A Diet of Alternative Facts

Originally published by David L. Katz, MD, MPH, FACPM, FACP, FACLM on LinkedIn: A Diet of Alternative Facts

The events culminating in our election outcome were characterized as the advent of a “post truth era.” We have since devolved from post-truth, to “alternative facts:” essentially, a choice between bald-faced lies about verified reality- or delusion, calling out for medical care. Either way, we are being fed a daily diet of unpalatable (to most of us), insalubrious (for all of us) deceit.

Tempting as it is to address that matter, I have a related case to make that keeps me ensconced more decisively in my native professional purview. We are now all dealing with a diet of alternative facts. While that’s a new twist, alternative facts about diet have been our cultural standard for decades. The perils overlap, and it may even be that alternative facts about diet were the appetizer, and a culture-wide diet of alternative facts the inevitable main course to follow.

Nutrition has been mired in a post-truth era in the U.S. since long before anyone in our country had thought to coin the term. Let’s go back a little over half a century.

Leaving aside the contentious particulars, rival perspectives, and forays into revisionist history, we may simply note that Ancel Keys did indeed note an association between variations in dietary patterns, and variation in the rates of heart disease. In this country, where corporate interests got involved early, that ultimately came to mean: eat low fat junk food, and all will be well. I have challenged my peer group to find me a single instance of Keys advocating for Snackwell cookies, and promised to give up my day job and become a hula dancer if ever they do. My wardrobe is still thankfully free of grass skirts.

Low fat junk food did not exist when advice about the benefits of more plant foods, less meat and cream, was simplified, excessively in hindsight, into “cut fat.” The only way to cut fat when the advice originated was to eat more foods natively low in it, notably vegetables, fruits, beans, lentils, whole grains, and such. In North Karelia Finland, Keys’ insights were applied in exactly that manner, and the result has been an 82% reduction in the rate of heart disease, and a ten-year addition to average life expectancy.

In this country, we not only contorted sensible advice about dietary pattern into a new variety of highly profitable junk food, we never in fact applied the advice at all. Had we actually reduced our fat intake, and replaced it with sugar and refined starch, it’s unlikely our health would have improved. But despite entire careers predicated on this notion, it is false. Dietary intake data from multiple sources confirm that Americans never reduced our intake of fat. Instead, we simply added the low fat junk foods- and reduced the percent of calories we derived from fat by increasing our total calories. We even know why this occurred. Is anyone really still confused about why this didn’t make us all lean and healthy?