Diet Advice We Never Followed

 In Preventive Medicine Column

 

Expert Dietary Guidance We Never Followed

No, Americans are not fatter and sicker because we followed flawed expert advice. I am not saying there were no flaws in expert advice; there were, are, and always will be. Humans don’t do perfection; not in nutrition, or any other realm. There are always flaws.

What I am saying is: we are fatter and sicker not because of those inevitable flaws, but because we NEVER followed expert advice, not any flavor of it, in the first place.

Given the intensity of misguided criticism at this particular juncture, in the immediate aftermath of the Dietary Guidelines release, I will repeat that: Americans NEVER followed expert dietary advice in the first place. Period.

For all the clamor about the harm done by “low fat” advice, the bracing reality could not be further removed. Those populations around the world with genuinely “low fat” diets that are, more importantly, comprised of wholesome foods in sensible combinations- count among the world’s healthiest, longest-lived peoples. This is by no means evidence that diets NEED to be low in fat to produce both longevity and vitality, but it certainly IS evidence that a diet that is optimal in its composition and happens to be low in total fat can be among the means to just those enviable ends.

Advice to lower fat intake in the U.S., flawed though the advice may have been, could have led us to a Blue Zone. Instead, it led us to Snackwells. And to reiterate bluntly a point I’ve made before: no nutrition expert EVER said: “just eat Snackwells, and everything will be fine.” Snackwells, of course, are a convenient flag-bearer; they stand for every variation on the theme of low-fat junk food.

No expert ever said it; but that’s what we did. That’s what we did because we heard what we wanted to hear. It’s what we did because Big Food got in the game, and manipulated us. Whatever the reasons, the historical record is clear: we garbled the message.

It’s even worse than that. For the most part, we didn’t even REPLACE questionable, high-fat foods with at-least-as-questionable low-fat foods. The national trend data suggest that our intake of fat stayed pretty constant; even our intake of saturated fat, about which even more silly noise is being made, stayed about the same. What did we do? We ADDED tasty low-fat junk foods to everything we were already eating.

Imagining you could find a nutrition expert benighted enough to have thought that substituting low-fat junk for high-fat anything could confer advantages, just imagine finding one who thought merely ADDING low-fat junk without reducing anything would magically produce vitality and weight loss. They will be riding a unicorn.

Failing to find any such expert, because they are fictional beings, we come to the main point. The noise being made about egregiously flawed, expert dietary guidance has nothing whatever to do with expert dietary guidance. In some cases, as with my own response to the 2015 Dietary Guidelines for Americans, it’s about what politicians have done with the reliable work of scientists. In most cases, it’s about someone encumbered by ulterior motives, a deficiency of relevant expertise in their own right, or both, misconstruing the results of what we have DONE for the results of what was ever recommended. They are as different as water and gasoline.

This is by no means limited to advice about cutting dietary fat, or saturated fat. When Atkins made his meteoric rise, he was advising people to eat less carbohydrate foods, not to eat LOW carbohydrate brownies; those hadn’t been invented yet. They were, in short order, to exploit the popularity of his message- just as Snackwells were invented to exploit the popularity of Keys, Castelli, and later on, Ornish and others. We never, as a population, followed with fidelity ANY “expert” dietary advice. We translated it all into gibberish and new varieties of junk food.

Those feeding on it now to propagate messages about meat, butter, and cheese; or saturated fat; or the irrelevance of calories, are doing us all a disservice. They are, intentionally or otherwise, propagating the great diet fallacy of the past half-century.

They are blaming bad expert advice no one ever followed for the mess in which we find ourselves.

The flaws in genuinely expert advice about diet are analogous to: this hose versus that hose; this water pressure, versus that to put out a fire. Spraying gasoline instead of water is a problem at a different level altogether. That’s the problem we have, and need to contemplate- by the light of the glowing embers that used to be our house.

-fin Dr. David L. Katz;www.davidkatzmd.com; author, Disease Proof; founder, True Health Initiative

Dr. David L. Katz
DAVID L. KATZ MD, MPH, FACPM, FACP, FACLM, is the founding director (1998) of Yale University's Yale-Griffin Prevention Research Center, and current President of the American College of Lifestyle Medicine. He earned his BA degree from Dartmouth College (1984); his MD from the Albert Einstein College of Medicine (1988); and his MPH from the Yale University School of Public Health (1993). He completed sequential residency training in Internal Medicine, and Preventive Medicine/Public Health. He is a two-time diplomate of the American Board of Internal Medicine, and a board-certified specialist in Preventive Medicine/Public Health. He has received two Honorary Doctorates. Dr. Katz has published roughly 200 scientific articles and textbook chapters, and 15 books to date, including multiple editions of leading textbooks in both Preventive Medicine, and nutrition. Recognized globally for expertise in nutrition, weight management and the prevention of chronic disease, he has a social media following of well over half a million. In 2015, Dr. Katz established the True Health Initiative to help convert what we know about lifestyle as medicine into what we do about it, in the service of adding years to lives and life to years around the globe.
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