The People's Perspective on Medicine

Show 966: The Benefits of Butter

Does a low-carb high-fat eating plan provide the basis for a healthy diet?
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The Benefits of Butter

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For decades, Americans have been warned to step away from the cheese and leave the butter untouched.

Saturated fat was believed to clog the arteries and lead to heart attacks and early death. But what was the basis for those admonitions?


Where’s the science?

The science of the popular prescriptions for a low-fat diet is surprisingly slim. Many of the recommendations that have become policy drew as much on politics as on research.

Are there unintended consequences of following a low-fat diet? What role should vegetable oil play in a heart-healthy approach to eating?

We discuss Mediterranean, low-fat and Atkins-type diets, learn about some interesting early research on nutrition and consider how dietary recommendations can become so emotionally charged.

This Week’s Guest

Nina Teicholz is an investigational reporter who has written for The New York Times, the Washington Post and the New Yorker.

Her bestselling book is The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet.

Listen to the Show

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

Buy the CD so you can listen to the interview with Nina Teicholz.

Download the mp3 of the interview to listen yourself or share it with a friend.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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It’s been a few weeks since this episode, but I recall the guest stating that the low fat diet came about in response to a large increase in heart disease around the 1950’s. The obvious question is what changed in the American diet and/or lifestyle around that time? This would be the actual cause of higher rates of heart disease. Does anyone have a supportable answer?

It was a very interesting podcast. I have always liked butter & as a child was known to have take a stick from the fridge & eaten the whole thing. I’ve always been able to tell the difference between butter & margarine. Margarine came as this white stuff when I was a kid & a package of coloring was given along with the purchase & you mixed it together. Margarine requires a “patent” to make it while butter is the “jiggling” process of cream. Since when are we wiser than what the Bible teaches us? Butter is frequently mentioned in the Scripture & I don’t think it would be bad if God didn’t mention it so many times. It sure tastes lots better than margarine & is the choice of any good cook. Thanks!

Keep up the good work. I loved the interview! It was like Nina was sitting at my kitchen table and we were chatting. We eat eggs, bacon and avocado for breakfast, salads and protein for lunch, and fish or meat and greens for dinner (with an occasional starch like winter squash or sweet potato). Why would we eat differently? This works for us!

So, if saturated fat is not causing heart disease, then what is? Nina and Joe said it during the show: sugar (particularly FRUCTOSE) and carbohydrates. This was not gone into in great detail, as that is not what the show was about, which was that: the diet-heart hypothesis is wrong. There is limited time during each show, so, naturally not everything can be addressed. If you want to hear more, the place to look is other shows, or on the net.

Regarding what really causes metabolic syndrome and cardiovascular disease, I highly recommend the double-bill on youtube by Prof. Richard Johnson: 1) ‘The Origins of Obesity and the Fattening of Man’:, and 2) ‘Sugar and its Role in Driving Obesity and Fatty Liver’: If you ask a Doctor: What causes metabolic syndrome? I bet hardly any will say: “fructose”. It is as simple as that.

And here is a little bonus for y’all from a different silo: Gary Taubes says that “Cancer is a disease of civilization.”

Thank you for this program on fats. I am certain that there will be some people, organizations and industries unhappy about it. It would be important to point out that, not all foods (and fats) are created equal. Factory raised animals are not healthy, good food. Meat and fat of animals that live in their natural environment, eat the foods they are meant to eat are able to provide good nutrition to the eater. We need to be mindful of the omega 3 and omega 6 balance. Also important is the quantity of what we eat. The volume makes the poison. Sometimes what makes people unhealthy is the foods they are not eating but should. In short: eat what your ancestors ate, eat fresh local foods in season, using minimal processing. Remember, life feeds on life.

Dr. Richard Bernstein is an 80 year old Type One diabetic. He is obviously doing something correct to even be alive now.

He was diagnosed at age 12 and the diet recommended at that time almost killed him.

Even whole grains turn into glucose. Then there is the fact that modern wheat has been messed with a LOT. It is not the same grain available about 1950.

Some seem to do quite well on low carb and others thrive on higher carb.

Notice what your own body tells you about how it likes what you are eating.

I thought that this article just published in “The Nutrition Journal” would be of interest. The article reviews how a low fat (less than 10%) and high carbohydrate ( 80%) diet resulted in weight loss, reduction in blood pressure in the majority of the participants to the extent that they went off their high blood pressure medications. This type of information should have been the basis for the type of serious questions that “The Peoples Pharmacy” should be asking the individuals they interview

Effects of 7 days on an ad libitum low-fat vegan diet: the McDougall Program cohort

Hi, I enjoyed the show! I’ve looked into a lot of different diets in the last 20 years searching for a healthy way to eat. For a time I was on the Atkins diet, but read that the high protein content of the diet can be tough on the kidneys and I have some kidney disease. So I’m wondering if the way your guest is recommending we eat might also be tough on the kidneys, even in a healthy person over many years of consumption. I do realize that she said that recommendations for a healthy person are different for a person with some kinds of disease. I guess the one conclusion I’ve drawn after a lot of years of reading on the subject of diet is that there’s no one “perfect” diet. No one right way. I think there are some general guidelines for everyone, but there are so many factors that go into making up our health (good or bad), not just what we put into our mouths. Thanks again for the show.

Good points, Paige!
It seems that humans can thrive on many different types of diets, but that the one we seem to have settled on for the majority of Americans at this point in time is not among them. With kidney disease, you would probably benefit from individualized dietary advice. Perhaps your doctor can recommend a nutrition consultant for you. You might also ask the physician about phosphorous:

Apparently you did not hear the message about the percentage of fat to protein she found to be healthy. That is 2/3 fat to 1/3 protein.

This is an interesting show. Butter is tasty. But—A recent report from Sweden Showed saturated fat increased abdominal fat. I also read somewhere that Dr. Walter Willett from Harvard had expressed opinion on this topic. He appeared in your show before. Would you like to invite him to your show again? I am a regular listener of your interesting and informative show. I am interested to listen to Dr. Willett’s opinion or comments.
Thank you, appreciated

Kings Lee

What was the name of the documentary you mentioned in this show? Something about a ten day period where people ate no sugar? Would love to watch it but forgot the name.

hi Gwen. The documentary is called “Fed Up” here is a link to it on YouTube
Have a nice day :j

Low fat does not always equal healthy. I thought it irresponsible to lump all carbohydrates into the same category. It is the over consumption of “low fat” refined carbohydrates (commercial flour/bread, crackers, snacks, breakfast cereals, pasta, etc.), along with other processed foods and sugars that contributes to most chronic health problems.

Whole foods are not problematic for most people. Fresh fruits and vegetables, truly whole grains (brown rice, quinoa, oats, barley, etc.), nuts and legumes contain carbohydrates and some fat. These are among the most nutritionally dense and environmentally sustainable foods on the planet.

OK, so eating vegan may not be for everyone, but for an interesting critique of “The Big, Fat Surprise” check out this article from the Physicians Committee for Responsible Medicine:
Hard to Swallow: How Meat Advocates Skewer Science

I have a pet cow on a grass diet and her butter is a very bright yellow and does not look or taste like store- bought. Does the life style of the protein source count too?

I am disappointed with this podcast as well as most of your other podcasts regarding diet and health outcomes. You have chosen individuals such as this author as well as other individuals who advocate a high fat low carbohydrate diet. Other than Dr David Katz from Yale you have not had researchers or physicians who advocate a high carbohydrate diet low in animal products. The author has made the following statements which are incorrect

1. Dr Ancel Keys cherry picked the studies he reported on. The fact is that Dr Keys stated specifically that he was excluding studies from countries whose statistical data did not meet current standards or they kept track of medical statistics in such a way that they could not be properly compared with other countries. If the author wishes to contest the reasons for the exclusions she would need to present an analysis as to why Dr Keys was wrong in his decision.

2. She has stated on many occasions that there are many long term studies showing that a low carbohydrate diet is healthier. She has specifically stated that these studies were as long as two years. A two year study is not considered a long term study. These studies look at bio markers and not actual health outcomes. Personally I could not care less if my cholesterol goes down but I die at the same age or earlier.

3. You do not seem to want to ask her pointed questions. Why is it that that the Okinawan’s are the longest lived people on the planet and they eat a very high carbohydrate diet. 60% of their calories comes from sweet potatoes. In fact all the people who live in the “Blue Zones” eat diets primarily composed of carbohydrates although most do eat some animal products but significantly less that what is consumed in the Western World.

4. During the interview the statement was made that in the US the percentage of calories from fat has decreased. This is an indisputable fact. For some unknown reason the fact that total fat consumption has actually increased due to the fact that people are consuming approx 500 more calories than a few decades ago was never mentioned. This is also an indisputable fact.

5. Not once during the interview did anyone distinguish between a cookie and a sweet potato. Not one word about unhealthy refined carbohydrates and healthy unrefined whole foods.

As one of the physicians I know who treats diabetes and cardiovascular disease with a high carbohydrate, whole foods plant based diet said, most of the studies in this area are comparing a catastrophic diet containing a very large amount of refined carbohydrates to a catastrophic diet containing unhealthy high fat foods. The results have no significance. The bottom line is that there are no known large populations that consume large amounts of animal products as the basis of their diet. Populations who do this are mainly living under extreme conditions and contrary to what was said they they are very unhealthy. They may have less heart disease but that is irrelevant because an individual wants to lead a long and healthy which these people do not live.

I’d suggest that Dr. Eliezer read Ms. Telcholz’s book where she discusses the history of research in the area to get a clearer view of what’s behind her statements on the radio show.
Also it would be helpful to read Dr. John Ioannidis’ 2005 essay in PLOS Medicine entitled “Why Most Published Research Findings are False” . This scholarly article gives ample reason to believe that Dry Key’s scholarship could be faulty.

Thank you for your recent programs on the effect sugar, and foods that produce sugar in our bodies, on insulin production, weight control, and cholesterol and triglycerides. The author is correct that we are a research unit of 1 and we vote with our bodies and experiences in nutrition.

I tried a paleo lifestyle (low carb, moderate protein, moderately high fat) about 3 years ago and I have never looked back. I know so many others who have had great success with low carb-high fat life styles. For myself, I lost a ton of weight, upped my energy, my back pain went away, and my sleep patterns became normal for the first time in a long time. And, for the first time in my memory, my ability to control my portion size was in check.

My brain was finally listening to my leptin production (produced when we start to store fat), telling me to stop eating when I’m full. I am just so bothered that there is so much data that supports (since before the 50’s!) low-carb diets for losing weight and increasing lipid profiles but the data is still being ignored.

I wish our doctors would use the amazing brains they have been blessed with and look into the research for themselves and not just take the word of their professors and leading experts that came before them.

Didn’t you have a show about the Loma Linda Adventist study, showing that strict vegetarians live longer than meat eaters? Didn’t you?? What the hell. I’m going to just eat what I like. And stop listening to this sort of story.

Early in the program you mention studies on Inuit and Masai eating high-fat diets and being quite healthy. I wonder how much is the diet and how much is the lifestyle? With the Inuit, that far north you’re burning a lot of energy just to stay warm, and they got lots of continuous exercise. Same with the Masai: we’re talking about the warrior caste, people who are training hard. And according to my mother, her grandfather ate a diet ridiculously high in fat, but the guy was a farmer. Meanwhile, I work in construction. These are occupations that burn a lot of Calories. So, I find myself skeptical about how healthy this is for someone who sits on his ass in an office all day.

Terry & Joe please do more podcasts for TuneIn Radio users? (apple)

We’ll look into it. Thanks for the suggestion!

Butter is better – this is old news but appears to be needed for USDA, FDA, CDC, state school nutrition programs, NPR commentators, and many others who are still out of date.

I see three main problems with show 966, in increasing order of severity: historicity, exercise, and sustainability. Caveat: I just listened to the broadcast, and lack access to a transcript, so my citations are approximate.

In the interview, Teicholz claims that meat “has been the centerpiece of meals for millennia.” This is pretty clearly false: available data suggests that daily meat-eating, much less eating red meat with every meal, was only available to tiny populations (e.g. aristocrats) for most of human history and geography. Specifically, archeological and modern evidence regarding diets of hunter-gatherers, valorized by proponents of “Paleo Diet,” suggests they consisted mostly of plant foods, while the animal foods they ate were mostly non-mammalian (especially insects and mollusks) and *extremely* lean (being pre-agricultural). Furthermore, modern evidence suggests that these populations (especially Inuit) were frequently subject to starvation–interruption of significant food intake–for extended periods due to warfare and variability in ecosystem productivity. Spatiotemporally, the only large human populations eating mostly-meat meals, with frequency >= once/day, and regularly (without frequent/long interruptions), are restricted to wealthier residents of North America and Europe in the 19th and 20th century. To claim that most of humanity for most of its history has had meals like Teicholz’s (e.g., breakfast “eggs, bacon, and sausage”) is almost certainly to lie–most people have never had access to that much animal fat, nor do most people on most of the earth today.

The second problem should be obvious to any consumer of Pharm: diet and exercise should not be considered in isolation! Yet I believe that there was not a single reference to exercise in this piece–shocking. To suggest that a diet that may be healthy for hunter-gatherers (such as the Inuit) or pastoralists (such as the Masai) would work for a sedentary population such as modern Americans seems questionable at best. Even 19th-century Midwestern farmers (whose diet seems to be the model for the modern US diet) had a *far* more active lifestyle than we do (again, with more frequent dietary interruption).

Finally, the brief mention of sustainability at the end of the piece was simply disgraceful. Joe and Terry: the world’s human population is 7 billion, and most of us still do not consume animal foods on a regular basis, yet we’ve already significantly depleted the world’s fisheries and overgrazed its grasslands. Intensive meat production already hugely harms ecosystems and human health in the small areas in which it is currently practiced, for the benefit of the relatively small, rich populations who can “afford it” (only by externalizing substantial costs). To suggest, as Teicholz did at the *very* end of the piece that we will somehow find a way to make sustainable mass/frequent animal consumption strains credulity, and IMHO depletes your credibility.

I come from a super obese family. My mother was 4’10” and weighed 250 plus for example. As a child I was obese. My mother put me on a reduced calorie diet when I was 12. I went up and down weight wise constantly.

In 1958 without the knowledge that I now have, I changed many dietary things gradually. I used to eat all the things mentioned on the program by your guest like meat butter etc. I weighed 235 lbs. The final change came about 50 plus years ago. I eat only fish and loads of carbs through fruits, vegetables, whole grains also low fat yogurt and other low fat dairy products. My weight at 5’7″ is 145 and my wast is less than 34″. All my tests, blood work up, blood pressure, cholesterol etc. are excellent each year according to my doctor. My wife’s diet is the same. She’s 5’5″ 112 lbs. That’s why people are so confused with all the conflicting information that’s out there. I think it all depends on which book they’re trying to sell.

Please, please bring on someone who represents real science in this discussion!

This individual grossly distorts the whole notion of what is healthy to eat. Your programming historically has provided reasonably accurate and science based information but this individual has distorted information to support her own theory: “the world is flat” and I will use any possible viewpoint or “finding” to support my contention. That is the idea that saturated fat and animal protein represents the healthiest way for someone with chronic disease to eat. This viewpoint conveniently ignores the data from countless meaningful well done epidemiological and prospective studies, such as the whole EPIC database from Europe, the HALE project data from Europe, Lyon Diet Heart Study and many other well designed studies, of which the WHI dietary fat intervention data was a non-study since the participants never reached the goal of 20% fat in their diet and did not meaningfully chance their fruit and veggie intake. The WHI participants simply changed their processed food intake from one category to another. The whole low fat craze was propagated by the food and beverage industry and the US population followed along eating processed garbage, filled with dangerous sugar substitutes and partially hydrogenated oils and not whole food. A whole food diet, principally incorporating REAL fruits, veggies, whole grains (not processed grain based garbage), nuts, seeds and legumes with no more than 10% animal protein clearly represents a standard that produces longevity and disease free living.

Consider the Seventh Day Adventist mortality data. Her contention that the US population is eating 17% more fruits and veggies is ridiculous when the average American is eating no more than 1 serving of veggies and 0.7 servings of fruit daily based on the North American Fruit and Vegetable Alliance data from 2010. Do the math on what a 17% increase in fruit and veggie consumption achieves when paltry fruit and vegetable consumption is the US standard to begin with. Furthermore, we can ill afford to eat the kind of inflammatory diet that she herself is eating. It IS an environmental and ethical disaster to consume this level of animal protein.

Again, please bring on a meaningful counterpoint to this individual’s statements. She simply doesn’t know how to review scientific data critically and conveniently chooses to ignore a wealth of science supporting the benefit of a whole food diet. Please consider interviewing such well known and respected individuals as Michael Pollan, Dean Ornish, Joel Fuhrman, Colin Campbell, Neal Barnard, Pam Popper, Caldwell Essylstein, and many others who more critically evaluate the scientific literature and can present a much more balanced and fair discussion. Let Michael Pollan present his view point from In Defense of Food, what is an obvious and simple recipe: “eat food, not too much and mostly plants.”

I just listened to your broadcast with Nina Teicholz. I am left wondering yet again why it doesn’t seem like anyone seems to be making the connection that maybe low body fat and a high activity level are the true keys to good health, not a specific diet. The illustration of the Masai diet of blood, milk, and meat seems to be the perfect example–we can all picture the Masai from our National Geographic days–they are stick thin! Perhaps it’s not what you eat as much as it is about having a low percentage of body fat and being active. Have there been studies on that hypothesis that are controlled for thinness and activity level, that exclude people who are thin because of an illness like cancer, or who smoke? (PS–love your show!! I listen at 6:00 AM on Saturday mornings on KSMU.)

Milk is high in fat. I don’t know what cut of meat they ate, but it also could have been a high fat cut. American Indians & Eskimos traditionally ate high fat diets. Lean cuts of meat were (literally) for the dogs.

Allan L – I too followed the eating plan that you did/do and your wife also but for me it resulted in obesity and diabetes. I do not think that there is one ‘diet’ that works for all people. It depends alot on what is broken in our metabolism, what is right in our metabolism and genetics. One thing I will say is that there are many of our modern foods that have been tampered with so much and over processed that no one should eat them – obese, slim, healthy or ill. I am very happy for you and your wife that you found something that keeps you healthy and able to maintain a good weight. Best to you

Thank you so much for bringing Nina Teicholz to your show. I found it fascinating. I love the fact that you bring a variety of views to your show. I know you heartily endorse the Mediterranean diet and I think it is to your credit that you welcome someone who does not endorse it.

My concern is that a diet high in animal products is not going to be available to the majority of people on this planet, is not sustainable, and at least in the U.S. relies on unethical farming practices. Most people cannot afford to eat meat on a daily basis and we need to look at healthy options for everyone. I appreciate that she gave a nod to this issue at the end of the show and it was not the issue she was addressing in the book. However, it is an issue that needs to be addressed. How can poor people follow a healthy eating regimen on a rice and beans budget?

Thank you again. The show was great!

Why is this news? Who hasn’t heard of Atkins? I would be very surprised if anything in this book, which I will not buy, is new to any of your listeners or subscribers.

bill w

I also have followed fat issue for many years and bought the book even though I doubted I would learn anything new. I was quite surprised at the amount of information the book contained of which I was unaware.

The last chapter had some important information that I had not encountered before especially as related fast food establishments and the oils they now use which volatilize, land on things, ie: clothing and turn them into combustible objects. After reading a review of it on the Weston A Price site I thought it was possibly worth a look and I was not disappointed. There was indeed more to learn!!!!!

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