It’s Not the Fat That Makes Us Unhealthy
***This is a re-post of Dr. Lundberg’s note found at MedScape it is also in video but you need to have an account to see it. The re-post is based on copy-paste, with link to the original. There is nothing added or subtracted from his comment. Here is what he said and wrote. Since this entire piece is a quote, I am not placing quotation around it. Just understand that it is not me talking here:
George D. Lundberg, MD
August 24, 2018
Hello and welcome. I am Dr George Lundberg, and this is At Large at Medscape. Today I am in my angry-old-man persona. I often write about nutrition and disease. And I usually admit in advance to knowing little about nutrition, much like most of my physician readers.
It has been 11 years since independent investigative science journalist Gary Taubes published his best-seller, Good Calories, Bad Calories,[1] after 15 years of serious study, enabled by that amazing new tool, the Internet. Turns out, it’s not fat that makes us unhealthy. In 640 total pages with 459 notes, 1700 references, and 924 Amazon customer reviews, Taubes demolished what the medical, scientific, and nutrition fields (since at least the 1960s) had spent countless billions of dollars building and profiting (but also dying) from: the fat food theory of the causation of “diseases of human civilization”—atherosclerosis, coronary artery heart disease, diabetes, obesity, hypertension, stroke, cancer, dementia, and even osteoporosis and arthritis.
As the ultimate insider (me: organized-medicine member since 1967; JAMAjournals editor for 17 years; faculty at University of Southern California, University of California, Northwestern, Harvard, Stanford) through that entire time, I am struck by how the ultimate independent outsider (Taubes) could look at the same mass of information all the rest of us had access to and come to such different conclusions.
In addition to the newly comprehensive access provided by the Internet, science-educated investigator Taubes also brought the open and questioning journalist’s mind, unfettered by the conflicts of traditional scientific education; professorial authoritarianism; established career path dogma; addiction to grant support; the limits imposed by establishment peer review; the medical publishing business; need for and love of medical money and collegial esteem; opportunities for vast commercialization; invidious government power and political “scientific” positions; mass production and marketing of professional and consumer products; plus advocacy groups and influence.
Big Public Health. Big Farming. Big Agriculture. Big Government. Big Academia. Big Industry. Big Marketing. Big Advertising. Big Advocacy. Big Medicine. Big Publishing. All were marching to the tune composed by what they thought—in good faith, I believe—was good science.
And it wasn’t all bad science. The massive effort at culture change—stop eating this, that, or the other fat—was excessive, considering the meager amount of supporting data. The unintended effects were so extreme and went so unrecognized because of this huge effort based on what had become dogma: that eating fat is bad (9 calories per gram vs 4 calories for protein and carbs). The laws of thermodynamics—calories in, calories out—had been everything in weight control.
As the scientist, medical journal editor, insider, I was even involved in the mass “Campaign Against Cholesterol,”[2] led by the American Medical Association, doing everything we could from within organized medicine, and using many industry partners who, of course, stood to profit via their new low-fat products.
Real-world application is where the science, and especially the public health, communities failed. They did not keep their eyes open to the evolving real-world experience. They did not challenge the dogma and prevailing practices as the truth became more and more obvious during the mass-fattening of the population in the developed world.
Where was the self-criticism, the peer criticism, the tough skepticism of clear-eyed, broad-based scientific thought? There were some voices but they were drowned out by the mass-marketing din. I suppose it should not be surprising that the diseases of human civilization may have been brought about by the very institutions that make up what we call human civilization.
Critically studying this whole schmear in retrospect may help us understand why modern medical science and public health can be conducted so poorly while the physical sciences of chemistry, biology, physics, astronomy, as well as computer science and mathematics are conducted so well.
Here are some of Taubes’ conclusions as iterated in the 2007 book and repeated in his 2010 equally well done but much less dense “consumer” paperback, Why We Get Fat.[3]
- “Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization.”
- “Obesity is a disorder of excess fat accumulation, not overeating, and not sedentary behavior.”
- “Consuming excess calories does not cause us to grow fatter, any more than it causes a child to grow taller.”
- “Expending more energy than we consume does not lead to long-term weight loss; it leads to hunger.”
- “Fattening and obesity are caused by an imbalance—a disequilibrium—in the hormonal regulation of adipose tissue and fat metabolism. Fat synthesis and storage exceed the mobilization of fat from the adipose tissue and its subsequent oxidation. We become leaner when the hormonal regulation of the fat tissue reverses this balance.”
- “Insulin is the primary regulator of fat storage. When insulin levels are elevated—either chronically or after a meal—we accumulate fat in our fat tissue. When insulin levels fall, we release fat from our fat tissue and use it for fuel.”
Meanwhile, fast-forward to 2018. Selecting from a cacophony of writings and speakings about fat, I choose to reference a single July 3, 2018, blog by Dr Malcolm Kendrick, who summarizes the current mess about as well as anyone, and does it briefly, with eight cogent clickable references.
That’s my current opinion, based on a professed lifetime of misunderstanding nutrition. I’m Dr George Lundberg, inviting you to return for part 2 on this topic in an upcoming At Large at Medscape column.
Follow George Lundberg on Twitter: @glundberg.
If you have a MedScape account (you need to be a healthcare professional at some level), you can leave a comment there. Otherwise comments are welcomed here as always, and they are moderated for appropriateness.
Angela
Clueless Doctors & Scientists 
This was put on my plate at 05.00 am today. Your comment(s)?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/
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I thought you ate real food for breakfast and not silliness. A study just came out–perhaps by the same guy? I had no time to look it up yet. It says that the ketogenic diet causes large percent of CVD. I find that interesting since humans are born in ketosis so we must all be dead then.. stupid stupid stupid.
That’s my opinion. But you could see that everything about this was based on the vegetarian/vegan plant support, you name it plant group, support. Definitely not an unbiased crowd. If it were coming with a million dollar attached for me to watch this all the way I woudl still walk away. He needs to read a bit more I think…
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On the subject: Stuff like that doesn’t do much to me. I’m just wondering about all those other people getting bombarded with “information” like this, believe it, and acting accordingly. Some of my acquaintances and clients are vegetarians and are very proud of themselves, even more so when becoming vegans. They often act like preachers, spreading their eating gospel to other people hungering for doing something good. I regularly try to convince them differently, like I do with that salt thingy, ADHD, DMS-crap, and other stuff, but mostly to no avail. Sugar they understand, but then keep on doing what they always were doing. Sad, milady, very sad.
Breakfast? At 05.00 am? Hmmm, maybe I could have a late night snack, and then turn in.
To give you an idea how things are around here: It’s 02.45 pm now, I just rolled out of bed, and haven’t had my breakfast yet 🙂
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Just you wait.. and article is out telling you that sugar is OK. “In Defense of Sugar: A Critique of Diet-Centrism” https://www.sciencedirect.com/science/article/pii/S0033062018300847?via%3Dihub wait till people discover that one lol.. veganism is a religion. I gave up on vegans completely. Most have blocked me on FB which is great as they came on MY page telling me this and that… I have no problems with them while they stay in their own little cave. I think it is a self eliminating process… those who believe in the wrong thing, by Darwinian mechanisms will be short lived. I came to accept that and I let them be. I have yet to see a healthy vegan. It is impossible to fool Mother Nature and convince her that you are healthy when you aren’t. However, it is not my job to tell them that they are sick so let them be.
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My take on the whole nutrition thing………..eat what makes me feel good, eat a variety of food, don’t go with “you have to do this, and never do that’, keep myself informed, and subscribe to the idea that people’s metabolism varies, hence “what is good for one person, could be not so good for another.
Because I know that sugar is “everywhere”, I monitor my sugar intake (e.g.no soft drinks, no sugar in coffee/tea, careful with potatoes, pasta, and rice). In contrast, low salt and low fat is also “everywhere”. So I put some extra ionized salt and fat to my daily food. The result? BP around 125/80, weight 70 kg (I’m 1,80 m tall), sugar around 6 mmol/L, and many young people (this month I’ll turn 74) are unable to keep up with me, e,g, running, climbing the roof to service an AC, clean gutters, doing other maintenance, or working 10-14 hours on a stretch 😈
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Happy birthday Roald!! I agree with you. I just turned 65 myself and shock the world with having started weight lifting and kickboxing in January this year, lifting now upwards of 120 lbs (depending on the lift type, it may be 110 lbs). Indeed, eat what your body tells you to eat. Some of us have to be more strict a bit–like me with my darn migraine brain–but if one has no problems, no reason to fuss. Your BS is a tad high though… I don’t ever let mine go over 99 mg/dl (5.5 mmol/l)–not even after meals. 🙂
So challenge some of your youngsters to keep up with you. I am sure my sons can still keep up with me–and pass me–but not for long!!!
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Yup, you’re right about my BS. But for many years now it stays more less around that figure and doesn’t change much, while when I was in my early sixties it revolved around 7 and up. I’m keeping an eye on it. No pills though.
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Pills make things worse–yeah they lower bs but they increase insulin resistance so better not take any pills… 6 is not too bad but definitely over the healthy so just keep more than 1 eye on it please. 🙂
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Yes Ma’am
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Cut him some slack! He’s been embedded in the dogma for decades, all power to him for starting to question and reject it, finally.
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It’s about time. I am all for him giving the truth at least at some point of his life while he is alive–I consider that to be courage. 😉 He may not understand it all even now but at least he is saying the right things.
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Yes “we” tend to forget that while low carb/Paleo/keto etc. is obviously beneficial in far more cases than the Standard American Diet, and the various “healthy” diets make very little improvement in most cases, these people have made a major step moving from “low carb will kill you stone dead!!!” to “perhaps you could try it for six months” . . .
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Agree. That paper must go but glad that Dr. Lundberg is willling to sacrifice his name for the good of the public at any level.
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Hmmm……better late than never? For instance, in 2012 he told quite a different story. Or are my reading and listening skills on hold today? https://www.medpagetoday.com/columns/at-large/31400
Note 1: “……….it is also in video but you need to have an account to see it.” I can watch it without having an account.
Note 2: Statements like “the value of a low-fat, purely plant-based diet for reversing type 2 and managing type 1 diabetes has been obvious for more than 75 years”, I can find all over the Internet as well as elsewhere, and allegedly are based on an enormous amount of scientific research. If “after 75 years” it has turned out all that was wrong, it’s not very promising what could happen to all the current scientific research findings when the next 75 years have elapsed, eh? What a scientific mess!
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Oh super cool that you can watch it without an account Roald–but you are in Aruba. In the US it cannot be watched in full without an account.
In terms of the scientific mess: indeed, we have it just at the moment with that Lancet PH article that doomed low carbs diet with amazing data manipulation, never testing low carbs diets, and I just did the calculation later that during the 25 years while the study lasted–still ongoing–the people they started with are now between 70 and 89 years old!! So when they come to the conclusion that 40% of them died and that was because of low carbs… hmmmm.. the CDC calculated lifespan is 78 years old and change… so what exactly killed the over 40%? Low carbs.. right.. and I am from Venus.
Stupid, stupid, stupid. That’s my answer. I am writing a comment to the Lancet PH that I am sure will be ignored. That $5,000 they received for the publishing of that junk can keep this new journal up and healthy, so what’s the incentive of retraction? Zero. But I am submitting my comment anyway–just to keep them working and being annoyed. Because I am sure I am not the only one who sends/sent them such commentary full of complaints.
It unfortunately hurts the “bottom line” of nutrition research in the right direction. I suppose that was the goal. This stupid article cuts research funds for those wishing to explore LCHF/keto longer and puts that money into continuing the low-fat dogmatic paradigm. Dr. Lundberg’s apology mey help in turning the wheels back up again. So I hope.
Ang
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Re: “Lundberg’s apology………………….”? The guy was reading it from a laptop or something, not straight from the heart. As soon as a thing like that happens, I have second thoughts about the message.
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I noticed that. I think though that since it is also in writing, it is acceptable. (He may have had too many carbs and PUFA to memorize this all). 😉 The mean me…
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