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January 22, 2017 by Leanne Vogel August 17, 2018
Interview with Nina Teicholz, author of The Big Fat Surprise, chatting with us about the truth behind low-fat diets, how saturated fat received a bad reputation, and what we can do to change the world’s view on low-carb, high-fat diets.
For podcast transcript, scroll down.
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Leanne Vogel: You’re listening to episode number 17 of The Keto Diet Podcast.
I’m Leanne from HealthfulPursuit.com and this is the Keto Diet Podcast where we’re busting through the restrictive mentality of a traditional ketogenic diet to uncover the life you crave. What’s keto? Keto is a low-carb high-fat diet where we’re switching from a sugar burning state to becoming fat burning machines. If you’re in need of keto recipe food prep inspiration, I’ve prepped a free seven-day keto meal plan exclusive for podcast listeners. The plan is complete with a shopping list and everything you need to chow down on keto for seven whole days. Download your free copy at HealthfulPursuit.com/ketomeal. Let’s get this party started.
Hey, guys. I am thrilled to be home. No, rather, I’m thrilled to be working again but we got back from our almost a month vacation back to the wintery winterness that is our home. I could really do without the cold. I really enjoyed the Caribbean. It was such a nice break and really helped me focus on what was important in my life and redirect a lot of my energy. I’m back and clearer than ever in all the things that I need to do and the things I don’t have to do anymore. It’s nothing like a vacation to really help you focus in on what’s important to you and to get rid of the stuff that you just don’t care too much about but you’ve been doing for a while.
The awesome thing this week ties into what I ate a lot of on the cruise that we were on and that was gravy. Seriously, I had gravy for lunch and dinner every day for three weeks. They made it with the most amazing beef and chicken broth. They made everything from scratch. It was so good. Because I’m allergic to all the things, they had to put a lot of care and attention into my meal. I got some of the best foods ever and my favorite was gravy. When we came home a couple days ago, the first thing I did was make a huge batch of bone broth and then convert that into gravy using drippings that I had had in my freezer for forever.
If you’re like me and you love gravy, what are you waiting for? Just make a huge batch. What I did is just froze them in little silicone trays. Then once they were in blocks, I put them in baggies so I can have gravy with every meal. It’s super fatty and delicious and adds so much flavor. I’m going to be sitting here from January till at least April eating all the gravy on all of my foods. What we’re covering in this episode today is a history of how the low-fat diet became to be why saturated fat isn’t scary, the ins and outs of cholesterol, and how to interpret medical studies. The show notes for today’s episode can be found at HealthfulPursuit.com/podcast/e17. Let’s hear from one of our awesome partners.
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I have one thing to share with you, and it involves a little bit more traveling. I’m headed to Expo West on March 8th. I think that’s when it is. Yeah, March 8th and I wanted to see if any you all are going to be there. I’m going to be meeting with a lot of our partners and sponsors of the show and the blog and the book and everything. If you’re there and you see me, please feel free to come up say hi, and I would love to chat with you. If you have an idea for a podcast episode or you want to submit praise over and above the review which you can leave by going to HealthfulPursuit.com/review. You can reach me at email@example.com.
Our guest today is Nina Teicholz. She’s an investigative journalist and the author of the international and New York Times bestseller The Big Fat Surprise. The Economist named it Number One Science Book of 2014, and it was also named a 2014 best book by the Wall Street Journal, Forbes, Mother Jones, and Library Journal. The Big Fat Surprise has upended the conventional wisdom on dietary fat and challenge the very core of our nutrition policy. A review of the book in the American Journal of Clinical Nutrition said, “This book should be read by every nutritional science professional.”
Before taking a deep dive into researching nutritional science for nearly a decade, Teicholz was a reporter for National Public Radio and also contributed to many publications including The Wall Street Journal, New York Times Washington Post, The New Yorker, and The Economist. She attended Yale and Stanford where she studied biology and majored in American Studies. She has a master’s degree from Oxford University and served as Associate Director of the Center for Globalization and Sustainable Development at Columbia University. She lives in New York City.
I was so glad that Nina agreed to be on the show. What I love about Nina’s book is that she goes through many of the studies that we hear about in the keto space, making them consumable and easy to understand. This book is organized in a way that makes grasping basic concepts such as why low-fat isn’t the best option for most people to more advanced concepts, making this very accessible regardless of your ability to read scientific studies. She does a really beautiful job at explaining the history of low-fat diets and fat demonization. It’s a well-written story. It’s amazing.
If you’re vegan, if you’re concerned about the saturated fat intake on the keto diet, if you’re using vegetable oils on your keto diet, you need to listen to today’s episode. We chat all about saturated fat and their benefits. If you’re dairy-free like me, saturated fat intake can come from things like coconut oil, red meat, beef tallow, palm oil, and more. Without further ado, let’s cut over to our chat.
Hey, Nina. How are you doing today?
Nina Teicholz: Hi. Good to talk to you.
Leanne Vogel: I’m so thrilled to have you on the show. For listeners that may not be familiar with your work, tell us a little bit about yourself.
Nina Teicholz: I’m a science and investigative journalist. My background is not in nutrition but more than a decade ago, I was assigned to do a story on trans fats by Gourmet Magazine and that sort of blew the whole story open on trans fats and I got a book contract to write about trans fats and then spent nearly a decade diving into the research that became my book, The Big Fat Surprise. I just read every single nutrition paper I get my hands on and talked to hundreds of nutrition experts all over the world and realized there was just this huge untold story about how we’d gotten it wrong. Our nutrition experts had gotten it wrong on fat and cholesterol. It’s just an incredible story.
That’s why it took so long to research and then you really, it’s because it’s so unbelievable you keep thinking, “This can’t possibly be true,” so you have to double and triple and quadruple check your work. That was a very long process but it’s been very interesting. My book has gotten a lot of attention and I think it’s because it tells this story that needs to be told and heard.
Leanne Vogel: You did such a beautiful job at putting together the story. I’ve read your book twice, and each time, I’m like, “How did she even organize all this?”
Nina Teicholz: Thank you.
Leanne Vogel: It’s epic.
Nina Teicholz: It was a lot of work. I wanted it to be also accessible to just the common reader. There are thousands and studies that are condensed in the text but I wanted it to be readable for the average reader and not to make it a story of people and personalities which it’s been, you know, is. My favorite description of it is by The Economist which named it their Number One Science Book for 2014. In their review, they said, “It’s a nutrition thriller.” I was just like, “Wow!” I didn’t even know that was possible.
Leanne Vogel: You’re the first one.
Nina Teicholz: Good, yeah.
Leanne Vogel: I like it. I have to ask like before you got assigned that trans fat story, do you remember what your take was on your diet or what you were eating? Do you remember what that was like before you knew what you know now?
Nina Teicholz: Yeah. I mean I was, for nearly 20 years, pretty much a vegetarian in a sense that I didn’t eat any red meat. I mainly got, I had some globule wouldn’t consider the strict vegetarian. I had some chicken and fish but I didn’t mean I tried to avoid eggs. I was your basic fat avoider. I would avoid any kind of, no butter, no cream cheese, no spreads, no sauces, like no salad dressing. I mean that was me for most of my adult life, really since my late teens.
Then over the course of doing this research, I never could have imagined then that I would write a book and put a picture of a red meat roast on the cover. Like it seems outrageous to me even now, but I came to believe that we really have the wrong idea about these foods. We had really gotten it wrong. The science was never strong and had been enshrined as policy before it was ever really proven or conducted. We’ve just gotten it wrong about those foods. My eating habits slowly changed over time. It wasn’t like an overnight aha moment but it slowly gradually changed the point where now I eat a lot of fat, and it doesn’t occur to me to worry about it. That’s been a huge transformation.
Leanne Vogel: Awesome. What were the highlights of your research. What are some of the things that stand on your head as being like everyone needs to know these three things?
Nina Teicholz: The main focus of my book is the subject of saturated fat. That’s the kind of fat in animal foods. All foods are a combination and fats, so they’re like half of your average porterhouse steak is half of that steak is saturated fat but half of it is the same kind of fat that you have in olive oil which is unsaturated. Saturated fat is generally in animal foods, also in coconut oil and palm oil. My book focus is essentially on the idea that those fat which, since the 1950s had been targeted being bad for health, for causing heart disease, that they had been unfairly maligned. Science had never been there to show it’s true and so it focuses unsaturated fats and, to some extent, cholesterol. The main focus is saturated fat.
Then, because of that, it has a number of other points and chapters that I think are also super interesting. There’s a lot on vegetable oils in my book because if you take out saturated fats, you put in unsaturated fats for polyunsaturated vegetable oils like corn, safflower, sunflower, soybean, and how those oils became king of the American kitchen. Margarine and & Wesson oil in your salad dressing and how they … Crisco replaced lard. All of those, the influx of vegetable oils and how that was an incredible marketing campaign and where they came from and how they’re in the end, I discovered really worrisome for, have a lot of negative health problems that they cause. That was an untold story about the huge influx of vegetable oils.
Then I also have a chapter on the Mediterranean diet which is really just a fun chapter but it shows how, like the incredible way that the food industry manipulates us when it comes to what we think about food because it’s all about how the European olive oil industry basically constructed this series of fantastic conferences all over the sun-kissed Mediterranean from Greece to Tunisia to Southern France invited all of the most influential nutrition scientist and most influential food writers.
Out of that came the Mediterranean diet which is really a marketing construct supported by a very tiny amount of very uncertain evidence and so it just tells that story about how food experts got so caught up in the way of their love affair at the Mediterranean diet and how out of that came this like doctor prescribed Mediterranean diet. Those are some of the highlights.
Leanne Vogel: Brilliant. To speak a little bit more about low-fat and how that came about, can you chat a little bit about the history of how we went from being okay with fat and not really thinking about it to demonizing fat completely, like what that process was?
Nina Teicholz: Yes. It began with saturated fat and cholesterol. It started in the 1950s when the whole nation was in a panic over the rising tide of heart disease which had come from pretty much out of nowhere in the early 1920s to be the nation’s number one leading cause of death, including President Eisenhower himself in 1955 and out of the oval office for 10 days had a heart attack. The nation’s attention is just absolutely riveted on the subject of what causes heart disease. No one really knew.
Into that vacuum stepped a researcher by the name of Ancel Keys. Probably some of your listeners have heard of him, a pathologist of the University of Minnesota. It was his idea that saturated fat and cholesterol raise the cholesterol in your arteries, in your blood and clogs your arteries, and causes a heart attack. That was his idea. It was called the diet-heart hypothesis. He was a very outsized and charismatic persuasive individual. He was able to get his idea implanted into the American Heart Association.
In 1961, the American Heart Association issues the very first dietary advice to telling Americans or any people anywhere in the world to avoid saturated fat and cholesterol to try to prevent a heart attack. That’s the beginning of it all. That’s like the tiny acorn that grew into the giant oak tree of advice that we now have today all over the world.
I examined what was the evidence for that at the time. It was minuscule. It was all amounted to a weak kind of science called epidemiology which can show association but not causation. I spent a lot of time looking at that original study that Ancel Keys did that supposedly underpinned those American Heart Association guidelines but really did not and how we cherry-picked the science. Then there was a series of huge large clinical trials that governments all over the world did at the more rigorous kind of science to try to show cause and effect on tens of thousands of people trying to prove Ancel Keys’ hypothesis and they could never prove it. They just simply couldn’t. Then that science was ignored, I mean literally just ignored and you mean you might say suppressed.
Recently, one of these, last year one of the studies that had been ignored for so long was unearthed and republished in the British Medical Journal and everybody said, “Oh, what’s this?” In fact, and they unearthed some new data that showed not only did restricting saturated fat not improve your protection against heart disease, it seemed that those people who had most successfully restricted saturated fat and cholesterol ended up having a higher risk of death from heart disease, infact the opposite of what you would have hoped. That’s not the only study. There are six or seven other large multicenter multi-year government-funded clinical trials that all had basically the same results. That was saturated fat.
It wasn’t until 1970 that we started being fearful of all fats and that was, again, the American Heart Association brought that idea to us and that idea was based on this notion that because fat has nine calories per gram compared to protein and carbohydrate which are the other two macronutrients. There are only three macronutrients: protein, fat, and carbohydrates. Fat had nine calories per gram. Protein and carbohydrate have four, five calories per gram and so there was just this logical intuition that if you limited fat you’d be limiting calories. Wouldn’t that be a good thing? That would help prevent obesity.
That was just a wild guess. It turns out that it’s not all about calories. Fat and protein are naturally satiating and so fewer of those calories and feel more full and all calories are not alike anyway. Calories from fat are different. Your body responds to calories in different ways.
Anyway, with the American Heart Association and that idea in 1970 that really launched the whole low-fat diet, generally, just restrict all fats because you restrict calories. Then the US government got on board in 1980, our very first dietary guidelines for Americans. They adopted low fat, low saturated fat, low cholesterol, and so the whole thing became completely enshrined as policy taught by health professionals, educators, dietitians, everybody, adopt that became on board. That’s what I grew up with. I mean I’m sure a lot of the women, your listeners, grew up with that, that idea like you count every single calorie, you don’t put it, you dread butter. You use only …
Leanne Vogel: Eat the low-fat cookies, the diet cookies, but you can’t just have one because you’re so starving for fat and protein.
Nina Teicholz: Then what happens is, because you’re starving for fat and protein, but you feel like, “Oh, I can’t eat those foods,” then you go overeat on whatever. What did I overeat when I would, rice cakes, those horrible dry cardboard things that like you can never eat enough of those and feel full. If I’d only known, if I just had an egg salad sandwich, that would fill me up and then I wouldn’t be hungry. All of that science is starting to unravel now. The first unraveling came a kind of backing off this restriction on total fat so this, the low-fat diet.
Just to give a sense of the numbers, in 1965, Americans are eating about 45% of their calories as fat. The low-fat diet advised anywhere between about 33% down to 25% of calories as fat. It was a pretty big reduction and Americans did successfully reduced their fat consumption from 1965 to today by about 25%. We did a pretty good job of taking the fat out of our diets.
Now, because they did finally do clinical trials and they found out, they did huge clinical trials, again, the more rigorous kind of evidence and they showed that the low-fat diet does not help protect against any kind of disease. It doesn’t help you lose weight. It actually seems to worsen some of your heart disease risk factors, meaning it might increase the risk of heart disease. It doesn’t help protect against diabetes. It doesn’t help protect against any cancer.
Finally and these again, big, large, rigorous, multicenter, government-funded clinical trials. At the end of all that, just last year, the American heart association and the US government both have backed off. You may not notice because they haven’t really done it in a public way but they’ve eliminated any language from their guidelines saying that you should restrict total fat.
It’s just to say like, “The low-fat diet is over. It’s over.” It’s just that they tiptoed away from that and they haven’t told the American public because it really, it’s unjustifiable, like the step these really show that people on that diet, their good cholesterol, it’s called their HDL cholesterol drops. That’s a bad worrying sign that your heart disease risk is going up. In a number of those studies, people’s triglycerides went up. Another worrying sign that your heart disease risk is going up. It’s unjustifiable to recommend the low-fat diet anymore, but for whatever reason, they just haven’t told the American people yet.
Leanne Vogel: More on my interview with Nina Teicholz after this message from one of our podcast partners.
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Leanne Vogel: What other hurdles do you think there are, like the low-fat them removing it from the guides? That’s a step in the right direction but do you see other hurdles that have to be addressed on more of a public scale in order for the people to change?
Nina Teicholz: Yeah. I think there should be a big public relations campaign around the fact that low-fat diet is over because I think like other than me and you and your listeners and a few other people, most people don’t know that. Most doctors are still advising a low-fat diet. The other hurdle, the big hurdle is that there’s still a limit on saturated fats which exist because the experts who are in charge of that review of saturated fats for our last dietary guidelines really ignored a lot of the evidence.
Just to as explained for your listeners, all those clinical trials that I discussed that where ignored and suppressed and researchers in the last five years have dug up those trials. There’s been a Renaissance of understanding about saturated fats. People have gone and dug up those trials and looked at the results and then systematic reviews of them and meta-analyses of them and all these things, groups all over the world have done this and the universal conclusion is that saturated fat is not associated with heart disease and that it has no effect on cardiovascular mortality. That means restricting saturated fat will not save you from cardiovascular, having a death from heart attack. There’s really no point to it.
The experts in charge of our dietary guidelines did not review that science in a way that was thorough or systemic which I wrote about in an article that was published by the British Medical Journal, the BMJ, and I’ve gotten a lot of hot water for doing that. The point is the science has shifted. There’s been an understanding that actually we got it wrong on saturated fats, and yet we still have these official guidelines that limit then. Why is that a problem? One, it’s just wrong, that’s not the science is wrong. Two, it’s the limit on saturated fats that limits or it makes us feel uncomfortable about eating animal foods. We feel like there’s something wrong with that, like eating red meat, eggs, full-fat dairy.
The reason that the government recommends or the American Heart Association recommends lean meat and low-fat dairy is due to trying to minimize the saturated fat content. Those recommendations aren’t warranted. You want to eat. In practical terms, you want to eat regular meat, full-fat dairy. You do not need to fear the fats in those foods. They’re good and healthy, coconut oil, palm oil which is used in manufactured, the food industry uses it in manufactured goods. It’s not those about tropical oils. Those are fine and healthy fats, and they should not be feared. There’s no evidence for it.
I’m going to give you three reasons why you should eat saturated fats. One is that saturated fats are the only foods known to increase your HDL. That’s, again, your good cholesterol. You go to the doctor, and he says, “Your HDL is kinda low.” You say, “Well, what can I do?” He’ll say, “Well, you can drink more red wine, or you can exercise but that really only has a little effect in HDL, and otherwise I’m out of ideas.” The most reliable, consistently reliable way to raise your HDL is to eat more saturated fat. That’s one reason. Second reason is saturated fats are stable. The saturated means that it’s saturated with hydrogen, which means it’s like it’s stable, it’s solid at room temperature. Butter and lard, I know most people are terrified of that, even the word lard.
Those are stable solid fats and the virtue of that it means they don’t oxidize especially when heated. What is wrong with oxidation? Oxidation is what causes inflammation all over your body. It manifests itself in all kinds of ways, arthritis, it’s thought to be one of the things that if you’re inflamed arterial wall is what provokes heart disease. All kinds of bad stuff are related to inflammation. What causes that is oxidation.
Oxidized fat is the principal source of oxidation and that’s mainly, what oxides are vegetable oils because they’re highly unstable. They’re liquid. You heat them. They oxidize into hundreds of toxic oxidation products. I’m talking about like even in canola oil, soybean oil, corn oil, any of those oils don’t cook with them. What you want to be cooking with is a solid fat like ghee or lard or …
Leanne Vogel: Tallow, beef tallow.
Nina Teicholz: Tallow, beef tallow, you can get these. There are little companies now making these. Coconut oil is a really good, really gives a delicious flavor to things but they’re stable and solid so they’re better for your body. The other reason to eat more saturated fats has really not to do with saturated fats themselves but the foods that contain them are the ones that are super nutrient-dense and thinking about diet, although we haven’t been trained to think this way but really want to think about getting all the essential nutrients you need, I mean for women especially like iron and folate especially for having babies you want to get, that’s all from red-meat, from liver, from organ meats.
Those are the foods that are super nutrient-dense, and you need those nutrients in order to be healthy. That’s another reason that, like getting rid of the cap on saturated fat would probably be the fastest way to make Americans a whole lot healthier.
Leanne Vogel: Are there specific studies or people out there like yourself fighting the good fight? Do you have a couple of friends or colleagues that are on the same path as you that you go to raise these concerns of the poor science and highlighting things?
Nina Teicholz: Yeah. We are a small but growing group of … It’s interesting. It really started with journalists to some extent, the people outside the mainstream nutrition world. If you grew up inside the nutrition world, you really learn the conventional dogma. It’s taking outsiders like myself, me, there’s a journalist Gary Taubes but there’s also now like hundreds of doctors in Canada and in the US and really all over the world who are finding out that high-fat lower carb diet it’s just so much better for all the conditions that they treat, that they struggle the treat. What you can do with diet is so much more powerful than what you can do with drugs.
Contrary to every single thing they learn in medical school, they’re taught nothing about nutrition, and they’re just taught to prescribed drugs and that here’s this diet that seems to do better than any drug. Now they’re also, quietly, a large number of academic researchers and scientists who sometimes will stick their nose out but are quietly working behind the scenes to shift the debate. Getting articles published, trying to get research going, it’s a fearful group. Why is it so scary? As I document in my book, it’s truly incredible how, like really you have to just call the kind of bullying tactics that go on against people who speak up against the status quo. They are truly bullied there. I have stories of people losing their funding grants. People can’t get their papers published, getting disinvited from conferences.
I, myself, experienced all these things. I was disinvited from a food policy conference because I was too controversial. Then I wrote this paper for the BMJ and then 180 scientists signed a letter asking for it to be retracted. How terrifying is that, right? Ultimately, the BMJ stood up very strongly for the piece, and I’m totally relieved. That not only tries to get rid of me but it tries to, it sends a warning sign out to any researcher who’s thinking of doing anything similarly controversial.
It’s trying to silence and shut down debate. It’s very scary for researchers or really for anyone who’s a critic. That’s why you will see, I think, effort for change happening from, I don’t know, very hardheaded people but also from people who are a little bit outside establishment. If you’re a career scientist, you just cannot afford to have 180 of your colleagues asking for retraction of your paper.
Leanne Vogel: Totally. I think like in the blogging space, I used to be vegan. I was a vegan blogger, and I have many recipes still on my site that are like, “Oil-free. This is the best thing. I’m using water for cooking instead of oil.” When I made the switch, I lost a ton of readers. For me, it was just like there’s more people out there. As a nutrition educator and blogger, it helped grow my business and find the people that were interested in it. I can see if it’s your livelihood and you’re relying on funding and all of a sudden that funding is taken away, it’s not like you can just easily find something else. I can imagine that being pretty mortifying.
For those listening who, our teachers and lawyers and stay at home moms, what can an individual do to help spread this message?
Nina Teicholz: I think that the most important thing is to, that that image of you’ve got to put on your own oxygen mask first, which is you take care of your health and your own body and then you need to take care of your family and your loved ones and the people around you and those I think it’s hard to make these changes. It’s hard to convince the people you love around you to make changes. My mom and dad, took me like maybe five years to get my mom to stop eating low-fat yogurt.
Leanne Vogel: Mad props, that is hard.
Nina Teicholz: My mom, and then I think you can move out into your communities. You can try to educate people at your school. What’s very hard is that no institution wants to go up against medical advice. A friend of mine went and try to educate her school about the problems of sugar and this and that. They just said, “Well, you know, this isn’t what the doctor says and we’re going by what the doctor says,” which really linked, I mean I think that the model for change ultimately is going to have to be that we’re going to have to change dietary guidelines because it’s like the Bible from which all knowledge flows.
Every professional society, every doctor, every dietitian, every nutritional consultant, they are sworn pretty much to follow those dietary guidelines. In the end, I think we have to change the guidelines. If people want to help do that, then they can go to a website called The Nutrition Coalition and just sign up to join in because that’s a group that’s trying to do that work. I’ve been involved in that group. I think because, until that changes, as long as you have all the experts saying, “This is the way to eat and it’s that the advice is wrong,” it’s going to be very hard to have a bottom-up movement going against that expert advice. I think that’s just the reality.
Leanne Vogel: More on my interview with Nina Teicholz after this message from one of our podcast partners.
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Leanne Vogel: Where does cholesterol play in all this? Because we’re told that you mentioned at the beginning of our talk like you avoided eggs. Maybe some of that was to do with because eggs have cholesterol and therefore your cholesterol would be crazy, and you would die of heart disease. Where is cholesterol in this and how does that play into this story really of the low-fat movement and how that’s changing?
Nina Teicholz: That’s a really good question. Remember that the original advice by Ancel Keys was to cut back on saturated fat and dietary cholesterol. Dietary cholesterol is what leads to, sorry, it’s what’s in eggs, liver, shellfish, those are the main foods that we cut back on to try to eat less cholesterol. The idea was that, if the more cholesterol you eat, the higher your blood cholesterol would be. There was this direct one-to-one correlation. We have known since the early 80s that that’s not true.
Your body produces cholesterol because cholesterol is used in every cell of your body. It’s essential for the functioning of all your cells including your sex hormones are made of cholesterol, your brain needs these cholesterol. Your body needs cholesterol so if you eat more of it your body just produces less of it. That’s just like this; it seeks to maintain homeostasis in your body. You could eat a lot of cholesterol. There’s a great experiment by a doctor who ate like, I don’t know, 21 eggs a day. His blood cholesterol was stable. They were bigger, more rigorous experiments than that but it just shows you that idea.
Then there’s also this question of all the cholesterol in your blood. We measure total cholesterol, then there is like your LDL and HDL and all these things that we measure and we worry about those because we’re told that if those are wrong, too high or too low or whatever, that’s a sign that you’re going to have a heart attack. For a long time, we’ve embraced the low-fat diet because we thought it lowered, and to some extent the saturated, lowering the limits on saturated fat because they lower your total cholesterol. Then when that was found not to be very reliable predictor of heart attack, then we switched to LDL, low-density lipoprotein cholesterol.
If your LDL cholesterol was going down which you could do by restricting fat and saturated fat, then that was seen as a good thing. Over time, there were a bunch of experiments that showed that you were just as likely to have a heart attack if your LDL was high as if it weren’t low. LDL turned out to be unreliable. This whole diet that had been pinned to LDL, that turn out that LDL wasn’t a good predictor of a heart attack. All that science about predictors of heart attacks and what you measure in your blood and all of that has changed dramatically in the last 30 years.
Now we understand probably the most reliable and commonly measured predictor of a heart attack is your HDL and your triglycerides. Your HDL over your triglycerides is probably the most reliable predictor that your average doctor can measure and look at. Those look better if you eat a higher fat diet including saturated fat. That means the most reliable cholesterol markers look the best on a higher fat, higher saturated fat diet. Low in carbohydrates I have to add, the things that really bring down triglycerides and help HDL go up as well is reducing your carbohydrates. What we’re talking about a high-fat, low-carb diet is what produces the best results.
Then there are other kind of up-to-date markers that are on the cutting edge like your LDL particle number and your LDL density and you want to have light, buoyant LDL and not small dense LDL. Those markers also look better on a high-fat, low-carb diet. There’s really no indication of any adverse marker on a high-fat, low-carb diet even when that diet includes saturated fats.
Leanne Vogel: That’s really cool. Like a lot of people that hear the low-carb message end up doing low-carb, low-fat. Have you looked at any of that and the impact? Because I mean, in my personal opinion, fat is where it’s at. By increasing that, you got to get rid of something and carbohydrates is the answer to that. A lot of people do the low-carb, low-fat thing. What are your thoughts on that? Have you read any papers on it or anything?
Nina Teicholz: Not so much. I don’t feel like I know that much. That would have to be a high-protein diet. I don’t know. I’ve read mixed papers on a high-protein diet, so I really don’t know. I think, historically, I’m not sure how many populations have really been on that diet because if you eat animal foods, animal foods are naturally high in fat so you have to, I don’t know how natural diet that is, but honestly I don’t feel like I can accurately say anything too intelligent about that.
Leanne Vogel: That’s fair. That’s fair. Totally. One question I did have is when I was doing some research, and you mentioned it just briefly is about vegetable oil. One thing I got a little bit caught up on was canola oil because, if it’s an unprocessed oil, the Omega ratio is pretty good. The PUFA is high but would you say that it’s good for salads? Like if it’s unprocessed, organic, non-genetically modified, would you say that you would wrap canola oil up in a pretty safe bucket when it comes to fats?
Nina Teicholz: Canola oil is made out of, it’s a highly processed product. Even if it’s organic or GMO, it’s still like a highly processed and it’s still a polyunsaturated fat. The poly refers to multiple double bonds. Any double bond is basically available to bond with oxygen. Those are all opportunities to become oxidized. I don’t think that canola oil is so much better than any other vegetable oil. If I were doing a salad dressing, I would go with olive oil and that’s because it’s a monounsaturated. It’s the only monounsaturated fat and that means it has only one double bond. Each molecule only has one double bond, and that’s only one opportunity to bond with oxygen.
Leanne Vogel: I would imagine that you would bucket canola and maybe flax and hemp oil in the same bucket because of the polyunsaturated ratio. Is that crosstalk?
Nina Teicholz: Yeah. They’re just very high in polyunsaturated fats.
Leanne Vogel: Which is unstable.
Nina Teicholz: Which are unstable, they’re inherently unstable. They try to stabilize them in various ways but to try to stabilize them, and they do further chemical processing, they do things like interesterified the molecules and change. I mean it’s all just, there are such artificial processes. You’re talking about a product that’s been gone through 15 stages of processing. It’s winterized, deodorize, stabilized, maybe interesterified. It’s such a highly processed food.Olive oil, at least you can get it cold-pressed olive oil as a relatively unprocessed kind of oil.
Leanne Vogel: Yes, you would say any of the processed like any oil that’s processed really. Go for the cold-pressed or extra virgin type of thing so you can make sure that it’s lightly touched and as natural as possible. Would that be fair?
Nina Teicholz: Yes, I think so. Again, particularly because it’s a monounsaturated fat. Olive oil is just chemically less prone to oxidation.
Leanne Vogel: Oxidation, we spoke about earlier about causing inflammation and a bunch of other things and inflammation you mean a lot of different things. Like you say inflammation and you think, “Oh, you know, my joints hurt,” but it goes so much further than that.
What are your thoughts on individuals that are maybe looking to read scientific studies or papers to gather their own thoughts? Do you have suggestions on how one would consume information in studies and what to look for in a good study?
Nina Teicholz: That’s such a good question and such a hard one to answer. The one thing I would say is that what has led to a lot of bad understanding are the kinds of studies that are called observational or epidemiological studies. Those are studies that show association but not causation, like this is associated with that; this may cause that. Those kinds of studies are just notoriously unreliable. They have big numbers of people in them and they follow those people over long periods of time but those are what they rely on what is called food frequency questionnaires where people have to fill out, like how many times in the last six months have you had peaches or prunes or whatever? It’s like it’s such unreliable data.
I would stick to reading those studies. Even though they’re published frequently they come out of highly respected universities, I would just stay away from them because, historically speaking, they’ve almost always been wrong. Then if you’re interested in reading studies as they come out, it’s very hard. One of the really tough things about this field is like learning how to read between the lines. There’s so much that happens in nutrition that is political and people, researchers who don’t even really report their own results because they’re afraid of them or what their colleagues might say. You want it, in a clinical trials are the best research.
They can demonstrate cause and effect, a good big clinical trial that is on humans and that mice, often you’ll see the headlines are about based on studies on my mice. Mice are totally different from humans when it comes to diet so if they’re to study that can’t show that the Paleo diet is not good on mice, what you’ve learned from that study is that the Paleo diet is not good for mice.
Leanne Vogel: Good one.
Nina Teicholz: Basically, the job of you’re trying to learn more is to try to realize how much bad nutrition science and bad nutrition journals in there is and just trying to recognize all the bad science out there and being cynical about what you read I guess. Unfortunately, that would be my top line message, really to be skeptical about what you read. It’s unfortunate, but there are so many headlines based on these tiny mice studies or unreliable epidemiological studies, and so occasionally there’s a good clinical trial that comes along that says something real and rigorous and that’s worth paying attention to.
Leanne Vogel: Brilliant. My last question is you wrote such a beautiful book, and it’s fabulous. I know that a lot of people have been very interested in your work over the years since you wrote the book. What’s next trio? What are you up to? What are you working on?
Nina Teicholz: I’m starting to pull together a proposal for another book which should really be a more contemporary look at the diet wars and some of them go into a little more detail about some of the politics involved which are truly so much. Even I, in the amount of work I did, could not really imagine the scope of the corruption that has gone on in this field. I would like to write another book about that and it’s very contemporary like this is what’s going on right now.
Meantime, I’m doing some articles in the newspapers and magazines and I have, for the last six months, been getting going on starting my newsletter. If you’re interested when that …
Leanne Vogel: How do you see it?
Nina Teicholz: Finally comes out, you can go and sign up and put your email address down on my website which is TheBigFatSurprise.com. I’ve also been working on trying to launch a new website and I have to say that one of the things that have taken up a lot of my time is I am interested in this need, tremendous need, for the entire population now to change in the dietary guidelines because they are not based on the best and most current science. If you want to change the world for all people, that’s where it has to happen. My hope is to be able to contribute to that effort. I just think things aren’t going to change for everybody until those change. That website again if anybody’s interested in that work is nutrition-coalition.org. That’s it. That and two kids, I can manage.
Leanne Vogel: That’s enough. I think that’s enough work for probably three people so I think you’re doing pretty good. I’ll include the links in today’s show notes for everything that you just mentioned including Nutrition Coalition and such. Everyone can find the show notes for today’s episode by going to HealthfulPursuit.com/podcast/e17. Thanks so much for being on the show today, Nina.
Nina Teicholz: Leanne, it’s been great talking to you so thank you for having me.
Leanne Vogel: Thank you.
That does it for another episode of the Keto Diet Podcast. Thanks for listening in. You can follow me on Instagram by searching Healthful Pursuit where you’ll find daily keto eats and other fun things. Check out all of my keto supportive programs, bundles, guides, and other cool things over at HealthfulPursuit.com/shop. I’ll see you next Sunday. Bye.
This entry was tagged: eating high-fat, eating keto, eating low-carb, fat-adapted, how eat keto, keto basics, keto diet, keto for women, keto life, ketogenic diet, ketogenic for women, ketosis, low-carb paleo, what is keto
HI! I’M LEANNE
Nutrition educator + keto enthusiast. I want to live in a world where every woman loves her body, nourishing fats are enjoyed at every meal, and the word “restriction” isn’t in the dictionary.