By Dr. Mercola
DM: Dr. Joseph Mercola
GT: Gary Taubes
Introduction:
DM: Welcome everyone. This is Dr. Mercola. We are honored today to be able to speak to Gary Taubes who is a prominent journalist. He has written a number of books. He has been featured in the New York Times. It‟s interesting that we both share very similar passions and have come to the same approach which is essentially we‟re both journalists in the health field. We‟re about the same age.
Gary went to Harvard and Stanford which institutions I have enormous respect for and studied disciplines dear to my heart which is applied physics and aerospace engineering but you wound up getting a journalism degree and then shifted over to health and medicine and nutrition. We actually featured one of your articles nearly 10 years ago on our new site – “What If It‟s All Been a Big Fat Lie?” That was a phenomenally successful article when we had it. That‟s when I first became aware of your information.
Welcome and maybe if you can expand on your journey in health education and understanding and how you came to do what you‟re doing.
GT: Thank you Joe. Thank you for having me. I started off as a science writer. In fact, right out of journalism school obviously because of my background. That‟s what I was most suited to do. I found myself in the 80s writing a lot about – my first book, I lived at the big physics lab outside of Geneva (indiscernible 3:26). I watched some very, very smart physicists discover non-existent elementary particles. They in effect screwed up while I was watching, writing a book about them.
I got obsessed with this question of how hard it is to do science right, to get the right answer and how easy it is to be misled by your evidence. I wrote another book along the same lines about this scientific fiasco in the late 80s called Cold Fusion. I originally taken that book hoping to be able to whip it out in nine months and I became obsessed with this mess of a science. Afterwards, some of my friends in the physics community said, if you are interested in bad science you should look at public health.
So I started doing that and I realized that a lot of the lessons I had learned from good experimental scientists in my other research about how carefully you have to control for variables and how meticulous you have to be with your experimental apparatus and how much attention you have to pay to negative results – the results that don‟t confirm your beliefs. I found were sort of just thrown out the window in a lot of public health research particularly this whole field of what‟s called observational epidemiology we hear a lot. It‟s constantly in the news.
Recently, there was just a study out of Harvard claiming that they can tell what foods make you fat by looking at, in this case, I think it was 70,000 nurses in the Nurse‟s Health Study and saying, the ones who got fat tended to eat these foods and the ones who stayed lean tended to eat these foods. That‟s a causal relationship. A lot of my writing in public health nutrition started off writing about this field of epidemiology.
And then towards the late 90s, I kind of stumbled into first this controversy over whether salt is really the cause of high blood pressure and hypertension. That led me into the science of dietary fat and heart disease and whether a low fat diet is really a healthy diet. I would spend, for both the salt and hypertension story and then the fat heart disease story – both of them were from the Journal of Science – I spent a year on each of those stories.
DM: If I could just interject there because some of our readers are not literate with the scientific literature. The Journal of Science from which you have assimilated your publication is probably considered one of the most prestigious scientific journals in the world along with Nature.
GT: Right. Science and Nature, the two in the harder sciences. That‟s where scientists ideally want to publish their work. Both these journals have news sections. Journalists who work for them and just get to cover science. I actually love writing for science because I could write a level that interests the scientists. I don‟t have to bring it down to a level that the lay public can understand. I have often been accused to failing to do that in my other writing anyway.
One story just led to another. I was fascinated back in 2001 when our knowledge of the obesity epidemic was still relatively fresh. I pitched the story to the New York Times magazine about let‟s see if we can come to some conclusions about what caused the obesity epidemic and that‟s what grew into the story, “What If It‟s Been a Big Fat Lie”.
I had two ideas about what might cause it both from my former research. One was the introduction of high fructose corn syrup in 1977 which pretty much more or less coincides with the beginning of the obesity epidemic.
The other was this institutionalization of the idea that a low fat diet is a healthy diet because when you lower the fat content of the diet, as you know, you‟re going to replace the fat with carbohydrates. And until the 1960s, the conventional wisdom was that carbohydrates were inherently fattening.
One of the articles I quote in my books was from the British Journal of Nutrition article in 1963 written by one of the two leading British dietitians. The first sentence was every woman knows that carbohydrates are fattening.
What happened is we decided that dietary fat caused heart disease and started pushing carbohydrates as sort of heart healthy diet foods and this was institutionalized between
1977 and 1984 so that same time period. In that article, as you know, I kind of concluded that this indeed was the most likely explanation for the obesity epidemic that we took all these foods that everyone inherently believe were fattening and told everyone to eat as much of them as you could.
Foods like yoghurt; we would remove the fat from the yoghurt and replace it with high fructose corn syrup in this case. So you take a little bit of fat out and you put a lot of sugar back. One thing led to another.
That article, as you put it, was very controversial. It got me a big book advance and that allowed me to spend five years of my life working on my first book in this field Good Calories, Bad Calories.
The most recent book “Why We Get Fat” is a kind of airplane reading version of Good Calories, Bad Calories. (indiscernible 9:22) produces 500 or 600 page book with notes and bibliography that was a history of the field in nutrition and chronic disease research and then a revision of science of the field saying this is why we came to believe what we believe today but here is this alternative hypothesis that the carbohydrates were to blame not the fats. Here is what the evidence showed.
But what I didn‟t take into account is that the researchers and the physicians who I wanted to get this book to didn‟t have time or the interest to read a 600-page book suggesting that everything they believed was wrong.
So I boiled it down and then made a more argumentative much more readable version which is the new book.
DM: Excellent. One of the reasons actually that I contacted you is I read your magnificent article earlier this year in the New York Times which was quite honestly the best comprehensive review of the fructose argument. It was just phenomenal. We, of course, featured in our site. I would like you to say a few words on that.
But before you do, I wanted to also comment on the statement you made about the transition from the understanding that carbohydrates were generally recognized by most experts and even lay people that they were fattening. This transition occurred in the 70s. Because you studied this really carefully and looked at the literature for years and this has been your full time job.
It was my understanding that Ancel Keys was kind of like the culprit here. He did some research in the 50s which sort of started that process of getting the scientific community to believe that fats were harmful. It‟s really a pernicious belief as we both I‟m sure are in agreement on.
I‟m wondering if you could really comment on that. Because that is really central to this whole point is to how that happened to make that transition to this low fat nonsense which you eloquently debunked. And then after you addressed that, to give your
impression as to where we are within the scientific community as to not believing that nonsense anymore. Have we really made the transition or is there still the bulk of experts so to speak and scientists believing this craziness?
GT: Let me start with the second one because that‟s the shortest story. If you look at the new My Plate that just came out, the USDA‟s replacement for the food guide pyramid, despite everything it is still a low fat high carbohydrate plate. It maybe better that half the plate is fruits and vegetables but however you interpret it, the Food Guide Pyramid.
I told you earlier, I was in Aspen earlier this week at the Aspen Ideas Festival where I was talking about the sugar issue. There were a lot of bigwigs. I would like to say I was hobnobbing with the upper wizards of the stratosphere.
So I was talking to among others Zeke Emmanuel who is the brother of Rahm Emmanuel. President Obama‟s former – I don‟t know what position he had – technically, he is now mayor of Chicago. Zeke Emmanuel is a very well respected bioethicist at the NIH. He was telling me like how much this My Plate was going to be this great success. It was going fight back obesity because fruits and vegetables were half the plate and this was a big change.
I feel like…how do I say it, but it‟s still mostly carbohydrates and isn‟t the potato a vegetable in America. And it is. It is a starchy vegetable. You could still end up with high glycemic index carbs as the bulk of your diet and you‟re still going to make people fatter and not thinner.
So in general even though there was much more nuances now discussed about omega-3 and omega-6 fats and about the different types of fats and monounsaturated, the general message is still a low-fat message. That‟s what most researchers I would say in this field, most practitioners still believe is the key thing.
I think most patients, if they go into the doctor and they‟re overweight obese so they have high cholesterol or even metabolic syndrome which we both know is a disorder for the most part of carbohydrate metabolism. The doctors are going to say cut your fat intake because they think that‟s how to make people thinner because fat has denser calories.
How did we get here? It‟s fascinating Ancel Keys, you‟re absolutely right, was the culprit. He was a very determined, very zealous University of Minnesota nutritionist who just from the moment he decided that it was cholesterol in the blood that caused heart disease – he was thinking then of total cholesterol, so he got that wrong. And that dietary fat was the cause of the high cholesterol and he probably got that wrong too. He just knew he was right.
So he started pushing this agenda, this hypothesis. Even when he said, I have done no studies to confirm it but still it‟s why we should all low-fat diets. That was the early 1950s. In the late 1950s, the American Heart Association put together a team of experts to analyze the data and they said you just can‟t make these claims. There are no experiments to support it. You can‟t talk about putting Americans on a low fat diet. This was a major article published in the American Heart Association Journal.
Keys‟ way of getting around that was to get himself on to the American Heart Association along with a Chicago-based cardiologist names Jeremiah Stamler who was equally as zealous about this hypothesis.
DM: Is Stamler still alive?
GT: Stamler is still alive.
DM: I didn‟t know he was that old. He started in the 50s. I know he‟s at Northwestern.
GT: When I was doing the salt story – Stamler is the leading proponent of salt. If it wasn‟t for Stamler, the idea that salt causes hypertension never would have happened. There was a guy at Brookhaven. There was a terrible scientist named Louis Dahl. He passed away in the 70s. He had done the only meaningful work on the subject and his science is terrible. Stamler just took it up and embraced and did experiment after experiment or study after study that failed to confirm the effect. He‟s just a terrible scientist.
When I was doing the salt story I got Stamler on the line and I spoke to him for about an hour. Remember, I had done a book on cold fusion and I had talked to some of the worst scientists in the world. I know what a bad scientist sounds like. I put the phone down and I called my editor at Science. I said, I just talked to easily one of the five worst scientists I have ever interviewed in my lengthy career.
Not only did he take credit for getting the American people to eat less salt. He took credit for getting Americans to eat less fat and less eggs also. So when I‟m done with the salt story, I‟m going to do a fat story. I don‟t know what the story is but I know if Stamler was really involved in any substantive way there is a story there.
That was one of the lessons I had learned from my previous research. Bad scientists don‟t get the right answer. Nature isn‟t that kind.
DM: Let‟s go back to where we got interrupted.
GT: 1960s, Ancel Keys, along with Jeremiah Stamler was the early adapter of this hypothesis, got themselves in an ad hoc American Heart Association Committee and came out in effect with their own report which if I remember correctly was maybe three pages long. It said in effect that there was enough evidence to tell Americans at least men at high risk of heart disease that they should eat less salt.
This got a lot of press. It got Ancel Keys on the cover of Time Magazine as a voice of nutritional wisdom in the United States. On that cover, Keys was saying in effect in that cover story – we don‟t really have any evidence but still all American men should cut their salt intake to some exceedingly low number. Again, I forget what it was exactly.
So the American Heart Association embraced this idea before there were any meaningful experiments done. And through the 1960 and into 1970s researchers started doing experiments where they take all these men in different populations. There was a famous one, Veteran Administration Hospital in Los Angeles. There was a study of men in high risk of heart disease in New York. There was one at a Finnish mental hospital.
They would put one group on a low fat or cholesterol-lowering diet which is actually a different thing. If you actually want to lower cholesterol you just don‟t lower the fat content. If you lower the fat content and you increase the carbohydrate content and that will raise triglycerides in the blood stream which shows up as part of the cholesterol number.
DM: If we could just stop there. That maybe a bit confusing for some people listening, you could expand on this – but the concept is there is only three nutrient categories; carbs, proteins, and fats.
If you‟re cutting down fat, you almost have to cut down protein because protein is really almost always associated with fats. It‟s common for it not to be. There is only one other nutrient you can increase and that‟s carbs and most people aren‟t going to eat up a boat load of vegetables.
GT: Right. And even in the 1960s, beginning as early as the late 1950s, researchers who are studying this knew that carbohydrates raised the blood fats called triglycerides which were also linked to heart disease risk. If you really you want to lower cholesterol, you change the proportion of the fats in the diet. You lower the saturated fats and you increase the unsaturated fats.
When they did these studies, on occasion, they could show that people had slightly less heart disease in the group eating this cholesterol-lowering diet but they tended to die just as their – they died at the same age or even they even died a little earlier than the people who weren‟t eating the cholesterol-lowering diets.
When they did epidemiological studies just looking at what people are eating in populations, they found the same mismatching results. Like sometimes lower fat would be associated with longer life but other times, higher fat would be associated with longer life. So what they did which is sort of the mainstay of bad scientists everywhere they only paid attention to the data that agreed with their theory and they ignored the data that didn‟t.
I documented this very carefully in the book in Good Calories, Bad Calories. How they would select that one result and say this confirms our hypothesis even if they had to jump through hoops to do it.
For instance, in one study in Puerto Rico, there was no association between fat consumption in their population and heart disease or mortality. In fact, the people who seem to eat a little more fats, seem to have a little lower mortality. They seem to live a little longer. But carbohydrate content was linked. The more carbs some people ate, the lower the heart disease so therefore this confirmed their theory. So everything was seen as confirming what they called the diet heart theory.
This just kept going through the 70s and they talked about doing the kind of definitive study that you would need to prove it. That study would really give you compelling evidence but that study would cost around a billion dollars even then. So they just decided they weren‟t going to do it and it might get the wrong answer. That‟s what they were afraid of because they might screw up the study. That‟s actually always a legitimate possibility in the clinical trials.
And then it even gets to the point, for instance, the biggest such study ever done was known as the Minnesota coronary survey. That showed that people on the cholesterol-lowering diet had significantly greater mortality than people who were just eating the normal diet that we all eat. So they just never published the study. Or rather, the study was completed around 1972 and they published it, the principal investigator published it I think in 1989 – 17 years later. When I interviewed this fellow later in around 2004 and I asked them why did you wait 17 years to publish the study? He said, we didn‟t like the results.
By selecting out the evidence you like and ignoring the rest and I compared it in my book, you could prove that a coin has one side. If every time you flip it and it lands on tails, you say, that doesn‟t count. Let me flip it again. That‟s in effect what they were doing.
This congressional sub-committee or congressional committee run by George McGovern gets involved and they decide that they‟re going to get involved in the subject of what they call over nutrition and killer diseases which are heart disease and diabetes and cancer. They decided that the people who really know what the truth is are the ones who have been zealously behind the fat hypothesis all along even though there is huge controversy in the scientific community. It‟s completely polarized about whether or not this theory is right.
They decide that they‟re going to tell the entire country to decrease fat content. This was 1977. By they, I don‟t even mean the congressmen, I mean the young staffers who work for the congressman, who are sort of lawyers and journalists.
There was one journalist who wrote the report single handedly who had been a labor reporter for the Providence Rhode Island journal. He got fired from there. He went to work in Washington for a consumer advocacy group. He decided that he wanted to help change the world after seeing documentaries on salmon in Africa. He got a job as the writer for this committee and single single-handedly in effect assimilated the data as he believed it to be.
I met this fellow several times. He‟s a wonderful guy. His heart was completely in the right place. He really wanted to do a good deed. He had no real understanding of science. No real understanding of nutrition and came out with this report that was backed by the committee, big press conference, a huge deal at the time saying that we should all be eating more carbohydrates and less fat. They also said we also should be eating less sugar and more complex carbs but the general message was more carbohydrates less fat.
This was then picked up by the USDA and again, one well meaning administrator there with a background in consumer advocacy. She thought that any scientist who disagreed with this message was basically a waffler. You know these scientists they‟ll never say anything definitively. They want to get more money for their – they‟re always going to tell you more money for research and we have to go with our best guess.
The only way you could get a best guess was by ignoring the fact – there was a best guess which was that dietary fat has no real meaningful influence on heart disease. But if you just ignore the scientists and look at the kind of zealous people like Keys who are making these declarative statements, we know what the truth is. It‟s all about fat then you can come to a consensus and that‟s what they did. And it just built from there.
They funded a couple of huge studies to try and – it‟s not as good as the billion dollar study they wanted to do but some of them thought they would get them close on one study which cost which I think was 125 million dollars or 115 million. The multiple risk factor intervention trial where they took again men at very high risk of heart disease with very high cholesterol like over 290 I think it was. They randomized them into two groups. One got this multiple risk factor intervention. They get counseled to quit smoking and they get a blood pressure lowering medication and they get cholesterol changing diet.
The other group just goes on and lives their life and they run the study for half a dozen years. At the end of it, it turns out that the group with the intervention, with the smoking cessation advice and the cholesterol-lowering diet advice and the blood pressure medication actually had more deaths than the control group. They said, we must have done that study wrong. Remember the key with bad scientists to ignore data that refutes your beliefs.
And they had another big study which was a drug trial. The first major – well, it want the first but the biggest study ever done at the time looking at a cholesterol lowering drug and there they saw some small improvement on mortality. The people on the drug lived longer than the people on the placebo. They just took this leap of faith.
They said that if cholesterol lowering drug can reduce heart disease and make people live longer then a cholesterol-lowering diet must do the same. So they took this drug
trial and they said this speaks to diet too and American over the age of two should be on a low fat diet. This became this iconic famous cover of Time Magazine.
You probably remember it with a plate with a couple of fried eggs for the eyes and the downturned piece of bacon for the frowning mouth. It was heads covered headlined with cholesterol, and now the bad news. And boom, by the mid-1980s we‟re all eating low fat, high carbohydrate diets and hoping desperately to prevent heart disease. By the mid-1980s the Americans start getting fatter and fatter and fatter and everyone was saying it‟s a mystery we don‟t understand why don‟t these fat people listen to us.
DM: Thank for you that detailed history. I certainly got caught up in that in my education training. I finished my family residency training in the mid-80s and bought that whole argument hook, line and sinker because that was really the conventional thinking back then. I personally complied to that. I got my cholesterol level down to 70 I think without drugs. It is by diet. I was crazy. I was killing myself.
GT: We all did. I moved out to Los Angeles in 1988. I never calculated what the fat content of my diet is because I didn‟t think that way but I can‟t tell you how many egg whites, how many hardboiled eggs I peeled and then threw out the yolks. I mean it must be in the many, many thousands. I would eat oatmeal, no butter, no milk and then apple juice on the oatmeal. That was my breakfast with these egg whites. Lunch was fresh pasta with fresh salsa. So there is no fat there. How many skinless chicken breasts I ate and pasta dinners I ate. You‟re hungry all the time when you eat like that. Snacking all the time on brown rice or some other fat free nutrient and the carb content is enormous. You just keep getting sort of heavier and heavier every year.
I lived in LA. I lived near the beach. I was working out about an hour a day because that‟s what you do in Los Angeles. You don‟t go to cafes or go shopping; you go to the gym or go for a run. You‟re getting heavier.
DM: Thank you for expanding on that. I don‟t feel as bad that we were both fooled following this craziness but eventually if you‟re really a seeker of the truth, the truth is going to come out. Science, at its foundation, does figure it out but the problem is as you very eloquently defined is that there are this conflict of interest and these self interest that cause people to ignore negative findings that really can bias these results.
GT: I also think what happens here is there is a sort of mentality – I often call it the Jurassic Park mentality. I don‟t know if you remember the first Jurassic Park movie but about every 10 minutes they would go, “But people are dying out there.” People are dying out there. As we‟re talking, I don‟t know, another 100 Americans have dropped dead from a heart attack. So you got to move fast. You can‟t wait for the definitive evidence to come through.
I would look in the literature and I was always told this by the research. We can‟t dot every I and cross every T. We‟re not like the physicist who studied who wanted to have the time and the patience to reproduce the experiment and make sure they controlled for all the variables. I said, basically, what you‟re saying is you don‟t have the time to figure out whether you‟re really right or not. Because if you don‟t dot every I and cross every T, you don‟t know. That‟s how cruel science is.
But because people are dying out there, we have to move fast. We have to take leaps of faith. We have to jump to conclusions and we have to hope that we‟re right. Unfortunately, all too often, some huge proportion of time when people do that they‟re not right. We‟ve been living with that ever since.
And then what happens is nutritionists embrace it, dieticians embrace it, personal trainers embrace it, people standing on the checkout line next to you have embraced it. It becomes this huge sort of all pervasive dogma. Now it‟s not like – it‟s hard enough if you read the history of science for say 200 physicists to change their mind. But now you‟ve got enormous institutions that have been pushing this dogma.
The American Heart Association, imagine if the American Heart Association, imagine when they decide they were wrong, what do they do? You can‟t just put out a press release saying we apologize for the last 40 years of advice we‟ve been giving you. We apologize if we got a lot of stuff wrong and we killed a lot of your loved ones. We haven‟t killed you yet obviously because you‟re reading the press release but we will. Now, we‟re going to tell you what the real answer is and we have confidence in this one and trust us, we‟re a good source of advice. It just can‟t be done. All that stuff is institutional self interest as well too.
The people in those institutions presented with what psychiatrist would call cognitive dissidence, you know, I‟ve been paying this, I‟ve been believing this for 30 years and now you‟re telling me not only that I was wrong but it‟s the exact opposite and I may have done more harm than good. Most of us when confronted with that situation just say, you know, our brains figure out a way to convince ourselves that we were right all along. So there are all these perfectly human well meaning beliefs that worked in this situation to keep the truth isolated and walled off in this little corner of the world where you and I live. It may be a little more than you. It‟s a tricky business.
DM: Yeah, I couldn‟t agree more and I really thank you for that explanation because it‟s not only true for nutrition with the issues that you‟re describing but also in other areas of health or public health especially ones that we‟re specifically interested in like fluoridation and mercury amalgams and the vaccine issues. These are all areas that really have the same variables you just addressed that contribute to a shift in the consciousness and the thinking that really perpetuates this myth.
GT: Yeah, and then you have the funding mechanisms perpetuate. They tend to fund people who agree with the conventional wisdom. If I was running the universe I would throw out the whole system and start again from scratch with a method of funding and addressing controversies that really work to do just that. That‟s another hour conversation.
We should talk a bit about the fundamental argument that I‟ve been making in my last book, “Why We Get Fat” and that pervades a second half of my first book is this idea of why do we get fat. Do we get fat because we eat too many calories and we‟re just gluttons and because we‟re sedentary?
DM: I definitely wanted you insights on that and that‟s one of the questions I wanted to ask you because my understanding of reviewing the literature is it seems to be – I‟m very curious as to what your thoughts on this is that one of the primary issues is this fructose. It‟s just basic common sense it‟s the number one of source of calories in the United States so it has to be an issue.
GT: It certainly is. The argument I‟ve been making is that we‟re making a fundamental mistake even thinking in terms of the calories. This is one of the places where the obesity…well, it‟s the place for the obesity research community went off the rails. Heart disease research did it with dietary fat and then that spread and affected everything else.
Prior to the Second World War, the European medical researchers had a different conception of what caused obesity. They said, the human body in essence is very well regulated. Every system in the body is very well regulated. Cells will not take up excess energy unless they‟re signaled to do so.
If you think about it, that‟s what insulin does. Insulin says, hey there is too much blood sugar. We have to tell the cells to take up more than they wanted to take up. So that‟s what insulin does. It tells your cells to take up nutrients in effect because there is too much in the blood stream and we‟ll burn some of it off in the lean tissue and we‟ll store some of it in the fat tissue. But you need singling molecules.
Hormones are out there to say take up this, take up that because there is too much of it. So if there is too much fat accumulating in the fat tissue that‟s because the various factors in the body, the hormones, the enzymes, the central nervous system that regulate the uptake of fat by the fat tissue and the release of fat are telling the fat to be taken up and we got to figure what that is. Unfortunately, this European school vanished with the Second World War.
Unlike in physics where we embraced German-Austrian researchers because we had a – there was an arms race going on with the Russians. We had to build nuclear weapons and we had to build rocket ships. So we don‟t really care what language someone spoke or what accent they had, in some cases even whether or not they were Nazis. We embraced them and we learned from them how to do science.
In medical research and public health research, in nutrition, these people were not embraced. They got jobs wherever they could and doing menial jobs in hospitals. So this theory kind of vanished. It was replaced by this idea that it‟s just all about how much you eat and exercise.
And then beginning in the late 1950s, early 1960s, researchers finally had the tools they needed to figure out what regulated fat tissue and they realized it was fundamentally the hormone insulin. When insulin level goes up you store calories as fat and when insulin levels come down you release those calories and tell the lean muscle, the muscle tissues, the organs, to burn back fat.
We secrete insulin in response to the – for all intents and purposes – in response to the carbohydrate content of the diet. You could say the type of carbohydrates and the quantity of carbohydrates more or less regulate our insulin levels. So this led to the concept of carbohydrate restricted diet. But as we talked earlier, if you‟re going to cut fat, you got to add carbohydrates. If you‟re going to cut carbohydrates you got to add fat.
DM: Really no other way around it.
GT: Yeah. Beginning actually the late 1940s and before they unraveled this regulation, they elucidated what regulates our fat accumulation. Physicians started looking at what happened when they put their patients on very carbohydrate restricted high fat diets and they lost weight effortlessly. And then some very successful books were written on this. The most famous was in 1960-61 was Calories Don’t Count by a European-born OB-GYN working in Brooklyn named Herman Taller. And then 11 years later, the Atkins Diet revolution.
They‟re pushing high-fat diets when we‟re beginning to think that dietary fat cause heart disease and the nutrition and heart disease community comes down on them like a ton of bricks saying you guys are killing people. Actually, there was a quote in 1965 New York Times article in which (indiscernible 9:48) the most influential nutritionist of that era in the 1970s says that to recommend a carb restricted diet to patients is equivalent to committing mass murder. That‟s a direct quote.
This was the exact same time actually that researchers had realized that insulin causes fat accumulation. If you want to lower insulin level the way you do it is cut the carbs out of the diet.
We got in this conflict where one of the two hypothesis had to go and like I said, the interesting thing is up until the 1960s for the 150 years previously, the conventional wisdom was that carbohydrates made you fat. One of the things I did in the book – because I read all of them. I probably read 95% of the (indiscernible 10:35) literature from the 1980s back to the 1890s.
You could find articles published in the major medical literature in 1940s and early 50s from doctors at Harvard, Stanford, and Cornell talking about the diet for obesity they used in their hospitals. The first thing you get rid of starches and anything made from flour and sweets and anything made from sugar. And they said you could eat as much as you want of the animal products, you know, meat, fish, fowl, eggs, cheese.
Basically, what they were saying is get rid – they didn‟t realize it in the 40s and 50s but get rid of the foods that stimulate insulin secretion because those were the foods that make you fat and keep the foods that don‟t stimulate insulin secretion, not a lot, considerably less and at a slower rate because those aren‟t fattening. It‟s like if you want to prevent lung cancer you get rid of the cigarettes because they cause lung cancer but you could do anything else you want because it doesn‟t except work around asbestos I guess.
Anyway, this is the alternative hypothesis. It‟s not about how much we eat or exercise. If you‟re getting fat or you have to take in more calories and you expand that. It‟s what the laws of thermodynamics tell us. That‟s always true but certain nutrients affect the hormone insulin that fundamentally regulates fat accumulation and that‟s the carbs.
Getting back to fructose. This is the issue I talked about and that sugar story is the worst that people have been allowed more or less to say about sugar is maybe is it‟s empty calories. White sugar (sucrose) is half glucose, half fructose. And high fructose corn syrup is 55% fructose, 45% glucose. It might actually be a little more. It‟s supposed to be 55-45.
Most human studies have shown, all human studies have shown that the biological effects of these two seem to be identical. So when I talk about sugar I‟m talking right now about both the sort of sugars we use it in, you know, we put it in our tea and our coffee and also high fructose corn syrup.
The glucose molecule goes into our blood steam, simulates insulin secretion and is oxidized and used for fuel by virtually every cell in the body. The fructose is mostly about 90-95 percent metabolized in the liver. It‟s fundamentally different. The pathway by which it‟s metabolized is fundamentally different. The place at which it‟s metabolized is different. It makes the liver do more work than just eating a starch which will break down to glucose only.
The idea and I quote Dr. Robert Lustig who was at the University of California, San Francisco in this lecture he gave at Sugar: The Bitter Truth which was viewed at the time I wrote the article about 900,000 times and the year and a half since it came out. I think now that number has probably close to doubled. The phrase that Lustig uses is isocaloric but not isometabolic which means you can have the same amount of calories from fructose or glucose, or fructose and protein, or fructose and fat but you‟re going to have an entirely different metabolic fate. And that metabolic fate is going to determine the hormonal response and that hormonal response is going to determine among other things how much fat you accumulate.
So this idea that it‟s only about calories that it‟s just all calories are created equal. Well, yeah, in terms of the energy in the calories, yes. That has to be. But in terms of the fate of the nutrient downstream entirely apart from the caloric content, the same amount of calories of different nutrients will have a dramatically different effect.
Fructose, in it‟s way, seems to be the worst carbohydrate because of what it makes the liver do which is convert it into fat. And then you get fat accumulation in the liver. The latest data suggest – I believe it but you really need far more definitive tests than we‟ve seen so far that the fructose content in sugar and then the sugars because of that are the fundamental cause of this condition called insulin resistance.
That‟s where you become resistant to the insulin you secrete so you have to secrete more and more insulin. Insulin resistance is at the heart of this metabolic syndrome and that could be called sort of a paradigmatic disease of Western civilization. It‟s the pathway home.
The metabolic syndrome can be perceived as sort of the step on the way to obesity, the diabetes, the heart disease, and probably even to cancer and likely even to Alzheimer‟s disease. All of these diseases are associated with metabolic syndrome. You‟re at a higher risk if you have metabolic syndrome or you‟re obese or you‟re diabetic.
It looks like sugar could be in effect the fundamental problem with Western diets. I‟m not going to absolve the other refined carbohydrates because I think they can play a role too but it‟s possible that if we never had sugar in our diet – you could go back in history and remove refined sugar. I‟m not talking the small amounts you find in fruit. I don‟t know what the reality is with things like honey and maple syrup because it‟s complicated but just refined sugars where you take the starches in sugarcane or beets or corn and refine and distill them down to all kinds of wonderful chemical process until you have this sort of refined little piece of sweeteners so those refined sugars are the cause of all the chronic disease, the major chronic diseases that kill us in the United States today. And it‟s possible.