In the final of a three-part series on the evidence US investigative journalist Nina Teicholz gave at the trial of scientist Tim Noakes, she covers the vexed world of nutrition science politics. Teicholz told the hearing that this helped to explain how and why people in positions of power and authority were able to ignore all the evidence that did not fit their favoured hypothesis.
“We know that the food industry is large and powerful and plays a role in our nutrition policy,” Teicholz said. She took 10 years of research and interviewed hundreds of executives for her groundbreaking book, The Big Fat Surprise.
Teicholz told how she came to realise just how profoundly the food industry has influenced and continues to influence science. Here’s more of what she had to say:
The HPCSA has charged Noakes with unprofessional conduct for giving unconventional advice. That followed a single tweet to a breastfeeding mother saying that good first foods for infant weaning are low-carb, high-fat (LCHF). Click here for more background on the real beef dietitians have with Noakes.
In her evidence at the fourth hearing session in Cape Town in October 2016, Teicholz said that the food industry started financing nutrition science back in the early 1940s. The then-emerging manufactured food industry understood early on that by far the most effective way to influence policy was to fund science at its very source. In other words, they targeted scientists, university chairs, etc.
The low-fat, high-carb industries continue to this day to have a vested interest in maintaining the diet-heart hypothesis as status quo.
All the carbohydrate companies who produce cookies, crackers, chips, serials, grains, rice benefit from the reduction in fat, Teicholz said. She presented evidence on the “brilliant” way vegetable oil companies, in particular, have promoted their products as “health foods”. They have even touted them as ways to reduce cholesterol.
“They marketed these foods practically as pharmaceuticals,” said Teicholz.
— Marika Sboros (@MarikaSboros) October 25, 2016
That would not have been possible were the diet-heart hypothesis not “powerfully enshrined in the US Dietary Guidelines”. These guidelines are enormously influential, Teicholz said. Doctors, nutritionists and dieticians have followed them “like the bible, with a kind of kind of religious faith”.
Saturated fat “phobia” has been an essential part of that abiding faith.
However, fat “is an important element in any manufacture of foods”, Teicholz told the hearing. Fat conveys flavour and enables texture. It is also “an essential ingredient in many foods”.
When you take fat out of a food item, you have to replace it with something and that something is what the industry calls “fat replacers”. Industry uses these replacers in low-fat foods, such as low-fat yogurt, peanut butter and salad dressings.
Conflicts of interest (with Coke, eg) compromise US public health agency’s mission, say scientists | The BMJ https://t.co/serIWJ4GPE
— Nina Teicholz (@bigfatsurprise) October 28, 2016
“Fat replacers are almost all carbohydrate-based and often they are just sugar,” said Teicholz. “If you lower fat, you increase carbohydrates. Low-fat foods are almost inevitably higher in carbohydrates. Low-fat yogurts, for instance, tend to have a much higher sugar content.”
She said that the scientific jury was still out on whether some carbohydrates are worse than others. It was also still out on whether whole grains are much better than refined carbohydrates in terms of their impact on metabolic health.
“These questions are still unfolding,” she said. “We do not know exactly why carbohydrates are now driving disease more than they did in the past. Nor do we know if it is some combination of total carbohydrates plus sugar that has an especially negative metabolic effect.
“We also do not know if it is that we have changed the way we produce wheat, if it is something about food processing, or if it is vegetable oils plus carbohydrates that are provoking obesity and diabetes.
Consequently, we “really do not know”, she said.
“All we do know is that if you restrict carbohydrates, you see benefit.”
As well, another problem is that official dietary guidelines claim to offer a range of diets, she said. In the US these are: US-style, Mediterranean and vegetarian diets. However, these diets are really just a “one-size-fits-all”. Teicholz presented a comparison slide to explain why there really is not much difference between all three. (See right.)
Teicholz said that the US dietary guidelines – and by implication, South Africa’s guidelines – should no longer be the “gold standard”.
That’s because the guidelines have hardly changed over the past 35 years, she said. Therefore, there’s no reason to expect different results. To do so was the definition of insanity: To do the same thing over and over and expect different results.”
As a way forward, Teicholz suggested two policy implications based on all the currently available evidence.
- Nutrition authorities should consider low-carb diets as a safe and effective option for people with metabolic conditions. There is no scientific reason to demonise fat or label low-carb diets as a “fad” or remotely dangerous, she said.
- As a general population-wide recommendation, it would be safe to “back out” of the high-carb diet and return to what we ate in 1965, before the epidemics of obesity and diabetes. That means less than 40% of calories as carbs and about 45% as fat.
An obstacle to progress is that vested interests still employ the tactics that Keys used to silence and stifle scientific debate. She said that a small group of “nutrition aristocrats” in the US still controls the major expert panels, major journals, etc, and they mainly come from Harvard, Tufts, John Hopkins. US journalist Thomas J Moore coined the term “nutrition aristocrats” in an explosive critique he wrote of the diet-heart hypothesis in 1989.
Teicholz also said that what has been happening to Noakes is happening globally.
“What you see is people who are trying to present alternative views of the science,” she said.
Those in positions of power and influence are punishing people who try to present alternative views. Teicholz speaks from personal experience. She described how the so-called Center for Science in the Public Interest (CSPI) organised a letter that 180 scientists signed calling for retraction of an article she wrote in The BMJ showing that the US dietary guidelines are “out of step with science”.
(Editor’s update: After an “unprecedented retraction battle”, The BMJ announced that it stood by Teicholz’s article. Click here to read: Victory for Teicholz in Battle of Butter. The CSPI continues to attack Teicholz’s article.)
More recently in the US, doctors and scientists have collected hundreds of scientists around the world to form a group called the True Health Initiative. Their motto is: “We agree.”
Teicholz clearly thinks little of that initiative and the motto and rightly so. The principle is that there should be no debate, that science is somehow settled, Teicholz said.
“But science is never settled.”