Low-fat diets were a "global, uncontrolled experiment"


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I have never seen such extreme hyperbole ever in the history of medicine!

The successful attempt to reduce fat in the diet of Americans and others around the world has been a global, uncontrolled experiment…

…except there have been many many controlled experiments. Nutrition isn’t as precise as physics, but there’s loads of evidence culled from hundreds of controlled experiments. Sadly, none of them gives an instant, easy answer, but I notice he didn’t include low-carb in the mass murder category.

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That might be because every study done on low carb has (as the article noted) produced more weight loss and lowered blood pressure.

It also can control (without medication) type 2 diabetes and from other studies has shown to have a strong ‘weight kept off after diet’ affect than calorie reduction.

But I suppose that’s bad for you because ‘fats’ - even though a proper ‘low-carb’ diet still eats carbs and (if following the actual plan) gets 90% of those carbs from vegetables - because low-carb really means just ‘unlimited bacon’ right?


From the article:

From low fat to Atkins and beyond, diets that are based on poor nutrition science are a type of global, uncontrolled experiment…

The article is critical of how diets are sold to the public. Not just critical of low fat diets, but also the Mediterranean and high-fat alternatives that followed. Maybe read past the first section?

Watching this get twisted and misrepresented by Atkins/low-carb/high-fat diet advocates the last few days has been bizarre.


Murder requires the intent to klil. Just sayin’.


And if you read past the introductory blurb:

By far the best of the books I’ve read to write this article is Nina Teicholz’s The Big Fat Surprise, whose subtitle is “Why butter, meat, and cheese belong in a healthy diet.”3 The title, the subtitle, and the cover of the book are all demeaning, but the forensic demolition of the hypothesis that saturated fat is the cause of cardiovascular disease is impressive.


Another consequence of the fat hypothesis is that around the world diets have come to include much more carbohydrate, including sugar and high fructose corn syrup, which is cheap, extremely sweet, and “a calorie source but not a nutrient.” More and more scientists believe that it is the surfeit of refined carbohydrates that is driving the global pandemic of obesity, diabetes, and non-communicable diseases. They dispute the idea that we get fat simply because energy in exceeds energy out, saying instead that the carbohydrates “trigger a hormonal response that drives the portioning of the fuel consumed as storage as fat.” This hypothesis would say that poor people are fat (which is true in many communities) not because they overeat or are particularly lazy but because they consume high levels of refined carbohydrates, the cheapest energy source, which causes them to become fat.


Thinking along these lines led to the diet advocated by the US physician Robert Atkins that drastically restricted carbohydrates but allowed any amount of protein and fat. […] The diet was tested in the A TO Z Weight Loss Study in 311 overweight or obese premenopausal women over a year against three other diets, including that advocated by Dean Ornish, another US physician, which requires that fewer than 10% of energy comes from saturated fat. Women on the Atkins diet lost more weight and “experienced more favourable overall metabolic effects,” including a fall in diastolic blood pressure of 4.4 mm Hg, against 2.1 mm Hg for those on the Ornish diet.

I don’t see how you get from that article to the suggestion that low-carbers are “twisting” or “misrepresenting”. The author simply summarized increasingly-sound scientific evidence that carbohydrates (of which sugars are a subset) cause obesity and its related diseases whereas saturated fats don’t.

To be fair to you, returning to a diet less dominated by carbohydrates and more inclusive of the saturated fats we’d erstwhile consumed for millennia is yet another of the “uncontrolled experiments” to which the author referred. But the evidence suggests to me (as it apparently did to him) that it’s at least the least worst option.


Ben Goldacre is a good man to read here. He is a doctor and particularly hot on TV nutritionists. He is a fun read, and does not rant with occasional lapses when faced with people like Dr Gillian McKeith (PhD). If you have not met him, here’s a good place to start…


Not all nutritionists are dishonest, but a great many of them get mail order qualifications, and give each other degrees and doctorates and professorships. Ben Goldacre got a nutritionist’s degree for his cat Hettie…



The cat was dead at the time. But that’s not really the point. The point is that nutrition is complex, and when and if someone comes up with a verifiable breakthrough, we will all know about it and celebrate. In the meantime, all that seems to be happening is that some people are suggesting random changes in our diet, or some new miracle fruit on the internet, without good science, and gathering anecdotal information from the people who got thinner while probably not hearing from the others that went the other way.


I’m skeptical of all these claims that exactly what you eat matters much. There are healthy societies that eat almost entirely reindeer and almost entirely rice.

Get exercise and don’t eat too much and you won’t get to fat, don’t exercise and eat to much and you will.*

I suspect that the real problem is that food that is to palatable and energy rich, whether fatty or sugary, combined with a relatively sedentary lifestyle induces most people to over eat.

A) carefully control intake
B) exercise a lot
C) have a simple rule that reduces palatability or energy density of your food (eg vegatarianism)
How much an individual has to do this will vary and can change with age.

*some people are highly resistant to over eating genetically, some people are highly susceptible to something (Pima Indians), but most are not highly resistant but are robust to many diets


The article begins with:

So, this whole diet-as-murder trope began with carb restriction. And now low fat diets are getting the same treatment.

How about: Eat a balanced diet; heavy on plants; light on red meat, processed sugar, and hydrogenated fats.

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The strongest point I saw was that manufacturers ramped up the use trans fats (in the form of partially hydrogenated vegetable oils) as a supposedly healthy substitute for naturally occurring saturated fat. Evidence clearly supports that having been a serious mistake. Beyond that, it doesn’t look to me as the rest is clear yet.

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I always find it so weird that the Atkins diet is portrayed as high protein. If you read the book, he advocates a two week period of ketosis followed by what is a pretty standard diet that is low in things like pasta, bread, and other foods made with white flour but high in whole grains - like, literally, every diet I ever read.

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The footnotes in this piece are the expected citations for a scholarly article appearing in a journal such as BMJ. Even in perspective or opinion pieces, the author is expected to support his or her claims with references to the literature.


My friend, who is a fully-qualified RD (who reads up on her journals) told me that dieters should try to include some fat in their diet. Why? It helps with satiety. People have all these weird solutions to weight-loss and maintenance, but the central “trick” is and always has been psychological. Humans are hardwired to eat nutritious food. By evolutionary standards, sugar and fat are AWESOME. Yet every diet is some variation on this theme.

  1. Control input. (Resist temptation while simultaneously increasing it.)
  2. Exercise more. (Generate hunger.)
  3. ???
  4. Profit? (If you can do it, welcome to the world of undoing everything within a year, give or take.)

Meanwhile, obesity just doesn’t seem to be the killer everyone claims it to be. Now, obesity is considered to be a disease in itself. Yet we don’t even have good criteria for measuring it. Even studies that link obesity to specific ailments point out that BMI is a horrible metric. I’m frankly a lot less worried about how much a little lipid dangling off people’s sides is going to hurt them and a lot more worried about the lack of access to care in the United States, combined with rising drug costs


Most people can’t digest lactose in adulthood. Many if not most can’t digest fructose and sugar alcohols. Many can’t break down ethanol as fast as others. Some can’t digest too much fat. Some can’t digest too much protein. Some have allergies.

All these have strong regional differences and have been subject to lethal selective pressures in cultures which rely on one or another as staples.

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Cory, they’re not footnotes, they’re citations.


If you think there have been studies proving the causation of heart disease from dietary fat, you are sorely mistaken. They have done studies again and again trying to prove the connection and they have come up empty every time. Seriously.


Yeah, all the (actual scientific) literature I read seems to point to genetic variations making a big different in what constitutes a healthful diet for an individual, how the body deals with various foods and with excess calories (and whether it turns them into fat), how we burn fat, etc. Although adding unnecessary processed sugar to diets likely didn’t do anyone any good (nor is adding extra processed meat such as bacon such a good idea, either).

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What the hell is low fat caramel? Isn’t caramel just melted sugar?

Caramel, as in candies, is usually made not only with sugar but also cream and butter.


Depends what you mean by “proven.” There certainly are studies that link heart disease and saturated fat, but many of the older studies are now considered to have been poorly done. Although even the most recent meta-study that caused the recently explosion of “Saturated fats are good for you” headlines found a weak link between some of the fatty acids found in meat and palm oils with heart disease.

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