Transcription
So really, the story of our government's nutritional advice all the way back to the 1950s, when heart disease was rising in America. Nobody knew what caused it. The theory that won the day and stepped into that vacuum was the one by Ancel Keys from the University of Minnesota. And his idea was that it was saturated fat and cholesterol that caused heart disease. So that is the core reason why the public believes that red meat is bad for health. Instead, we're eating Cheerios, Froot Loops, all these unhealthy grains because we're basically following the guidelines. And we found that 95% of them had a tie with a food or pharmaceutical company. These are not guidelines that promote good health.
Nina Teicholz is an investigative journalist turned researcher and one of the most influential voices in food policy reform today. Her best-selling book, "The Big Fat Surprise," challenged the low-fat dogma and reshaped how we think about dietary guidelines. I can only conclude there are pretty powerful forces that keep journalists in line on this topic. Our current nutritional guidelines don't work. So, they've just ignored the evidence.
In today's interview with Dr. Nina Teicholz, we look at how the US dietary guidelines were built on weak science, shaped by conflicts of interest, and used to push seed oils. Even though large government studies showed that this didn't work, we'll talk about why honest voices in nutrition often get shut down and how the supermarket itself is stacked against your health. At the end, you'll hear what Dr. Teicholz really thinks about the current administration's promises to fix all this and whether real change is even possible. But before we start, let me share with you something that does work. It's my seven-step heart attack prevention protocol. You can get this for free just by clicking on the link in the description below.
So, Nina, the government tells us that we should limit red meat, saturated fat, and whole milk, full-fat dairy. And then on the other hand, they say we should be drinking chocolate milk and Cheerios and Kashi cereal. Can you explain how we ended up here?
So really, the story of our government's nutritional advice uh goes all the way back, reaches back to the 1950s when uh heart disease was um rising in America. Nobody knew what caused it. President Eisenhower himself had a heart attack in 1955. He's out of the Oval Office for 10 days. There are a number of theories about what causes heart disease, including vitamin deficiency and type A personality, where you run around yelling at everybody and then suddenly you have a heart attack and die. But the pro—the theory that won the day and stepped into that vacuum was the one by Ancel Keys from the University of Minnesota. And his idea was that it was saturated fat and cholesterol that caused heart disease. He was able to get his idea implanted into the American Heart Association such that that group in 1961 became the first in the world to issue a public advice for all men and women that they, the best measure of protection against heart disease was to limit saturated fat and cholesterol and replace saturated fat, like you find in butter and beef, with call seed oils, but in that time, it's vegetable oils. So instead of butter, you have margarine because beef is high in saturated fat. You're—we were also told to avoid red meat, replace it with chicken, which you did. And also that meant also that you couldn't drink whole milk; instead, that you should have skim milk. Uh, which really only came into existence in the 1970s. So that was in 1961 when our federal government got into the business of issuing guidelines, which started in 1980. The US Dietary Guidelines for America. They adopted this platform by the American Heart Association 100%. So ever since 1980, the entire country has been told, and in many cases mandated, in like in schools and prisons and hospitals, where they are required by law to follow the guidelines. We are all told to limit our saturated fat. We're told to consume seed oils instead. So that is the core reason why we believe widely, the public believes, that red meat is bad for health, that we should have skim over whole milk. And then when you take the fat out of food, what do you replace it with? Grains, carbohydrates. And that's where the advice for, or where the de facto difference is, that we, instead of meat and dairy, we're eating Cheerios, Froot Loops, all these these unhealthy grains because we're basically following the guidelines. That's what the guidelines tell us to do.
So, let me just continue these questions that may be really obvious to you, but again, I've got an audience of folks that are um, what, over half males, 60, 50 and above. And so, for that group, these recommendations don't matter, right? Because it's just the government. That group still eats what they want, right?
Well, you have to consider that nursing homes follow the guidelines. I mean, I don't want to project out too far, but I mean, when we get old and enter a nursing home, that's the food that they will be serving. They're most likely to cook everything in seed oils. They're unlikely to have beef much on the menu. So, it will impact them. Public schools are required by law to follow the guidelines. In some cases, like in New York City, even preschools that are not funded by the government are required to follow, like, only allow skim or non-fat milk to send your kid in preschool. So, yes, I mean, they really have a society-wide impact. And then if we think beyond ourselves and our loved ones, it affects the military, which has an obesity problem practically equal to the population at whole. The ma—obesity is the major reason that that men and women are not able to serve in active duty due to all kinds of injuries that are attributed to obesity, um, like musculoskeletal injuries. So it affects our military. It affects our readiness. I think it's 30% of kids are not qualified to join the military due to obesity or other chronic diseases. You know, it affects the productivity of our our economy because disability is often due to something like diabetes or some other disease. So, it really affects all of us at a very profound level.
How aggressive has the government gotten with these recommendations? Have they ever defunded a some a group or someone over serving whole milk or eggs?
Yes. So, by law, the dietary guidelines are required to be followed by all federal programs. And I just discovered last week that a 1994 congressional act makes it impossible even to grant a waiver to explore a program like, say, a school lunch program, that would allow something other than the dietary guidelines. Let's say you wanted to do a school pilot, uh, that serves kids more whole foods, um, including meat and whole-fat dairy, whole milk. You're not allowed to do that. I'll tell you a story that there was a group of activists in, um, Pennsylvania who wanted just to give away whole milk in the school, and they were prohibited from doing that. They were told to take their free milk down the uh, down the road to a parking lot. They weren't even allowed to distribute it on school property. Then, when a school in Pennsylvania tried to implement a policy of providing whole milk, I think that was a legislative bill that was um, going to sail through the the legislature in Pennsylvania. And the USDA apparently, I can't—I am not positive about this, but they, the USDA, which runs the school lunch program, told them that they would cut funding to all Pennsylvania schools if this one school decided to, or or if this, if Pennsylvania wanted to serve whole milk in their schools. Yes. So, it's, it's impossible to deviate from these guidelines.
So when you look at these guidelines, I'm going to make another, uh, naive assumption, and, uh, that's also wrong. So these, the committees that come up with this, they're focused on health, not money. Right?
I think many people on the committee are dedicated to improving health. I, I have, I have done the uh, along with a team of co-authors, done the only systematic review of all the conflicts of interest on a dietary guideline committee. These committees are formed every five years for every new iteration of the guidelines. We did an analysis of the committee that served for the 2020 guidelines, and we found that 95% of them had a tie with a food or pharmaceutical company, and half the committee, the 20-person committee, half of them had 30 such ties or more. One member had 152 ties. So I think the reality is that these committees are full of nutrition experts who have come to see nutrition through the lens of their funders. Um, and we, you know, we see that in the product of what they come up with, which is that these are, you know, these are not guidelines that promote good health. That is self-evidently true, and it's also been shown in clinical trials when tested. The dietary guidelines do not prevent any type of chronic disease, not obesity, type 2 diabetes, heart disease, or cancer.
So, pardon me, that last question was sort of putting words in your mouth as a, as a well-known influencer in this space. I didn't mean to to do that, but I think what you're saying is, number one, the people on this committee, this group, are have a boatload of financial conflicts, and number two, the evidence right now just doesn't indicate that all the recommendations are based on evidence and based on health.
Yes, that's correct. I mean, the committee is, and let's just, let's broaden out the conversation just a tiny bit. I mean, almost all nutrition scientists receive money from the food industry. There's not enough money coming out of the NIH for nutrition science. Food, the food industry fills that gap. And that's true of almost all nutrition scientists that I have come across. Many, many hundreds of people whose work I've studied. Some of these are extreme cases, like the most recent committee. There's, um, a professor from Stanford University whose entire center has been underwritten by Beyond Meat, the fake meat company in California. Most of them have lesser ties. These committees are full of top nutrition scientists who therefore, due to the way the field is, they receive, they, their work has in large part been funded by the food companies, the giant food companies. And it's interesting to note they also have mostly received money from the pharmaceutical companies. Why would that be true? When I started my work, I could not understand why somebody who's researching food would be funded by pharma. I think there's, you know, maybe the most cynical interpretation, but one I've come to believe is that if you're funded by pharma, the pharmaceutical industry, really their sweet spot is to make money off of chronic disease, right? The average American takes four or five pills every day. When you get to be older, you're taking nine or 10 pills or every day or every month on average. If that, if people reverse chronic disease, that entire business model goes away. So there really is an incentive for pharma, big pharma, to undermine, uh, any effort towards an effective diet that really reverses chronic disease. Maybe the most dramatic example of that, or recent dramatic example, is, uh, was a scientist from Harvard named Fatima Cody. She had been funded by Pfizer and she went on 60 Minutes saying, also a show funded by by Pfizer, saying that obesity was a genetic disease. Well, if you think obesity is a genetic disease, then it's impossible to cure because it's in your genes, right? So, that narrative of obesity being caused by your genes is completely antithetical to reversing obesity with diet. Why would she even be on a committee if she believed that diet made no difference for obesity? So, yes, there's just a huge amount of conflicts of interest, financial conflicts of interest on the very committee that is supposed to be finding a natural solution through whole foods for reversing chronic disease. The second part of what I was saying is about the lack of any evidence base for our dietary guidelines. This is something that I have spent now two decades researching. And I can tell you there have been large NIH-funded randomized control clinical trials, really the gold standard of evidence, that have tested our dietary guidelines on tens of thousands of people. And the results of those trials are that this is a diet where we're talking about fruits, vegetables, whole grains, lean meats, nuts, seeds, lugs. That diet has never been shown to have any ability to prevent obesity, type 2 diabetes, heart disease, or any kind of cancer. So, that's pretty dramatic. And the results from those studies, again, funded by NIH, which is our taxpayer dollars, the results from those studies have never been reviewed or considered by any dietary guideline advisory committee. So, they've just ignored the evidence that shows that our current nutritional guidelines don't work. And that's how these guidelines endure because the evidence that contradicts them is is ignored.
So you're getting to a part that's critical to me personally. I'd like to talk about it, uh, your journey, but let me tell you why it's something, why it's so important to me personally. I, and we haven't talked about this before, I'm a physician. I think you know that. But I got my start in this space as an epidemiologist at Johns Hopkins. I ran the preventive medicine program there. So you look at different types of research, and the bottom line is the only research that has an agenda is research that was done by a human being. In other words, all of them have an agenda. It's interesting that you bring up big pharma because the, the research done by folks at big pharma, people automatically seem to know, okay, so I know what their agenda is. They've already spent millions on this product, this drug. They're going to want to make sure that it, that it appears to be safe and that they can make a lot of money with it. So, so many people understand that already. There seems to be a little bit more clarity regarding the playing rules, so to speak, within the science and interpreting it. There doesn't seem to be nearly so much understanding about quote science as it relates to food epidemiology. So again, to get back to your journey, you, you started as a journalist. You're still a journalist. To me, much more than that, you're somebody who's now developed a, a strong reputation as one of the most reliable voices, influencers regarding food policy. I noticed just, uh, recently you got a doctorate, your PhD in food science. And again, heaven help you. I know food scientists can be such a nightmare. Uh, comments about your journey, comments about where food science is, what needs to happen with it, how we can use what we have for policy.
Well, my PhD was in nutrition and covered a lot of the same territory that I wrote about in my book, which is called "The Big Fat Surprise." And that book, which came out about a decade ago now, but is still, I think, the text to go to to read what is the history of erroneous recommendations. I also really introduced the idea that saturated fats have been unfairly vilified. What is the history of that? How did that happen? It's a really fascinating story. I think I was the first to document also how seed oils came into the food supply and why those are bad for health, the oxidation effects, inflammatory effects, potential cancer effects. And, um, to your question of where do we go from here, I don't think the problem is that we can't do nutrition science. I think there have been large randomized control clinical trials that are, that do provide reliable results. The problem, in a nutshell, what has gone wrong in nutrition science is that the results of those trials, because they always contradicted our conventional wisdom, those, the results of those trials were ignored. So what we really have is more of a political problem than a science problem. It's not that we can't do the trials. We've done them on saturated fats. What happens when you lower saturated fats? We've done them on total fat. What happens when you lower total fat in the diet? But the results of those trials were always that no effect against obesity, no effect on, you know, no prevention of type 2 diabetes, no prevention of heart disease. And so those inconvenient results were always ignored. So what we have is a problem, a political problem in nutrition science where the science really can't be heard. You know, another topic on which the science cannot be heard is on the low-carbohydrate diet. That diet has been studied as much or more than any other diet in the history of diets, including in the Mediterranean diet, and the results are simply ignored. You know, the fact that this diet can reverse type 2 diabetes and is the only whole foods nutritional approach that has been known to do so, do so, that has also been ignored. I think what we have here is really a problem of not being able to, like, having a very closed status quo system that is hanging on to a nutritional dogma and is unable to evolve and and respond to the science that we have.
It's a really good point. It reminds me of one of our more common battles, and that is, believe it or not, stress tests do not predict heart attacks, and stents don't prevent heart attacks. The evidence is crystal clear, and even the standards committees that that provide the standards for medicine say the same thing, and they say we're doing too many. But we're still doing too many. So, you know, the obvious question is why? And and the answer is follow the money.
Yeah. I mean, take the example of saturated fats, on which I've done the most work. So, saturated fats have been tested, the the idea that saturated fats are bad for health has been tested more than any other hypothesis in the history of nutrition science. There have been clinical trials on nearly 80,000 people on that idea. And they did really rigorous experiments. They lasted years. They had intervention diets where saturated fat was reduced to about the level that we're eating or we're told to eat now, which is about 10% of calories. And they had the control group that was eating up to 18% of saturated fats of calories of saturated fats. Those experiments, really, none of them resulted in preventing heart disease or preventing cardiovascular or total mortality. Those are the results, AC—across the board. We've had systematic reviews of those trials. We have now two dozen systematic reviews of those trials. Where is the change in policy? Right? That it's not that the science doesn't exist, it's that the science can't rise up to change policy. It's the same thing on LDL cholesterol and heart disease. LDL cholesterol is not a reliable predictor of heart disease. Um, something called metabolic syndrome is a far better predictor of heart disease, or your HDL to triglyceride ratio is a much better predictor of your risk for heart disease or having a heart attack. But that knowledge, that science, also cannot get translated into policy. And there are very powerful interests in supporting the LDL hypothesis, primarily the pharmaceutical industry. Again, it's not that we don't have the science, it's that we can't translate that science into policy due to a lot of political, bureaucratic, financial interests that keep an incorrect, non-evidence-based policy in place.
So, it brings up a point, and I think you mentioned it. It's, yes, you may be a journalist, but you're much more activist than that. You're looking at what need, what should have happened, and you're asking the questions, why didn't what should have happened? I would call that investigative journalism. Who else is doing that in in your space, and why are you doing it? And tell us how that feels.
Yeah, I mean, it is the subject of journalism to look into what are the political and institutional forces that are acting in a space where, you know, all journalists in in various fields are taught to follow the money. I should say, all journalists except for nutrition journalists, who never follow the money. And, well, they do if there's a beef or dairy in, uh, interest behind it, but when it comes to other food industry interests, like the ultra-processed food industry, they, they just sort of turn a blind eye. There are few to no journalists in this space. Um, I would say there are just a handful of them. It's interesting. I don't know why. I've seen in various, I think back when the, the kind of legacy media was more rigorous on a number of issues, there were journalists who were looking into some of these conflicts, especially on the topic of sugar and what were the soda and sugar companies doing to influence policy. But I would see very clearly that these, you know, each and every one of these journalists, they would do some courageous reporting. They would come out with challenging pieces of the kind that I would say I would root for them. Hey, go, go, go, go. Or I would, you know, I'd have conversations with them, and then each and every one of them, I would see retreat from that position. They would get assigned elsewhere. They would be fired. They would retreat to doing what almost all nutrition journalists do, which is just sort of regurgitating the status quo. So, you know, I can only conclude there are pretty powerful forces that keep journalists in line on this topic. I mean, I will tell you a personal story I had, which is when I was getting my start in this field, I wrote a big article for Gourmet Magazine, which your readers might remember, in the early 2000s. It revealed a lot of the really wild behavior of the seed oil industry and how it, it suppressed science, negative science about their oils. And it was pretty hard-hitting. And the editor-in-chief of Gourmet Magazine, Ruth Reichl, she was apparently, or she recounts in her memoir, something I found out much later, that she was threatened by Proctor & Gamble, maker of Crisco Oil, that they would, they would withdraw all their advertising from the magazine if she went ahead with this story. I don't even know how they got a copy. They shouldn't have, but she resisted that pressure and published a story. It became a pretty well, became the most read story in Gourmet Magazine in a very long time. It was a big hit for her, and, and she recounts this in her autobiography as one of the most important moments in her career as editor. So that's just a little glimpse that I have into some of the forces on the media, uh, in reporting honestly and in a tough, rigorous way, uh, against, you know, on these topics. I think I can only assume there's a lot of advertising dollars that have to be guarded and, you know, protected.
As we're talking about this, it reminds me of something that you and I haven't discussed yet. I'd be interested in your thoughts. You know, Robert Lustig, right? Mhm. So, I had him on the channel, and he made a point one time. He talked about there was a, a CEO of Pepsico company who came on board. She was from India, and her, she focused on doing, she said, "Okay, we're going to start giving options, healthy options." Quarterly earnings tanked, and so did she. And so the moral story behind that is, well, people are eating what they want to eat. And so the public is driving a lot of these errors. What, what are your thoughts? What's your reaction to that?
I think, you know, food companies have a corporate obligation to maximize their profits. I mean, that's just the way they're structured. And you could call it some kind of pathological corporatism, or it's, that's what they're designed to do. And, uh, I, nobody can really fault them for that. Uh, and I, what I bridle against is the idea that corporations should be leading the charge on creating or helping to define what is a healthy diet or reforming our food system in some way, because, you know, so-called stakeholder capitalism that is promoted, where we're going to have public-private partnerships so that we can include food companies, corporations in trying to create better food policy in the future. I think that is doomed to fail. Those kinds of projects, just a way to open the door to big food to enable them to distort those efforts so that they're less genuine. I mean, we see it at a global level, um, and we see it in this country as well. Well, I mean, once you let Kellogg's, General Mills, Pepsi, Mars into the room to discuss how to create healthier foods, what you're really talking about is how to pretend to create healthier foods that they can keep selling their product in some way, and, um, meanwhile, not really moving the needle or not moving the needle at all on improving health in America. Um, I do also agree with you that ultimately consumer behavior has to change, but there is this idea of a toxic food environment. I mean, and that it is extremely hard for anyone to get healthy. When you go into the supermarket, and there are aisles and aisles and aisles, practically, you know, I would say like 90 to 95% of the supermarket is filled with brightly colored, very alluring cookies, crackers, chips. I mean, all these foods that are made from usually just like three main ingredients: seed oils, grains, salt, sugar. It's almost impossible to leave a supermarket without some unhealthy foods in them. So, I think, you know, I'm not saying we should have a mandate on how to change supermarkets, but we definitely need to have guidance on what it is to eat a healthy diet. We need to have more healthy foods around us to enable consumers to make healthier choices. I would say even somebody who knows how to eat well, if I think I do, there's very little in the supermarket that I can buy. There's often not much of a selection for meat. The dairy section is half plant-based milks. It's very difficult to eat a healthy diet, even when you know how to.
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So you might be interested in this story also, something we haven't talked about. Uh, another part of my career for about five years was as basically the medical director for Kroger. I came on because Kroger was just then starting, uh, the Little Clinic, and I was basically the medical director for the Little Clinic. But I learned a lot about groceries while I was there. One of them was that they talked about how people, how groceries influence the flow through the store. And they talked about one of the competitors, for example, Publix, paying more, having bigger, shinier apples, bigger, greener avocados, spending a lot of money to make sure that the produce looked great. And that was the first thing you'd see as you walk into the grocery store at Publix, and some other, most of the others as well. Kroger's view of Publix's approach, their strategy, was not that Publix thought that more people were going to buy fresh produce because all the grocers knew people are not really buying fresh produce. They spend the time in the middle of the store, which is the place that you're talking about with all of that ultra-processed food. Any comments when you hear that story?
That's interesting. Actually, I didn't know that. I think that's pretty fascinating. Fruits and vegetables are like the rainbow. Beautiful colors in the food supply. And people say, "Eat the rainbow." Every picture, if you Google what's a healthy diet, you'll see some beautiful picture of fruits and vegetables. It's so alluring. And, you know, I can see why they might be used to bring people into the supermarket. Yeah, it's definitely a challenge that say, meat and dairy are just not the most beautiful picture that you can, you know, that you can make of food, and is not the rainbow. Am I surprised that supermarkets try to manipulate consumer behavior? Not at all. I mean, one of the things that just crushes me in supermarkets is, and why I never go shopping when I'm hungry, ever. That is a major strategy for not buying food that you don't want to eat. You get to the checkout counter, if you're lucky enough not to put any, you know, forbidden item in your cart, um, for me, it's usually chips. You get to the checkout counter, and there's like 20 more things that are so tempting, and that you could just grab and put in your, which is of course by design. But, um, yeah, I feel sorry for people. It is really hard to stay healthy in these environments that are clearly not designed to help us make good choices.
Another personal comment. I've been, um, as we discussed earlier, I'm on my second, uh, marriage relationship, and both partners have said to me, "You really overspend at the grocery." And I do. And here's why. And I, I'll also go to the grocery when I am hungry because, first of all, because I'm cheap, and you're always going to spend less at the grocery than the restaurant. So, if you can get food there you like, good. The other thing is for health reasons. I know if I get something at the grocery and prepare it myself, I know what's in it, and I'm much less likely to have ultra-processed food. So again, maybe a different approach to grocery shopping than what I usually hear.
Well, as somebody who's just spent nearly $500 in Costco, mainly on meat, I completely understand that. Yeah, I think that, um, you know, there's a saying, you know, "Pay, it's better to pay the farm than the pharma." You definitely are saving money if you invest upfront in good food, and you save it on the back end by not having medical bills and not paying for pills and procedures.
We get into the other two questions, Nina. Tell me about seed oils. I first learned about those when I read your book, "The Big Fat Surprise," and I have to tell you, it hit me totally unaware. Uh, then I started digging a little bit deeper. What are your thoughts on seed oils, the evidence, the science behind it?
Yeah, my book really was the first to bring those to the public attention, the history of how they came into our food supply. So starting in 1911 with the introduction of Crisco, which was meant to replace lard in, uh, the American kitchen. Crisco was, uh, hydrogenated seed oils, and then their steady trajectory upwards, why they kept increasing in, they're the ingredient that has increased the most in our food supply, more than any other, over the past 100 years. And seed oils, you know, we adopted them because they're supposed to replace saturated fat. So margarine instead of butter, and frying with, um, corn oil or or soybean oil instead of frying in tallow or lard, which were the major or butter, which were the major fats used by all over the western world before 1900. I think that there, you know, they've obviously, as a, an issue in health, it's just taken off this issue over the last five years or so. And everybody seems to know something about seed oils, the health claims against them. And I will just give you my short answer on this, which is I document in my book pretty rigorously how seed oils, seed oils oxidize when heated, especially when heated, but even at room temperature. They create oxidation products, peroxidation products, hundreds of them. Those products will enter into your food. That's been shown and proven. And then when you eat that food, they're absorbed into your body. Some of those products, like aldehydes and acrolein, are known toxins. And then there's hundreds of others that we really don't even know any much about. So these are not good to ingest. There are many unknown oxidation products. And in clinical trials where seed oils replace saturated fats, large clinical trials, the group eating seed oils in a number of those trials died at higher rates of cancer, which they could never understand, despite analyzing and calling high-level meetings at the NIH all throughout the 1980s, they could not understand why they saw higher death rates from cancer in the group consuming more seed oils. And that mystery remains true today. The other problem of oxidation is that oxidation drives inflammation in the body. And that's why you take antioxidants, is to deal with those oxidation products. And so, um, inflammation is well known to be a problem in in driving heart disease and other conditions in your body. So it's just prudent to avoid seed oils. Do they also cause obesity, diabetes, all these chronic health conditions that we're afflicted with? I think the evidence there is quite weak. It's what we call epidemiological or associational evidence, which means these two things are associated with each other, but, you know, so are umbrellas and rain. Do umbrellas cause rain? No, they don't. But they reliably appear when it's raining. I mean, that's a very basic kind of example of how epidemiology goes wrong. But the fact that two things are associated with each other does not prove a cause and effect relationship. And that low level of evidence is what is being employed to suggest seed oils cause all chronic diseases in general, I should say. So, I'm not convinced of that evidence, but I think there's enough evidence that we do have to just say it's just wise and prudent to remove seed oils from your diet, especially don't eat them. And to replace them with, you know, for heated, when you're heating something in your kitchen, use tallow, so it, lard, duck fat, butter, coconut oil. All of those are higher in saturated, stable fats that will not oxidize when heated. And olive oil is is sort of an in-between fat. Uh, and it will oxidize a little, but not as much as other, as seed oils. So olive oil is good for anything you make cold in a kitchen, like a salad dressing.
How about ultra-processed foods? To me, that's like worthy of a video in and of itself. It's like the biggest issue, maybe the biggest challenge that we have right now, especially when you talk about ultra-processed grains, cereals, pastas, breads, etc. Where are you on that? Would you agree with me, or or would you be at a place where you say, "Well, Ford, it's important, but did you think about something else?"
Well, Ford, I do have a little bit of an unconventional view on ultra-processed foods. I think that the term ultra-processed foods is very poorly defined. And in fact, the FDA just put out a request for proposals to, uh, to scientists to get a better definition for ultra-processed foods. Currently, meat sticks are an ultra-processed food. A can of soup is an ultra-processed food. Uh, so is, uh, you know, a, a keto bar, which is low in sugar and carbohydrates, is just as ultra-processed as a, a bar that is high in sugar and grains. Um, so there's a problem with the definition. I'll give you another one. A hamburger is one of the most reliable, uh, illustrations for ultra-processed food articles, and isn't considered an ultra-processed food. But, you know, a hamburger is basically a meat sandwich with lettuce and tomato, and other sandwiches, say a turkey sandwich, is not ultra-processed food. And when I asked the scientist who came up with the term ultra-processed foods why that was so, he said, "Well, in general, we eat hamburgers with French fries and and milkshakes, so that's why that's an ultra-processed food." And, you know, which is guilt by association, which doesn't seem very scientific. And one last example, if you make a home-baked batch of chocolate chip cookies, that's not ultra-processed food, but if you buy them from a store, that is ultra-processed food. So, ultra-processed food is a, it's a vague, not very helpful definition, and it takes us away from where we really do have good science, which is on the specific ingredients that make us sick and fat. Right? What are those? Those are grains, sugar, carbohydrates generally. And so we need to focus on the science that we have, that is where we have good clinical trials. Ultra-processed foods, because they're so difficult to define, don't have clinical trials. I mean, there's been like two, two-week-long clinical trials on ultra-processed foods. And even those are undermined by the fact that there really is no rigorous definition. I mean, anybody who remembers their science class in grade school remembers that the first most important thing in a scientific experiment is defining your terms so that you can accurately test something. I'm not sure ultra-processed foods is helpful as a scientific concept. It's certainly helpful rhetorically. I mean, is it that much more useful than junk food, which is what we used to call? I mean, you sort of know it when you see it, but I don't think it it advances our knowledge of what is, you know, good and bad for health. So, I feel like it's not that useful as a scientific or a policy term.
I think I've spent too much time on YouTube. The reason is I remember when I first heard that term ultra-processed food, I had, I was confused about what it meant, and now I hear it not every day, but multiple times per week. And, uh, I think I've redefined it in my head. So I think you're helping me again learn something else. I appreciate it. Not very popular what I'm saying because, you know, ultra-processed food is the sort of term dour for everyone, but, you know, if you're really looking at how to unmake your health better, if you, if you focus on where we have the science, really, where we have the science is really on total carbohydrates. So reducing those is your best bet for improving health. Uh, in my view of the science, we spend a lot of time doing a very old medical test called an oral glucose tolerance test, and we look at the insulin levels that accompany those. And one of my favorite examples is steel-cut oats, which are like little BBs, versus instant oatmeal or quick oatmeal, both of which are like flakes. And it's very interesting and very easy to see in my practice with patients. I cannot tell you the number of times that, uh, patients would say, "Doc, no, I eat oatmeal, and yet instant or whatever, and you cannot tell me that that's not healthy for my heart." I used to just get bogged down in that discussion. And then I figured out, it took me a long time, too long, to figure out that, you know what, I don't have to get involved in that debate. All I have to do is tell them to check their blood sugar before and after they eat that instant oatmeal. And it was, it was like that. Never had to have that debate again. So I use that as my explanation of what an ultra-processed food is. Any comments about that?
Well, I do think continuous blood glucose monitors or just blood pricks are incredibly useful information for people to teach themselves. As you say, it avoids the whole conversation of trying to get information to enter somebody's head, and it allows them to see inside their body to learn for themselves. And also, continuous ketone monitors are just one of the best wearables, uh, for people learning about their own bodies and their own health, especially because people do have different reactions, blood glucose reactions, to different foods. And you can have different reactions depending on the order in which you eat your foods. Like, if you eat your protein and fat first, and then eat your carbohydrates afterwards, that will blunt the blood glucose response of the carbohydrates. You know, I just want to go back to ultra-processed foods for one second, which is that I do want to emphasize that I, I think that there is a problem with all these ingredients that are put into our foods now that have were largely unrecognizable, unpronounceable names. I think that there's some evidence to show that they can be damaging and harmful. So, trying to minimize the number of ingredients in your food. I think in general, like avoiding anything in a package, cooking at home is a good strategy. Uh, I just also recognize that people are busy and they're, you know, they're trying, they might be working two jobs, and grabbing a can of chicken soup or something to feed your family is an okay option for people.
Given who I'm talking to, I'm going to make one more pitch for grinding up food. We have a lot of folks on keto diet. We'll often have somebody who's struggling because they've lost their ketosis. And one of the more common things we find is these protein shakes. So even though it's protein, it's not something that you would think is is going to be unhealthy, especially or against a keto diet, these ground-up powdered proteins we often see is a challenge.
The ketogenic diet is not high in protein. It's high in fat. And if you eat too much protein, that will kick you out of ketosis. Um, you will see a blood sugar response to excessive protein in your diet. So that's just something to know, whether it's a protein powder or just, you know, too many steaks. I think it's almost impossible to overeat on steak. It's probably a lot easier to over, overeat on a protein shake, but excessive protein will kick you out of ketosis.
Good point. Let me take you back to that third question. RFK Jr. and the current administration's "Make America Healthy" efforts. One of the things that they've promised is that they're going to, one of the campaign promises is that they're going to help rectify a lot of the stuff that we're talking about. As a reporter who covers this, an investigative reporter, what do you have a grade you would give them so far? Do you have thoughts? Where do you think they are?
I think the "Make America Healthy" movement has done an extraordinary job of raising public awareness about the problems in our food supply, the fact that we have all these artificial ingredients and dyes, and the fact that we have a huge chronic disease problem that is was really not talked about much until they came along. Elevating the profile of that problem and and pressing the urgency of that problem is, I think, an extraordinary contribution to our public conversation in America, and people's awareness has just gone way up, and people are really mobilized around this. So that in itself is a huge accomplishment, and I think we have seen some progress. I mean, getting soda and candy out of, uh, SNAP programs, those are used to be called food stamps, but disallowing those in states across the country. The food industry is really kicked back on its heels. It is promising to get food dyes out of their products. It's promising to reduce the number of ingredients. That is something I thought I would never see. The the food companies have are really taking this very seriously, and I think we have yet to see changes in the most influential policy, which is the Dietary Guidelines for America, that, as we've discussed, are so powerful in driving what we think is a healthy diet, what is fed to school children, what is fed in hospitals, nursing homes, everywhere. Those guidelines are due out by the end of this year, expected in October, probably, and that will probably be the most important food policy change that this administration makes. So, you know, I'm optimistic that they will include meaningful changes that will improve health.
So, any, uh, predictions?
Well, the FDA commissioner, Marty Makary, has said a number of times that we've gotten it wrong on saturated fats. And so, I am hoping and anticipating that the cap on saturated fats that has existed since the beginning of the gu—guidelines in 1980, which is 10% of calories of saturated fats. I am hoping that that, and there are indications that that will be eliminated, which would be huge. I think there are also pretty strong indications that there will not be a prohibition on red meat. You know, Secretary Kennedy himself has said that he's mostly carnivore, and, and I think there's a movement towards saying like, we can have regular dairy again, which would mean whole milk. Those are the things that I would predict and I would like, but I'm not sure if we'll see some kind of reductions in grains and sugars.
Good point. You, I was going to ask you a question about that, the grains. We haven't had a chance to talk about it very much, but from my perspective, I see, think, you know, things labeled as whole grains, and I see dietary guideline committees, advisory committees saying those things are great. And on my side, I see those things continuing to increase the problem with the people that I have that are pre-diabetic, have metabolic disease. Any predictions or comments about that?
Well, you know, the way that they, the tried and true way of fattening pigs is to feed them grains and skim milk. And that is exactly what our dietary guidelines recommend. I mean, we no longer use the food pyramid, but remember that big bottom slab was all breads, pastas, grains, and we're still recommending at least six servings of grains a day, including three servings of refined grains. But as you mentioned, if you slop on a blood glucose monitor, your blood sugar will go up just as much, if not more, with whole grains as they do with refined grains. So ultimately, we're not doing ourselves a lot of favors by pretending that whole grains are healthier. And often these, the whole grain cereal, like whole grain Froot Loops or whole grain Dora the Explorer cereal, they just add fiber to the cereal to in order to meet some kind of whole grain labeling target. You know, I think that's entirely a myth. And what we see in clinical trials is that it's the reduction in total carbohydrates, so that's refined grains or whole grains, that is the powerful intervention that can reverse chronic disease. So, I, that's one of my biggest, uh, advice points, and first advice points to patients, is just start with a very simple thing of taking all the grain products out of your diet, and then we can start discussing details like quinoa versus whole grains versus something else. Um, but the current administration, they're getting ready to come out with some guidelines. Do you think that slab down at the bottom is still going to say six servings of grains?
I really don't know. I don't know what this new pyramid will say in terms of grains and sugars.
Well, this has been, this has been a great interview. I've, I've learned a lot. I've learned about you as an expert, think, "Make America Healthy" is going. I've learned a little bit about definitions on like ultra-processed food, and I've learned a little bit about the science on, uh, clinical trials and, um, seed oils. What have I not learned? What am I missing? Anything from your side that I, we should mention before we close?
You know, Ford, I think we could probably talk for hours, but this is good for me. So, I really appreciate you having me on the show.
Well, you're very, very welcome.