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It’s a message many doctors and dietitians don’t like to hear: that some advice they give to the public on healthy eating is just plain nonsense. So nonsensical, it makes diets into a weapon of mass destruction. (Cape Town consumer activist Sonia Mountford has her theory on why some dietitians do it so often. Just follow Big Food and the money, Mountford says). University of Cape emeritus professor Tim Noakes has been saying something similar since making a spectacular about-turn on the role of carbohydrates in the diet in 2010 in favour of ‘Banting’, as low-carb, high-fat (LCHF) is known in South Africa. He has been viciously attacked for it by members of the medical and dietetic professions ever since, though the number of his attackers is reducing as the evidence is expanding that he isn’t wrong after all. Noakes uses science to demolish the arguments easily. Scottish GP Dr Malcolm Kendrick is similarly scathing in this blog. (Kendrick is another of my favourite medical doctors – the ones with a scientific bent, and open minds, who don’t mind admitting when they get things wrong.) Here, he explains why he thinks advice to avoid saturated fat is just nuts – and dangerous. (He wrote this before Christmas last, hence his relatively restrained swipe at the end.) – Marika Sboros
By Malcolm Kendrick
Yes, hallelujah, the headline (Are some diets ‘mass murder’?) on a 2014 paper in the BMJ by Richard Smith, the previous editor of the journal. He has finally, if belatedly, come to realise that the dietary advice that has dominated western medicine for the last fifty years, or so, is complete nonsense.
This damascene conversion is mainly due to the fact that he read Nina Teicholz’s book The Big Fat Surprise. As he states:
“…the forensic demolition of the hypothesis that saturated fat is the cause of cardiovascular disease is impressive. Indeed, the book is deeply disturbing in showing how overenthusiastic scientists, massive conflicts of interest, and politically driven policy makers can make deeply damaging mistakes.
“Over 40 years I’ve come to recognise which I might have known from the beginning – that science is a human activity with the error, self-deception, grandiosity, bias, self-interest, cruelty, fraud, and theft that is inherent in all human activities (together with some saintliness), but this book shook me.”
Complete crock
The amazing thing, to me, is not that Richard Smith has finally realised the diet-heart hypothesis is a complete crock. The amazing thing is that it still holds sway, despite the fact that it was never based on anything other than the propaganda of a power-mad egotist (Ancel Keys). Any evidence that saturated fat, or any other fat consumption, causes heart disease has always been weak at best, more usually non-existent, or just flatly contradictory.
Many years ago, Dr George Mann (who was running the Framingham Study at the time) stated that: “The diet-heart idea – the notion that saturated fats and cholesterol cause heart disease – is the greatest scientific deception of our times…The public is being deceived by the greatest health scam of the century.”
And what effect did this comment have? Well, none. In 2008 the Food and Agricultural Organisation concluded the “there is no probable or convincing evidence” that a high level of fat in the diet causes heart disease. A 2012 Cochrane review found no benefit from total fat reduction and no effect on cardiovascular or total mortality.
More recently we have the Women’s Health Initiative, which enrolled fifty thousand women in the randomised trials of the low fat diet and cost £460m. To quote Richard Smith again:
“The women were followed for 10 years, and those in the low fat arm successfully reduced their total fat consumption from 37% to 29.5% of energy intake and their saturated fat from 12.4% to 9.5%. But there was no reduction in heart disease or stroke, and nor did the women lose more weight than the controls.”
A 23% cut in saturated fat intake, and no impact on anything. What effect has this had? Well, none. Evidence has never had the slightest effect on this hypothesis.
As of today, you can still order posters and other information from the British Hear Foundation which announce, in bold, “I cut the Saturated Fat. The blurb underneath states1:
“Find out how to reduce the amount of saturated fat you eat using our A2-sized wallchart. It includes information on the different types of fat in food and advice on the healthiest options to choose both when cooking and eating out.”
So, saturated fat still demonised. And the BHF are still saying that: “At the crux of this debate is the role of saturated fat in our diet. Diets that are high in saturated fat have been shown to increase cholesterol.
A high cholesterol level is linked to an increased risk of cardiovascular disease, so that’s why current recommendations emphasise the importance of reducing the saturated fat in our diets2.”
I suppose one could laugh at all this. Because, the BHF also states (in the same article) the following:
“Last week saturated fat came back to the top of the news agenda because research we’d helped to fund suggested there isn’t enough evidence to support current guidelines on which types of fat to eat.
“While the latest study didn’t show saturated fat is associated with cardiovascular disease, it also didn’t show that eating more of it is better for your heart health2.”
In short, the British Heart Foundation states that they funded a study which shows there is no evidence that saturated fat is bad for the heart. However, they also state that diets high in saturated fat have been shown to increase cholesterol and a high cholesterol level is linked to an increased risk of cardiovascular disease.
Be careful guys. If saturated fat does raise cholesterol, yet a high saturated fat diet does not cause heart disease then, logically, you are stating that cholesterol does not cause heart disease/cardiovascular disease. In fact, this is exactly what they are stating. There is no escape from logic my friends.
This is just one example of the knots that people tie themselves into when they try to defend the indefensible. Luckily, for them, no-one seems able to draw the obvious conclusion from their incomprensible gibberish. Either the diet/heart (saturated fat) hypothesis is wrong, or the cholesterol hypothesis is wrong, or both. (The correct answer is, or course, both).
Of all the stupid scientific hypotheses of the twentieth century the idea that fat/saturated fat causes heart disease – or any other disease – is by all possible measures the most stupid. It is the most stupid because it has driven dietary advice to eat more and more carbohydrates, aka “sugars”. Anyone who understood anything about human biochemistry and physiology could tell you what this would do
1: Cause millions upon millions of people to get fatter and fatter
2: Cause millions upon millions of people to become diabetic
3: Cause millions upon millions of diabetics to completely lose control of their sugar and fat metabolism, get even fatter and die prematurely
All of these things have happened, exactly as could have been predicted. Yet, our esteemed experts still propagate the dangerous myth that saturated fat is bad for us and we should stuff ourselves with carbohydrates instead.
Yes, some diets are “mass murder”. To quote Richard Smith for the last time:
“Jean Mayer, one of the ‘greats’ of nutritional science, said in 1965, in the colourful language that has characterised arguments over diet, that prescribing a diet restricted in carbohydrates to the public was ‘the equivalent of mass murder’.”
Having ploughed my way through five books on diet and some of the key studies to write this article, I’m left with the impression that the same accusation of “mass murder” could be directed at many players in the great diet game. In short, bold policies have been based on fragile science, and the long term results may be terrible.’
Richard, there is no may about it. The long term results have been terrible. So, to those “experts” who continue to propagate the idea that saturated fat causes cardiovascular disease: Merry Xmas – you dangerous idiots. As it is the festive season, I shall refrain from calling them mass murderers.
• Malcolm Kendrick is a Scottish medical doctor and author of Doctoring Data, How to Sort Out Medical Advice From Medical Nonsense, and The Great Cholesterol Con.
• This blog first appeared on Dr Malcolm Kendrick’s website.
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