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The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet, by Nina Teicholz
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A New York Times bestseller
Named one of The Economist’s Books of the Year 2014
Named one of The Wall Street Journal’s Top Ten Best Nonfiction Books of 2014
Kirkus Reviews Best Nonfiction Books of 2014
Forbes’s Most Memorable Healthcare Book of 2014
Named a Best Food Book of 2014 by Mother Jones
Named one of Library Journal's Best Books of 2014
In The Big Fat Surprise, investigative journalist Nina Teicholz reveals the unthinkable: that everything we thought we knew about dietary fat is wrong. She documents how the low-fat nutrition advice of the past sixty years has amounted to a vast uncontrolled experiment on the entire population, with disastrous consequences for our health.
For decades, we have been told that the best possible diet involves cutting back on fat, especially saturated fat, and that if we are not getting healthier or thinner it must be because we are not trying hard enough. But what if the low-fat diet is itself the problem? What if the very foods we’ve been denying ourselves—the creamy cheeses, the sizzling steaks—are themselves the key to reversing the epidemics of obesity, diabetes, and heart disease?
In this captivating, vibrant, and convincing narrative, based on a nine-year-long investigation, Teicholz shows how the misinformation about saturated fats took hold in the scientific community and the public imagination, and how recent findings have overturned these beliefs. She explains why the Mediterranean Diet is not the healthiest, and how we might be replacing trans fats with something even worse. This startling history demonstrates how nutrition science has gotten it so wrong: how overzealous researchers, through a combination of ego, bias, and premature institutional consensus, have allowed dangerous misrepresentations to become dietary dogma.
With eye-opening scientific rigor, The Big Fat Surprise upends the conventional wisdom about all fats with the groundbreaking claim that more, not less, dietary fat—including saturated fat—is what leads to better health and wellness. Science shows that we have been needlessly avoiding meat, cheese, whole milk, and eggs for decades and that we can now, guilt-free, welcome these delicious foods back into our lives.
- Sales Rank: #8560 in Books
- Published on: 2015-01-06
- Released on: 2015-01-06
- Original language: English
- Number of items: 1
- Dimensions: 9.00" h x 1.20" w x 6.00" l, 1.10 pounds
- Binding: Paperback
- 496 pages
Review
"Teicholz may be the Rachel Carson of the nutrition movement..." (Leah Binder Forbes)
“Solid, well-reported science… Like a bloodhound, Teicholz tracks the process by which a hypothesis morphs into truth without the benefit of supporting data.” (Kirkus Reviews (Starred Review))
"Nina Teicholz reveals the disturbing underpinnings of the profoundly misguided dietary recommendations that have permeated modern society, culminating in our overall health decline. But The Big Fat Surprise is refreshingly empowering. This wonderfully researched text provides the reader with total validation for welcoming healthful fats back to the table, paving the way for weight loss, health and longevity." (David Perlmutter, MD, author of the #1 New York Times bestseller Grain Brain: The Surprising Truth About Wheat, Carbs)
"A page-turner story of science gone wrong: what Gary Taubes did in Good Calories, Bad Calories for debunking the connection between fat consumption and obesity, Nina Teicholz now does in Big Fat Surprise for the purported connection between fat and heart disease. Misstep by misstep, blunder by blunder, Ms. Teicholz recounts the statistical cherry-picking, political finagling, and pseudoscientific bullying that brought us to yet another of the biggest mistakes in health and nutrition, the low-fat and low-saturated fat myth for heart health." (William Davis, MD, author of the #1 New York Times bestseller Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Bac)
"At last the whole truth about the luscious foods our bodies really need!" (Christiane Northrup, M.D., ob/gyn physician and author of the New York Times bestseller Women's Bodies, Women's Wisdom)
"This meticulously researched book thoroughly dismantles the current dietary dogma that fat--particularly saturated fat--is bad for us. Teicholz brings to life the key personalities in the field and uncovers how nutritional science has gotten it so wrong. There aren't enough superlatives to describe this journalistic tour de force. I read it twice: once for the information and again just for the writing." (Michael R. Eades, M.D., author of the New York Times bestseller Protein Power)
"The Big Fat Surprise delivers on its title, exposing the shocking news that much of what “everybody knows” about a healthy diet is in fact all wrong. This book documents how misunderstanding, misconduct and bad science caused generations to be misled about nutrition. Anyone interested in either food or health will want to read to this book." (Nathan Myhrvold, author of Modernist Cuisine)
"Teicholz has done a remarkable job in analysing. . . [the] weakscience, strong personalities, vested interests, and political expediency." (British Medical Journal)
"Thisis the most provocative and assumption-shredding food book I've read inyears.... All in all, a must read." (Tom Phillpot Mother Jones)
"It's so important for everyone to read this book." (Alice Waters)
About the Author
Nina Teicholz has written for Gourmet magazine, The New Yorker, The Economist, The New York Times, and The Washington Post. She also reported for National Public Radio. She lives in New York with her husband and two sons.
Excerpt. © Reprinted by permission. All rights reserved.
The Big Fat Surprise Introduction
I remember the day I stopped worrying about eating fat. It was long before I started poring over thousands of scientific studies and conducting hundreds of interviews to write this book. Like most Americans, I was following the low-fat advice set forth by the US Department of Agriculture (USDA) in its food pyramid, and when the Mediterranean diet was introduced in the 1990s, I added olive oil and extra servings of fish while cutting back further on red meat. In following these guidelines, I was convinced that I was doing the best I could for my heart and my waistline, since official sources have been telling us for years that the optimal diet emphasizes lean meats, fruits, vegetables, and grains and that the healthiest fats come from vegetable oils. Avoiding the saturated fats found in animal foods, especially, seemed like the most obvious measure a person could take for good health.
Then, around 2000, I moved to New York City and started writing a restaurant review column for a small paper. It didn’t have a budget to pay for meals, so I usually ate whatever the chef decided to send out to me. Suddenly I was eating gigantic meals with foods that I would have never before allowed to pass my lips: pâté, beef of every cut prepared in every imaginable way, cream sauces, cream soups, foie gras—all the foods I had avoided my entire life.
Eating these rich, earthy dishes was a revelation. They were complex and remarkably satisfying. I ate with abandon. And yet, bizarrely, I found myself losing weight. In fact, I soon lost the 10 pounds that had dogged me for years, and my doctor told me that my cholesterol numbers were fine.
I might have thought no more about it had my editor at Gourmet not asked me to write a story about trans fats, which were little known at the time and certainly nowhere near as notorious as they are today. My article received a good deal of attention and led to a book contract.
The deeper I dug into my research, however, the more I became convinced that the story was far larger and more complex than trans fats. Trans fats seemed to be merely the latest scapegoat for the country’s health problems.
The more I probed, the greater was my realization that all our dietary recommendations about fat—the ingredient about which our health authorities have obsessed most during the past sixty years—appeared to be not just slightly offtrack but completely wrong. Almost nothing that we commonly believe today about fats generally and saturated fat in particular appears, upon close examination, to be accurate.
Finding out the truth became, for me, an all-consuming, nine-year obsession. I read thousands of scientific papers, attended conferences, learned the intricacies of nutrition science, and interviewed pretty much every single living nutrition expert in the United States, some several times, plus scores more overseas. I also interviewed dozens of food company executives to understand how that behemoth industry influences nutrition science. The results were startling.
There’s a popular assumption that the profit-driven food industry must be at the root of all our dietary troubles, that somehow food companies are responsible for corrupting nutrition recommendations toward their own corporate ends. And it’s true, they’re no angels. In fact, the story of vegetable oils, including trans fats, is partly about how food companies stifled science to protect an ingredient vital to their industry.
Yet I discovered that on the whole, the mistakes of nutrition science could not primarily be pinned on the nefarious interests of Big Food. The source of our misguided dietary advice was in some ways more disturbing, since it seems to have been driven by experts at some of our most trusted institutions working toward what they believed to be the public good.
Part of the problem is easy to understand. These researchers ran up against an enduring problem in nutrition science, which is that much of it turns out to be highly fallible. Most of our dietary recommendations are based on studies that try to measure what people eat and then follow them for years to see how their health fares. It is, of course, extremely difficult to trace a direct line from a particular element in the diet to disease outcomes many years later, especially given all the other lifestyle factors and variables at play. The data that emerge from these studies are weak and impressionistic. Yet in the drive to fight heart disease (and later obesity and diabetes), these weak data have had to suffice. And this compromise by researchers appears to have driven many of nutrition policy’s failures: well-intentioned experts, hastening to address growing epidemics of chronic disease, simply overinterpreted the data.
Indeed, the disturbing story of nutrition science over the course of the last half-century looks something like this: scientists responding to the skyrocketing number of heart disease cases, which had gone from a mere handful in 1900 to being the leading cause of death by 1950, hypothesized that dietary fat, especially of the saturated kind (due to its effect on cholesterol), was to blame. This hypothesis became accepted as truth before it was properly tested. Public health bureaucracies adopted and enshrined this unproven dogma. The hypothesis became immortalized in the mammoth institutions of public health. And the normally self-correcting mechanism of science, which involves constantly challenging one’s own beliefs, was disabled. While good science should be ruled by skepticism and self-doubt, the field of nutrition has instead been shaped by passions verging on zealotry. And the whole system by which ideas are canonized as fact seems to have failed us.
Once ideas about fat and cholesterol became adopted by official institutions, even prominent experts in the field found it nearly impossible to challenge them. One of the twentieth century’s most revered nutrition scientists, the organic chemist David Kritchevsky, discovered this thirty years ago when, on a panel for the National Academy of Sciences, he suggested loosening the restrictions on dietary fat.
“We were jumped on!” he told me. “People would spit on us! It’s hard to imagine now, the heat of the passion. It was just like we had desecrated the American flag. They were so angry that we were going against the suggestions of the American Heart Association and the National Institutes of Health.”
This kind of reaction met all experts who criticized the prevailing view on dietary fat, effectively silencing any opposition. Researchers who persisted in their challenges found themselves cut off from grants, unable to rise in their professional societies, without invitations to serve on expert panels, and at a loss to find scientific journals that would publish their papers. Their influence was extinguished and their viewpoints lost. As a result, for many years the public has been presented with the appearance of a uniform scientific consensus on the subject of fat, especially saturated fat, but this outward unanimity was only made possible because opposing views were pushed aside.
Unaware of the flimsy scientific scaffolding upon which their dietary guidelines rest, Americans have dutifully attempted to follow them. Since the 1970s, we have successfully increased our fruits and vegetables by 17 percent, our grains by 29 percent, and reduced the amount of fat we eat from 43 percent to 33 percent of calories or less. The share of those fats that are saturated has also declined, according to the government’s own data. (In these years, Americans also began exercising more.) Cutting back on fat has clearly meant eating more carbohydrates such as grains, rice, pasta, and fruit. A breakfast without eggs and bacon, for instance, is usually one of cereal or oatmeal; low-fat yogurt, a common breakfast choice, is higher in carbohydrates than the whole-fat version, because removing fat from foods nearly always requires adding carbohydrate-based “fat replacers” to make up for lost texture. Giving up animal fats has also meant shifting over to vegetable oils, and over the past century the share of these oils has grown from zero to almost 8 percent of all calories consumed by Americans, by far the biggest change in our eating patterns during that time.
In this period, the health of America has become strikingly worse. When the low-fat, low-cholesterol diet was first officially recommended to the public by the American Heart Association (AHA) in 1961, roughly one in seven adult Americans was obese. Forty years later, that number was one in three. (It’s heartbreaking to realize that the federal government’s “Healthy People” goal for 2010, a project begun in the mid-1990s, for instance, was simply to return the public back to levels of obesity seen in 1960, and even that goal was unreachable.) During these decades, we’ve also seen rates of diabetes rise drastically from less than 1 percent of the adult population to more than 11 percent, while heart disease remains the leading cause of death for both men and women. In all, it’s a tragic picture for a nation that has, according to the government, faithfully been following all the official dietary guidelines for so many years. If we’ve been so good, we might fairly ask, why is our health report card so bad?
It’s possible to think of the low-fat, near-vegetarian diet of the past half-century as an uncontrolled experiment on the entire American population, significantly altering our traditional diet with unintended results. That may sound like a dramatic assertion, and I never would have believed it myself, but one of the most astonishing things I learned over the course of my research was that for thirty years after the low-fat diet had been officially recommended and we were taking its supposed benefits for granted, it had not been subjected to a large-scale, formal scientific trial. Finally, there was the Women’s Health Initiative (WHI), a trial that enrolled 49,000 women in 1993 with the expectation that when the results came back, the benefits of a low-fat diet would be validated once and for all. But after a decade of eating more fruits, vegetables, and whole grains while cutting back on meat and fat, these women not only failed to lose weight, but they also did not see any significant reduction in their risk for either heart disease or cancer of any major kind. WHI was the largest and longest trial ever of the low-fat diet, and the results indicated that the diet had quite simply failed.
Now, in 2014, a growing number of experts has begun to acknowledge the reality that making the low-fat diet the centerpiece of nutritional advice for six decades has very likely been a bad idea. Even so, the official solution continues to be more of the same. We are still advised to eat a diet of mostly fruits, vegetables, and whole grains with modest portions of lean meat and low-fat dairy. Red meat is still virtually banned, as are whole-fat milk, cheese, cream, butter, and, to a lesser extent, eggs.
A line of argument in favor of eating these whole-fat animal foods has sprung up among cookbook authors and “foodies,” who can’t believe that all the things their grandparents ate could really be so bad for them. There are also the Paleo eaters, who swap information on Internet blogs and survive on little else but red meat. Many of these recent animal foods devotees have been inspired by the doctor whose name is most closely associated with the high-fat diet: Robert C. Atkins. As we will see, his ideas have endured to a surprising extent and have been the subject of a great deal of scholarship and scientific research in recent years. But newspapers still carry alarming headlines about how red meat causes cancer and heart disease, and most nutrition experts will tell you that saturated fat is absolutely to be avoided. Hardly anyone advises otherwise.
In writing this book, I had the advantage of approaching the field as a scientifically minded outsider free from affiliation with or funding from any entrenched views. I’ve reviewed nutrition science from the dawn of the field in the 1940s up until today to find the answer to the questions: Why are we avoiding dietary fat? Is that a good idea? Is there a health benefit to avoiding saturated fat and eating vegetable oils instead? Is olive oil truly the key to a disease-free long life? And are Americans better off having attempted to rid the food supply of trans fats? This book does not offer recipes or specific dietary recommendations, but it does arrive at some general conclusions about the best balance of macronutrients for a healthy diet.
In my research I specifically avoided relying upon summary reports, which tend to pass along received wisdoms and, as we’ll see, can unwittingly perpetuate bad science. Instead, I’ve gone back to read all the original studies myself and in some cases have sought out obscure data that were never intended to be found. This book therefore contains many fresh and often alarming revelations about flaws in the foundational work of nutrition as well as the surprising ways in which it was both ill-conceived and misinterpreted.
What I found, incredibly, was not only that it was a mistake to restrict fat but also that our fear of the saturated fats in animal foods—butter, eggs, and meat—has never been based in solid science. A bias against these foods developed early on and became entrenched, but the evidence mustered in its support never amounted to a convincing case and has since crumbled away.
This book lays out the scientific case for why our bodies are healthiest on a diet with ample amounts of fat and why this regime necessarily includes meat, eggs, butter, and other animal foods high in saturated fat. The Big Fat Surprise takes us through the dramatic twists and turns of fifty years of nutrition science and lays out the evidence, so that a reader can fully understand the evidence to see for him- or herself how we arrived at our present understanding. At its heart, this book is a scientific investigation, but it is also a story about the strong personalities who corralled colleagues into believing their ideas. These ambitious, crusading researchers launched the entire American population, and subsequently the rest of the world, on the low-fat, near-vegetarian diet, a regime that ironically may have directly exacerbated many of the ills it was intended to cure.
For all of us who have spent much of our lives believing and following this diet, it is of vital importance to understand how and what went wrong, as well as where we might go from here.
Most helpful customer reviews
629 of 671 people found the following review helpful.
Destined to change the national conversation about what constitutes a "healthy" diet
By Adam
Okay, look. I'm about as biased a reviewer as you can get. I read Gary Taubes' Good Calories Bad Calories in 2008 and was so moved by it that I radically overhauled my diet and started writing and researching about nutrition and obesity as a hobby.
So when I had the opportunity to review an advance copy of Nina Teicholz's Big Fat Surprise, I assumed I would enjoy it and agree with her conclusions... but I was in no way expecting to be so surprised and delighted by it... and so infuriated by the nasty nutrition politics that she exposes.
Could a single man, Ancel Benjamin Keys, indirectly be responsible for more mayhem than any other figure from the 20th century?
Was Keys' so-called “diet-heart hypothesis” -- which convinced a generation to eschew eating fat and turn instead to sugar, carbohydrate and processed vegetable oils -- one of the most deadly ideas of modern civilization?
These and other troubling thoughts can’t help but bubble to mind as you read Teicholz's nutritional thriller.
I’ll get to the juicy details in a second. But first, the overview:
In the middle of the 20th century, thanks to Ancel Keys and several other arrogant researchers, we began to fear dietary fat as an agent of heart disease and other ills. So we revised our diet to be “healthier” and wound up, ironically, suffering through profound epidemics of obesity, type 2 diabetes and other metabolic diseases as a result.
Teicholz’s lucid summary of this disaster, The Questionable Link Between Saturated Fat and Heart Disease, was the #1 most read editorial in a recent issue of the Wall Street Journal. Her piece prompted conservative pundit, Rush Limbaugh, to do a lengthy expose on his talk show about the low fat diet myth.
I hesitate to be optimistic, but we may be witnessing a wave of mainstream support for Teicholz and Taubes’ signature ideas about nutrition and health.
In addition to Limbaugh’s harangue against Keys and the low fat diet, Dr. Oz — arguably the most influential doctor on TV — recently admitted that he was “wrong” about saturated fat being dangerous. Guest appearances by Dr. Peter Attia and Dr. David Perlmutter on Oz’s show also attest to Oz’s change of heart.
Meanwhile, documentarian Morgan Spurlock (of Supersize Me fame) recently admitted: “I am not eating carbohydrates, no bread, no pasta, no sugar. I feel better than I ever have.”
Katie Couric’s new documentary, Fed Up, which opens this weekend (as I write this review), also calls B.S. on the low fat high sugar diet and questions the idea that all calories are equal.
And a massive meta-analysis of 72 studies published in February in the Annals of Internal Medicine ,which exonerated saturated fat in no uncertain terms, is just the latest in a growing fusillade of attacks on the conventional “eat less fat and more carbs” nonsense.
We’ve still got a long road ahead, though, and many misconceptions persist. That’s one of the reasons Teicholz’s book is so important.
Interview with Jeremiah Stamler
Stamler was a colleague and contemporary of Keys, and he and Keys advocated aggressively for the diet-heart hypothesis. Stamler led the Multiple Risk Factor Intervention Trial (MRFIT), a $115 million dollar experiment carried out from 1973-1982. It was a catastrophic failure for the diet-heart hypothesis, as Teicholz describes, yet its failure changed nothing about how the nutrition establishment operated.
In an interview with Stamler, she pointed out the following paradox: a 1997 follow up to MRFIT found that the treatment group had higher rates of lung cancer than the control group did, despite the fact that 21% of the treatment group had quit smoking compared with 6% of the control group. Stamler responded: “I don’t know! That could be a chance find… it’s just one of those findings. Troublesome. Unexpected. Not explained. Not rationalized!”
Fascinating stuff.
Slaying Dean Ornish’s Cherished Study Claiming That His Diet “Reversed” Heart Disease
Teicholz also interviewed Dean Ornish, the most celebrated modern advocate of low fat diets, and analyzed the study that made him a nutritional star. A 1998 article published in the Journal of the American Medical Association (JAMA) helped make Ornish a household name. But this study was PLENTY flawed and got outsized pressed.
Teicholz writes: “Curious about the findings, I called Key Lance Gould, director of cardiology at the University of Texas, who helped Ornish launch his research career and was a co-author with Ornish on the JAMA papers…. On the phone, I could almost hear Gould’s incredulity over how Ornish promoted their study results. ‘Most people do a study and get one paper. Dean does one study and gets a bunch of papers. There’s a certain skill in marketing a small little piece of data. He’s really a genius at PR.’”
Fascinating Critical Reappraisal of Olive Oil and the Mediterranean Diet
We all “know” olive oil is one of the healthiest substances known to humanity. Right? Well, how did these beliefs develop, and is there good science to back them up? Teicholz’s explosive expose on the origins of the Mediterranean Diet and our (modern) fetishization for olive oil will blow your mind.
Here’s a nice gem: “…when [famous Harvard University nutrition professor] Walter Willett unveiled the Mediterranean pyramid in 1993, no controlled clinical trials of the diet had ever been done.”
The Scary Rise of Soybean Oil
Teicholz recounts the bizarre story of multimillionare, Philip Sokolof, who bought a full page ad in the New York Times in 1988 trumpeting “THE POISONING OF AMERICA” by saturated fats.
She also reveals a deeply disturbing graph published in the American Journal of Clinical Nutrition showing how soybean oil consumption has skyrocketed. “Americans now eat over 1,000 times more soybean oil than they did in 1909, the biggest change in the American diet.”
I could go on. The book is a brilliant whodunnit, and I cannot recommend it highly enough. Stop. Do not pass go: get your copy NOW.
181 of 193 people found the following review helpful.
Upend the Food Pyramid and Eat!
By Dean Freedman
The Big Fat Surprise is not a diet book or a book about dieting, though you will learn a lot about what you should and shouldn't eat if you read it. It's more of an exposé on how today's diet recommendations came to be and why they're so out of whack with reality and actual scientific research.
The basic conclusion is that we should eat more fat and protein and fewer carbohydrates. That will help keep us healthy and lean.
Important points the author brings out:
- Our misunderstanding and misuse of cholesterol measurements often drives treatments and diet changes that are unnecessary and counterproductive.
- Carbohydrates, even complex carbs (like those found in whole wheat products), are unhealthy when eaten in large quantities.
- Overall, a diet based on meat (fatty is better than lean), eggs, and full-fat dairy products, including real butter, is better for you than one based on breads, cereals, potatoes, corn, rice, and sugary products (even fruit). This type of high-fat diet will also help you keep your weight down, believe or not.
- Overuse of vegetable oils in restaurants, especially for deep-frying, could be especially bad for our health.
As the author points out, we tend to jump to conclusions based on hype and promotion instead of science and long-term research. The Big Fat Surprise brings to light the results of the best, most current research and lays it out for you so you can make your own decisions about what, and what not, to eat. I'm having bacon & eggs!
228 of 253 people found the following review helpful.
What? That fatty steak may be good for me? I'm blown away by the impeccable research and fact presentation in this book.
By Ryan J. Dejonghe
What can I say? I’m blown away by the impeccable research and fact presentation in this book. At first, I thought this would be a mildly interesting book with some interesting insight. Nope. Nina Teicholz brought out the big guns. She lays out her well substantiated thesis and systematically digs in. She “specifically avoided relying upon summary reports which tend to pass along received wisdoms” and she went “back to read all the original studies…in some cases [seeking out] obscure data”. In other words, she meticulously lays out the evidence, slam dunking the point: fat ain’t bad.
My first instinct for a book that venerablizes one food would villainize another. This sort of happens here; those villains being: sugar, white flour, and refined carbohydrates. Most modern health articles seem to easily coincide with this. More paradoxical: “Our rush to banish animal fats from our diet has exposed us to the health risks of trans fats and oxidizing vegetable oils.” This oxidization of vegetable oils was the big one for me.
Now, about that yummy fat. Teicholz goes through the history of fat research, presenting hundreds of footnotes, showing previous cases of extreme selection bias, selective reporting, and overlooking of methodological problems. Furthermore, these clunky studies were presented to the public by the AHA since 1961 and adopted by the USDA in 1980 as health recommendations. Time magazine put it on their front cover, newspapers proclaimed the goodness of low-fat diets, and everyone bought in wholeheartedly.
Teicholz turns that tide through her research, not only using the source material, but often going back to interview the original researchers. She proves with the latest and thorough studies “that a higher-fat diet is almost assuredly healthier in every way than one low in fat and high in carbohydrates.” And she doesn’t just leave it there. She includes a plethora of follow-up information and resource links for you to continue your own fact-finding.
So, yeah, maybe that “steak salad is preferable to a plate of hummus and crackers.” Maybe “a snack of full-fat cheese is better than fruit.” Sounds ludicrous, right? After reading through this well-presented book of studies, don’t be so sure. It makes more sense than ever.
Thanks to Simon & Schuster for providing me an electronic review copy of this book.
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