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on May 13, 2014
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.
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on May 21, 2014
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!
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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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on July 14, 2014
Low Fat Diet darn near killed me!!!! After my heart scan in 1998 my cardiologist put me on low fat diet and 80 mg Lipitor per day
After that I had only 2 pieces of red meat a year, for me it was skim milk, whole grains, no butter, eggs, or cheese, I ate chicken without skin, lots of fish and pasta - Dr said I should have 5 stars as I got my LDL down to 90 - Diagnosed type 2 diabetic spring 2002 told to stay on AHA-ADA low fat diet diet - I did have trouble controlling blood sugar and blood pressure -

In July of 2003 Dr. was so pleased with my cholesterol numbers he wrote me a letter congratulating me and went on to say that if I kept up following his recommendations I probably would not have to worry about any cardiovascular problems - 2 MONTHS LATER I HAD A QUADRUPLE BYPASS!!! WHAT THE HECK????

The surgeon who did the bypass remarked "I DON'T KNOW WHEN THESE DRS ARE GOING TO GET IT - IT'S THE SUGARS AND CARBS NOT THE SATURATED FAT, RED MEAT, BUTTER, FULL CREAM MILK, OR CHEESE - AND I HAVE BEEN TELLING THEM THAT FOR OVER 11 YEARS"!

After the bypass I started doing my own research - and switched to low carb high fat and gained control of blood pressure and sugar.

Sweden in Sept of last year, after 2 years of a doctors special committee examining over 16,000 clinical studies, comparing statured fat, cholesterol and cardiovascular disease - after finding "0", coloration (zip, none, nada) Sweden threw out the low fat diet. SWEDEN NOW RECOMMENDS HIGH FAT LOW CARB DIET AS THE HEALTHIEST (Search: Sweden becomes first Western Nation to reject low fat diet)

Countries in Europe (France, Switzerland etc.) that eat the most saturated fat have THE LOWEST RATES OF HEART DISEASE!

Also in 2009 UCLA medical school released a nationwide survey taken among patients being admitted to emergency rooms with heart attacks: "A new national study has shown that nearly 75 percent of patients hospitalized for a heart attack had cholesterol levels that would indicate they were not at high risk for a cardiovascular event, based on current national cholesterol guidelines.
Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels below 130 that met the then current guidelines, and close to half had LDL levels classified in guidelines as optimal (less than 100 mg/dL)".

Two weeks ago my current cardiologist told me "YOU ARE RIGHT SATURATED FAT HAS NOTHING TO DO WITH HEART DISEASE" as he smiled and shook my hand.

He must have read the new the new research, published on recently in the journal "Annals of Internal Medicine", did not find that people who ate higher levels of saturated fat had more heart disease than those who ate less. Nor did it find less disease in those eating higher amounts of unsaturated fat, including monounsaturated fat like olive oil or polyunsaturated fat like corn oil. "My take on this would be that it's not saturated fat that we should worry about" in our diets, said Dr. Rajiv Chowdhury, the lead author of the new study and a cardiovascular epidemiologist in the department of public health and primary care at Cambridge University.

This book is an excellent read and loaded with provable scientific facts - with over 100 pages of references. The veg heads who wrote the negative reviews have an obvious agenda and probably never read the book and can't just admit they quite possibly have been wrong for years!

There is one more piece to the puzzle you need to read the book "Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life" by Rheaume-Bleue, Kate 1st (first) Edition (11/7/2011)

Get all the information on both sides don't only get one side of the story. Don't just depend on what your doctor tells you, he/she gets their information from the big drug companies.

Read the book and make up your own mind - also TIME magazine had a cover article "Eat Butter" this June that arrives at the same conclusion.

Get the facts - your life depends on it!
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on August 18, 2014
We need a separate review process for the ebooks. The book is amazing, 5-star. Thank you Nina Teicholz. I plowed through it in a week because it was so fascinating and informative.

The bad stars are for the ebook. While the book is nicely formatted and has the illustrations in color, it also has about 75 pages of end-notes, NONE of which are hyperlinked from the text. There are hyperlinks for the end-of-chapter notes, and they work, but the huge number of end-of-book notes are not linked from the text they are footnoting.

You can browse the notes section, which indeed has hyperlinks BACK to the main text, but you can't get from the main text to the notes section that goes with it.

Another demerit for the Kindle version is that this ebook uses the old fashioned "locations" instead of real page numbers.

Come on people, we need usable, clean ebooks.
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on May 22, 2014
Three time in my life I've gone on Atkins, three times I lost 60 lbs, and three times I quit because of the pseudo science fostered by the government that said it was unhealthy. I ignored the reality in front of my eyes.

I have always wondered why Eskimos on their traditional diets don't die from lack of vitamin C. She explained it. Liver has 8 times the vitamin C of apples!

This book is half references from the research obviously done over ten years. You ignore it at your own peril.

So my sorry half German, half English metabolism is finally explained. I'm perfectly evolved for famine, and do not do well in times of continuous plenty, including year round fruits and vegetables and simple carbohydrates.

Read this book - we have suffered from bad food science for fifty years. Science is like justice, it grinds along very slowly, but exceedingly fine.

Got to go, I'm making up some deviled eggs with a side of liverwurst.
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on May 22, 2014
This is a stunning and well researched book that outlines the sad path that led Americans (and a great deal of the world) to follow a diet low in saturated fat -- a diet based on a still unproven and shaky hypothesis linking saturated fat to heart disease. It is certainly a diet that has not delivered on its promise of improved health, but has given us sky-rocketing increases in obesity, heart disease, diabetes, HBP, etc. as well as dreary meals.

Through books by other authors, I'm familiar with many of the incidents of cherry-picked data, false conclusions, missteps, bullying, misrepresentations and outright lies that led to our current dietary recommendations ("Death By Food Pyramid", "Why We Get Fat", "Good Calories, Bad Calories", "Wheat Belly" to name just a few) but Ms. Teicholz does a remarkable job of presenting the details, complete with footnotes, endnotes and one-on-one interviews that underline the facts of this sad tale. She is not giving you her opinion as a few crazed vegans have asserted here - she is a journalist presenting the "what happened", the actual facts that led us to low fat and increased disease.

If you eat....and particularly if you are a woman or a person responsible for the feeding of children, you need to read this book to understand how deeply you have been deceived, the damage you are doing, and what changes you can make to save your & their health.

A personal note: I followed the low saturated fat/high carb advice for many years, all the time getting fatter and more ill. Nearly five years ago - I walked away from those recommendations and began to eat a diet high in saturated fat, low in carbs, with moderate protein. My weight (a high of nearly 200 lbs.) dropped to my current 124, my BP readings are reliably well under 120/80, my skin got glowing, my arthritis has nearly disappeared, all bloodwork is normal, I'm on no medications...and I'm 68 years old. I wish I had realized sooner what a sham the recommendations of our government, the AHA, AMA, etc. are.

You owe it to your health to read this book!
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on July 10, 2014
Angry that we've all been lied to for decades. Angry that the federal government took sides in this debate based on no evidence--or even contrary evidence. Angry that a bunch of bullies were unable to see past their egos and correctly interpret the data before them. But angry mostly because based on these lies, I've spent the majority of my fifty years on this planet starving myself on dry salad and fat-free yogurt, and feeling physically horrible because of it.

I began my (personal) research about the myth of the lipid hypothesis about a year ago after seeing the documentary Fat Head. I don't buy into an idea easily; I have to do a lot of exploratory research before I'll accept something as true. And boy, has my journey into the history of the fat-free diet been illuminating.

After reading Gary Taubes "Good Calories, Bad Calories," I made some changes to my diet, eliminating most carbohydrates and including red meat for the first time in years. I'm hardly ever hungry now; I have energy to spare; my joints don't ache anymore; and I have lost 25 pounds without even trying. Seriously...without lifting a finger above and beyond my normal routines, 25 pounds just fell off. I'm still retraining myself not to recoil at the sight of butter, cheese, and meat (proof at just how brainwashed I was), but it's such a relief not to feel all that guilt anymore. Not to think I have to jog three miles because I had a hamburger and I'm BAD BAD BAD.

And now, Nina Teicholz lays out the astonishing trickery that has likely caused millions of people to suffer heart problems and early death. This book should be required reading for every person on the planet.
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on June 4, 2014
While this is not the first book to expose the facts regarding the low-fat, high carbohydrate dietary guidelines, it is an excellent addition to the growing number of books that go a little deeper into the studies that have been relied upon for our collective well being.

I have read Gary Taubes' Good Calories, Bad Calories, as well as Why We Get Fat, and both books were life changing for me. I immediately came to the realization that my 30 year struggle to lose weight was not because I was lazy, or "doing it wrong," but because I was following fatally flawed advice! I turned to a high fat, low carbohydrate diet and was able to get my weight down 30 lbs., lower than I had been in my 30s, and I am now 62. All my health markers improved, and I've never felt better. I will never go back to a semi-vegetarian, low fat diet ever again.

I expected to find pretty much the same information in Teicholz's book, but I didn't expect to be so hooked! This book reads like a thriller, pushing you to keep reading "just one more page." Truthfully, none of this is surprising, but it can goad one to anger at the total lack of critical thinking by our governmental entities, the food manufacturers, and health professionals who should know better. If you are in the mood to get good and terrified, read the chapter on the vegetable oils that have replaced the trans fats in fast food restaurants. It will chill you to the bone.

The author lays out the facts about how we were essentially conned into thinking that the science was all wrapped up in a pretty ribbon, when in fact, the gift box was empty.

Having tried every diet out there for the past 30 years, I am convinced that had I not paid attention to the prevailing dietary guidelines, I may never have gained the excess weight in the first place. It wasn't until I actually focused on all those whole grains and boneless, skinless chicken breasts that I started gaining weight.

The Big Fat Surprise is a great addition to the growing roster of books that lay out the truth of the dietary disaster that is our current paradigm.
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on June 3, 2014
Ancel Keys certainly started something big. His "Seven Countries Study" was the modern basis for the hypothesis that saturated fat and corresponding blood cholesterol levels are predictive, if not directly causative, of heart disease, particularly atherosclerosis ("clogging of the arteries"). This hypothesis has been the basis for official government public health policy to reduce saturated fat intake and dietary cholesterol and replace them with carbohydrates or (more recently) polyunsaturated fats from seed oils, such as corn and safflower. Commercial interests support this effort with all sorts of "Fat-Free" and "Cholesterol-Free" foods, foods your grandmother (certainly your great grandmother) never heard of.

The Diet-Heart hypothesis has had scientific critics from the get-go, but their voices were easily drowned out by exponents of the dominant view. Alternative perspectives, such as John Yudkin's proposal that sugar should be viewed as the dietary bad guy, never gained much traction, while Robert Atkins' low carbohydrate (and correspondingly higher fat) diet was attacked as dangerous to the public health.

But the accumulation of scientific data from randomized control trials (RCTs) demonstrating the validity of the Diet-Heart Hypothesis has been sparse and conflicting at best. Gary Taubes' Good Calories, Bad Calories (reprinted as a paperback in 2008) summarized the evidence (and counter-evidence) and found the hypothesis lacking. If Taubes' was (is) correct, then we, the eating public, have been led astray for the past 40 years or so--with no obvious improvement in the incidence of cardiovascular disease along with a noticeable rise in diabesity--among the so-called "diseases of civilization."

Taubes opened the gate to a flood of new books and articles arguing this dietary emperor has no scientific clothes, despite the insistence of governmental (USDA) and scientific organizational (American Heart Association, for example) loyal subjects that the Hypothesis's garb is golden indeed, and always has been.

Nina Teicholz is the latest to review and summarize the scientific, governmental, political, and commercial history of the "Diet-Heart Hypothesis" and to lay out it's (fatal?) inadequacies. Sure, she covers ground previously illuminated by Taubes and other writers. But she does so with crisp, understandable prose, the perspective of a persistent investigative reporter, and illuminating summaries of interviews she conducted with some of the still-living proponents (and critics) of our dietary policies.

I strongly recommend this book to readers for whom all this is new, or mostly new, stuff. You will be informed, and you can--if desired--follow up with reading of the detailed references Teicholz provides.

Many of us have, over the years, heard the mantras of the Diet-Heart Hypothesis so often, from so many trusted sources (your personal physician, for example), that it is almost impossible to conceive that it may be very, very wrong. But scientific accuracy and truth are not decided by either popular vote or authoritative pronouncements. Instead, the evidence from the best scientific research--however imperfect or incomplete--should be heeded and incorporated into our plans for healthy living (and eating).

The skepticism associated with a scientific perspective can be unsettling ("Is there nothing that is permanently true?"), but we all could use at least a dose of it from time to time. In this connection, Michael Bracken's quotation on the guidelines for the Oxford Tutorial (from his book on epidemiology, Risk, Chance, and Causation) might apply:

"No beliefs are unquestionable, no statement is safe from scrutiny, no evidence is incontrovertible, and no conclusion is inescapable."
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