Thursday, September 04, 2014

Book Review: 'The Big Fat Surprise' by Nina Teicholz

By Michael R. Eades, M.D.
13 May 2014

This review of The Big Fat Surprise by Nina Teicholz is the most difficult and demanding I have ever written. It is demanding for a couple of reasons.
First, it is psychologically demanding on me because I want to write a review so good it inspires everyone to buy the book immediately and read it. Why? Because I think it is one of the most important books on nutrition ever written. Maybe the most important. And I feel a responsibility to inspire as many people as I can to get their hands on it.
Second, this book is so brimming with valuable information that I was almost paralyzed in trying to figure out which parts to excerpt. A book review always comes with excerpts, and this book presented me with such a bounty of choices, it took me forever to decide which to use.
I can categorically tell you that there are not enough superlatives – at least not in my vocabulary – to adequately describe how wonderful and important this book is. But I’m going to try because I really believe it is that good.
I met Nina Teicholz five or six years ago when I was in New York. She told me she had converted from a low-fat to a low-carb diet and that she was writing a book. We really didn’t discuss the book she was writing, so I was clueless. We kept in sporadic touch via email and exchanged a scientific paper or two, but that was about it. I hadn’t heard from her in a couple of years when last September out of the blue I got an email from her saying the first draft of her book was finished. She asked if I would mind reading it and giving her feedback.
I hate these requests because it is really time consuming to read an entire manuscript. And if it sucks, what do you say? I’ve written a number of books in my time, and I know how much effort goes into writing one. Even a bad one. So I hate to be put in the position of having to say to someone, Your book is a loser.
But, Nina’s request came when I was traveling and had some airplane time on my hands, so I said, Sure, send it on.
What she sent was a number of files, some in Word, some pdf. And she didn’t send the entire book, just the first half of it.
I started to read and was absolutely riveted. Instead of trying to carve out time to read her manuscript, I started carving out time from reading her book to do all the other things I needed to do. It was that good.
As I was approaching the end of the part she sent, I emailed asking for the rest. Which she sent, and which I voraciously devoured.
I made a few suggestions – a very few – and we emailed back and forth a bit. Then a few months later, her publisher sent me a bound review copy of basically the printout of her manuscript. It wasn’t typeset as most galleys are. I read this version and made copious notes. Here are what a typical couple of pages in my copy looks like. You can now see why it was difficult for me to decide what small parts to excerpt.
BFS pages The Big Fat Surprise
Since then, I’ve received the actual typeset galleys, which I have also read. So, I’ve gone through this book three times. All I’m asking is for you to go through it once. I guarantee you will thank me for pushing it on you.
Nina Teicholz is a married mother of two living in New York City. She is an investigative journalist and food writer by trade. When she first moved to New York, she was following a low-fat, USDA Food Pyramid style diet. Her life changed when she began writing restaurant reviews. She ate whatever the chefs she was reviewing sent out, which was often “paté, beef of every cut prepared in every imaginable way, cream sauces, cream soups, foie gras – all the foods [she] had avoided [her] entire life.”
She ate an enormous amount of fatty food, and despite her worries to the contrary, her cholesterol numbers didn’t go through the roof. But best of all, she lost the ten pounds she had been struggling to shed.
Her editor at Gourmet asked her to write an article about trans fats. The article ended up getting her a book contract, and the research she did for it launched her on her Herculean task of researching and writing The Big Fat Surprise (BFS). She tells the story of how we Americans went from eating enormous amounts of saturated fat (all the while suffering virtually no heart disease) to now eating fats in restaurants that, when heated, throw off a shellac-like substance so toxic it requires workers in hazmat gear to clean up after them.
The more I probed, he greater was my realization that our dietary recommendations about fat—the ingredient about which our health authorities have obsessed most during the past sixty years—appeared to be not just slightly offtrack but completely wrong. Almost nothing we commonly believe today about fats generally and saturated fat in particular appears, upon close examination, to be accurate.
Finding out the truth became, for me, an all-consuming, eight-year obsession. I read thousands of scientific papers, attended conferences, learned the intricacies of nutritional science, and interviewed pretty much every single living nutrition expert in the United States, some several times, plus scores more overseas. I also interviewed dozens of food company executives to understand how that behemoth industry influences nutrition science. The results were startling.
There’s a popular assumption that the profit-driven food industry must be at the root of all our dietary troubles, that somehow food companies are responsible for corrupting nutrition recommendations toward their own corporate ends. And it’s true, they’re no angels. In fact, the story of vegetable oils, including trans fats, is partly about how food companies stifled science to protect an ingredient vital to their industry.
Yet, I discovered that on the whole, the mistakes of nutrition science could not be pinned on the nefarious interests of Big Food. The source of our misguided dietary advice was in some ways more disturbing, since it seems to have been driven by experts at some of our most trusted institutions working toward what they believed to be the public good.
Based on my own research on Paleolithic man and his diet, I knew that early man ate mainly meat. And the meat he ate wasn’t what we today consider the choice cuts. Not T-bones and tenderloins, but viscera, marrow, brain, and fat pads—all sources of saturated fat were doubtless his foods of choice. I also knew that prior to the early years of the 20th century, heart attacks were rare. So rare, in fact, that they were almost nonexistent. Doctors could go through their entire careers without seeing one.
What I didn’t know was that during this heart-disease-free period, folks in the United States were up to their elbows in animal foods and saturated fat. Same in Great Britain. In fact, people ate more meat then than they do now. But today cardiovascular disease is the leading cause of death. (Take a look at these two old papers (clickhere and here) Nina referenced to see the change.)
I had fallen victim to the myth that the agrarian pre 1900s America meant everyone ate grains and vegetables and a smattering of meat when they could get it. As Nina goes to great lengths to point out in The Big Fat Surprise, that ain’t how it was.
Not only did the Americans of European origin eat mainly meat, so did the Native Americans.
Meanwhile the Native Americans of the Southwest were observed between 1898 and 1905 by the physician-turned-anthropologist Aleš Hrdlička, who wrote up his observations in a 460-page report for the Smithsonian Institute. The Native Americans he visited were eating a diet predominantly of meat, mainly from buffalo, yet, as Hrdlička observed, they seemed to be spectacularly healthy and live to a ripe old age. The incidence of centenarians among these Native Americans was, according to the 1900 US Census, 224 per million men and 254 per million women, compared to only 3 and 6 per million among men and women in the white population. Although Hrdlička noted that these numbers were probably not wholly accurate, he wrote that “no error could account for the extreme disproportion of centenarians observed.” Among the elderly he met of age ninety and up, “not one of those was either much demented or helpless.”
Hrdlička was further struck by the complete absence of chronic disease among the entire Indian population he saw. “Malignant disease,” he wrote, “if they exist at all — that they do would be difficult to doubt — must be extremely rare.” He was told of ‘tumors’ and saw several cases of the fibroid variety, but never came across a clear case of any one kind of tumor, nor any cancer. Hrdlička wrote that he saw only three cases of heart disease among more than two thousand Native Americans examined, and “not one pronounced instance” of atherosclerosis. Varicose veins were rare. Nor did he observe cases of appendicitis, peritonitis, ulcer of the stomach, nor any “grave disease” of the liver. Although we cannot assume that eating meat was responsible for their good health and long life, it would be logical to conclude that a dependence on meat in no way impaired good health. [My italics]
To put these census numbers in a little perspective, I took a look at the most recent statistics for centenarians. In 2012, in the United States, the rate of centenarians per million people was 173. So even if Hrdlička was correct about the 1900 census being somewhat off, it is still amazing that a group of buffalo-eating, primitive people sported as many centenarians as we do today with our antibiotics, parasite-free clean water and our state-of-the-art medical care.
How did we go from a meat-eating, butter-slathering, lard-cooking society to the fat-fearful, heart attack prone, constantly dieting people of today? The blame for that can be laid directly at the doorstep of one man.
Ancel Benjamen Keys.
Ancel Keys came up with the diet-heart hypothesis and singlehandedly catalyzed the movement that led us where we are today. And he did it because he let his monstrous ego override whatever modicum of scientific integrity he had.
Here’s what happened.
In a 1952 presentation at Mt. Sinai in New York (later published in a paper that received enormous attention), Keys formally introduced this idea, which he called his “diet-heart hypothesis” [fat in the diet -> increased blood cholesterol -> heart disease]. His graph showed a close correlation between fat intake and death rates from heart disease in six countries.
It was a perfect upward curve, like a child’s growth chart. Key’s graph suggested that if you extended the curve back down to zero fat intake, your risk of hear disease would nearly disappear.
This connect-the-dot exercise in 1952 was the acorn that grew into the giant oak tree of our mistrust of fat today. All the ailments that have been ascribed to eating fat over the years—not just heart disease but also obesity, cancer, diabetes, and more—stem from the implantation of this idea in the nutrition establishment by Ancel Keys and his perseverance in promoting it. Now, as you eat a salad with a lean chicken breast for lunch and choose pasta over steak for dinner, those choices can be traced back to him. The influence of Keys on the world of nutrition has been unparalleled.
Six Countries Graph The Big Fat Surprise
Keys traveled the world promoting his fat-causes-heart-disease theory using this famous six-countries chart. While presenting at a conference in Geneva, Switzerland, however, he ran into a serious scientist who was highly skeptical.
Jacob Yerushalmy, founder of the Biostatistics Department at Berkeley, realized Keys had cherry picked his data, and that had all the data been included, the graph showing the strong correlation between fat consumption and heart disease would have resolved into a bunch of dots scattered willy-nilly on the page.
Yerushalmy and his colleague Herman Hilleboe published a scathing rebuttal of Keys’ work. You can click on their paper, Fat in the Diet and Mortality from Heart Disease: A Methodologic Note, which I have put in my Dropbox, so you can see what a real scientific smack down looks like. Reading it almost makes me feel sorry for Keys.
How did Keys respond when this paper came out?
Nina interviewed Henry Blackburn, Key’s longtime associate who was there when Keys got the word.
“I remember the mood I the lab when that study came out,” he said.
“The mood…Not good”? Nina asked.
“Mmmmmm,” replied Blackburn, followed by a long pause.
His savaging at the hands of Yerushalmy and Hilleboe strengthened Keys’ resolve to forge ahead. Not to forge ahead and do good science, but to forge ahead to prove his point.
The skeptical response to his Geneva talk and the resultant paper
represented a humiliating but important moment for him: “*the* pivotal moment in Keys’ life,” remembers Blackburn. After the confrontation in Geneva, “[Keys] got up from being knocked around and said, ‘I’ll show those guys’ … and he designed the Seven Countries Study.”
What Keys did was spend the rest of his career wallowing in the confirmation bias. Instead of following the scientific method and trying to refute his diet-heart hypothesis, he made it his mission to look for anything and everything that confirmed it. And ignored or belittled any conflicting data.
Keys’ formidable powers of persuasion along with his academic credentials led over time to his diet-heart hypothesis being accepted by just about everyone. Anyone who dared to disagree was attacked with great vitriol in the pages of any journal in which the opposing argument appeared.
Thanks to his non-stop promotional abilities, Keys ran roughshod over his detractors, and in his annus mirabilis, 1961, scored three major triumphs. First, he graced the cover of  Time, he wrangled the American Heart Association (AHA) into his low-fat corral, and he got the National Institutes of Health (NIH) to buy into his theory. The AHA and NIH coups were particularly important because the first was an enormous lobbying agency and the second was the largest source of funding. With these two aboard Keys could both promote his anti-fat ideas to doctors and the public and could get the funds to do studies to confirm his bias.
As the diet-heart juggernaut rolled on, Americans cut their fat intake, and what fat they did eat, they made sure was polyunsaturated.
Which posed an enormous problem for Big Food. Saturated fats have certain cooking properties that are difficult to reproduce with polyunsaturated fats. But Big Food had had already developed trans fats, so they switched to them. Trans fats had been around for a half century, so they were there for the taking. And take they did. Soon just about every processed food had replaced saturated fats with trans fats, which they didn’t call trans fats in those days. They called them polyunsaturated fats. And everyone thought of them as health foods.
Keys final triumph was when the United States Government itself tumbled to the diet-heart hypothesis.
A non-scientist named Nick Mottern ended up writing the final report that came out of Washington recommending a diet in which fat in general was slashed, saturated fat was reduced to 10 percent of calories and the recommended dose of carbohydrates was 55-60 percent. A huge change from the lard-eating years during which most doctors had never seen a heart attack.
The public was kind of blah, as the public usually is with government reports. But Big Food had a different take. They were ecstatic.
The promotion of carbohydrate-based foods, such as cereals, bread, crackers, and chips, was exactly the kind of dietary advice large food companies favored, since those were the products they sold. Recommending polyunsaturated oils over saturated fats also served them well because these oils were a major ingredient of their cookies and crackers and were the principal ingredient in their margarines and shortenings. The pro-carbohydrate, anti-animal-fat orientation of Mottern’s emerging report thus suited food manufacturers just perfectly.
First, the AHA and the cardiologists were the only physician groups buying into the low-fat diet. But sooner or later, they all toppled like dominoes. One of the last holdouts was the pediatricians. Kids didn’t get heart disease, so why should they cut their fat, drink skim milk, etc? But soon they fell into line, too.
In one of the more disturbing descriptions in BFS, Nina describes studies done by British researchers on African children. Gambian children were put on low-fat diets (most of their fat calories were polyunsaturated and came from nuts and vegetable oils) after weaning and were compared to English babes who got a majority of their calories from whole milk and meat. Both groups of growing toddlers got the same number of calories, but
by the age of three, the Gambian babies weighed 75 percent less than they should, according to standard growth charts, while the Cambridge  babies were growing according to expectations and weighed, on average, 8 pounds more than the Gambians.
Writes Nina:
As an American parent, it’s hard to read this study without immediately running to see the fat content of one’s own “early weaning” foods—with unsettling results. While rice porridge, the first solid food fed to Gambian infants, was analyzed as containing 5 percent energy as fat, a jar of Earth’s Best Whole Grain Rice Cereal (an organic brand) that an American parent might feed a baby has zero grams fat. Later on, when Gambian babies were eating rice with groundnut sauce, at 18 percent fat, an American child might get barely 1 percent fat from a salubrious-sounding jar of Earth’s Best Vegetable Turkey Dinner (and this is one of the few dinner options with meat). Government data show that American children have reduced their intake of fat including saturated fat in recent decades.
If the results of the studies on Gambian children are any indication, American kids raised on the low-fat diet could be in for some health problems down the road. Already, children in other countries that haven’t stupidly encouraged reduced consumption of fat for children are passing US kids in height.
This is just one of many truths revealed in BFS that made me want to punch through a wall. Believe me, there are many, many more. Which is why it’s so important that this meticulously researched book reaches a wide audience. Only then will some changes be made and future generations spared the low-fat idiocy.
As with all things that bring about a nagging discomfort, the low-fat diet began to wear on people. And they began to yearn for something new. Some kind of regimen with maybe a little more fat. And who came to their rescue? Non other than our old friend Ancel Keys.
During the years Keys had been promoting his diet-heart hypothesis, he had been traveling the world and spending a lot of time in Italy at the palatial estate he built overlooking the sea south of Naples. (I’ve always wondered how he could afford such a place on an academician’s salary, but I guess that’s another story.) In his time in Italy and other countries bordering the Mediterranean, Key’s took note of the parts of the diet these different peoples ate that matched up with his own dietary philosophy and more or less combined all the disparate diets into one. And he published a study on the diet of the people from Crete that was to lay the foundation of what has now become the Mediterranean Diet with a capital D versus the Mediterranean diet with a small d that actually represents what the various peoples involved actually eat.
In 1975, Keys reissued his 1959 cookbook, Eat Well and Stay Well, with a few changes to Eat Well and Stay Well the Mediterranean Way, which was basically a repackaging of his low-fat diet under the term Mediterranean. This was the first time the Mediterranean Diet with a large D came into the lingo. Keys had pretty much retired by this time, so the banner was taken up by other scientists from Italy and Greece.
The story of how these scientists, using Keys’ bogus data from Crete (which in and of itself is a unbelievable story), teamed up with what amounted to a PR firm for the olive oil industry to seduce scores of American scientists and food writers is one of more fascinating parts of BFS. It was a perfect storm. The scientists and food writers were ripe to be lured into spending time on the Mediterranean coast, imbibing wine and eating the food. These all expense paid trips were ostensibly medical conferences, but in reality, they were marketing ploys. Food writers and journalists were looking for something new and exciting to write about. The masses, wearied of their tasteless low-fat fare, were ready to start adding fat back into their diets, even if it was in the form of olive oil. And the olive oil industry was more than ready to oblige. And to fund.
A handful of researchers started working on studies of the Mediterranean Diet, but there really wasn’t a Mediterranean Diet. There were a lot of people around the Mediterranean eating diverse diets, but no single Mediterranean Diet. So each research group basically created its own idea of the Mediterranean Diet and studied it.
To say you will be surprised to learn not only the structures of these various Mediterranean Diets but the outcome of the studies is a vast understatement.
I’m forever being accosted at parties and other events with questions about diet. When I explain what I do, I can’t tell you how many people then tell me they eat a Mediterranean Diet or that their doctor put them on a Mediterranean Diet. Even doctors believe the Mediterranean diet is the one diet that has stood the test of vigorous scientific investigation.
If only they knew.
Since the government got into the low-fat diet business, the health of the populace has gone to hell. We’re in the midst of an obesity epidemic the proportions of which now make the old TV star Jackie Gleason, who went by the moniker The Fat Man, look absolutely normal. Even worse, we’re in a diabetes epidemic that threatens to break the bank if it isn’t reversed.
As all this has been happening, the populace had been chewing through about 18 billion (billion with a B) pounds of soybean oil (through 2001), most of which had been partially hydrogenated. Partially hydrogenated fats are trans fats, of course, but few people knew what they were until recently. Which is just how Big Food wanted it.
By carefully grooming scientists and funding their research, Big Food had managed to keep the deleterious effects of trans fats from becoming public knowledge. Which was important because, as Nina writes, trans fats “were the backbone of Big Food.”
They had a scare early on by the Malaysian producers of naturally saturated tropical oils, which would have easily taken much of the market from trans fats had the public but known. But the American Soybean Association (ASA) was not about to let that happen, so they mounted an attack on tropical oils, branding them as dangerous saturated fats. Which, of course, they were. Saturated fats, that is, but certainly not dangerous.
One of the people Nina interviewed, David Drake, a top exec at the ASA, tells how one of their marketing people came up with the name “tree lard” for the tropical oils. Funny and clever. But devastating for the tropical oils.
Despite the work and outrage of a couple of scientists Big Food managed to keep marginalized, trans fats continued to quietly glide along under the surface of the consciousness of almost everyone. The masses thought they were eating polyunsaturated fats and Big Food kept them in the dark. How much in the dark?
..from the day hydrogenated oils were introduced in the form of Crisco in 1911 right up until the year 2005, nearly a century later, not one major scientific conference was devoted to the discussion of trans fats.
It really beggars belief.
Nina’s description of the Waterloo for trans fats is fascinating. They went from being unknown and in everything to being identified, vilified and banned in record time. And in a real twist of fate, their demise came about virtually overnight based on the same type of shoddy science that scared everyone off of saturated fats. Not that trans fats aren’t bad, because they are, but it is ironic that they were excoriated and killed off by the same kind of public-relations-driven schlock science that gave them their preeminence in the first place. I suppose it’s only fair.
The most frightening part of The Big Fat Surprise comes next. It is the absolute must read chapter. It details what has come after trans fats, and it’s not pretty. It’s a big step into the unknown, and those steps typically lead to an end that is not good.
Big Food finds itself in a real quandary. People read labels, and the great unwashed masses still think saturated fat is bad. So when they grab up a package and look at the label to see the saturated fat content
…any tick upwards in these fats by even 0.5 grams might alienate [Big Food’s] customers.
Says one Big Food exec Nina interviewed
Everyone is so sensitive to saturated fat content. That’s just our basic reality.
So Big Food can’t use saturated fats, even tropical oils, and now they can’t use trans fats, so what’s a packaged food manufacture to do? You don’t really want to know, but for your health’s sake, you better read about it to find out.
Nina ends her book with a redemption of saturated fats. She goes into great detail on why saturated fats are not just not bad for you, but are actually good for you. And they are. Trust me. Once you’ve read this final chapter, you’ll know why.
If you are a low-carb dieter, yet you’ve had this kind of nagging doubt about eating saturated fat, this last chapter is for you. What if all the experts are right?, you’ve probably asked yourself. Hell, I’ve asked it myself. I eat a ton of saturated fat, so I’m literally betting my life that saturated fat isn’t harmful. Reading The Big Fat Surprise will relieve you of a lot of angst. It will convert even the fiercest of skeptics, unless they’re so mired in their ideology that they can’t be budged. But just as we saturated fat eaters have suffered our angst, they will now suffer theirs.
As I wrote at the start, there are not enough superlatives to describe this book. It’s a life changer.
I predict that within a few years, one of two things will have happened as a result of this important book.
Either Nina will be burned at the stake. Or we will all be eating our food cooked in lard, butter, beef tallow and duck fat, just as we ate it back in the days before Ancel Keys came on the scene. We’ll eat the way we ate when a case of heart disease was an anomaly.
Buy this book now. You will not be disappointed. Give it to every lipophobe you know who is able to read. It will change many minds.
Thanks for hanging in there with me for this very long review. If you’ve read the book, or when you do, feel free to write your own review in the comments section. I look forward to reading them all.

Wednesday, September 03, 2014

The Islamic State Is Nothing New

Its differences with other Islamic-supremacist groups are irrelevant. 

Tuesday, September 02, 2014

In Maryland, a Soviet-Style Punishment for a Novelist

An eighth-grade teacher who writes fiction under a nom de plume is ordered to undergo an "emergency medical evaluation" for his novel about a school shooting.

September 1, 2014

Patrick McLaw

From the Dept. of Insane and Dangerous Overreactions to Fictional Threats:

A 23-year-old teacher at a Cambridge, Md. middle school has been placed on leave and—in the words of a local news report—"taken in for an emergency medical evaluation" for publishing, under a pseudonym, a novel about a school shooting. The novelist, Patrick McLaw, an eighth-grade language-arts teacher at the Mace's Lane Middle School, was placed on leave by the Dorchester County Board of Education, and is being investigated by the Dorchester County Sheriff's Office, according to news reports from Maryland's Eastern Shore. The novel, by the way, is set 900 years in the future. 

Here is part of a breathless, law enforcement-friendly report from WBOC, which describes itself as "Delmarva's News Leader":

He's a man with many names, and the books he has written have raised the concerns of the Dorchester County Board of Education and the Dorchester County Sheriff's Office.

Early last week the school board was alerted that one of its eighth grade language arts teachers at Mace's Lane Middle School had several aliases.  Police said that under those names, he wrote two fictional books about the largest school shooting in the country's history set in the future.  Now, Patrick McLaw is placed on leave.

Dr. K.S. Voltaer is better known by some in Dorchester County as Patrick McLaw, or even Patrick Beale.  Not only was he a teacher at Mace's Lane Middle School in Cambridge, but according to Dorchester Sheriff James Phillips, McLaw is also the author of two books: "The Insurrectionist" and its sequel, "Lillith's Heir."

Those books are what caught the attention of police and school board officials in Dorchester County.  "The Insurrectionist" is about two school shootings set in the future, the largest in the country's history.

Phillips said McLaw was taken in for an emergency medical evaluation. The sheriff would not disclose where McLaw is now, but he did say that he is not on the Eastern Shore. The same day that McLaw was taken in for an evaluation, police swept Mace's Lane Middle School for bombs and guns, coming up empty. 
Imagine that—a novelist who didn't store bombs and guns at the school at which he taught. How improbable! Especially considering that he uses an "alias," which is apparently the law-enforcement term for "nom de plume." (Here is the Amazon page for The Insurrectionist, by the way. Please note that the book was published in 2011, before McLaw was hired.) 
According to an equally credulous and breathless report in the Star-Democrat, which is published in Easton, Md., the combined efforts of multiple law-enforcement agencies have made area children safe from fiction. Sheriff Phillips told the newspaper that, in addition to a K-9 sweep of the school (!), investigators also raided McLaw's home. "The residence of the teacher in Wicomico County was searched by personnel,” Phillips said, with no weapons found. “A further check of Maryland State Police databases also proved to be negative as to any weapons registered to him. McLaw was suspended by the Dorchester County Board of Education pending an investigation and is no longer in the area. He is currently at a location known to law enforcement and does not currently have the ability to travel anywhere.”
I've tried to reach the sheriff, so far unsuccessfully, to learn whether McLaw's "inability to travel anywhere" means that he is under arrest. It is somewhat amazing that local news reports on this case don't make clear whether McLaw is under arrest, and if so, on what charge. It is equally astonishing that the reporters on this story don't seem to have used the words "First Amendment" in their questioning of law-enforcement officials, and also astonishing they don't question the Soviet-sounding practice of ordering an apparently sane person who has been deemed unacceptable by state authorities to undergo a psychological evaluation. 
It would be useful to know if McLaw is under investigation for behavior other than writing two novels—and perhaps he will be shown to be a miscreant of some sort—but so far, there is no indication that he is guilty of anything other than having an imagination, although on Maryland's Eastern Shore, as news reports make clear, his imagination is considered an active threat.
Dorchester County Superintendent of Schools Dr. Henry Wagner told WBO that police will be present at the middle school "for as long as we deem it necessary," and the sheriff said that law-enforcement officials across the Delmarva peninsula have been given McLaw's photo in case he shows up in their jurisdictions—though again, it is not clear if he is, in fact, in police custody at the moment. 
If law-enforcement authorities in Dorchester County have additional information that implicates McLaw in a crime, or in the planning of a crime, it is imperative that they release it immediately. As it stands now, they appear to be violating the constitutional rights of a citizen, and also, by the way, teaching the children of their county something awful about the power of fear over reason.

Monday, September 01, 2014

Today's Tune: Sharon Van Etten - Serpents

Book Review: 'Obama's Enforcer' by John Fund and Hans von Spakovsky

No Longer Just

July 20, 2014
In the 1966 film A Man For All Seasons, which depicts Sir Thomas More’s steadfast disapproval of King Henry VIII’s marital infidelities, More stirringly defends the rule of law. Rebutting his son-in-law, who says he would hypothetically “cut down every law in England” to find the devil, More asks, “And when the last law was down, and the Devil turned ’round on you, where would you hide, Roper, the laws all being flat?”
More argues that abandoning equal enforcement of the law imperils all citizens. Unfortunately for today’s United States, this is exactly what John Fund and Hans von Spakovsky say the Department of Justice is doing under Attorney General Eric Holder. To this enterprise, Fund brings tireless reporting, and Spakovsky brings his own experience in the Justice Department (as counsel to the assistant attorney for civil rights) and contacts therein.
Together, they have assembled a brief yet persuasive argument that, as one former career lawyer put it, “Holder is the worst person to hold the position of attorney general since the disgraced John Mitchell, who went to jail as a result of the Watergate scandal.” The authors guide us through Holder’s unique judicial malpractice: his Department’s long Supreme Court losing streak; his convenient memory lapses, lack of knowledge, and outright lies about what he knew and when he knew it; and his becoming the first-ever attorney general to be held in contempt by the House of Representatives.
But the authors do not limit themselves merely to what Holder has done or failed to do. We also see rampant abuse in particular divisions of the Justice Department: the strategic non-enforcement on behalf of environmentalists known as “sue and settle” practiced by the Environment and Natural Resources Division; discrimination in the Civil Rights Division, especially concerning voting; and the Pigford Scam, which entitled anyone who had ever given a thought to farming to a government payout.
Focusing on both Holder and the DOJ helpfully reminds us of scandals, some fresh and some old, and their oft-forgotten victims. Some stories, especially former Assistant Attorney General for Civil Rights Tony Perez’s unconscionable, trans-divisional dropping of one DOJ lawsuit against St. Paul, Minnesota, so that it would not pursue a case against the DOJ that could have killed his precious, dubious theory of “disparate impact,” deserve far more attention than they have yet received.
On many occasions, moreover, the Justice Department has abused its status as “the largest law enforcement agency in the world with investigators and agents, lawyers, and prison officials all combined in one government department” to transform life into a living hell for objects of its ire.
These targets have ranged in size from Gibson Guitar, raided SWAT-style and then prosecuted by the Justice Department on the ultimately dubious charge of using illegal wood, to the Sacketts, an Idaho family that the EPA decided lived on government “wetlands,” with the family incurring daily fines for not moving (fortunately, the Supreme Court saved them).
In one moving passage, the authors detail how department employees viciously insulted Spakovsky himself, accusing a child of parents who bitterly opposed and fled the Nazi and Soviet regimes of fascist sympathies.
It all adds up to an agency in dire need of reform. But the authors’ call to action is somewhat lacking. They suggest mostly administrative tweaks, and approvingly quote former attorney general Edwin Meese’s counsel that nothing can compare to “making sure good people are elected who will appoint good people to offices within the executive branch.”
This is all well and good, but by their conclusion the authors seem almost to have forgotten that they’ve indicted not just Attorney General Eric Holder, who will leave with President Obama in January 2017, but also the entire Department of Justice, including career employees who will outlast almost any administration.
If Holder alone were responsible for Justice’s problems, righting the agency would be far easier than if its general character had become leftist and lawless. In More’s terms, it is not a case of cutting down the laws to pursue the devil. Instead, if the DOJ now suspends and refashions laws for its own ends, then what we have is the devil himself cutting down laws that stand in his way.

Sunday, August 31, 2014

The science of saturated fat: A big fat surprise about nutrition?

26 August 2014

When Ronald M Krauss decided, in 2000, to review all the evidence purporting to show that saturated fats cause heart disease, he knew that he was putting his professional career at risk. Krauss is one of the top nutrition experts in the United States, director of atherosclerosis research at Children’s Hospital Oakland Research Institute and adjunct professor of nutritional studies at the University of San Francisco at Berkley. But challenging one of his field’s most sacrosanct beliefs – that the fats in meat, cheese and butter are bad for health – was a near-heretical act.

A few years earlier, when a colleague of Krauss’s had merely tried to speak about his positive findings regarding the high-fat Atkins diet, he was met with jeers and derision. One member of the audience yelled “I am absolutely disgusted that the [government] would waste my money on a study on the Atkins diet” – to the applause of many.

Challenging any of the conventional  wisdom on dietary fat has long been a form of professional suicide for nutrition experts. And saturated fats, especially, are the third rail. But Krauss persevered and concluded in 2010, after reviewing all the scientific literature, that saturated fats could not be said to cause heart disease. In March, another group of  scientists, including faculty from Cambridge and Harvard, came to the same conclusion after conducting a similar “meta-analysis”. These were stunning results. It seemed that saturated fat, our principal dietary culprit for decades, had been unfairly convicted.

Yet the truth is there never has been solid evidence that these fats cause disease. We only believe this to be true because nutrition policy was derailed over the past half-century by personal ambition, bad science, politics, and bias.

Recipe for success: Vilijamur StefanssonRecipe for success: Vilijamur Stefansson (Corbis) 

Our fear of saturated fats began in the 1950s when Ancel Keys, a pathologist at the University of Minnesota, first proposed that they raised cholesterol and therefore caused heart disease. Keys was an aggressive, outsized personality with a talent for persuasion. He found a receptive audience for his “diet-heart hypothesis” among public-health experts who faced a growing emergency: heart disease, a relative rarity three decades earlier, had skyrocketed to be a leading cause of death. Keys managed to implant his idea into the American Heart Association and, in 1961, the group published the first-ever guidelines calling for Americans to cut back on saturated fats, as the best way to fight heart disease. The US government adopted this view in 1977 and the rest of the world followed. But the evidence backing these guidelines was weak. 

Mainly, it amounted to Keys’s own “Seven Countries Study”, which purported to show a link between the consumption of saturated fats and heart disease among 13,000 men surveyed in the US, Japan and Europe. Critics have pointed out that this study violated several basic scientific norms. For one, Keys did not choose his countries randomly but instead selected only those likely to prove his beliefs – including Yugoslavia, Finland and Italy – while excluding countries with low rates of heart disease despite diets with a lot of fat – such as France, Switzerland, Sweden and West Germany.

Moreover, due to difficulties in collecting accurate nutrition data, Keys ended up sampling the diets of fewer than 500 men, far from a statistically significant sample. And the study’s star subjects – men on the Greek island of Crete who tilled their fields well into old age and appeared to eat very little meat or cheese – turned out to have been partly sampled during Lent, when the study subjects were foregoing meat and cheese. This must have led Keys to undercount their saturated-fat consumption. These flaws weren’t revealed until much later. 
By then, the misimpression left by the erroneous data had become international dogma.

There were subsequent trials, of course. In the 1970s, half a dozen important experiments pitted a diet high in vegetable oil – usually corn or soybean, but not olive oil – against one with more animal fats. But these trials had serious methodological problems: some didn’t control for smoking, for instance, or allowed men to wander in and out of the research group over the course of the experiment. The results were unreliable at best.

Citing this lack of solid science, British sceptics were feisty holdouts against Keys’s hypothesis for decades. Editors of the prestigious scientific journal The Lancet mocked the New World’s obsession: why would Americans put up with the sacrifices of a low-fat diet? They were appalled that “some believers long past their prime were to be seen in public parks in shorts and singlets, exercising in their free time, later returning home to a meal of indescribable caloric severity [when] there is no proof that such activity offsets coronary disease”.

British scientists also had long found the diet-heart hypothesis perplexing. “There was a very big emotional component into the interpretation in those days,” Michael Oliver, the influential British cardiologist, told me. “It was quite extraordinary to me. I could never understand this huge emotion towards lowering cholesterol.”

Stefansson described the fat-laden Canadian Inuit as the healthiest people he had ever lived withStefansson described the fat-laden Canadian Inuit as the healthiest people he had ever lived with (Getty) 

Oliver and others pointed out that a great deal of evidence from around the world contradicted Keys’s ideas. For instance, the Masai warriors in Kenya were observed in the 1970s eating nothing but meat, milk and blood – not a vegetable in sight – yet they were not overweight, their cholesterol levels remained low even as they aged and scientists could find no evidence of heart disease, despite conducting electrocardiographs on 400 of them. In India researchers studied a million railway workers and found that those in the north ate 8 to 19 per cent more fat (mainly from dairy products) than their co-workers in the south, yet the northerners lived, on average, 12 years longer. This disparity led the study authors to conclude, in a 1967 paper, that to prevent heart disease people ought to “eat more fermented milk products, such as yoghurt, yoghurt sherbet and butter”.

Half a world away, scientists observed Inuit populations in the Arctic eating mainly  caribou, salmon, and seal – altogether some 70 to 80 per cent fat. “They should have been in a wretched state,” wrote Vilhjalmur Stefansson, the Harvard-trained Canadian anthropologist who lived with the Inuit for years. “But, to the contrary, they seemed to me the healthiest people I had ever lived with.”

Keys aggressively criticised these observations, which were like missiles aimed at the very heart of his theory. After all, as the British biologist Thomas Huxley remarked, a great hypothesis can be slain by an ugly fact, and these were no doubt some ugly facts. Of the Inuit, for instance, Keys wrote,  “their bizarre manner of life excites the imagination”, especially that “popular picture of the Eskimo... happily gorging on blubber”, but on “no grounds” was it possible to suggest that the case of the Inuit “contributes anything” to the scientific record. And in response to a prominent Texas A&M University professor who wrote a critique of Keys, he said that the paper “reminds one of the distorting mirrors in the hall of jokes at the county fair”.

Rolling over the opposition by sheer force of will was typical of Keys and his acolytes in defending their saturated-fat hypothesis. Keys was “tough and ruthless and would argue any point”, Oliver, a prominent opponent, said. Since Keys’s allies controlled so many top government health posts, critics were denied research grants and key posts on expert panels. As retribution for defending the healthiness of eggs, despite their cholesterol content, Oliver was publicly branded by two of Keys’s main allies as a “notorious type” and a “scoundrel” because “he opposed us on everything”.

In the end, Keys and his colleagues prevailed. Despite contrary observations from India to the Arctic, too much institutional energy and research money had already been spent trying to prove Keys’s hypothesis. The bias in its favour had grown so strong that the idea just started to seem like common sense.

Early on, however, The Lancet sounded a note of alarm that would soon be picked up by others. “The cure should not be worse than the disease,” wrote the editors in 1974, echoing the medical dictum, “first, do no harm”. Perhaps reducing fat in the diet might lead to an increase in carbohydrates, they suggested. In fact, this is precisely what happened. Grains, pasta, rice and potatoes replaced meat, cheese, and eggs on dinner plates. Breakfasts of eggs and fried kippers ceded to bowls of cereal and orange juice. The British now eat 46 per cent less saturated fat than they did in 1975. Meanwhile, UK authorities recommended that two-thirds of calories should come from carbohydrates.

The problem, as researchers have suggested since the 1950s, is that carbohydrates are uniquely fattening. Whenever they’re eaten, the body is stimulated to release insulin, which turns out to be fantastically efficient at storing away fat. Meanwhile, fructose, the main sugar in fruit, causes the liver to generate triglycerides and other lipids in the blood that are altogether bad news. Excessive carbohydrates lead not only to obesity but also, over time, to Type 2 diabetes and, very likely, heart disease.

The best possible science from the past decade now indicates that too many carbs overall – even of the supposedly healthy, whole-grain kind – increase the risk of these diseases compared with a diet low in carbohydrates. In other words, too much whole-grain cereal for breakfast and whole-grain pasta for dinner, with fruit snacks in between, add up to a less healthy diet than one of eggs and sausage, followed by fish.

And scientists are now exploring the idea that sugar might have a particularly toxic effect. Here again, a British scientist led the fight against Keys. In the early 1950s, John Yudkin, a professor of physiology at Queen Elizabeth College, first posited that sugar might cause obesity and other diseases. Keys, ever alert to any challenges to his own hypothesis, jumped on Yudkin and repeatedly attacked him in scientific journals. Yudkin’s idea is a “mountain of nonsense”, he wrote at the end of a nine-page critique in Atherosclerosis. “Yudkin and his commercial backers are not deterred by the facts; they continue to sing the same discredited tune,” he wrote later.

Remarkably, it turned out that a reanalysis of the Seven Countries Study data many years later found that sugar intake correlated better with heart-disease risk than any other nutrient. Keys, however, “was very opposed to the sugar idea”, recalls Daan Kromhout, a Dutch collaborator on the study. “He was so convinced that fatty acids were the thing in relation to atherosclerosis, he saw everything from that perspective.”

Our dietary guidance has followed Keys’s view for 50 years now. Despite half-a-billion pounds spent trying to prove his hypothesis, the evidence of its health benefits has never been produced. Meanwhile, rates of obesity and diabetes are rising and heart disease remains a leading cause of death. It’s worth wondering if our working hypothesis about diet and health is not working. And if alternative ideas are to be considered, nutrition science must, like any science, provide an open, civil and unbiased climate for genuine debate. For reasons of substance and style, it’s time to enter a post‑Keysian era.

‘The Big Fat Surprise: Why Butter, Meat, and Cheese Belong in a Healthy Diet’, by Nina Teicholz (Scribe, £14.99) is out now