Nina Teicholz Reveals a Big Fat Surprise

Jonathan: Hey everybody, Jonathan Bailor back with another SANE show. Very excited about today’s show because we have someone who is really near and dear to my heart because it is an individual who took a decade plus of their life to just dig into research. And I’m excited to learn about why because I know that takes a lot of time and effort and to find out a big fat surprise which is also the name of her new book, again it’s The Big Fat Surprise. We have the, just, blazingly hot author, I mean, she’s just taken over right now, Nina Teicholz, welcome to the show.

Nina: Thank you so much for having me, Jonathan.

Jonathan: Oh well, Nina, thank you for coming and again the name of the new book is The Big Fat Surprise: Why Butter, Meat and Cheese Belong In A Healthy Diet and has been described to me as the — as almost like a continuation of what Gary Taubes did in Good Calories, Bad Calories a while back. So tell us a bit about your background, what inspired this book and what we can expect inside.

Nina: Well, I got interested in this subject because I — well there were two reasons; one is that I was writing this little, dinky restaurant review column that didn’t have any money to pay for my meals so I just had to go in and eat whatever the chef decided to send out for me. At that point I was a near vegetarian, basically eating a low fat diet, but I discovered that chefs were not interested in sending out stir fry vegetables and chicken breast, which is pretty much what I had been surviving on. They are interested in sending out red meat pâté, foie gras, interesting, earthy, rich tastes, I had almost, you know, rarely ever had before and I found that they were delicious, that I lost the stubborn ten pounds I had been fighting for decades and that my cholesterol levels, my doctor told me they were fine and that presented a mystery in scientific terms, it’s a paradox. And as a journalist, I wanted to get to the bottom of that.

It was also true that I had written an article in Gourmet magazine in 2004 on trans fats, what really blew that story open and got a book contract to write about trans fats. When I started researching that, I spoke to Gary Taubes and realized that it was not simply a story about trans fats and how we had missed that problem, but really all dietary fat, there was this huge story there that had gone underreported and some of my book is — repeats what Gary Taubes has done and goes over some of the same history. But there is also — I sort of take it to the next step. I include sections on women and children, there’s a really surprising chapter on the Mediterranean diet, there are chapters on trans fats and what happened, why we didn’t know about them for so many decades and what happens, what is happening replacing them and then there’s a — the last chapter is really about the last decade of scientific research that has happened in this field.

It described Gary Taubes’ contribution and the contribution of other — of scientists who have done now a decade of really important clinical trial work and so, it’s sort of, you know, takes it off — it takes it to the next step from where Gary Taubes left, I think, the field. It’s also written for more of a little bit less — more of a general audience, not so much of a scientific audience, it’s a little bit lighter on the facts and figures, a little less dense of a book than his book, although I love his book.

Jonathan: And Nina, what I’ve also heard folks describe is that Gary’s work, if someone actually reads it and understands it, it’s very difficult to say that eating fat makes you fat, like that mythology was thoroughly debunked and continuous to be debunked, but then people who continue to live in the low fat mythology camp would say, Okay, well it doesn’t make you fat but it does give you heart disease. So you’ll be thin but you’ll die of heart disease when you’re fifty if you eat fat. And I’ve heard that your book really takes a step in the direction of saying, Look, not only does it not make you fat, but really the scientific literature has never shown that it causes heart disease and really blowing that myth up.

Nina: Right, that’s right. So if there’s one sustained argument throughout my whole book it is — it really lays out the evidence about not just fat but saturated fat, right. The greatest dietary culprit of our lifetimes, of the last fifty years, it lays out the evidence showing that the evidence behind the hypothesis that saturated fat causes heart disease was never good, that it has since been re-examined and crumbled, really, under that re-examination, not just by me but by two groups of prominent scientists who studied all those early foundational clinical trials that were used to support that — this hypothesis that saturated fats cause heart disease. And so, my book really goes through all of that evidence in great detail and it shows what happened to the [05:00] American diet by getting rid of saturated fats, right. So we eat 11 percent less — fewer — less saturated fats now than we did thirty years ago; what happened as a consequence of that?

You know, the consequences are we have a lot more vegetable oils, we have a lot of heated vegetables oils with problems and we eat a lot more carbohydrates, right, 25 percent more carbohydrates over the last thirty years. So my book kind of charts what happened by — with this — what happened as a result of all these misunderstandings around saturated fats.

Jonathan: Nina, the science, in my own experience is amazingly clear, and in fact I had — and this isn’t internet — as you know it’s not internet chat rooms, I mean, we have a Dr. Dariush Mozaffarian from the Harvard Medical School, published in the Journal of the American Medical Association, like, look, saturated fat has never been shown to cause heart disease, I mean, basically, literally saying those words. So even — however, if you look at the Harvard Medical School’s — Harvard School of Public Health’s website, their actual dietary guidelines still deter eating saturated fat.

Nina: Right.

Jonathan: So, what’s going on?

Nina: Well, good question. So there’s a couple of things going on. One is Dariush Mozaffarian is, one, a professor at the Harvard School of Public Health and he is — does not run that department. The person who runs his department is Walter Willett, who I don’t think agrees with Mozaffarian. But in any case, it’s a consensus statement that they come out with, and it’s still — it’s a radical thing for — to say that saturated fats don’t cause heart disease, that’s still a radical idea and Dr. Mozaffarian is out on the cutting edge of that in his department and in the nutrition expert world generally. But — so for your listeners who are near your — your viewers who really understand this issue in greater detail, I’ll just walk you through one argument. What — the remaining argument against saturated fats is, okay, the evidence was never good against them, but we still don’t have a long-term clinical trial, two years, showing that they’re not dangerous.

So in other words, they were put in jail unfairly, the evidence against them has crumbled, but now they have to stay in jail until they prove themselves on good behavior for two years in a clinical trial. And I’m just saying, let them out of jail, treat them the same way you treat broccoli at this point, are we — is we broccoli presumed guilty until a two year clinical trial approves it innocent? Saturated fats should be let out of jail, there’s no evidence against them, they shouldn’t be — remain imprisoned and they have a four thousand year record of good behavior that they should be able to draw upon. We’ve — humans have consumed them for four thousand years. And there’s a long written record going back to the chine of ox fatted with lard that was laid upon the — roasted for Odysseus in Homer, I mean there’s so much written evidence of these foods being eaten in human history. And so, saturated fats should just be let out of jail, that is my argument. You should not require that they now go through a two year long clinical trial to prove that they are okay.

Jonathan: Nina I love this get them out of jail argument and so let’s dig into that a little bit because I think that there is, to some readers and — excuse me — some viewers and listeners, there’s a bit of a spectrum for saturated fats. So on one end of the spectrum they hear things like, the message in folks over knives and the China study and things like that, which is literally like saturated fat is, like, crap. It will just kill you and eating it is just going to kill you. And then they hear things in early Atkins’ work, which is like, you should go out of your way to eat — and this is an exaggeration — seventy percent of your calories should be saturated fat. And then there’s something in the middle which is, like, saturated fat can be part of a healthy diet and don’t be so freaked out about it. Where do you fall and where does the research you looked at put you on that spectrum?

Nina: Well, I think that I endorse this view that saturated fats can be part of a healthy diet. And I think what the science shows us now, the last decade of really rigorous trials, the really excellent work that has been done now, well controlled clinical trials show unequivocally that a higher fat diet, a high fat, low carbohydrate diet is better for health in terms of outcomes for diabetes, obesity and heart disease, right. So let’s say 50, 60 even percent of your calories is fat. How do you get to that high fat diet without eating animal foods, right? It’s almost impossible unless you’re drinking bowlfuls of olive oil or, you know, eating massive handfuls of nuts all day long, you can’t get to that higher fat diet without eating some animal fats, right? So I’m saying they should just be part of that healthy diet, eggs, cheese, [10:00] whole fat, dairy, red meat, they’re nutritionally — they are very densely nutritional foods and they should be part of that diet.

Whether or not you can eat 70 percent of your diet — you know you can eat 70 percent of your diet as saturated fat, just because they — what would you — I guess you could just eat sticks of butter, but you can’t really, practically speaking, eat that much saturated fat.

Jonathan: Well Nina, I appreciate your calling that out, because, ironically there are lots of people on the internet who say you should eat sticks of butter. I mean, so —

Nina: You can find anything on the internet.

Jonathan: No, absolutely, but I mean, apparently popular. So it sounds like what you’re saying is, for example, at this point, things like monounsaturated fats, omega-3 fats, like there’s definitely a concept of fats that are actively helpful. Like we have this, I think, pretty strong belief in even the mainstream that for example, omega-3 fats, you should go out of your way to eat more omega-3 fats and I think it’s pretty universally recognized, thanks in part to your work that you should go out of your way to avoid trans fats. It sounds like what you’re saying — I’m curious at what you’re saying though — let’s call omega-3 fats and potentially even monounsaturated fats, I’m curious as to your thoughts as therapeutic fats, meaning they help to reduce inflammation, they help with certain brain functions, things like that; would you classify saturated fats in that therapeutic category or more of just a benign source of calories category?

Nina: Saturated fats are essential for some biological functions, your immune system health, your lung functioning, it’s really essential to have some saturated fats in your diet. And I think that it’s important also to get away to from a reductionist’s language about that, because what do we eat? We eat foods. So, it’s good to have fish, which contain omega-3 fatty acids, it’s also good to have red meat and eggs and dairy and, you know, cheese and in those, all foods contain a mixture of fatty acids, right? Half of chicken is monounsaturated fat, which is the same kind you find in olive oil, so really, we’re just talking about the whole foods that contain whole fats. And those foods should include red meat, chicken, fish, eggs, whole milk and you know, and cheese.

And so we don’t — you don’t have to — you’ll never be able to quantify exactly how much of which kind of fats are in all those foods, I mean, nobody goes into the kitchen and says, Mum can I have 25 percent protein and 13 percent monounsaturated fat for dinner? You’re like, No, I’ll have spaghetti and meatballs. So, you know, it’s whole fats in whole foods is what I’m — I would argue.

Jonathan: So Nina, if you were to get — saturated fat is a really interesting topic because it’s one of the areas that you can find whole books, such as The Big Fat Surprise, that lay out compelling arguments that say, look, saturated fat, let it out of jail. At the same time you’ll have other experts who as assuredly tell us — continue to tell us, saturated fat is bad for you. I mean, there’s just, you know, a lot of these individuals in the what is it P-C-C-M or whatever the heck it is, like physicians for responsible medicine, that they’re very low fat advocates, I mean they — again they release movies, literally saying that eliminating fat from your diet is a miracle, it is a miracle cure. So how can we have, quote unquote, experts that literally say one thing and experts that are saying the exact opposite?

Nina: You know, that’s — it’s a complicated question and there’s a complicated answer too. The flip-flopping of nutritional headlines for people is maddening and there is this extreme diversity of opinion. And now there’s a variety of, you know, there’s a tremendous range of interpretations of a huge body of evidence out there. One of the reasons there are so many flip-flopping headlines, or there’s such a diversity of opinion or that, you can say, the evidence can be interpreted in so many different ways, is there’s a lot of reliance on very weak nutritional studies. One of the themes I go after in my book is about the weakness of epidemiological studies which show association without — they could never prove causation but they have been used — I mean the history of this whole idea that fat and saturated fat cause heart disease stems from the problem of scientists relying — over-relying on this weak epidemiological science and over-interpreting it.

From the very start a [sic] epidemiological study was used as the foundation for our very first anti-saturated fat guidelines. In 1961 when the American Heart Association [15:00] issued its first guidelines recommending that Americans avoid saturated fat to fight heart disease that was based on an epidemiological study. So, alone, no clinical trials. So, and that has been compounded through the literature, then there’s this phenomenon, studies being done with a lot of methodological problems, like for instance, not controlling for smoking, a huge problem, at the time was discussed at length, but over time, those caveats are lost and they’re, you know, now those studies can’t be viewed. It’s like a game of telephone, you know, you start with interesting findings but we have these caveats about smoking and this and that and by the end of, you know, three decades later, it’s just the headline that anybody has remembered.

So scientists have relied on these review studies, they rely on summary statements and all the details are lost. That’s one of the things that I do in my book is go back and look at this work and to look, you know, in a granular level, what did these studies actually show, you really have to dig into the literature, I think you have too, to find the tremendous methodological problems and to really get to the bottom of this mystery.

Jonathan: Nina I love that you’ve called out that in these studies, for example, they won’t control for smoking because I know, like, looking at these studies for — this is an exaggeration, but you’ll have the group that ate more saturated fat, who also happen to exercise less, smoke more, not eat vegetables and then the group that ate less saturated fat and exercised, ate a lot of vegetables and all this other stuff and they’re like, Oh, it’s the saturated fat that made those people sick, it’s like, Wait a second, what?

Nina: I know. And you know this still goes on today, I mean, and just last year I think it was that there were those incredibly scary headlines about how just a few more ounces of red meat increased rates of heart disease and stroke on the front page of the New York Times and all over the world. Who are the people in the group of big red meat eaters in today’s world? They are people who haven’t listened to their doctors or taken any — you know, listened to anything their doctors have told them for a decade, people who do not exercise regularly, people who do not take care of their health, there’s so many compounding factors and I should just add that again that was an epidemiological study that that result came out of, with by the way a tiny, tiny difference in the — what’s called the relative risk, like 1.29.

Okay, so the only way that epidemiological studies can be used to make conclusions is like in instances of smoking, where heavy smokers have fifteen times more lung cancer than non-smokers. So that’s the only instance where you can really use those studies to say anything that’s scientifically conclusive.

Jonathan: You know what, you just kind of reminded me of a silly quote from one of my favorite shows, The Simpsons, and Homer goes into his doctor and he’s having some problems and he says, “But doctor, I’ve been drinking eight cups of gravy a day like you told me,” or something like that, so pretty funny. Well, Nina, this is extremely helpful and the book again is The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. Nina, you’re all over the news, what’s next for you?

Nina: Well, one of the things that I found in my book was that women and children have been particularly ignored by the scientific literature, you know. When the low fat diet was extended to women and children, there were zero data on them. And, you know, women, and children especially I think, their health has declined so precipitously and I feel — I really want to research and investigate what — how we understood what was a nutritious diet for children before the entire nutrition community became uniquely obsessed with providing nutrition only to prevent heart disease in middle aged men. So I would like to research that, but in the meantime I’m working really hard on promoting my book, it’s — I have a bunch of media on the website is thebigfatsurprise.com, pretty easy to remember so I’m really working hard on getting this message out which I feel is so important, it’s still, as you know, a really — it’s an uphill course, but I think that people are responsive to it and I really think it’s really important for people to know. So I’m working on that.

Jonathan: Nina, I really appreciate that, I especially appreciate you calling up the women and children angle because one of the things also that I found to be advantageous about overcoming one’s fear of saturated fat is it sure makes eating vegetables a lot easier, because if you try to get your kids to eat raw kale, they’re probably not going to. But if you are not afraid to sauté it with some bacon drippings and put a little salt on it, that’s good eating, so…

Nina: That’s totally true. And you eat the fat to absorb the vitamins in the vegetables. Without the fat, you can’t absorb the vitamin, the fat soluble vitamins A, D, E and K. So fat is essential.

Jonathan: I love it, well Nina, thank you so much for joining us for today it’s been an absolute [20:00] pleasure.

Nina: Thank you, it’s great to be here.

Jonathan: Listeners and viewers I hope you enjoyed todays show as much as I did. Again, our guest today is Nina Teicholz and her book is The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet and remember this week and every week after, eat smarter, exercise smarter, and live better. Chat with you soon.