Op-Ed: Chewing, and Choking, on False (Nutritional) Equivalence

Nutrition researcher David Katz blasts defenders of saturated fat

A recent lead story on MedPage Today positions the conclusions of a multidisciplinary panel of prominent nutrition researchers -- spelled out in exacting detail across 24 pages in Circulation -- as the intellectual equivalent of the opinion of one journalist whose entire career and following are based on defending the idea that carbohydrate, and insulin responses to it, are the one and only root of all dietary evil. Such false equivalence is gasoline on the fire of post-truth alternative facts, and perpetual confusion.

Contrary to the views expressed by the author in MedPage Today (and their various affiliated publications promoting the same item), the article in Circulationneither gilds the lily, nor mistakes dross for gold. The highly qualified panel readily noted limitations to the literature they reviewed, but reached reliable conclusions based on the overall weight of evidence. Their findings were entirely concordant with recent research they did not cite, by diverse authors, many decisively NOT known for a bias in favor of their conclusions, notably this group, and this group, as well as this group which does include some known partisans.

In my concerned opinion, and with all due respect to my friends at MedPage Today (and yes, I do indeed have actual friends there), I think by propagating the public perception of equivalence between most of the most accomplished people in nutrition and one-journalist-defending-the-theory-on-which-he-has-based-his-career, MedPage is fostering the very thing they are presumably intended to redress: public confusion about the pursuit of health.

The irony, or perhaps hypocrisy in the mix is that the contrarian journalist invokes Francis Bacon to argue against the prevailing conclusions of the nutrition community. The charge is that minds don't change once they have latched onto a conviction. If there is a better example of this than the author, I have not met them. Francis Bacon is surely turning in his grave.

The nutrition community at large has certainly changed its collective mind over the years as new evidence has accumulated. The view that total fat intake, rather than the types and sources of dietary fat, is important was formally abandoned in the 2015 Dietary Guidelines Advisory Committee Report, and was on its way out 5 years prior. Despite the relentless lobbying of the meat and dairy industries, the nutrition community can and does evolve its thinking to keep pace with the flow of evidence. They do not, and certainly should not, abandon the baby with the bathwater just to keep pace with fads, fashions, and the pop culture dietary boondoggles of the hour.

In contrast, iconoclasts are entirely locked into their positions, since their careers and followings are entirely dependent on defense of a fixed position and ideology.

In this particular case, a career was effectively launched with the argument that we had picked the wrong macronutrient -- since we, the American people, had cut our intake of dietary fat but gotten fatter and sicker as a result. The problem with that? Our intake of dietary fat only ever went up, not down -- whether you look here, or here, or here at the trends. Our intake of total calories went up more -- so fat as a percent of total calories trended down slightly.

If anyone is stunned that adding Snackwells to a meal of pepperoni pizza did not alleviate our vulnerability to obesity and diabetes, I would like to discuss the sale of a lovely bridge in Brooklyn.

There are two potential reasons for defending the position that beans, and berries, and broccoli are genuinely good for us- while bacon is not. One is the liability of which Francis Bacon warns. The other is that careful attention to the aggregation of ever more evidence over time proves it to be ... true. I also can't help but note that those arguing against the basic conclusion that health is fostered by diets emphasizing vegetables, fruits, beans, lentils, whole grains, nuts, and seeds rather than meat, butter, and cheese, are reliably, and unforgivably, inattentive to the impact of dietary patterns at scale on the fate of the planet. They are, quite simply, on the wrong side of history.

The public has been fed the false equation of nutrition "opinions" for decades, and we have grown fatter and sicker all the while -- to a parade of redundant scapegoats and silver bullets. Progress toward the crucial, and readily achievable, goals of public health nutrition has been forestalled -- as we have choked for years on distortions, deceptions, predatory profiteering -- and just such false equivalence.

David L. Katz, MD, MPH, is director of the Yale University Prevention Research Center and immediate past-president of the American College of Lifestyle Medicine. This post also appeared on the Huffington Post and Katz's Linkedin blog.

For more viewpoints on the AHA's and Taubes's positions, click here and here.

This article was first published on MedPage Today and reprinted with permission from UBM Medica. Free registration is required