When Fat Makes You Thin
When Joe first saw me he was desperate. At 42 years old he had his first bypass. Terrified he would die before he was 50 years old; he followed his doctor’s advice perfectly. He ate a perfect low fat diet, exercised daily, took an aspirin, a cholesterol lowering medication and a beta-blocker to protect his heart.
After 8 years he once again developed chest pain and went to see his doctor. Another angiogram showed that his new “bypass” arteries had clogged. The doctor performed a procedure call an angioplasty where a balloon is opened inside the artery to correct the blockage. Again his doctor advised him to eat even less fat. Worried for his life, he reduced his fat intake further.
Over the next year he had eight more angioplasties and after each one the doctor advised further reduction in his fat intake. He gained weight after each angioplasty. “Don’t worry” his doctor said, as long as your fat intake is low you will be fine. He complained about the weight gain each time and each time he was reassured. Finally he needed another bypass.
By the time he saw me he was tired, 30 pounds overweight, having night sweats and feeling terrible. I took one look at him and told him that his low fat diet of pasta, rice, bagels and potatoes was killing him. Without ever seeing his blood tests and simply looking at his round belly, and hearing his story, I told him he had a low cholesterol but high triglycerides and a low HDL or good cholesterol from pre-diabetes or insulin resistance. I had him cut out the high glycemic load carbs (quickly absorbed refined carbs), eat more nutrient-rich whole foods including vegetables, fruit, and beans, and add back foods that contained healthy fats including olive oil, nuts, seeds, avocadoes, coconut oil and fish oil into his diet.
Within a few months he had lost 30 pounds, his night sweats were gone, his energy was better than ever and all his blood work was normal. Despite his growing belly, both he and his doctor believed so strongly that fat makes you fat that they missed the obvious.
“Mainstream nutritional science has demonized dietary fat, yet 50 years and hundreds of millions of dollars of research have failed to prove that eating a low-fat diet will help you live longer.”[i]
– Gary Taubes, MD
Diets high in fat do not appear to be the primary cause of the high prevalence of excess body fat in our society, and reductions in fat will not be a solution.”[ii]
- Walter Willett, M.D, Ph.D
- Professor, Harvard School of Public Health
We have been brainwashed to believe that if we eat fat, we will get fat. We hear these messages everywhere we go: “Eat fat and you will gain weight, avoid fat and you will lose weight.”
The government (US Department of Health and Human Services 1988), the American Heart Association (1996), and the American Diabetes Association (1997) have all recommended a low fat diet to prevent and treat obesity. It seems perfectly logical, if you don’t eat fat you won’t gain fat. There’s one problem—science does not support these recommendations.
We have been hoodwinked by shaky science and political lobbying into believing that if we eat fat we will get fat because fat has more calories per gram than carbs (9 vs. 4). But there is more to the story than calories or fat grams.
The American Paradox: We Eat Less Fat, We Gain More Weight
Recently Dr. Walter Willett from Harvard and others have shown that high levels of dietary fat do not promote weight gain, and any weight loss from a low-fat diet is usually modest and temporary. Two studies published in the New England Journal of Medicine[iii] found that a low-carbohydrate diet leads to more weight loss than a low-fat diet.
Over the last 30 years, Americans have tried to get healthy by cutting fat out of their diet. But we have tripled our obesity rate since 1960, and a full two-thirds of our population is presently overweight. We now have a rampant epidemic of diabetes and obesity in children. Because of the obesity epidemic, for the first time this century life expectancy is declining, not increasing so that children of this generation will live sicker and die younger than their parents.[iv]
In the last 40 years, our national fat consumption has decreased from 42% to 34% of our total calories. We’re eating less fat than we ever have (as a percent of total calories), but we’re growing fatter. This is the American Paradox.
One of the major reasons this is the case is because low-fat diets are often rich in starchy or sugary carbohydrates. In our attempts to avoid fat we began to replace “fatty foods” with easy-to-access carbohydrates (white flour, white rice, pasta, potatoes, and sugars are examples). These carbohydrates help temporarily replace the feelings of hunger that are left by a lack of fat in the diet. In addition, they are incredibly easy to produce and distribute, so the food industry has invested a great deal of money and energy in doing so. Now they are nearly ubiquitous in our culture. These types of carbohydrates raise insulin levels, which, in turn, promote weight gain. It is also easier to eat a lot more of them because while fat makes you full, sugar just makes you hungrier. You will learn more about this and other carbohydrate myths in chapter 4.
There is No Evidence That Fat is Bad For You
The great irony in all this is the fact that there is absolutely no scientific evidence to support the idea that a low-fat diet either contributes to weight loss or good health. You may find that a little bit hard to swallow, because the idea is so prominent in our culture. Nonetheless, it’s true. Have a look at the following studies.
Consider the data on the relationship between high-fat diets and heart disease. We all “know” that a high-fat diet causes heart disease. We have been taught that eating fat increases our cholesterol and high cholesterol causes heart attacks. From this information we conclude that decreasing the fat in our diet would lead to fewer heart attacks. But while death from heart disease seems to be dropping, the number of people acquiring heart disease is not. The American Heart Association’s own statistics show that between 1979 and 1996, medical procedures for heart disease have increased from 1.2 million to 5.4 million a year. Heart disease isn’t decreasing with the low-fat diet America has adopted; we are just better at treating heart disease once you have it.
Another famous project, the Lyon Heart Study,[v] had to be stopped prematurely because people eating the low-fat American Heart Association diet were dying, while those eating the healthy higher-fat Mediterranean diet including olive oil, olives, nuts, avocadoes, and fish, were doing fine.
A more recent study[vi] found that over 10 years healthful lifestyle practices in an older population (70-90 year olds) including a higher-fat, Mediterranean diet, moderate physical activity, non-smoking status and moderate alcohol consumption were associated with nearly a 70% reduction in death from ANY cause.
An example that is almost too absurd to believe is the Harvard’s Nurse’s Health Study that involved over 300,000 women studied over a 10-year period to find out if there was any correlation between dietary fat and heart disease. The US government spent nearly $100 million dollars on the study hoping to prove that dietary fat was indeed a killer.
The study ultimately found there was no connection between the two, but the government refused to change public policy that had been built on the idea that a low-fat diet was a healthier way to eat years before the study was complete. Dr. Willet, the lead researcher and spokesperson for the project, even publicly decried the government’s reaction as “scandalous”, but there was no effect. Public policy for a low-fat diet is still on the books to this day though it was adopted without a shred of scientific evidence.
The truly unfortunate part about this scandalous decision is the fact that US policy on low-fat diets has contributed to an epidemic of obesity, diabetes, heart disease, and even cancer related disorders. How? By encouraging Americans to adopt a low-fat diet and recommending in the 1992 USDA Food Pyramid that it’s healthy to eat 6-11 servings of cereal, rice, bread and pasta in place of fat. This pattern of eating has been proven to contribute to every one of these fatal health conditions.
How Pharmaceutical Companies and the Food Industry are Conspiring to Keep you Fat
To make matters worse, the public’s belief in the mythology that surrounds dietary fat has been supported for years by some of the most powerful corporate entities in this country: the pharmaceutical and food industries. The support these people give to a low-fat diet isn’t founded on scientific data anymore than the medical industry’s is. And the unfortunate truth is that there is a great deal of evidence to suggest they have promoted these unfounded, unhealthy beliefs simply for financial gain.
Drug companies would have you believe that “bad” cholesterol, LDL (low density lipoprotein cholesterol), is the single biggest factor in acquiring heart disease. But the truth is that the determining factor is the ratio of your total cholesterol to your “good” cholesterol HDL (high density lipoprotein cholesterol). (There is an easy way to remember which cholesterol is good and which is bad: the “L” in LDL is for lousy, and the “H” in HDL is for happy.)
The pharmaceutical industry promotes this unfounded belief not because there is scientific evidence that supports it, but because the main classes of drugs available for treating high cholesterol are statins, which mostly lower LDL and these drugs are among the biggest selling drugs in history.
The truth is that the ratio between your total cholesterol and your HDL is almost entirely determined by the type and amount of carbohydrates you eat, not by the amount of fat you consume[vii].
The chart below illustrates this point nicely. All the items below the mean value line improves the ratio between your total cholesterol and your HDL. Everything above the line puts it out of balance. If you look at the chart, you will see that carbohydrates are by far the greatest culprit in affecting the ratio between your total cholesterol and your HDL.
“Bad” carbohydrates are a staple of the food industry and the low-fat diet as stated above. Shifting from refined carbohydrates like bread, pasta, rice and sugar in all its forms, to ”good” (healthy) carbohydrates such as vegetables, beans, whole grains and fruit would lead to a dramatic reduction in all the diseases of aging and obesity. But the food industry spends $30 billion a year on advertising to convince us to eat foods that include bad carbohydrates like fast food, sodas, snacks and candy bars. Indeed, can you imagine the loss of profit such companies would endure if they changed their menus from super-sized French fries to fruit? That food industry makes up 12% of our GNP or gross national product – so it is both a health issue and an economic one.
There is only one way to overcome the scandal that surrounds fat in this country. You need to develop a better understanding of what fats do, what fats tell your metabolism, and that not all fats are created equal.
Not All Fats are Created Equal
So are all fats created equal? Fat chance! Some fats are good for you and actually help you lose weight; others make you put it on. As you know from chapter 2, different kinds of food interact with your body in different ways. This holds true for fat. There are certain types of fat that are healthy and certain types that are lethal. The problem is that most of the healthy kinds of fat have been eliminated from our diet, and most of the fats that are lethal are so predominant in the modern day food supply they are hard to avoid.
Whether or not a particular fat is healthy or unhealthy depends largely on the kind of information the fat communicates to your genes. “Good” fats communicate messages of health and weight loss, “bad” fats communicate unhealthy messages that contribute to weight gain.
To communicate these various messages, molecules from fat cells bind to a special receptor on the nucleus of your cells called PPAR.
Different types of fat interact with your PPAR receptors in different ways. Bad fats (see below for more information on different fats) turn off your fat burning genes, making it much harder for you to lose weight. On the other hand, when you consume good fats, they bind to the same PPAR receptor, but these fats turn on genes that increase your metabolism, help you burn fat, and make you more insulin sensitive. (Insulin resistance is a condition where you develop a tolerance to insulin. Generally this is because you eat too many sugars or bad carbs. Doing so is a major contributor to every know degenerative health condition. You want to be insulin sensitive, not insulin resistant. There will be more information on insulin resistance and sensitivity in the next chapter.)
For example, studies have shown that the fat in fish oil, EPA, (a good fat) binds to the PPAR receptor turning on fat burning and improving insulin sensitivity, while trans fats (really bad fats) actually have the exact opposite effect blocking your metabolism and slowing down fat burning.
So here’s the take home message in all this: Eat the right fats and you turn up your fat burning capacity; eat the wrong fats and you switch on genes that make you gain weight and slow down your metabolism. The type of fat you eat is more important than the amount of fat you eat.
The trick is knowing what kinds of fats are “good” and which ones are “bad.”