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Obesity, Fatty Foods, Death, and Science
Something is killing us — beyond the fact that life itself is a terminal condition. This week brought news that the US mortality rate overall has risen slightly since 2014. “It’s a definite milestone in the wrong direction, and the concern a lot of us have is that it reflects largely the approximately three-decade-long epidemic of obesity,” Stephen Sidney, a California research scientist, told the Wall Street Journal. Death rates rose for eight of the 10 leading causes, including heart disease, stroke, chronic respiratory disease, injuries (including drug overdoses), diabetes, kidney disease, Alzheimer’s disease, and suicide. Cancer death rates continue to decline, and influenza deaths were unchanged. The uptick in deaths means that life expectancy rates for babies born today have dropped a bit.
For something as multifactorial as overall death rates, a certain modesty is necessary in interpreting the data and/or offering hypotheses. I have my favorite suspicion, and I freely acknowledge that it’s a hunch. A large number of Americans are living alone (27 percent in 2014 compared with 13 percent in 1960) and becoming alienated from community, church, and neighborhood groups (the so-called mediating institutions of society). A 2010 AARP survey found that one third of adults over 45 reported that they were chronically lonely, whereas only 20 percent said the same a decade earlier. Not everyone who lives alone is lonely, and some people who live with others are, but the rise of loneliness is real and has measurable health effects.
As Judith Shulevitz explained in The Atlantic:
Psychobiologists can now show that loneliness sends misleading hormonal signals, rejiggers the molecules on genes that govern behavior, and wrenches a slew of other systems out of whack. They have proved that long-lasting loneliness not only makes you sick; it can kill you. Emotional isolation is ranked as high a risk factor for mortality as smoking.
A large retrospective study published earlier this year found that isolated individuals had a 32 percent higher risk for stroke and a 29 percent higher risk of heart disease. Many studies have shown that married people (particularly men) are less likely to die from post-surgical complications, cancer, heart disease, and other causes.
Last year, the wife/husband team of Anne Case and Angus Deaton made headlines with a study showing something that had not been seen for many decades in the United States: The death rate for non-Hispanic whites between 45 and 54 years old in the United States was actually ticking up. The mortality rates for African-Americans, Hispanics, and other age cohorts were continuing a downward trend that had been steady and steep for decades (centuries by some measures). Even more disturbing, the Case/Deaton study suggested that these white Americans were dying not of heart disease or cancer (though some do, of course), but of diseases that imply a sickness of spirit as much as of body – suicide, drug overdoses, and cirrhosis of the liver. This could be a signal of the declining economic prospects of lower skilled workers, or it could be a symptom of the loneliness and despair that the breakdown of families has left in its wake.
But something else may be at work as well. This week, the British Medical Journal, after careful consideration, rebuffed the efforts of the Center for Science in the Public Interest to force the BMJ to retract an article by Nina Teicholz. She is the author of The Big Fat Surprise: Why Butter, Meat, and Cheese Belong in a Healthy Diet, a great debunking of standard nutritional advice. In what has been dubbed “the battle of butter,” Teicholz assails the US Dietary Guidelines, which have (informally since the 1960s and officially since 1980), urged Americans to eat less fat and more carbohydrates (i.e., the food pyramid). Teicholz argues, and the BMJ confirms, that the “strong” link between consumption of saturated fat and heart disease is not supported by the evidence. Meanwhile, assiduously eliminating fat from the diet has caused Americans to substitute processed carbohydrates like grains, which are less filling than fat and may lead to obesity. It is notable that as Americans have followed the dietary guidelines, obesity has skyrocketed. And with obesity come the killers – heart disease, cancer, and diabetes.
Teicholz’s careful review of the origins of the fat/heart disease orthodoxy is a case study in why skepticism of experts is, well, healthy. This is not to suggest that we abandon the scientific method or give the rumor Uncle Fred sends on Facebook the same weight as an article in Nature. It is an argument for remembering that the term “settled science” is an oxymoron.
Published in General
It’s not that it was “science”, it’s that it was science pushed by government for decades. Government kills.
Also, I’m not sure people without pieces of paper from government-funded finishing schools (colleges) are properly described as “lower skilled”.
Interesting point about loneliness, Mona.
I am an attorney who works with foster children, which means a lot of what I encounter at work is … well, the type of stuff that many writers aren’t even creative enough to think of. On a number of occasions, I’ve found myself cutting a day short and driving to the daycare/school to pick up my kids early in the afternoon. I need to give them hugs, go for bike rides, take them to the park. Obviously, there is a heck of a lot more to being a husband and father than viewing your family as “therapy,” so I don’t want to create the wrong impression, only to make a point – much of the joy that we experience in life comes from those sorts of relationships, and I think it makes perfect sense to suspect some correlation between a sort of detached narcissism and a reduction in physical health.
I think Mona’s intuition is very sound. That a healthy moral, social and psychological context for life is more likely to be found by traditional means than by way of government-managed expert interventions ought to be blindingly obvious by now.
Mona,
Before you agree with Teicholz, you might want to read the following links:
http://www.jeffnovick.com/RD/Articles/Entries/2014/12/6_Saturated_Fat__Still_Unhealthy_After_All_These_Years.html
http://www.jeffnovick.com/RD/Articles/Entries/2014/12/27_Saturated_Fat__Still_Unhealthy_After_All_These_Years,_Pt_2.html
And since Teicholz’s arguments are similar to those of Gary Taubes, you might want to watch this video.
http://plantpositive.com/2-the-journalist-gary-taubes-2/
Teicholz is either incapable of understanding why saturated fat consumption is harmful or prefers to mislead people.
One reason why some studies find that there is no correlation between saturated fat consumption and cardiovascular disease or total mortality is because the many of these studies perform “over adjustment.”
What this means is that if a study adjusts for systolic blood pressure, the conclusion might be that saturated fat consumption is not correlated with total mortality because saturated fat consumption raises blood pressure over time. So, by trying to compare low saturated fat consumers with high saturated fat consumers with equivalent systolic blood pressures, a study will be obscuring its own findings.
Also, if one compares 100 people who consume 9 percent of their calories as saturated fat to 100 people who consume 10 percent of their calories as saturated fat, one might not find a difference that rises to the level of statistical significance.
I realize that this is not a nutrition forum. But it’s too bad so many people get misled by people like Teicholz.
The way things are looking, unless you chose your ancestors extremely wisely,
IF you eat 5+ servings of leafy greens and some “all colors” veggies, plus some dark purple fruits
AND you avoid the trans fats which are confounding factors in all or almost all the studies @spiral links to
AND your fructose consumption is < 25 g/d (some may be able to manage more, but population wise it looks like 25-40 is it)
AND you get a sufficiency of omega-3 fatty acids to have a 1:1(ish) ratio of omega 3:omega 6 at the cellular level, with a sufficiency of EPA and DHA (which means either you have the metabolism to adequately convert vegetable sources to EPA and DHA or you supplement with preformed EPA/DHA)
AND you’re spending a fair amount of time in metabolic ketosis on a regular basis
AND you get adequate sleep
AND you don’t consume isolated “antioxidant” nutrients
AND you get sufficient quantity and quality of exercise (probably NOT including extended cardio)
AND the animal protein sources you use are consuming the sorts of foods they are evolutionarily suited for (bovids are grass eaters, minidinosaurs ate vegetable matter and whatever critters they could get their beaks around, etc.)
You’re probably fine with a significant proportion of your energy intake being saturated fats.
If this means, “eat sensibly, eat mostly real food, and enjoy everything in moderation,” I’m all for it!
For me, the money quote (from one of the linked articles in a comment above, from the Harvard Gazette), is this one:
These people don’t know what they’re doing. Any of them. They go on a crusade against a particular food item–saturated fat–and they replace it with something even less healthy, because they have not yet determined yet that this thing they’re replacing it with will later be “determined to be detrimental.” And when it is, instead of just fessing up, they take off after the next shiny object.
Best thing to do, IMHO, is ignore all their hooting and hollering, and eat rationally, making sure you’re consuming mostly real food. And get up off the couch. (This applies especially to kids, who are increasingly proscribed from any sort of healthy exercise because one or another person or entity fears a lawsuit if someone gets hurt on their property, while using their equipment, while associating with their own children, and on and on.
It’s a miracle any of us survived till adulthood. It really is.
Sean Croxton coined (or popularised) an acronym I love:
JERF.
Just Eat Real Food.
A more geeky phrase that is also good: Isocaloric does not equal isometabolic.
And it’s definitely not one diet fits all.
One thing I heard was to see of you’re shopping around the periphery of the grocery store. That’s where all the real food is. The produce, dairy, meat. All the more highly processed stuff is in the interior. When we cut out a lot of carbs from our diet, I found I spend most of my time at the store around the periphery, only dive into the interior for a few things.
It’s not just your hunch. Connection with friends and community is linked to longevity. According to the Blue Zones work, “engagement in spirituality or religion” is an important contributor to longevity, as are “engagement in family life” and “engagement in social life.” I especially like the “moderate alcohol intake, especially wine” recommendation, but that’s just me.
I don’t necessarily agree with all aspects of the Blue Zones agenda but it’s noteworthy that diet is mentioned in only two of nine points (not counting alcohol as diet).
Let me get this straight: you are asking us to take the word of a random nutritionist (ex. of Whole Foods) writing in his blog over a peer-reviewed article in the BMJ? I guess that’s because nutritionists have served us so well in the past (cf. the federal government’s nutrition guidelines). I see exactly zero publications in Mr. Novick’s CV other than articles in a trade mag.
Speaking of trans fats, here is a profoundly and inadvertently ironic commercial from the 1970s when the “heart healthy” omega 6 trans fats were flooding the marketplace:
Where you really get in trouble is when you only sorta kinda reduce carbs and you read “fat is healthy” but you’re eating crappy fats. Yet another pick two out of three thing except very few people can be healthy on lots of refined carbs. We may each have a lifetime limit, after which can’t eat any without very careful planning and maybe consequences anyway.
For some dairy is a problem, but for reasons other than we thought before and other than reacting to casein or lactose. Dairy products raise insulin (which if you’re a calf working on growing is fine) even without raising blood sugar.
By the way, it’s now looking as though the primary signaling driving insulin resistance isn’t elevated blood sugar though elevated insulin can fuel the fire; incretins released from the gut are upstream signals and connect to (drumroll) gut flora in ways we currently don’t understand and, given that your gut microbiome is pretty much determined in your first couple of years of life, if you’re reading this we may never be able to actually fix.
Other valuable things to include in your diet: bitter tasting foods, rosemary, turmeric, sulfur containing foods especially onions and garlic, and, last but not least, dark (>85%) chocolate.
Speaking of chocolate more than 85% cacao, the following are popular among the cool kids out my way:
Taza Wicked Dark (95%)
and
Tcho Organic 99% Unsweetened Baking Drops
Is this the Mountain Dew thread?
[Drop Mic]
[Walk Away]
You’re suggesting there’s an overall consumption ceiling on sugar, etc. Am I reading you right? Is it because of some limit on the ability to the pancreas to produce insulin? The islets of Langerhans get tired ;) That would be interesting.
Please tell us what you do for a living! Actually, I don’t want to know. I’m going to assume that you are a genius scientist and faithfully follow your prescriptions about fruits, vegetables, and DARK CHOCOLATE.
I don’t know about mechanism but… maybe. Consider that Dale Bredesen’s take is that for cognitive protection (his work is in Alzheimer’s but there sure looks to be a lot of overlap to other degenerative disease) your hemoglobin A1c should be 4.8. He looks at other parameters too, but 4.8 is a long term project and about the only way I can think of to get there is to be fat adapted. That’s major lifestyle change.
This is a pretty interesting interview with a guy who really knows fat adaptation:
Time Restricted Feeding: There are different styles. Some of us use stimulants with fats. The best results come from abstaining from ingesting anything of caloric value during fasting. It instigates different glucose regulations and ketone readings. There is also alternate day fasting (a full 24 hrs). The more fat adapted you become and the more regular your ketones in both breath and blood, the stronger the correlation to a sustained increased HRV (heartrate variability), though not necessarily associated with heartrate. Time restricted feeding and intermittent fasting well suits changes within inflammatory responses and sympathetic activation.
…Ketones are signaling molecules, not just substitutions for macronutrients or energy substrates…ketones have functions of their own, supporting the reduction of strong sympathetic activation, thus better controlling the inflammatory response.
@drlorentz, here are some factoids that tend to boggle the mind:
Rigorous caloric restriction can reverse non alcoholic fatty liver and the fatty infiltration of the pancreas that not just accompanies but seems to lead to type 2 diabetes.
Insulin resistance improves rapidly after bariatric surgery before weight loss ensues.
One thing that has happened over the last decades is the decrease in consumption of bitter foods and the debittering of many previously more bitter ones (Romaine lettuce anyone?) We’ve got over a dozen types of bitter receptors not just in our mouths, or even just in our intestines, but throughout our bodies. In our testes for crying out loud. Molecules that interact with those receptors are probably very important signaling compounds.
Gymnema sylvestre contains compounds which temporarily anesthetize sweet receptors; high enough doses 2-3x/d can significantly dial back sweet and starch cravings within a week or so and over the long term, lower doses may also be protective or regenerative to the islet cells.
Non-caloric artificial sweeteners can worsen our glycemic health. Stevia – which is bitter, too – in terms of health coaching around sweets is often, like artificial sweeteners worse than nothing, contains compounds that appear regenerative to the islet cells.
Speaking of which, using digestive bitters seems to be a useful strategy for dealing with sweet cravings. One theory I’ve heard which has some interesting metaphoric resonance is that we can’t handle bitterness like grownups anymore, and want sweets like children do.
The death rate is 100%. I don’t care how well, or poorly, you eat. You’re going to die. Enjoy life while you can.
Those that occupy the Ivory Towers must be obeyed. Came to regard them in the same light a The Ministerium from films. Yet they dare not don the robes. Snake oil is Snake oil.
I don’t call years of at least partly preventable dementia “living.” I’ve been living with multiple autoimmune disorders and I feel and function a lot better when I eat well and exercise. Enjoy life more, too. I’d rather die with my faculties intact and will do my best to come as close to that as I can. YMMV.
An amusing video, in which Dr. Plantpositive displays textual evidence highlighting mentions of steaks and sausages in his subject’s diet while passing over his switch to all-carb breakfasts, a polyunsaturated diet, vegetable oils and margarine, etc.
At the end of the video, Dr. Plantpositive indicated that his next video would attempt to rehabilitate Ancel Keys — the same Ancel Keys who Teicholz thoroughly exposed as the farcical egomaniac behind the misguided government dietary guidelines that misled the country for half a century..
I’ve read Gary Taubes’ masterpiece Good Calories, Bad Calories cover to cover, and and found it a highly accessible, engaging, and informative explanation of nutritional science. I recommend it highly.
I’ll give Dr. Plantpositive credit for one thing: punching up. His pathetic nitpicking of Taubes’ introductory anecdote has brought him far more attention than he deserves.
Thanks for this link. Interesting stuff, although between the accent and some of the jargon it’s a bit difficult to absorb. Do you know of any books he may have written?
If you read the pages on Jeff Novick’s web page that I referenced, you will find links to peer reviewed analysis of saturated fat. Reading just one peer reviewed article does provide enough information considering the tens of thousands of such articles available.
It’s very easy to create evidence that makes it appear that saturated fat isn’t really that bad for you after all.
Check out this peer reviewed article showing how tightly saturated fat consumption and coronary mortality are correlated.
Differences in coronary mortality can be explained by differences in cholesterol and saturated fat intakes in 40 countries but not in France and Finland. A paradox.
https://www.ncbi.nlm.nih.gov/pubmed/8252690
I’ll let you click the link if you want. But here is the conclusion.
CONCLUSIONS:
Over the years, France and Finland, with similar intakes of cholesterol and saturated fat, consistently have had very different CHD mortality rates. This paradox may be explained as follows. Given a high intake of cholesterol and saturated fat, the country in which people also consume more plant foods, including small amounts of liquid vegetable oils, and more vegetables (more antioxidants) had lower rates of CHD mortality. On the other hand, milk and butterfat were associated with increased CHD mortality, possibly through their effects on thrombosis as well as on atherosclerosis.
Also look at this peer reviewed article which implicates saturated fat.
The combination of high fruit and vegetable and low saturated fat intakes is more protective against mortality in aging men than is either alone: the Baltimore Longitudinal Study of Aging.
https://www.ncbi.nlm.nih.gov/pubmed/15735093
Let’s just make sure to sort this out before I get old enough for it to really matter. :)