Larger Lesson of “We Were Wrong about Saturated Fat”

My sister sent me a link to an article (“Butter is Back”) by Mark Bittman, the New York Times food columnist, about a recent review that found saturated fat didn’t cause heart disease. I told my sister I had clicked on the link but had forgotten to read the article.

My sister was incredulous. How could you not want to say “I told you so”? she wondered. (In a 2010 talk I questioned the danger of butter.)

Here is the relevant passage, according to my sister:

A meta-analysis published in the journal Annals of Internal Medicine found that there’s just no evidence to support the notion that saturated fat increases the risk of heart disease. (In fact, there’s some evidence that a lack of saturated fat may be damaging.) The researchers looked at 72 different studies.

I told you so. But this part interests me more:

No study is perfect and few are definitive. But the real villains in our diet — sugar and ultra-processed foods — are becoming increasingly apparent.

Uh-huh. The experts were staggeringly wrong about saturated fat…but they couldn’t possibly be wrong about “sugar and ultra-processed foods”. That makes no sense, but that’s what Bittman wrote (“increasingly apparent”). To me, what is increasingly apparent is that nutrition experts shouldn’t be trusted.

I don’t know what “ultra-processed foods” are but I am beginning to believe the experts are utterly wrong about sugar, too. As far as I can tell, sugar in the evening improves sleep — by a lot, if you get the details right — and nothing is more important than good sleep. If you have read The Shangri-La Diet, you already know that sugar alone cannot have caused the obesity epidemic. It is more complicated than that.

31 Responses to “Larger Lesson of “We Were Wrong about Saturated Fat””

  1. David Says:

    Great post. I am always amazed at how confident people are in answers that turn out to be wrong. I find it depressing that journalists continue to make these errors, instead of saying “Finding out that we were wrong about saturated fat makes me question whether we are right about other supposed ‘angles and demons’ in our food supply.”

  2. nicole Says:

    “To me, what is increasingly apparent is that nutrition experts shouldn’t be trusted.”

    Made me spit our my coffee laughing…so true.

  3. RAD Says:

    Seth, I’m with you that nutrition experts shouldn’t be trusted on macronutrient research (fats, carbs, proteins) but I’m much more inclined to trust micronutrient research (e.g. Vitamin D, Zinc, etc.).

  4. Nancy Lebovitz Says:

    Workplace wellness programs are designed to get people to follow theories of what causes health– there’s no feedback from the person about whether the program is making them healthier.

    http://www.newsworks.org/index.php/thepulse/item/64755-whats-next-for-workplace-wellness-lifevest-health-wellnow

    https://www.lifevesthealth.com/

    How sure are you that obesity is a disease? That losing weight will make fat people healthier?

  5. Gina Says:

    Maybe it’s too soon for a victory lap?:

    “The meta-analysis of dietary fatty acids and risk of coronary heart disease by Chowdhury et al. (1) contains multiple errors and omissions, and the conclusions are seriously misleading, particularly the lack of association with N-6 polyunsaturated fat. For example, two of the six studies included in the analysis of N-6 polyunsaturated fat were wrong. The relative risks for Nurses’ Health Study (NHS) (2) and Kuopio Ischemic Heart Disease Study (KIHD) (3) were retrieved incorrectly and said to be above 1.0. However, in the 20-year follow-up of the NHS the relative risk for highest vs lowest quintile was 0.77 (95 percent CI: 0.62, 0.95); ptrend = 0.01 (the authors seem to have used the RR for N-3 alpha-linolenic acid from a paper on sudden cardiac death), and in the KIHD the relative risk was 0.39; 95% confidence interval [CI], 0.21-0.71) (the origin of the number used in the meta-analysis is unclear). Also, relevant data from other studies were not included (4 and 5).

    Further, the authors did not mention a pooled analysis (6) of the primary data from prospective studies, in which a significant inverse association between intake of polyunsaturated fat (the large majority being the N-6 linoleic acid) and risk of CHD was found. Also, in this analysis, substitution of polyunsaturated fat for saturated fat was associated with lower risk of CHD. Chowdhury et al. also failed to point out that most of the monounsaturated fat consumed in their studies was from red meat and dairy sources, and the findings do not necessarily apply to consumption in the form of nuts, olive oil, and other plant sources. Thus, the conclusions of Chowdhury et al. regarding the type of fat being unimportant are seriously misleading and should be disregarded.”

    https://www.hsph.harvard.edu/nutritionsource/2014/03/19/dietary-fat-and-heart-disease-study-is-seriously-misleading/

    I love coconut milk dishes, but I probably won’t be having them every night just yet. I do agree that nutrition experts shouldn’t be trusted, but that includes the authors of the meta-analysis.

  6. JV Says:

    This just supports the work of Fred Kummerow the 99 year old researcher at the University of Illinois. (I know his work has been mentioned here) His method of dissecting arteries removed in heart bypass operations showed that it was not saturated fat he found but trans fats that caused atherosclerosis – and he has been saying it for 30 years! I find his research more compelling than some of these nutrition studies.

  7. dearieme Says:

    I want to be appointed Sugarfinder General.

  8. jimk Says:

    I’d be careful about confidence in “micro nutrients” as well, here’s just a few examples, there’s lots more.

    http://gettingstronger.org/2012/11/why-i-dont-take-vitamin-d-supplements/

    http://joshmitteldorf.scienceblog.com/2014/03/25/life-extension-supplements-a-reality-check/

    Some of this is about unknown or unexpected confounders, some are about cause and effect like does low Vitamin D cause poor health or does poor health cause low vitamin D.

  9. Todd Fletcher Says:

    A lot of the knowledge about diet we need was embedded in traditional cuisines. Reviving those and the husbandry practices around them seems to me a safe way to make improvements in our health.

  10. Joe Says:

    Seth, this may sound a bit like blasphemy on your site, but I must admit that I find your fascination with sugar to be very puzzling. It has zero nutrients (just empty calories), zero fiber, it can lead to obesity, it damages the endothelium (the lining of the arteries), it can be addictive, yadda yadda yadda. You know the rest.

    If a dose of sugar before bedtime causes you to sleep better, why not EXPERIMENT with ways to essentially “have your cake and eat it” too? By getting your nightly carb injection from a real food source that at least provides you with some nutrition and fiber too, like a banana, some almond butter, a small bowl of oatmeal and warm milk, magnesium and potassium supplements during the day, etc?
     
    Also, isn’t it just possible that your current diet may be causing you to have difficulty sleeping? I’m definitely with you on questioning the experts, self-experiments, the scientific method, etc., but sometimes they’re right, right? They can’t be wrong all the time. I think they’re right about sugar. But even if they aren’t, it would be healthier for you to get your sugar from some real foods, with real nutrients and real fiber. And isn’t that why you want better sleep? To be healthier?

  11. Joe Says:

    Gina, Willet’s attempt at “rebuttal” is not surprising. There will be others to come. How can they not try to rebut that study (of course, their have been other studies, which arrive at precisely the same conclusion?:

    http://ajcn.nutrition.org/content/91/3/535.full.pdf

    People like Willet, and schools like Harvard, are so heavily invested in the lipid theory of CVD that they really have no choice but to go down swinging, much like climate alarmists. To admit that they’ve been wrong all along would essentially mean that their careers are over, their reputations damaged beyond repair.

  12. Matt Says:

    Seth’s fascination with sugar is probably exactly because it has zero nutrients, zero fiber, can be damaging in certain circumstances, etc. That the observed results are so at odds with conventional wisdom are particularly interesting to me, and I’d guess to Seth as well.

  13. Joe Says:

    Matt: “That the observed results are so at odds with conventional wisdom are particularly interesting to me, and I’d guess to Seth as well.’

    But there is no conventional wisdom to be at odds with. Quite the contrary. Many, maybe most, experts would conclude that a little sugar (or other forms of carbohydrate) at bedtime, in and of itself, is relatively harmless, and may even improve sleep.

    And even I would have to agree. On the other hand, why not totally eliminate the potential for damage (which isn’t unsubstantial), by eating some real food, some real fiber, and get some real nutrients, and also improve his sleep? If improving Seth’s health is his main objective (by getting better sleep), I fail to understand why he doesn’t think more nutrients, fiber, etc. wouldn’t be better at accomplishing that.

    And I’m pretty sure that he’ll be along shortly to explain that to me. :)

  14. Mark Says:

    I’ve said it before and I’ll say it again… Walter Willett is a hack. All of his Havard nutritional epi group’s studies have clear, obvious flaws. So, as Joe said, his rebuttal is not at all surprising.

  15. John Says:

    @Joe the whole point of eating food is to get energy and refined sugar is great for that. All the nutrients you get from food are pretty damn useless without some “empty calories” ( yea I think saying empty calories is really stupid). I expect the “experts” to reverse course on their opinions of sugar.

    The “experts” opinion of fiber I think is pretty damn laughable also. I have very little fiber in my diet and yet somehow manage to have 3 quick bowel movements a day.

  16. Seth Roberts Says:

    I found in an experiment that Vitamin D in the morning improved my sleep. Others found the same thing. Experimental evidence does not have the problems of the evidence discussed on Getting Stronger.

    http://blog.sethroberts.net/category/sleep/vitamin-d3-and-sleep/

  17. Joe Says:

    John, I really don’t know what to say. I’m almost speechless.

    That said, I think just about everything you just said is “really stupid.” And trying to debate someone who says really stupid things is…really stupid.

    So…

  18. kxmoore Says:

    ” But the real villains in our diet — sugar and ultra-processed foods — are becoming increasingly apparent.” (Bittman)

    One little interesting study that echos this sentiment found that the form a food took had vastly different impact.

    See Kindke’s post “Powdered food ( carbs? ) appears to be very evil”

    http://kindkehealthnotes.blogspot.com/2013/04/powdered-food-carbs-appears-to-be-very.html

    Seth: Reminds me of several of Israel Ramirez’s results. For example, that adding water to chow made it more fattening.

  19. Stu Says:

    If sugar is so bad for your health and causes obesity then why is Robert Lustig (the guy leading the anti sugar movement) overweight? He also has a red face (malar flush), bags under his eyes, a swollen face and a thinning outer third of his eyebrows (and thinning eyebrows in general) which are all symptoms of hypothyroidism. A zero carbohydrate diet is know to contribute to thyroid problems and hypothyroidism.

    Don’t believe me? Then just do a google image search.

    I once had someone tell me that they were avoiding eating carrots and onions because of the sugar content which is ridiculous.

    Maybe refined sugar isn’t ideal due to a lack of nutrients, but I don’t think people should be avoiding fruit and vegetables because of sugar. The days where I have felt the best and slept well are often the days I eat the most fruit and sugary/starchy vegetables.

  20. Nancy Lebovitz Says:

    Joe, why do you think such small amounts of sugar are dangerous to most people?

  21. Adam Says:

    I was traveling for work this past week and left my honey at home. Normally I dip a spoon in it and twirl it around a bit, then eat whatever is left on it about 20 to 30 minutes before sleep. While I still slept well, I did wake up during the night and experienced not one but two nightmares. I can’t remember the last time I had a nightmare before this.

  22. Joe Says:

    Stu: I don’t really think that Lustig is overweight. He’s got a little bit of padding, yes, but for someone his age, that’s pretty normal. A BMI of 27-28 is the sweet spot (relative to longevity) for men his age. On the other hand, Lustig has said many times that’s he’s NOT a fan of low-carb (you can look it up). So those “extra” pounds you see may be due to eating too many carbs, too many calories, etc. And I agree with you. I don’t think people should be avoiding fruit and vegetables. Quite the contrary. Refined sugar, yes. But fruits and veggies come with nutrients, fiber, etc. That is, they’re real foods.

    Nancy: On the assumption that we’re talking refined sugar, here’s what I think: One of the discoverers of insulin, Fred Banting, discovered that among sugar plantation owners who ate the refined version, diabetes was rampant. But among the native cane workers, who only got to chew the raw cane, there was no diabetes. Yes, it’s only a simple observational study, but I think there is a strong message there. I just don’t think that humans are able to deal with refined sugar.

    But do I think small amounts of sugar are dangerous to most people? That would depend on what you mean by dangerous, and by small amounts. Do I think that a single teaspoon of sugar at bedtime is dangerous? No, not really. Not for most people. But do I think eating processed and refined foods all day, foods that are usually heavily laden with sugar, are dangerous? Absolutely. In fact, I think it’s deadly. That’s why I stick to real foods, foods that don’t require an addictive drug (which means, by definition, that it’s very hard to keep it to “small amounts”) be added to it to induce me to eat it.

    I also think that too much sugar (of any variety) can seriously damage the endothelium, the lining of the arteries. Over time, that can lead to heart disease, diabetes, renal dysfunction, Lupus, etc. And the more damage, the more cholesterol that’s needed to repair it. So you can see why I think that artificially lowering one’s cholesterol level with statin drugs is counter productive. And dangerous.

    It’s just doesn’t seem logical to me, in this age of obesity, diabetes, etc., why we would want to add something like refined sugar to our diets, knowing how addictive it is, without at least getting some actual nutrients and fiber in return. Our food stuffs today are already short of nutrients (thanks to modern farming techniques), then we often cook the remaining vitamins and minerals right out of them, so the part we actually consume often lacks any nutrients at all. So, to someone like me, it’s just another lost opportunity to improve one’s health.

    That’s probably more than you wanted to hear, but sometimes I just can’t help myself.

  23. Seth Roberts Says:

    I think fruit and Yakult (which is sweetened with glucose) are good substitutes for honey. I wouldn’t take honey on a trip — too messy.

  24. babar Says:

    i think you can get honey in little packets like they have jelly in at ihop. just don’t forget them in your coat pocket when you put it in the wash.

  25. daz Says:

    Seth Says “I found in an experiment that Vitamin D in the morning improved my sleep”…

    Hi Seth,

    on the Vit D subject, have you made any changes since you started your D3 supp routine…
    ie. do you vary your dose at all, possibly depending on how you feel, or the season (sun exposure), etc

    also, do you ever bother getting your Vit D blood levels tested (if so, what are/were your numbers & do/did you adjust your D3 supp based on the result).

    cheers

    Seth: No I haven’t made any big changes. I will get my Vit D blood level measured soon.

  26. Nancy Lebovitz Says:

    Joe, based on what you’ve said, it sounds like you’re overly worried about sugar. I agree that it’s a bad idea to use it as a staple, but that doesn’t mean there’s a reason to avoid the teaspoon or even tablespoon of honey before bedtime.

    There’s at least one confounding factor in Banting’s research– amount of exercise. Also, do you have information about lifespans for workers vs. plantation owners?

  27. fi Says:

    Where’s the high5-icon? I totally agree with you, Seth. Sure too much sugar, probably like too much of anything is bad, but I find it really hard to believe that nature would evolve such an enduring love of the taste of sugar if it really was that “toxic”. It just doesn’t make any sense to me. Plus, if I recall correctly, our brains (and pretty much our bodies) run on sugar.

    And I agree that nutritionists are not to be trusted. They have been wrong about a lot, like 180 wrong, so how are we ever supposed to trust anything they say? I have seen dietitians and nutritionists on tv say they make their recommendations based on the evidence, but honestly, at some point you have to wonder if they are really understanding what they are reading. It’s like the whole field has no b.s. detectors at all.

  28. Joe Says:

    Nancy, yes, I am worried (concerned would be a better word) about sugar, but I don’t think I’m overly concerned about it. “Given its many links to obesity, diabetes, heart disease, etc.) And I think I said that one daily teaspoon is probably no big deal – for most people. But like with any addictive drug, self-limiting the daily dosage can be problematical.

    I don’t think Banting’s research looked at exercise. But, yes, it certainly could be a confounding factor. I don’t think it looked at lifespans (although T2D can usually be expected to knock off ~ 10 years, on average), or other aspects of the diets, or even things like vitamin D levels, for example. It was just one factor, but a pretty startling one, in my opinion. You might be interested in reading the book “Sugar Blues”, by William Duffy, just to name one.

  29. Joe Says:

    fi, actually, our brains and body do very well on relatively small amounts of glucose.

    http://www.marksdailyapple.com/the-definitive-guide-to-sugar/#axzz1zRCTnHV4

    The excess goes to your liver. See: non-alchoholic fatty liver disease.

    http://authoritynutrition.com/sugar-liver-diabetes/

  30. Jack Says:

    Seth,

    Thanks for posting this. Any way you look at it, you, seth Roberts, are a genius and way ahead of your time!

  31. Patti Says:

    Tom Naughton gives a speech regarding experts and the wisdom of crowds. If you are interested here is the link https://www.youtube.com/watch?v=KzPnnDDCIjo. Title Diet, health, and the wisdom of crowds.