look up 'hexane' and see if it is something you'd want to eat) the antioxidants are rendered useless. The previously natural 5-6 sided geometric molecular shapes of the natural fats are mangled and twisted into molecular "mousetraps" which bind to our body's important enzymes after consumption and wreak havoc at the cellular level. These processed fats impair so many basic physiological functions, like circulation and immunity, that consuming them can indeed kill you. That is not an overstatement. Conversely, natural, unadulterated fats (saturated and unsaturated in their raw form) are in fact, good for you. These include butter (grass-fed is the best), virgin olive oil, virgin coconut oil, lard, tallow, palm oil and even peanut oil. Yes butter does undergo a degree of processing, as does cheese and virgin olive oil but this gentler "processing" leaves the basic structure of these fats intact.

Our bodies have had millennia to learn how to digest and utilize these essential nutrients because they were consumed in their natural state. Fat and cholesterol are very important to natural physiological processes and as long as they are consumed in conjunction with whole/healthy unprocessed foods, there is really little to be concerned about. Let that sink in and become the new norm when deciding what to eat: Fats are an essential part of your everyday diet. I can't stress enough the need to research nutrition for yourself. But remember, most of the studies about saturated fat and cholesterol leading to increased heart disease fall into the correlation versus causation trap. Just because we see a correlation does not mean it is the cause. In fact, it was found that individuals who haven't paid attention to the past 50 years of erroneous nutrition advice for low-fat dieting were "medically rebellious" in a sense. This meant they ignored calls for eating less red meat and cholesterol! But more importantly, they also ignored the advice of not smoking, drinking in moderation and exercising regularly, all of which have a CAUSAL relationship with atherosclerosis and heart disease. You also have to take into account genetic profile and congenital lipid abnormalities. A good physician takes all this into account before making dietary advice. 

Below is my A-LIST of nutritional references. Read them and school your friends and neighbors! Knowledge is contageous!