It’s no secret that we’ve become a nation of obese, chronically ill people. But what many people don’t know is how we got there. Although the easy, and oft-used explanation is “We have no self-discipline” and “We sit on our fannies too much,” the truth is much more complicated. And the truth is, nearly 40 years ago, our government got it wrong, and we’ve been paying the price ever since. But before that story unfolds, I want to apologize.
When I was a clinical dietitian several decades ago, some of the advice I gave to patients who wanted to lose weight or were battling cardiac disease was dead wrong. Granted, I was following guidelines from the experts in the field, such as The American Dietetics Association and The American Heart Association. But their guidelines were based on what was understood at the time, and unfortunately, they were way off base.
So I am asking forgiveness from anyone whom I told to eat processed margarine instead of real butter. To avoid anything made with coconut oil. To use diet dressing and artificial sweeteners. To eat toast with jelly, not butter. To use cholesterol-free egg substitutes instead of whole eggs. To drink skim milk rather than whole milk. And more. Please accept my deepest apologies.
How We Ended Up So Sick and Fat
Dietary fat was first villainized as a major contributor to heart disease and obesity in the ‘60s and ‘70s, when a robust disagreement flourished between anti-fat proponents and anti-carbohydrate proponents. While there was research that supported both perspectives, much of this research did not have well-controlled variables and was undertaken to support the funders’ theories—many of whom had significant skin in the game.
As it turns out, this fat vs. carbohydrate debate was settled in 1977 by guidelines developed by The United States Senate Select Committee on Nutrition and Human Needs, which was sometimes referred to as the McGovern committee, after its only chairperson, Senator George McGovern of South Dakota. Admittedly, there were many sensible suggestions in these guidelines, including to reduce sugar, eat a variety of foods, and maintain ideal weight. However, the recommendations to “substitute starches for fat and sugar, “ and “avoid too much fat, saturated fat, and cholesterol” were most likely the two guidelines that put into play a national dietary catastrophe. And not to digress—but why was our government leading the charge anyway? That will have to be a discussion for another day!
These dubious Dietary Guidelines were subsequently included in school curricula and frequently referenced by healthcare professionals. Predictably, consumer demand for low-fat food skyrocketed, and by the mid ‘80s, manufacturers started producing a super-abundance of low-fat products, in which carbohydrates were substituted for the fat in traditionally high-fat foods. Low-fat cookies, candies, bread products, cereals, yogurt, milk and more flew off the shelves. But what consumers failed to realize was that to make the food taste palatable after the fat was removed, numerous unhealthy ingredients were added, such as cane sugar, high-fructose corn syrup, artificial ingredients, and many other substances. Furthermore, since it is the fat in foods that helps make us feel full, and stay full, in the absence of fat, many people consumed more and more of the low-fat foods to satiate their hunger. In turn, they were consuming more calories overall, getting hungry more often, and messing with their metabolisms. (We’ll talk more about the catastrophic metabolic results of high carb, low fat foods in my next post.)
Is it any wonder that somewhere between the late '70s and '80s, obesity rates nearly doubled?
Was the Food Pyramid Upside Down?
And then came the first Food Pyramid, an infographic published in 1992, which was born from the 1977 Guidelines. This pyramid became a primary teaching tool for school children, healthcare professionals, and the population at large.
The key message was that everything was OK as long as it was low in fat. At the base of the pyramid were those foods recommended for repeated daily consumption, such as bread, pasta, rice and potatoes. The peak of the pyramid represented those items we were to consume most sparingly—fats, oils, and sweets (well, at least they got one out of three right).
What began with a governmental committee attempting to improve the health of the American people, turned into disastrous results for our country’s public health. Talk about good intentions run amok!
Of course, there are additional societal changes that have been in play throughout these decades. Certainly more sedentary lifestyles; the introduction of thousands of new processed foods replete with additives and pesticides; environmental toxins, and more have negatively affected our overall health and weight management. But based on numerous metabolic and epidemiologic studies, the consumption of significantly more processed carbohydrate and fewer healthful fats continue to emerge as the major players in many of today’s chronic conditions such as obesity, metabolic syndrome, Type II diabetes, and cardiac disease.
Stay tuned for my May post, when we’ll explore some common myths around fats and differentiate the healthful from unhealthful fats.