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Nutrition Past and Future

11 The Journalist Gary Taubes 11: Oil-Based Nutrition 1

I am combining the Minnesota Coronary Survey, the Los Angeles Veterans Study, and the Anti-Coronary Club Trial into a single chapter in this video series. They all represent to me terrible wasted opportunities that reflected the unsophisticated nutritional concepts that arose out of the early diet-heart research. Metabolic ward experiments demonstrated that polyunsaturated fats lower cholesterol and saturated fats raise cholesterol. Because they could be easily exchanged for one another, they were easy for researchers to work with and they produced nice, clean-looking experiments that could be easily understood and reproduced. Why not apply the techniques from the metabolic ward experiments to large-scale diet trials? All you need to do is switch up some fats. Researchers should have looked at cultures around the world with low cholesterol and without much heart disease and recognized that whole, unprocessed carbs could be used to produce realistic, healthy diets that accomplish the diet-heart mission. Unfortunately, that’s not quite how history played out. A trial conducted in Minnesota exemplifies where some went off track. On this slide, you see that Gary Taubes says that the Minnesota Coronary Survey paper is unlikely to be read by anyone outside of the cardiology world because it appeared in the obscure journal Arteriosclerosis. Had it been published and noticed in a timely way, it might have provoked second thoughts about the wisdom of cholesterol-lowering diets. During this trial in Minnesota, more men died in the group eating the experimental diet than in the control group. That wasn’t supposed to happen. The lead investigator, Ivan Frantz, told Taubes he was disappointed by this. Mr Taubes, if you don’t want this paper to be ignored, I’ll try to raise its visibility a bit with this video.

Here is the abstract. Pause the video and read it and you’ll see that the treatment diet that led to more deaths was loaded with 38% fat, of which 9% was saturated. While this diet did accomplish a drop in cholesterol in those consuming it, that did not translate into any benefit when measured against hard endpoints, like death. You can see why Dr Frantz was unhappy. Where did his team go wrong? Well first, you may notice that the mean duration of the diet was only a little more than a year. It seems a little unreasonable to expect that a disease that everyone, including low carbers, understands takes many years to develop should be reversed in a year unless the treatment given is amazingly effective. Which brings me to the big problem here.

Their dietary treatment was pretty bad. Read these excerpts and you’ll see that these investigators were overly concerned with creating a blinding effect in their participants. They wanted them unaware of whether they were assigned to the experimental group or the control group. They tried to create foods for the intervention group that were indistinguishable from those served in the high-saturated fat arm. Notice the word “stable” in my highlight. They wanted “stable” foods in the treatment diet. To anyone with a basic knowledge of nutrition, that should sound suspicious. How do manufacturers make foods more stable?
This attempt to match foods closely enough to fool the mental hospital patients eating them  probably explains the remarkably high fat content of the experimental diet. No doubt they believed food had to be high in fat in order to be considered palatable. Back then diet-heart researchers operated in ignorance of basic principles of sound nutrition. It is safe to say that most of those fats came in the form of refined oils, empty calories basically devoid of any nutriment beyond calories and perhaps some vitamin E.

Here are the nutrition facts for a cup of sunflower oil. Despite those ridiculously high calories, we are pretty much seeing just a bunch of zeroes. This is what empty calories are all about.

This isn’t the worst of it, though. Some of those refined oils were also “stable”.

Through an earnest collaboration with industry, these investigators concocted an unholy doppelganger menu of processed milk, meat, and cheese all “filled” with oils, egg substitute, and trans fat creations like margarine and whipped topping. Yes, this was a heart disease trial that identified whipped topping as a therapeutic food. Say what you will about the detriments of animals foods – and you know by now I will – at least those foods do have nutrients beyond fat and protein that aren’t easily removed through processing. This can’t be said of the processed junk that was dumped onto the plates of those unfortunate folks in that cafeteria. It might be hard to believe today, but this reflects the state of nutrition science in those days. This study was begun in 1968. What is harder to believe is that in preparing this, I have not seen a single paper making reference to this trial even in recent years that tried to interpret its results which noted the processed junk fed to people on this diet. This study is usually just mentioned in passing as a diet intervention trial that happened to fail. Do your own search on this and see what I mean. This is what sets my project apart from other sources of opinion about nutrition you may encounter. These videos were done from the perspective of someone who considers whole plant foods to be the foundation of a proper human diet. That means fruits, vegetables, nuts, potatoes, and legumes and other healthy starches. Apparently, despite the rhetoric you may hear from others about how yes, of course you should favor plant foods, it seems that most of the experts don’t really look at nutrition science from that perspective. They hold unstated biases about fats, processed foods, and animals foods that prevent them from considering that a dietary trial that used fake whipped topping might be suspect. That should tell you something.

If Mr. Taubes thinks this was a well-conducted study that should cause us to doubt the effects of blood cholesterol, then it should also cause him to doubt his beliefs about triglycerides, as the experimental diet lowered triglycerides, too.

There was plenty of research into trans fats in the old days, most finding that they did raise cholesterol. But as you probably know, the trans fat science wasn’t clear to everyone until the 1990s. This study was done in 1960.

Here in 1961 trans fats were shown to raise cholesterol.

This one was from 1964. Hydrogenated fat was said to be identical to unhydrogenated fat in its effects on cholesterol.

You can see that whereas these researchers couldn’t detect an effect of trans fats, they could see that dietary cholesterol did raise plasma cholesterol significantly. Dietary cholesterol looked worse than trans fats in this one.

These researchers in 1975 opined that the trans fats sold in the US were neutral in their effects on cholesterol.

Look at the old research into diet heart and it is often impossible to tell if trans fats were used in trials. Here is a rare mention of the composition of margarines by Ancel Keys all the way back in 1957. He said that manufacturers were reluctant to disclose the makeup of their margarines. If the makers of margarines wouldn't reveal what was in their margarines, it's pretty hard to know if they were free of trans fats. Amusingly, you can see here that the Japanese thought that eating fats would cause diarrhea. This may have been an unreasonable belief that actually served them well.

This book from 1972 references a research trial in Cleveland which used trans fats, apparently because they didn't see any harm in using them.

The author remarked on the difficulty one might have had in ascertaining the fat composition of margarines sold at the time. As you know, people mistakenly believed that these “hardened” fats were not harmful.

Ancel Keys provided a little more clarity on the subject in 1974. He said that the majority of experiments exchanging fats for one another did not use hydrogenated oils. That is somewhat reassuring but we still don’t have any actual numbers on this. Many old trials didn't comment one way or the other so it's hard to know what happened for sure.

I’ll remind you that beside processed fats, the only other place one can find trans fats in the diet is from foods that come from ruminant animals like cows.

My favorite example of the tyranny of fat-loving palates in the research of the old days is this dietary trial conducted by “A Research Committee”. An actual low-fat diet was attempted here, so they probably didn’t resort to a lot of trans fats. Despite that, it wasn’t all that low in fat and it was still likely based on processed foods. The authors had to admit that their participants had a hard time choking down their dry sandwiches without the usual slathering of butter. I think it’s safe to say that a vegetable and lentil stew plus a few pieces of fruit were not on anyone’s lunch menu during this trial.

Lacking the usual fake fats we’ve seen like filled cheese and whipped topping, they likely added animal protein to meet the dietary expectations of their participants, so unsurprisingly their trial failed. But it wasn’t a total loss. Some interesting information came out of this one.

In yet another contradiction of the ideas of John Yudkin, there was no relationship in this trial between sugar intake and cardiac events.

As their table made clear, there was no tendency for added sugar to promote angina, reinfarction, or any other relapse, and they had a huge spread of sugar usage to make any effect apparent if one existed. In Gary Taubes’ combing of the old literature on dietary trials and heart disease, somehow this escaped his notice.

I have shown you already that in low-carb trials conducted by Yudkin, margarines were used. No information is given in any of his studies that I have read about the nature of those margarines.

Now that we've seen one oily study and some background information on processed fats used in the old days, we will have an easier time understanding the LA Veterans Study and the Anti-Coronary Club trial. Those are in Part II.