In my latest book, The Fallacy the Calorie: Why the Modern Western Diet Is Killing Us and How to Stop It, I describe some of the original errors that have led to unnecessary, persistent and misdirected campaigns against such dietary constituents as salt and fat. I also discuss in depth another misguided attempt to achieve health by simple caloric reduction. In such an approach fat – and especially saturated fat – is often reduced because it is the easiest and the most expedient way to reduce the caloric content of any meal. The devil is in the details of walking such a path; because as the latest evidence shows, such a path sits upon a house of cards.
A new meta-analysis has examined the research behind the introduction of the dietary fat guidelines in 1977 in the United States and similar guidelines introduced in the United Kingdom in 1983. These guidelines proposed reduction of overall fat consumption to 30% of total energy and to reduce the saturated fat consumption to 10% of total energy intake. Such approaches remain popular and are often adopted by self-styled experts and promulgated to the populace; citing such governmental backing as their raison d’être.
As this new report details, these recommendations were actually made without a single randomized controlled study (RCT), the gold standard for such data acquisition, that actually looked at a 30% total fat and 10% saturated fat diet being performed. Such a course of action affecting the diets of over 276 million people were based on the secondary studies of less than 2500 males. Even worse, such studies showed no difference in all-cause mortality. In other words, even though the goal was to reduce the incidence of coronary artery disease (CAD) and subsequent death by reducing fat – and specifically saturated fat – intake there was no statistically significant difference in the overall death rate or the death rate from cardiovascular disease in the six trials that formed the basis of this governmental dietary strategy.
As for determining the 30% total fat and 10% saturated fat levels, five of the six studies did not even investigate the effects of such an intervention. These studies examined the effects of vegetable oils, the replacement of saturated fats with vegetable oils, and the effects of a 20% fat diet. Only a single RCT examined the effects of a 10% saturated fat diet. It found a higher all-cause mortality rate and a higher CAD mortality in the group consuming the low-fat diet.
Interestingly, there were significant cholesterol reductions in the lower fat group; but that did not result in lower death rates from cardiovascular causes. Although the government issued such paternalistic advocacy on the back of just such a mechanism; lower fat, especially saturated fat yields lower cholesterol which in turn yields lower death rates from CAD; the data from the studies contradicts just such an extrapolation.
And there were warning signs. Dr. Robert Olson of St. Louis University asked then Senator George McGovern (who also oversaw the introduction of the first salt intake guidelines), “for more research on the problem before we make announcements to the American public.” The response was that, “Senators don’t have the luxury that the research scientist does of waiting until every last shred of evidence is in.”
But when it comes to public policy affecting the health of every American, shouldn’t we at least accumulate a pretty irrefutable bulk; if not waiting on the last shreds to form an incontrovertible argument? This most recent research concludes that our “dietary advice not merely needs review; it should not have been introduced.” Despite other studies validating that such demonstrations were premature,, if not outright demagoguery; we still wander lost. We search with artificial, calorie free beverages in one hand and fat free sythno-wraps in the other stuffing our gob precisely because such proclamations have embedded themselves as science fact and conventional wisdom. When, in fact, they are neither-and it appears they never were.
It is but one tale in the story of The Fallacy of The Calorie.
 (Harcombe, et al., 2015)
 (CBS News, 1977)
 (Harcombe, et al., 2015)
 (DiNicolantonio, 2014)
 (Chowdury, et al., 2014)
CBS News. (1977, July 26). Exchange between Dr Robert Olson and Senator George McGovern from The United States Senate Select Committee on Nutrition and Human Needs. Washington, DC, USA.
Chowdury, R., Wamakula, S., Knustsor, S., Crowe, F., Ward, H. A., Johnson, L., . . . DiAngelantonio, E. (2014). Association of dietary, circulating and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Annals of Internal Medicine, 160(6):398-406. doi:10.7326/M13-1788 .
DiNicolantonio, J. J. (2014). the cardio metabolic consequences of replacing saturated fats with carbohydrates or Omega six polyunsaturated fats: did the dietary guidelines have it wrong? Open-Heart, doi:10.1136/openhrt-2013-000032 .
Fenster, M. S. (2014). The Fallacy of The Calorie: Why the Modern Western Diet is Killing Us and How to Stop It. New York, NY: Koehler Books.
Harcombe, Z., Baker, J. S., Cooper, S. M., Davies, B., Sculthorpe, N., DiNicolantonio, J. J., & Grace, F. (2015). Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. open-heart, 2:e000196. doi:10.1136/openhrt-2014-000196.